Adherence to Mediterranean diet, high-sensitive C-reactive protein, and severity of coronary artery disease: Contemporary data from the INTERCATH cohort

Waldeyer, Christoph; Brunner, Fabian J.; Braetz, Julian; Ruebsamen, N; Zyriax, Birgit-Christiane; Blaum, Christopher; Kroeger, F; Kohsiack, Rebecca; Schrage, Benedikt; Sinning, Christoph; Becher, Peter Moritz; Karakas, Mahir; Zeller, Tanja; Westermann, Dirk; Sydow, Karsten; Blankenberg, Stefan; Seiffert, Moritz; Schnabel, Renate B.

doi:10.1016/j.atherosclerosis.2018.06.877

Cited by 40 publications

(28 citation statements)

References 32 publications

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“…For example, Western-style dietary patterns that are rich in refined carbohydrates, sodium, and trans- and saturated fatty acids (SFA) have additionally been linked with higher levels of inflammatory markers, which in turn increase CVD risk [30–32]. Conversely, Mediterranean-style dietary patterns that are rich in fiber, lean protein, monounsaturated (MUFA), and omega-3 polyunsaturated fatty acids (PUFA) are anti-inflammatory and cardioprotective [33–35].…”

Section: Evaluation Of Inflammatory Dietary Patterns Utilizing Diementioning

confidence: 99%

“…Concerning the type of diet, there is mounting epidemiological evidence that specific dietary patterns, such as adherence to Mediterranean-style dietary patterns, are anti-inflammatory and concomitantly protective against CVD. Additionally, this diet can also benefit coronary artery disease (CAD) patients [35, 51, 52].…”

Section: Evaluation Of Inflammatory Dietary Patterns Utilizing Diementioning

confidence: 99%

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Assessment of Dietary Patterns Represents a Potential, Yet Variable, Measure of Inflammatory Status: A Review and Update

Calle

Andersen

2019

Disease Markers

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Chronic low-grade, systemic inflammation is a well-characterized risk factor in the development of chronic metabolic diseases, such as cardiovascular disease, type 2 diabetes, and metabolic syndrome. Diet could be an effective strategy for reducing inflammation associated with chronic disease. While anti-inflammatory properties of isolated dietary bioactive and functional foods have been routinely studied, the evaluation of dietary patterns on inflammation warrants further review—especially given the recent inclusion of dietary pattern recommendations into dietary guidelines and policies. Therefore, the objective of this narrative review is to examine current evidence linking diet to low-grade, systemic inflammation within the context of chronic disease. Specifically, we provide an update on the findings from human trials that have characterized anti-inflammatory properties of dietary patterns, defined by various methods and indexes. Given the complexity of interpreting results from dietary pattern analysis, we further present recent evidence on the anti-inflammatory roles of isolated bioactive nutrients and functional foods that are common components of distinct dietary patterns, in addition to considerations for interpreting dietary pattern research, population-specific dietary recommendations, and future studies. Overall, we observe a vast range of variability in the evidence from observational studies that have evaluated the relationships between healthy dietary patterns and inflammatory markers. These studies highlight the need for additional intervention studies with study designs that account for metabolic status, diversity in populations, breadth of inflammatory measurements, fasting vs. postprandial effects of diet, and control of confounding factors (e.g., genotype, microbiome profiles, and dietary adherence) in order to better understand the effect that diet has, as a whole, on inflammation. These strategies will help to strengthen diet recommendations aimed at reducing inflammation and chronic disease risk.

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Section: Evaluation Of Inflammatory Dietary Patterns Utilizing Diementioning

confidence: 99%

Section: Evaluation Of Inflammatory Dietary Patterns Utilizing Diementioning

confidence: 99%

Assessment of Dietary Patterns Represents a Potential, Yet Variable, Measure of Inflammatory Status: A Review and Update

Calle

Andersen

2019

Disease Markers

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“…Design and rationale have been described previously. 23,24 Comorbidities, information on lifestyle risk factors, and medication were assessed by a questionnaire at enrolment as well as written medical reports.…”

Section: Methodsmentioning

confidence: 99%

“…To quantify adherence to Mediterranean diet, an established Mediterranean diet score (MDS) was derived, as described previously. 24,26 In short, a food frequency questionnaire nearly identical to that used in studies like STABILITY 26 or INTERHEART 27 assesses consumption of six food groups plus alcohol. Based on consumption frequencies, a score ranging from 0 to 28 points is calculated, with 0 points reflecting no adherence to a Mediterranean diet, and 28 points reflecting highest adherence to a Mediterranean diet.…”

Section: Assessment Of Modifiable Lifestyle Cardiovascular Risk Factorsmentioning

confidence: 99%

“…Failure to adhere to a Mediterranean diet was defined as a MDS 12, a threshold which was recently shown to be predictive for the severity of CAD and prognosis for patients with stable CAD. 24,26 Cardiovascular risk factor assessment Patients taking antihypertensive medication or with arterial hypertension documented as a diagnosis in a written medical report were classified to have arterial hypertension. Patients were defined to have diabetes mellitus in the case of intake of oral blood-glucose-lowering therapy, regular substitution of insulin, HbA1c levels >6.5%, or documented diabetes in a written medical report.…”

Section: Assessment Of Modifiable Lifestyle Cardiovascular Risk Factorsmentioning

confidence: 99%

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Modifiable lifestyle risk factors and C-reactive protein in patients with coronary artery disease: Implications for an anti-inflammatory treatment target population

Blaum¹,

Brunner²,

Kröger³

et al. 2019

European Journal of Preventive Cardiology

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Background Modifiable lifestyle risk factors (modRF) of coronary artery disease (CAD) are associated with increased inflammation represented by elevated C-reactive protein (CRP) levels. Lifestyle changes may influence the inflammatory burden in patients with CAD, relevantly modifying the target population for emerging anti-inflammatory compounds. Aims The aims of this study were to analyse the association of modRF and CRP levels in CAD patients, and to define a potential target population for anti-inflammatory treatment with and without the optimisation of modRF. Methods We included all patients with angiographically documented CAD from the observational cohort study INTERCATH. Patients with recent myocardial infarction, malignancy, infectious disease, and pre-existing immunosuppressive medication including a history of solid organ transplantation were excluded. Overweight (body mass index (BMI) ≥ 25 kg/m2), smoking, lack of physical activity (PA; <1.5 h/week), and poor diet (≤12 points of an established Mediterranean diet score (MDS), range 0–28 points) were considered as modRF. CRP was measured by a high-sensitivity assay (hsCRP) at baseline. We performed multivariable linear regressions with log-transformed hsCRP as the dependent variable. Based on these associations, we calculated potential hsCRP levels for each patient, assuming optimisation of the individual modRF. Results Of 1014 patients, 737 (73%) were male, the mean age was 69 years, and 483 (48%) had an hsCRP ≥ 2 mg/l. ModRF were significantly overrepresented in patients with hsCRP ≥ 2 mg/l compared to patients with an hsCRP < 2 mg/l (BMI ≥ 25 kg/m2: 76% vs 61%; PA < 1.5 h/week: 69% vs 57%; MDS ≤ 12: 46% vs 37%; smoking: 61% vs 54%; p < 0.05 for all). hsCRP increased with the incremental number of modRF present (median hsCRP values for N = 0, 1, 2, 3, and 4 modRF: 1.1, 1.0, 1.6, 2.4, 2.8 mg/l, p < 0.001). Multivariable linear regression adjusting for age, sex, intake of lipid-lowering medication, and diabetes mellitus revealed independent associations between log-transformed hsCRP and all modRF (BMI ≥ 25 kg/m2: exp(ß) = 1.55, p < 0.001; PA < 1.5 h/week: exp(ß) = 1.33, p < 0.001; MDS ≤ 12: exp(ß) = 1.18, p = 0.018; smoking: exp(ß) = 1.18, p = 0.019). Individual recalculation of hsCRP levels assuming optimisation of modRF identified 183 out of 483 (38%) patients with hsCRP ≥ 2 mg/l who could achieve an hsCRP < 2 mg/l via lifestyle changes. Conclusion modRF are strongly and independently associated with CRP levels in patients with CAD. A relevant portion of CAD patients with high inflammatory burden could achieve an hsCRP < 2 mg/l by lifestyle changes alone. This should be considered both in view of the cost and side-effects of pharmacological anti-inflammatory treatment and for the design of future clinical trials in this field.

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Joint Effects of Dietary Patterns and Paraoxonase1 rs662 Polymorphism on Coronary Artery Disease Severity (Gensini and SYNTAX Scores) and Its Risk Factors in adults Undergoing Angiography

Darand,

Askari,

Feizi

et al. 2024

Molecular Nutrition Food Res

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ScopeThe present study aims to assess the interaction of dietary patterns (DPs) and paraoxonase1 (PON1) rs662 polymorphism on coronary artery disease (CAD) severity and its risk factors.Methods and resultsThis cross‐sectional study is conducted on 425 patients undergoing angiography. The PON1 genotypes are detected by the polymerase chain reaction‐restriction fragment length polymorphism (RFLP‐PCR) technique. DPs are extracted by exploratory factor analysis. Two dietary patterns Western (WDP) and Traditional (TDP) are extracted. A gene‐diet interaction concerning a high Gensini score is observed. Accordingly, high adherence to the WDP increases the odds of a high Gensini score in R allele carriers compared to QQ genotype carriers by 2.48 times (odds ratio [OR]: 2.48, 95% confidence interval [CI] 0.98–6.26, p = 0.05). Also, the risk of high systolic blood pressure (SBP) is higher in R allele carriers with high adherence to the WDP compared to QQ genotype carriers (OR: 3.49, 95% CI 1.38–8.82, p < 0.001. No significant interaction is observed between TDP and PON1 rs662 on any cardiometabolic risk factors (p‐value > 0.05). The results remain significant after adjusting for confounders.ConclusionThe present study's findings indicate the existence of an interaction between the PON1 rs662 polymorphism and the WDP on the risk of stenosis severity and high SBP.

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Adherence to Mediterranean diet, high-sensitive C-reactive protein, and severity of coronary artery disease: Contemporary data from the INTERCATH cohort

Cited by 40 publications

References 32 publications

Assessment of Dietary Patterns Represents a Potential, Yet Variable, Measure of Inflammatory Status: A Review and Update

Assessment of Dietary Patterns Represents a Potential, Yet Variable, Measure of Inflammatory Status: A Review and Update

Modifiable lifestyle risk factors and C-reactive protein in patients with coronary artery disease: Implications for an anti-inflammatory treatment target population

Joint Effects of Dietary Patterns and Paraoxonase1 rs662 Polymorphism on Coronary Artery Disease Severity (Gensini and SYNTAX Scores) and Its Risk Factors in adults Undergoing Angiography

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