Daily habits, including the number and quality of eating occasions, are potential targets for primary prevention strategies with large health impacts. Skipping breakfast is considered a frequent and ...unhealthy habit associated with an increased cardiovascular (CV) risk.
The study sought to explore the association between different breakfast patterns and CV risk factors and the presence, distribution, and extension of subclinical atherosclerosis.
Cross-sectional analysis was performed within the PESA (Progression of Early Subclinical Atherosclerosis) study, a prospective cohort of asymptomatic (free of CV events at baseline) adults 40 to 54 years of age. Lifestyle and multivascular imaging data along with clinical covariates were collected from 4,052 participants. Multivariate logistic regression models were used in the analysis.
Three patterns of breakfast consumption were studied: high-energy breakfast, when contributing to >20% of total daily energy intake (27% of the population); low-energy breakfast, when contributing between 5% and 20% of total daily energy intake (70% of the population); and skipping breakfast, when consuming <5% of total daily energy (3% of the population). Independent of the presence of traditional and dietary CV risk factors, and compared with high-energy breakfast, habitual skipping breakfast was associated with a higher prevalence of noncoronary (odds ratio: 1.55; 95% confidence interval: 0.97 to 2.46) and generalized (odds ratio: 2.57; 95% confidence interval: 1.54 to 4.31) atherosclerosis.
Skipping breakfast is associated with an increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors. (Progression of Early Subclinical Atherosclerosis PESA; NCT01410318)
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Breakfast is considered to be one of the most important meals of the day. Its omission has been reported to be associated with increased disease risk, such as obesity, diabetes, and coronary heart ...disease, as well as unhealthy lifestyle and lower dietary quality. Using data from the National Adult Nutrition Survey (NANS)-a food consumption survey conducted among 1500 Irish men and women over 18 years of age, residing in the Republic of Ireland at the time the survey was conducted-we aimed to characterize breakfast regularity, identify dietary patterns associated with regular breakfast consumption, and assess the nutritional quality of such dietary patterns, using the nutrient-rich food index score NRF9.3. We determined two breakfast regularity categories and assessed dietary quality, by means of adherence to the principal component analysis derived dietary patterns and the NRF9.3 dietary index. Regular breakfast consumers were identified as those who consumed breakfast 3⁻4 times out of the 4 days of the collection period; such consumers comprised the majority of the population (94.4%). They had the highest adherence to healthier dietary patterns, namely, the "vegetarian" (odds ratio (OR): 2.59: 95% Confidence Interval (CI): 1.40, 4.77), "fish and vegetables" (OR: 2.88: 95% CI: 1.63, 5.10), and "breakfast cereals" (OR: 4.62: 95% CI: 2.43, 8.79) dietary patterns. Breakfast significantly contributed to the daily micronutrient intake by providing, on average, 24% of dietary fiber, 32% of iron, 30% of calcium, 32% of folate, and 37% of riboflavin. The importance of regular breakfast consumption on those who skip breakfast should be highlighted, in order to improve compliance with nutritional recommendations and adherence to a healthy lifestyle.
(1) Background: Working night shifts has been associated with altered circadian rhythms, lifestyle habits, and cardiometabolic risks. No information on the potential association of working shift and ...the presence of atherosclerosis is available. The aim of this study was to quantify the association between different work shifts and the presence of subclinical atherosclerosis objectively measured by imaging. (2) Methods: Analyses were conducted on the baseline data of the Aragon Workers Health Study (AWHS) cohort, including information on 2459 middle-aged men. Categories of shift work included central day shift, rotating morning-evening or morning-evening-night shift, and night shift. The presence of atherosclerotic plaques was assessed by 2D ultrasound in the carotid and femoral vascular territories. Multivariable logistic models and mediation analysis were conducted to characterize and quantify the association between study variables. (3) Results: Participants working night or rotating shifts presented an overall worse cardiometabolic risk profile, as well as more detrimental lifestyle habits. Workers in the most intense (morning-evening-night) rotating shift presented higher odds of subclinical atherosclerosis (odds ratio: 1.6; 95% confidence interval: 1.12 to 2.27) compared to workers in the central shift, independently of the presence of lifestyle and metabolic risk factors. A considerable (21%) proportion of this association was found to be mediated by smoking, indicating that altered sleep-wake cycles have a direct relationship with the early presence of atherosclerotic lesions. (4) Conclusions: Work shifts should be factored in during workers health examinations, and when developing effective workplace wellness programs.
The workplace offers a unique opportunity for effective health promotion. We aimed to comprehensively study the effectiveness of multicomponent worksite wellness programmes for improving diet and ...cardiometabolic risk factors.
We did a systematic literature review and meta-analysis, following PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library, Web of Science, and Education Resources Information Center, from Jan 1, 1990, to June 30, 2020, for studies with controlled evaluation designs that assessed multicomponent workplace wellness programmes. Investigators independently appraised the evidence and extracted the data. Outcomes were dietary factors, anthropometric measures, and cardiometabolic risk factors. Pooled effects were calculated by inverse-variance random-effects meta-analysis. Potential sources of heterogeneity and study biases were evaluated.
From 10 169 abstracts reviewed, 121 studies (82 68% randomised controlled trials and 39 32% quasi-experimental interventions) met the eligibility criteria. Most studies were done in North America (57 47%), and Europe, Australia, or New Zealand (36 30%). The median number of participants was 413·0 (IQR 124·0–904·0), and median duration of intervention was 9·0 months (4·5–18·0). Workplace wellness programmes improved fruit and vegetable consumption (0·27 servings per day 95% CI 0·16 to 0·37), fruit consumption (0·20 servings per day 0·11 to 0·28), body-mass index (–0·22 kg/m2 –0·28 to –0·17), waist circumference (–1·47 cm –1·96 to –0·98), systolic blood pressure (–2·03 mm Hg –3·16 to –0·89), and LDL cholesterol (–5·18 mg/dL –7·83 to –2·53), and to a lesser extent improved total fat intake (–1·18% of daily energy intake –1·78 to –0·58), saturated fat intake (–0·70% of daily energy –1·22 to –0·18), bodyweight (–0·92 kg –1·11 to –0·72), diastolic blood pressure (–1·11 mm Hg –1·78 to –0·44), fasting blood glucose (–1·81 mg/dL –3·33 to –0·28), HDL cholesterol (1·11 mg/dL 0·48 to 1·74), and triglycerides (–5·38 mg/dL –9·18 to –1·59). No significant benefits were observed for intake of vegetables (0·03 servings per day 95% CI –0·04 to 0·10), fibre (0·26 g per day –0·15 to 0·67), polyunsaturated fat (–0·23% of daily energy –0·59 to 0·13), or for body fat (–0·80% –1·80 to 0·21), waist-to-hip ratio (–0·00 ratio –0·01 to 0·00), or lean mass (1·01 kg –0·82 to 2·83). Heterogeneity values ranged from 46·9% to 91·5%. Between-study differences in outcomes were not significantly explained by study design, location, population, or similar factors in heterogeneity analyses.
Workplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardiometabolic risk indicators. The heterogeneity identified in study designs and results should be considered when using these programmes as strategies to improve cardiometabolic health.
National Heart, Lung, and Blood Institute.
Nutritional data reduction methods are widely applied in nutrition epidemiology in order to classify individuals into meaningful groups with similar dietary patterns. To date, none of the existing ...studies have applied latent class analysis to examine dietary patterns which include meal types consumed throughout a day. We investigated main meal patterns followed on weekend and weekdays, and evaluated their associations with cardio-metabolic biomarkers. The analyses were performed within the NANS (National Adult Nutrition Survey) a cross-sectional national food consumption survey of 1500 nationally representative Irish adults. A total number of seven dietary patterns were identified using latent class analysis. The typical meal pattern followed by the majority of the population was characterized by consumption of cereal or toast for breakfast, skipping or consuming a sandwich for light meal, and meat or fish with potatoes, pasta or vegetables for the main meal. Eating patterns differed on weekends, and those participants who consumed meat and eggs for breakfast instead of breakfast cereal and skipped light meal were more likely to have an unhealthier dietary pattern, a higher diastolic blood pressure, and increased serum ferritin. The application of data reduction techniques to simplify the multifaceted nature of dietary data is a useful approach to derive patterns, which might shed further light on the typical dietary patterns followed by populations.
Abstract Background The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would ...contribute greatly to inform effective primary prevention strategies. Objectives This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults. Methods The PESA (Progression of Early Subclinical Atherosclerosis) study enrolled 4,082 asymptomatic participants 40 to 54 years of age (mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis in multiple vascular territories. A fundamental objective of this cohort study was to evaluate the life-style–related determinants, including diet, on atherosclerosis onset and development. We conducted a cross-sectional analysis of baseline data, including detailed information on dietary habits obtained as part of the overall life-style and risk factor assessment, as well as a complete vascular imaging study that was performed blinded to the clinical information. Results Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern, characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, and sugar-sweetened beverages and frequent eating-out behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile and, after adjustment for risk factors, increased odds of presenting subclinical atherosclerosis (odds ratio: 1.31; 95% confidence interval: 1.06 to 1.63) compared with participants following a Mediterranean diet. Conclusions A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy life-style, is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis. (Progression of Early Subclinical Atherosclerosis PESA; NCT01410318 )
The present study set out to explore the option of developing food portion size for nutritional labelling purposes using two European Union (EU) dietary surveys. The surveys were selected as they ...differed in (a) methodologies (food diary versus food frequency questionnaire), (b) populations (Irish National Adult Nutrition Survey (NANS) versus a seven-country survey based on the pan EU study Food4Me), (c) food quantification (multiple options versus solely photographic album) and (d) duration (4 consecutive days versus recent month). Using data from these studies, portion size was determined for 15 test foods, where portion size was defined as the median intake of a target food when consumed. The median values of the portion sizes derived from both the NANS and Food4Me surveys were correlated (
= 0.823;
< 0.00) and the mean of the two survey data sets were compared to US values from the Recognized as Customarily Consumed (RACC) database. There was very strong agreement across all food categories between the averaged EU and the US portion size (
= 0.947;
< 0.00). It is concluded that notwithstanding the variety of approaches used for dietary survey data in the EU, the present data supports using a standardized approach to food portion size quantification for food labelling in the EU.
Traditional Mediterranean diet is known for its health benefits in prevention of cardio-metabolic diseases and risk factors associated with it. The role of red meat in Mediterranean diet is to some ...extent overlooked with the main focus on foods of plant origin. The majority of existing guidelines encourage general population to limit intakes of red meat. However, in reality, it is a significant part of the Mediterranean cuisine. Red meat is an excellent source of macro and micronutrients: high-quality protein, B vitamins, essential amino acids, omega-3 polyunsaturated fatty acids, phosphorus, zinc, iron, and selenium. Currently, there is not enough scientific evidence to suggest the strict limitation of the red meat consumption among the general population, however, there is a substantial evidence to support the advice to eliminate the consumption of processed meat from the diet.
Daily habits, including the number and quality of eating occasions, are potential targets for primary prevention strategies with large health impacts. Skipping breakfast is considered a frequent and ...unhealthy habit associated with an increased cardiovascular (CV) risk.
The study sought to explore the association between different breakfast patterns and CV risk factors and the presence, distribution, and extension of subclinical atherosclerosis.
Cross-sectional analysis was performed within the PESA (Progression of Early Subclinical Atherosclerosis) study, a prospective cohort of asymptomatic (free of CV events at baseline) adults 40 to 54 years of age. Lifestyle and multivascular imaging data along with clinical covariates were collected from 4,052 participants. Multivariate logistic regression models were used in the analysis.
Three patterns of breakfast consumption were studied: high-energy breakfast, when contributing to >20% of total daily energy intake (27% of the population); low-energy breakfast, when contributing between 5% and 20% of total daily energy intake (70% of the population); and skipping breakfast, when consuming <5% of total daily energy (3% of the population). Independent of the presence of traditional and dietary CV risk factors, and compared with high-energy breakfast, habitual skipping breakfast was associated with a higher prevalence of noncoronary (odds ratio: 1.55; 95% confidence interval: 0.97 to 2.46) and generalized (odds ratio: 2.57; 95% confidence interval: 1.54 to 4.31) atherosclerosis.
Skipping breakfast is associated with an increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors. (Progression of Early Subclinical Atherosclerosis PESA; NCT01410318).
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