Fish Consumption and Acute Coronary Syndrome: A Meta-Analysis Leung Yinko, Sylvie S.L., RD, MSc (candidate); Stark, Ken D., PhD; Thanassoulis, George, MD, MSc ...
The American journal of medicine,
09/2014, Letnik:
127, Številka:
9
Journal Article
Recenzirano
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Abstract Background Findings on the association between fish consumption and acute coronary syndrome are inconsistent. We assessed the role of fish consumption in acute coronary syndrome by ...conducting a dose-response meta-analysis. Methods We conducted a literature search of MEDLINE and Embase databases from 1966 to June 2013 for prospective cohort and case-control studies that evaluated the association between fish consumption and acute coronary syndrome among general populations without cardiovascular disease history. Additional studies were identified via hand search of references of relevant articles. Estimates of relative risk (RR) were pooled using random-effects model. Sex and age effects were also evaluated. Results Our search retrieved 11 prospective cohort and 8 case-control studies, totaling 408,305 participants. Among prospective cohort studies, the highest category of fish consumption (ie, ≥4 times per week) was associated with the greatest risk reduction in acute coronary syndrome (RR 0.79; 95% confidence interval CI, 0.70-0.89). In dose-response analysis, each additional 100-g serving of fish per week was associated with a 5% reduced risk (RR per serving 0.95; 95% CI, 0.92-0.97). Subgroup analysis and meta-regression suggested that the risk reduction did not differ across sex or age groups. No heterogeneity was observed among prospective cohort ( P = .73) and case-control ( P = .29) studies. There was no evidence of publication bias. Conclusion Our meta-analysis demonstrated that there is an inverse association between fish consumption and the risk of acute coronary syndrome. Fish consumption appears beneficial in the primary prevention of acute coronary syndrome, and higher consumption is associated with greater protection.
Abstract Background Canadian dietary sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) include marine and non-marine whole foods, functional foods, and nutraceuticals. ...Objective/design In the present study, these sources were incorporated into a nutrient-specific, semi-quantitative food frequency questionnaire (FFQ) and the ability to measure the EPA and DHA intakes of Canadian adults was assessed. Specifically, the EPA and DHA intakes estimated by FFQ of 78 men and women, 20 to 60 years of age, were compared with EPA and DHA measurements from 3-day food records and measures of EPA and DHA in fasting whole blood. Results Mean (±standard deviation) and median intakes of EPA+DHA were 0.34±0.34 and 0.21 g/day by FFQ and 0.47±0.71 and 0.13 g/day by food record, with no significant differences between mean intakes ( P =0.93). The FFQ provided higher estimates than the food record at low intakes of EPA and DHA and lower estimates at high intakes based on Bland-Altman plots. The FFQ was moderately correlated with food record ( r =0.31 to 0.49) and with blood biomarker measures of EPA and DHA ( r =0.31 to 0.51). Agreement analysis revealed that 42% of participants were classified in the same and 77% into same or adjacent quartile when EPA and DHA intake was assessed by food record and by FFQ. Similar quartile agreement was found for EPA and DHA intakes by FFQ with blood biomarker EPA and DHA. The range of the validity coefficients, calculated using the method of triads, was 0.43 to 0.71 for FFQ measurement of EPA+DHA. Conclusions The FFQ is an adequate tool for estimating usual EPA and DHA intakes and ranking Canadian adults by their intakes.
Malnutrition is common in residential care environments, primarily due to poor intake. Micronutrient deficiency, although poorly investigated to date, is also reported to be high. Improving the ...nutrient density of consumed foods is a potential mechanism to promote increased nutrient intake. A scoping review was conducted to: (1) explore the evidence on micronutrient food fortification strategies, (2) identify candidate nutrients and food vehicles for successful food fortification, and (3) identify gaps for future research.
The scoping review framework of Arksey and O'Malley was used. A comprehensive search strategy of 4 electronic databases (MEDLINE, EMBASE, CINAHL, and Web of Science) was completed. Two reviewers were involved in screening and data extraction for all selected articles.
A total of 4394 relevant articles were identified for screening, and application of inclusion/exclusion criteria resulted in 6 food fortification studies (8 citations; 1 study had 3 citations). Overall, vitamin D (n = 5 studies) and calcium (n = 4 studies) were the most common micronutrients fortified; milk products, margarine, bread, and pureed foods were fortification vehicles. Most studies fortified below the RDA recommendation and did not include clinical outcomes. Samples were small and intervention periods were short (3-6 months).
Fortification is a viable strategy for improving the nutrient density of foods consumed in residential care. Although disparate, this literature suggests the potential for further undertaking of fortification to prevent micronutrient deficiencies among residents and future research should consider multinutrient preparations and clinical outcomes.
Abstract Objectives The association between depression and cardiovascular disease severity in younger patients has not been assessed, and sex differences are unknown. We assessed whether major ...depression and depressive symptoms were associated with worse cardiovascular disease severity in patients with premature acute coronary syndrome, and we assessed sex differences in these relationships. Methods We enrolled 1023 patients (aged ≤55 years) hospitalized with acute coronary syndrome from 26 centers in Canada, the United States, and Switzerland, through the GENdEr and Sex determInantS of cardiovascular disease: From bench to beyond-Premature Acute Coronary Syndrome study. Left ventricular ejection fraction, Killip class, cardiac troponin I, and Global Registry of Acute Coronary Events score data were collected through chart review. Results The sample comprised 248 patients with major depression and 302 women. In univariate analyses, major depression was associated with a lower likelihood of having an abnormal left ventricular ejection fraction (odds ratio, 0.70; 95% confidence interval, 0.51-0.97; P = . 03) and lower troponin I levels (estimate, −4.04; 95% confidence interval, −8.01 to −0.06; P = .05). After adjustment for sociodemographic and clinical characteristics, neither major depression nor depressive symptoms were associated with disease severity indices, and there were no sex differences. Conclusion The increased risk of adverse events in depressed patients with premature acute coronary syndrome is not explained by disease severity.
