The Dietary Approaches to Stop Hypertension (DASH) diet score lowers blood pressure (BP). We examined interactions between genotype and the DASH diet score in relation to systolic BP.
We analyzed up ...to 9 420 585 single nucleotide polymorphisms in up to 127 282 individuals of 6 population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (n=35 660) and UK Biobank (n=91 622) and performed European population-specific and cross-population meta-analyses.
We identified 3 loci in European-specific analyses and an additional 4 loci in cross-population analyses at
<5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency, 0.03) and the DASH diet score (
=4e-8;
for heterogeneity, 0.35) in European population, where the interaction effect size was 0.42±0.09 mm Hg (
=9.4e-7) and 0.20±0.06 mm Hg (
=0.001) in Cohorts for Heart and Aging Research in Genomic Epidemiology and the UK Biobank, respectively. The 1 Mb region surrounding rs117878928 was enriched with cis-expression quantitative trait loci (eQTL) variants (
=4e-273) and cis-DNA methylation quantitative trait loci variants (
=1e-300). Although the closest gene for rs117878928 is
, the highest narrow sense heritability accounted by single nucleotide polymorphisms potentially interacting with the DASH diet score in this locus was for gene
at 15q25.1.
We demonstrated gene-DASH diet score interaction effects on systolic BP in several loci. Studies with larger diverse populations are needed to validate our findings.
Objective.—To determine the prevalence and predictors of injury and illness among long-distance hikers. Methods.—This was a cross-sectional study of long-distance hikers (>500 miles 805 km) along the ...Appalachian Trail and Pacific Crest Trails between August and October of 2006. An 8-page survey instrument was made available to hikers at a designated station near the northern terminus of the respective trails. The survey questions were yes/no or multiple choice. Independent variables included packweight, footwear, and type and frequency of water purification. χ2 tests to compare categorical data and the Cochran-Armitage test for trend were used (P < .05 significant). We used logistic regression to compare the variables concurrently, and significance was determined using likelihood ratio tests. Profile likelihood confidence intervals for the odds ratios are reported. Results.—Of the 128 hikers completing surveys that met inclusion criteria, the mean age was 33 years (range = 18–65 years), 94% walked >1500 miles (2400 km), and 70% were male. Using univariate analysis, trends were noted in the proportion of hikers reporting paresthesias and increasing packweight (35% with 10–20 pound 4.5–9 kg packs, 50% with 21–30 pound 9.5–13.5 kg packs, and 69% with >31 pound 14 kg packs P < .002), as well as in the proportion of hikers reporting paresthesias and increasing footwear rigidity (29% sandals, 36% running shoes, 42% hiking shoes, and 68% hiking boots P < .001). In multivariate analysis compared to sandals, the odds ratio of suffering from paresthesias with running shoes was 1.57 (95% CI 0.3, 12.2), hiking shoes 1.73 (95% CI 0.3, 13.9), and hiking boots 3.9 (95% CI 0.7, 32.1) (P = .16). Compared to 10 to 20 pound (4.5–9 kg) packs, the odds ratios of suffering from paresthesias with 21 to 30 pound (9.5–13.5 kg) packs was 1.5 (95% CI 0.6, 3.9), and for >31 pounds (14 kg) was 2.2 (CI 0.7, 7.1) (P = .03). Adjusting for footwear and pack weight, only pack weight was significantly associated with paresthesias. Packweight and footwear were not significantly associated with other musculoskeletal injuries, such as joint sprains or chronic pain, and muscle injuries. Conclusions.—There is an association between packweight and the prevalence of paresthesias among long-distance hikers. The association between type of footwear and the prevalence of paresthesias is significant when analyzed independently, but loses its significance when the variables are examined together. This suggests that there is confounding between footwear and packweight.
High dietary calcium and phosphorus may accelerate vascular calcification, but epidemiological data are inconsistent. Most of those studies assessed diet at one point and have not been systematically ...evaluated.
The purpose of this study was to assess the associations of dietary calcium and phosphorus intakes in middle age with coronary artery and extra-coronary calcification at older age.
We studied 1,914 participants from the ARIC (Atherosclerosis Risk In Communities) study (mean age 80.5 years) without coronary heart disease who underwent chest computed tomography scans at visit 7 (2018-2019) and completed a 66-item food frequency questionnaire at 2 earlier visits (visit 1 1987-1989 and visit 3 1993-1995). Dietary calcium and phosphorus intakes were averaged between these 2 visits. Calcification was quantified by the Agatston score in coronary artery, ascending aorta, descending aorta, aortic valve ring, aortic valve, and mitral valve.
Dietary calcium intake was inversely associated with coronary artery and ascending aorta calcification, whereas the association was not significant for other measures of extra-coronary calcification. For example, the highest vs lowest quartile of calcium intake showed an adjusted OR of 0.66 (95% CI: 0.45-0.98) for coronary artery calcification (Agatston score ≥75th percentile). Dietary phosphorus intake demonstrated similar results, but the magnitude of the association was weaker than dietary calcium intake.
Dietary calcium and phosphorus intakes at middle age were not positively associated with vascular and valvular calcification at over 75 years old. Our findings did not support the link between a calcium or phosphorus-rich diet and vascular and valvular calcification.
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The ability to preferentially protect high-risk groups in COVID-19 is hotly debated. Here, the aim is to present simple metrics of such precision shielding of people at high risk of death after ...infection by SARS-CoV-2; demonstrate how they can estimated; and examine whether precision shielding was successfully achieved in the first COVID-19 wave. The shielding ratio, S, is defined as the ratio of prevalence of infection among people in a high-risk group versus among people in a low-risk group. The contrasted risk groups examined here are according to age (≥70 vs <70 years), and institutionalised (nursing home) setting. For age-related precision shielding, data were used from large seroprevalence studies with separate prevalence data for elderly versus non-elderly and with at least 1000 assessed people≥70 years old. For setting-related precision shielding, data were analysed from 10 countries where information was available on numbers of nursing home residents, proportion of nursing home residents among COVID-19 deaths and overall population infection fatality rate (IFR). Across 17 seroprevalence studies, the shielding ratio S for elderly versus non-elderly varied between 0.4 (substantial shielding) and 1.6 (substantial inverse protection, that is, low-risk people being protected more than high-risk people). Five studies in the USA all yielded S=0.4–0.8, consistent with some shielding being achieved, while two studies in China yielded S=1.5–1.6, consistent with inverse protection. Assuming 25% IFR among nursing home residents, S values for nursing home residents ranged from 0.07 to 3.1. The best shielding was seen in South Korea (S=0.07) and modest shielding was achieved in Israel, Slovenia, Germany and Denmark. No shielding was achieved in Hungary and Sweden. In Belgium (S=1.9), the UK (S=2.2) and Spain (S=3.1), nursing home residents were far more frequently infected than the rest of the population. In conclusion, the experience from the first wave of COVID-19 suggests that different locations and settings varied markedly in the extent to which they protected high-risk groups. Both effective precision shielding and detrimental inverse protection can happen in real-life circumstances. COVID-19 interventions should seek to achieve maximal precision shielding.
Potatoes have a high glycemic load but also antioxidants, vitamins, and minerals. It is unclear what mechanisms are involved in relation to their effect on blood pressure (BP) and hypertension.
This ...study aimed to assess the association between potato consumption, BP changes, and the risk of hypertension in 2 Spanish populations.
Separate analyses were performed in PREDIMED (PREvención con DIeta MEDiterránea), a multicenter nutrition intervention trial of adults aged 55–80 y, and the SUN (Seguimiento Universidad de Navarra) project, a prospective cohort made up of university graduates and educated adults with ages (means ± SDs) of 42.7 ± 13.3 y for men and 35.1 ± 10.7 y for women. In PREDIMED, generalized estimating equations adjusted for lifestyle and dietary characteristics were used to assess changes in BP across quintiles of total potato consumption during a 4-y follow-up. Controlled BP values (systolic BP <140 mm Hg and diastolic BP <90 mm Hg) during follow-up were also assessed. For SUN, multivariate-adjusted HRs for incident hypertension during a mean 6.7-y follow-up were calculated.
In PREDIMED, the total potato intake was 81.9 ± 40.6 g/d. No overall differences in systolic or diastolic BP changes were detected based on consumption of potatoes. For total potatoes, the mean difference in change between quintile 5 (highest intake) and quintile 1 (lowest intake) in systolic BP after multivariate adjustment was −0.90 mm Hg (95% CI: −2.56, 0.76 mm Hg; P-trend = 0.1) and for diastolic BP was −0.02 mm Hg (95% CI: −0.93, 0.89 mm Hg; P-trend = 0.8). In SUN, the total potato consumption was 52.7 ± 33.6 g/d, and no significant association between potato consumption and hypertension incidence was observed in the fully adjusted HR for total potato consumption (quintile 5 compared with quintile 1: 0.98; 95% CI: 0.80, 1.19; P-trend = 0.8).
Potato consumption is not associated with changes over 4 y in blood pressure among older adults in Spain or with the risk of hypertension among Spanish adults. This trial was registered at www.controlled-trials.com as ISRCTN35739639.
EVALUATING THE EFFECTIVENESS OF A Reserch Ethics Committee or Institutional Review Board (IRB) continues to be a difficult task. There are limited data that examine the perceptions of members of IRBs ...about their own performance or methods that would allow comparison among IRB panels at a single institution or between institutions. We piloted an anonymous survey instrument that examined members' attitudes about the efficiency, procedures and outcomes of IRB meetings and developed a process for presentation and discussion of these results with panel members. This quality improvement process was initially completed with one panel, and then replicated with two other IRB panels at one institution. This allowed comparison of perceived IRB performance across panels at a single institution. Further research is required to determine the association between IRB members' perception of performance and other measures of IRB effectiveness and to examine the perceived performance of IRBs by other research stakeholders.
DNA methylation patterns associated with habitual diet have not been well studied.
Diet quality was characterized using a Mediterranean-style diet score and the Alternative Healthy Eating Index ...score. We conducted ethnicity-specific and trans-ethnic epigenome-wide association analyses for diet quality and leukocyte-derived DNA methylation at over 400 000 CpGs (cytosine-guanine dinucleotides) in 5 population-based cohorts including 6662 European ancestry, 2702 African ancestry, and 360 Hispanic ancestry participants. For diet-associated CpGs identified in epigenome-wide analyses, we conducted Mendelian randomization (MR) analysis to examine their relations to cardiovascular disease risk factors and examined their longitudinal associations with all-cause mortality.
We identified 30 CpGs associated with either Mediterranean-style diet score or Alternative Healthy Eating Index, or both, in European ancestry participants. Among these CpGs, 12 CpGs were significantly associated with all-cause mortality (Bonferroni corrected
<1.6×10
). Hypermethylation of cg18181703 (
) was associated with higher scores of both Mediterranean-style diet score and Alternative Healthy Eating Index and lower risk for all-cause mortality (
=5.7×10
). Ten additional diet-associated CpGs were nominally associated with all-cause mortality (
<0.05). MR analysis revealed 8 putatively causal associations for 6 CpGs with 4 cardiovascular disease risk factors (body mass index, triglycerides, high-density lipoprotein cholesterol concentrations, and type 2 diabetes mellitus; Bonferroni corrected MR
<4.5×10
). For example, hypermethylation of cg11250194 (
) was associated with lower triglyceride concentrations (MR,
=1.5×10
).and hypermethylation of cg02079413 (
;
) was associated with body mass index (corrected MR,
=1×10
).
Habitual diet quality was associated with differential peripheral leukocyte DNA methylation levels of 30 CpGs, most of which were also associated with multiple health outcomes, in European ancestry individuals. These findings demonstrate that integrative genomic analysis of dietary information may reveal molecular targets for disease prevention and treatment.
Rationale & Objective: Novel metabolite biomarkers of kidney failure with replacement therapy (KFRT) may help identify people at high risk for adverse kidney outcomes and implicated pathways may aid ...in developing targeted therapeutics. Study Design: Prospective cohort. Setting & Participants: The cohort included 3,799 Atherosclerosis Risk in Communities study participants with serum samples available for measurement at visit 1 (1987-1989). Exposure: Baseline serum levels of 318 metabolites. Outcomes: Incident KFRT, kidney failure (KFRT, estimated glomerular filtration rate <15 mL/min/1.73 m2, or death from kidney disease). Analytical Approach: Because metabolites are often intercorrelated and represent shared pathways, we used a high dimension reduction technique called Netboost to cluster metabolites. Longitudinal associations between clusters of metabolites and KFRT and kidney failure were estimated using a Cox proportional hazards model. Results: Mean age of study participants was 53 years, 61% were African American, and 13% had diabetes. There were 160 KFRT cases and 357 kidney failure cases over a mean of 23 years. The 314 metabolites were grouped in 43 clusters. Four clusters were significantly associated with risk of KFRT and 6 were associated with kidney failure (including 3 shared clusters). The 3 shared clusters suggested potential pathways perturbed early in kidney disease: cluster 5 (15 metabolites involved in alanine, aspartate, and glutamate metabolism as well as 5-oxoproline and several gamma-glutamyl amino acids), cluster 26 (6 metabolites involved in sugar and inositol phosphate metabolism), and cluster 34 (21 metabolites involved in glycerophospholipid metabolism). Several individual metabolites were also significantly associated with both KFRT and kidney failure, including glucose and mannose, which were associated with higher risk of both outcomes, and 5-oxoproline, gamma-glutamyl amino acids, linoleoylglycerophosphocholine, 1,5-anhydroglucitol, which were associated with lower risk of both outcomes. Limitations: Inability to determine if the metabolites cause or are a consequence of changes in kidney function. Conclusions: We identified several clusters of metabolites reproducibly associated with development of KFRT. Future experimental studies are needed to validate our findings as well as continue unraveling metabolic pathways involved in kidney function decline.
Background: The Dietary Guidelines for Americans (DGAs) provide dietary recommendations for the general population with the intent of preventing chronic disease such as cardiovascular disease. An ...evaluation of whether updated versions of the DGAs accomplish this goal is lacking. Objective: The objective of this project was to determine whether updates to DGAs over time, reflected in subsequent versions of diet quality indices, strengthened the associations between diet quality and risk of cardiovascular disease outcomes. Methods: Dietary data collected using an FFQ in the Framingham Heart Study Offspring cohort were used to assess adherence to sequential versions of the Healthy Eating Index (HEI) (1990, 2005, 2010, and 2015) and Alternative HEI (2000 and 2010) (n = 3267). We conducted prospective analyses using Cox regression to estimate the associations between diet indices and incident cardiovascular disease outcomes. Results: Among the 3267 study participants, 54% were female, mean age was 55 y, and BMI was 27 kg/m (2) . There were a total of 544 events for the composite outcome of cardiovascular diseases (324 coronary artery disease events, 153 stroke events, and 187 heart failure events). Adherence to any dietary index was inversely associated with risk of cardiovascular disease, coronary artery disease, and heart failure, but not stroke. Compared with HEI-1990, scores for the more recent diet indices were more strongly associated with coronary artery disease risk, but not cardiovascular disease, heart failure, or stroke. Conclusions: More recent iterations of diet indices, reflecting updates to the DGAs over time, are more strongly associated with risk of incident coronary artery disease than the original diet index (HEI-1990). Curr Dev Nutr 2019;3:nzz 123 Keywords: diet, cardiovascular disease, coronary artery disease, heart failure, stroke
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