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Tag: nutrition

Dairy Intake Linked to Decreased Diabetes, Hypertension Risk 

Characterized by elevated blood pressure, abdominal obesity, elevated triglycerides, low high density lipoprotein cholesterol, and elevated blood glucose, metabolic syndrome (MetS) has been associated with an increased risk of cardiometabolic diseases. Researchers continue to evaluate the role of nutritional behaviors in the development of these conditions, including cardiovascular disease and type 2 diabetes. In particular, diary intake has been studied for its impact on lipid levels, blood pressure, and other risk factors as emerging evidence suggests whole fat and fermented dairy products may influence diverse metabolic pathways.

Although prior research implicates that dairy consumption is associated with a decreased risk of MetS, diabetes, and hypertension, the majority of these studies have been conducted in North American and European populations, limiting the generalizability of their findings. A new international study published online in BMJ Open Diabetes Research & Care reports that a diary-rich diet has the potential to reduce the risk of certain cardiometabolic conditions – including diabetes and high blood pressure – along with several cardiovascular disease risk factors.

Association of Dairy Consumption with Cardiometabolic Conditions

The most recent trial evaluated 147,812 participants aged between 35 and 70 from 21 countries, to verify the generalizability of prior findings and ascertain whether the associations between diary consumption and reduced cardiometabolic disease risk can be found on an international scale. As part of the Prospective Urban Rural Epidemiology (PURE) study, investigators assessed the association between dairy intake and MetS prevalence as well as its components over a median follow-up period of 9.1 years. This included the incidence of hypertension and diabetes in the cohort.

Dietary dairy intake was assessed using Food Frequency Questionnaires and evaluated whether participants consumed milk, yogurt, yogurt drinks, cheese, and dishes prepared with dairy products classified as either full or low fat. The average daily total dairy intake was 179 grams, this included 124.5 grams of full fat and 65 grams of low fat products.

Additionally, the research team collected data on individual personal medical history, prescription medicine use, educational level, smoking status, weight and height measurements, blood pressure, and fasting blood glucose.

Reduced Incidence of Metabolic Syndrome Components

After an average of 9 years of follow-up, 13,640 participants developed hypertension while 5,351 developed diabetes. Over 46,660 subjects had metabolic syndrome, defined as at least 3 of the 5 components. The team’s findings reveal that total dairy and full fat – but not low fat – dairy intakes were associated with a decreased prevalence of most components of metabolic syndrome, especially in countries with typically lower daily dairy consumption.

Compared with participants who did not consume dairy, those who had an intake of at least 2 servings of dairy a day experienced a 24% reduction in metabolic syndrome risk. The risk reduction grew to 28% in participants who consumed full fat dairy products. Similarly, at least 2 servings a day of total dairy were linked to a 12% reduction in the risk of both hypertension and diabetes, while 3 servings contributed to a 13-14% lower risk.

The latest findings indicate the potential benefits of increasing whole fat dairy intake for the reduction of MetS risk and its component factors, as well as for lowering the incidence of hypertension and diabetes. While the recent study proves that prior findings linking dairy consumption to cardiometabolic health implications are generalizable across an international population, further large-scale randomized trials need to be conducted to ascertain the connection between whole fat dairy products and decreased risk of MetS, hypertension, and diabetes.

 

Caloric Deficiencies Increase Risk of HF Hospitalization

Heart failure (HF) remains a deadly disease tied to a high risk of hospitalizations, reduced cardiorespiratory fitness and a subsequently reduced quality of life. Targeted treatments and lifestyle interventions continue to show promising results in improving HF outcomes although, there is limited evidence of their role in decompensated patients admitted to the hospital for acute heart failure.

The most common non-pharmacologic therapy for HF patients is dietary sodium restriction, aimed at mitigating excess fluid retention. However, this method is supported by limited and controversial evidence as some studies have shown sodium restriction can even worsen health outcomes by leading to unintended reductions in calorie, macro-, and micro-nutrient intake. Additionally, the effects of sodium restriction as an intervention on quality of life and clinical outcomes remain unknown.

As patients with heart failure commonly present with poor nutritional status – which significantly affects disease progression and prognosis – new research from the University of Michigan in Ann Arbor aims to uncover the clinical implications of dietary patterns on HF. Published in JACC: Heart Failure, the GOURMET-HF trial found that heart failure patients who had an insufficient calorie intake faced an increased risk of hospital readmission  and a poor quality of life after being discharged.

Hospitalizations in HF Patients

Led by Feriha Bilgen, MPH, RD, a group of researchers analyzed data gathered from 57 patients – mean age of 70 years, 31% women, mean BMI 32 kg/m2 – hospitalized for decompensated heart failure. To assess nutritional intake, participants completed the Block Food Frequency Questionnaire at baseline and serum albumin and body weight were then used to calculate Nutritional Risk Index. Insufficient calorie intake was defined as meeting less than 90% of estimated nutritional needs; a 15-point deficiency score was developed taking into account the intake of certain micronutrients – such as folate, magnesium, iron, and calcium.

The primary measured outcomes of the study included all-cause hospital readmission and change in Kansas City Cardiomyopathy Questionnaire clinical summary score, which was assessed 12 weeks after hospital discharge.

Importance of Nutritional Patterns

Overall, the median sodium intake of patients in the trial was 2,987 mg per day and the median calorie intake was 1,602 kcal/day. Only 11% were considered malnourished according to the Nutritional Risk Index equation.

Researchers found that patients who consumed less than 2,000 mg of sodium per day – the standard recommendation in heart failure patients – often consumed an insufficient amount of calories overall and had protein and micronutrient deficiencies as well.

At the 12-week point, participants who had insufficient calorie intake were more likely to be readmitted to the hospital and showed less improvement in the Kansas City Cardiomyopathy Questionnaire clinical summary score. These patients were readmitted to the hospital for longer than those who had a sufficient calorie intake during the study.

Implications

The latest findings suggest that sodium restriction may not have favorable results in patients with HF. Instead, experts recommend lifestyle interventions aimed at increasing unsaturated fatty acids intake or improving adherence to the DASH diet for patients with chronic and stable HF.

“Of note, both the Mediterranean diet and DASH diet are primarily composed of plant-based foods, suggesting that a prudent plant-based dietary pattern might be beneficial in HF,” Kathleen E. Allen, MS, RD of Dartmouth College Geisel School of Medicine wrote in an accompanying editorial to highlight potential benefits of certain diets.

“The main message of this paper is that patients who are eating low-sodium diets may also have deficiencies in other important dietary components like micronutrients that help with mitochondrial function and protein for building muscle,” Scott L. Hummel, MD, MS, section chief of cardiology at VA Ann Arbor told Healio in an interview.

Researchers hope that the results of their findings raise awareness of the potential adverse consequences of sodium restriction and emphasize the need for lifestyle interventions to be introduced under the supervision of a dietitian. Physicians must exercise caution to help maintain overall nutrition while reducing sodium intake to reduce potential consequences of dietary deficiencies in patients hospitalized with HF.