Research

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12 pages, 557 KiB

Open AccessArticle

Factors Associated with Potentially Inappropriate Screening for Vitamin D Deficiency among Women in Medically Underserved Regions of West Texas

by Duke Appiah, Samira Kamrudin and Cornelia de Riese

J. Clin. Med. 2023, 12(3), 993; https://doi.org/10.3390/jcm12030993 - 28 Jan 2023

Viewed by 1204

Abstract

Testing for vitamin D deficiency (VDD) has been on the increase due to its association with several diseases. However, inappropriate testing for VDD, defined as screening for VDD among individuals with a low risk, has been reported. The aim of this study was [...] Read more.

Testing for vitamin D deficiency (VDD) has been on the increase due to its association with several diseases. However, inappropriate testing for VDD, defined as screening for VDD among individuals with a low risk, has been reported. The aim of this study was to evaluate the prevalence and factors associated with potentially inappropriate screening for VDD among medically underserved populations in West Texas. Data were from 21,407 women who were hospitalized from 2016 to 2018 at a large regional health system. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The median age of patients was 40 years. While the proportion of patients tested for VDD reduced from 8.9% to 7.6% (p = 0.013) from 2016 to 2018, the prevalence of inappropriate testing increased from 32.3% to 46.8% (p < 0.001), with the 3-year prevalence of VDD being 27.6%. White race (OR = 2.71, CI: 1.95–3.78), an age ≥ 65 years (OR = 3.07, CI: 2.05–4.59), the use of public-sponsored insurance (OR = 1.62, CI: 1.20–2.17), cardiovascular disease (OR = 0.75, CI: 0.63–0.90), and vitamin D supplement use (OR = 7.05, CI: 5.82–8.54) were associated with inappropriate testing for VDD. In this study, an increasing prevalence of potentially inappropriate testing for VDD was observed. Sociodemographic and health-related conditions were associated with potentially inappropriate testing for VDD. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

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13 pages, 319 KiB

Open AccessArticle

Serum Selenium and Incident Cardiovascular Disease in the PREvención con DIeta MEDiterránea (PREDIMED) Trial: Nested Case-Control Study

by Mario Gutiérrez-Bedmar, Fernando Gil, Pablo Olmedo, Miguel Ruiz-Canela, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Nancy Babio, Montserrat Fitó, Jose Luís Del Val García, Dolores Corella, José V. Sorlí, Emilio Ros, Miquel Fiol, Ramón Estruch, José Manuel Santos-Lozano, Fernando Arós, Lluís Serra-Majem, Xavier Pintó, Enrique Gómez-Gracia and Carlos Muñoz-Bravo

J. Clin. Med. 2022, 11(22), 6664; https://doi.org/10.3390/jcm11226664 - 10 Nov 2022

Cited by 3 | Viewed by 2084

Abstract

Background: Selenium is an essential trace mineral with potential interest for cardiovascular disease (CVD) prevention owing to its antioxidant properties. Epidemiological data on selenium status and CVD remain inconsistent. The objective of this study was to ascertain whether low serum selenium (SSe) concentrations [...] Read more.

Background: Selenium is an essential trace mineral with potential interest for cardiovascular disease (CVD) prevention owing to its antioxidant properties. Epidemiological data on selenium status and CVD remain inconsistent. The objective of this study was to ascertain whether low serum selenium (SSe) concentrations are related to an increased risk of a first CVD event in a population at high cardiovascular risk. Methods: We undertook a case-control study nested within the “PREvención con DIeta MEDiterránea” (PREDIMED) trial. A total of 207 participants diagnosed with CVD (myocardial infarction, stroke, or cardiovascular death) during the follow-up period (2003–2010) were matched by sex, age, and intervention group to 436 controls by incidence density sampling. Median time between serum sample collection and subsequent CVD event occurrence was 0.94 years. SSe levels were determined using inductively coupled plasma mass spectrometry analysis. Covariates were assessed through validated questionnaires, in-person interviews, and medical record reviews. Conditional logistic regression was used to calculate multivariable-adjusted odds ratios (ORs). Results: Among women, the mean SSe concentration was lower in cases than in controls (98.5 μg/L vs. 103.8 μg/L; p = 0.016). In controls, SSe levels were directly associated with percentage of total energy intake from proteins and fish intake (p for linear trend < 0.001 and 0.049, respectively), whereas SSe concentrations were inversely associated with age, body mass index, and percentage of total energy intake from carbohydrates (p for linear trend < 0.001, 0.008 and 0.016 respectively). In the total group, we observed an inverse dose–response gradient between SSe levels and risk of CVD in the fully-adjusted model (highest vs. lowest quartile: OR = 0.47, 95% CI: 0.27–0.81; ptrend = 0.003). Conclusions: Among elderly individuals at high cardiovascular risk, high SSe concentrations within population reference values are associated with lower first CVD incidence. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

14 pages, 787 KiB

Open AccessArticle

Independent and Joint Associations of Pessimism, Total Calorie Intake and Acid-Producing Diets with Insomnia Symptoms among Breast Cancer Survivors

by Tianying Wu, Cesar Arevalo, Fang-Chi Hsu, Suzi Hong, Humberto Parada, Jr., Mingan Yang and John P. Pierce

J. Clin. Med. 2022, 11(10), 2828; https://doi.org/10.3390/jcm11102828 - 17 May 2022

Cited by 2 | Viewed by 1647

Abstract

Insomnia is prevalent in up to 40% of breast cancer survivors. Few studies have examined pessimism and dietary factors as risk factors for insomnia among breast cancer survivors. We leveraged a cohort of 2944 breast cancer survivors who enrolled in the Women’s Healthy [...] Read more.

Insomnia is prevalent in up to 40% of breast cancer survivors. Few studies have examined pessimism and dietary factors as risk factors for insomnia among breast cancer survivors. We leveraged a cohort of 2944 breast cancer survivors who enrolled in the Women’s Healthy Eating and Living study; these survivors provided dietary, insomnia, mental health, demographic, and lifestyle information at baseline and at 1- and 4-year follow-up assessments. Insomnia symptoms were assessed using the Women’s Health Initiative (WHI)-Insomnia Rating Scale, and pessimism was assessed using the Life Orientation Test Revised (LOT-R). Total calorie intake and acid-producing diets were assessed using 24 h dietary recalls. Multivariable-adjusted generalized estimating equation (GEE) models were used to test the independent and joint effects of psychological and dietary factors on insomnia. In the multivariable model, women in the third tertile of pessimism had greater odds (OR = 1.57 95% CI [1.37–1.79]) of insomnia when compared to women in the lowest tertile. Total calorie intake and acid-producing diets were each independently and significantly associated with insomnia symptoms. Further, pessimism and calorie intake/acid-producing diets were jointly associated with insomnia. For instance, women with pessimism scores in tertile 3 and total calorie intakes < median reported 2 times the odds (OR = 2.09; 95% CI [1.51–3.47]) of insomnia compared to women with pessimism score in tertile 1 and calorie intakes < median. Our results highlight the need for patient care regarding mental health, and recommendations of healthy dietary intakes for breast cancer survivors. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

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12 pages, 2073 KiB

Open AccessArticle

Trends of Dietary Intakes and Metabolic Diseases in Japanese Adults: Assessment of National Health Promotion Policy and National Health and Nutrition Survey 1995–2019

by Muhammad Fauzi, Indri Kartiko-Sari and Hemant Poudyal

J. Clin. Med. 2022, 11(9), 2350; https://doi.org/10.3390/jcm11092350 - 22 Apr 2022

Cited by 7 | Viewed by 2391

Abstract

Health Japan 21 is Japan’s premier health promotion policy encompassing preventive community health measures for lifestyle-related diseases. In this repeated cross-sectional survey, we report 24-year trends of type 2 diabetes mellitus (T2DM), obesity, hypertension, and their association with dietary intakes to evaluate Health [...] Read more.

Health Japan 21 is Japan’s premier health promotion policy encompassing preventive community health measures for lifestyle-related diseases. In this repeated cross-sectional survey, we report 24-year trends of type 2 diabetes mellitus (T2DM), obesity, hypertension, and their association with dietary intakes to evaluate Health Japan 21’s impact and identify gaps for future policy implementation. We analyzed data from 217,519 and 232,821 adults participating in the physical examination and dietary intake assessment, respectively, of the National Health and Nutrition Survey 1995–2019. Average HbA1c and BMI have significantly increased along with the prevalence of T2DM and overweight/obesity among males. Despite a significant decrease in daily salt intake, the decline in the combined prevalence of Grades 1–3 hypertension was non-significant. Seafood and meat intakes showed strong opposing trends during the study period, indicating a dietary shift in the Japanese population. Neither salt nor vegetable/fruit intake reached the target set by Health Japan 21. Metabolic disease trend differences between males and females highlight the need for a gender-specific health promotion policy. Future Health Japan 21 implementation must also consider locally emerging dietary trends. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

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17 pages, 319 KiB

Open AccessArticle

Dietary and Physical Activity Habits in Adolescent Girls with Polycystic Ovary Syndrome (PCOS)-HAstudy

by Małgorzata Mizgier, Grażyna Jarząbek-Bielecka, Dorota Formanowicz, Elżbieta Jodłowska-Siewert, Kinga Mruczyk, Angelika Cisek-Woźniak, Witold Kędzia and Justyna Opydo-Szymaczek

J. Clin. Med. 2021, 10(16), 3469; https://doi.org/10.3390/jcm10163469 - 05 Aug 2021

Cited by 8 | Viewed by 5116

Abstract

The role of inappropriate lifestyle in the etiology of polycystic ovary syndrome (PCOS) and its metabolic and reproductive complications has attracted much attention in recent years; however, most studies involve adult patients. Thus, the study aimed to compare dietary patterns, physical activity, metabolic, [...] Read more.

The role of inappropriate lifestyle in the etiology of polycystic ovary syndrome (PCOS) and its metabolic and reproductive complications has attracted much attention in recent years; however, most studies involve adult patients. Thus, the study aimed to compare dietary patterns, physical activity, metabolic, anthropometric and inflammatory markers of 14–18-year-old girls with and without PCOS (n = 61 and n = 35, respectively) as well as to assess correlations between concentrations of metabolic and inflammatory markers and macronutrient intake and to identify the independent predictors of PCOS, related to diet and physical activity (PA). Compared to the control group, PCOS girls consumed significantly more total fat (p = 0.0005), including both saturated (SFA) (p = 0.03), monounsaturated (MUFA) (p = 0.0003) and polyunsaturated fatty acids (PUFA) (p = 0.01). A significantly higher percentage of PCOS patients consumed high and medium glycemic index (GI) foods (p = 0.03) and represented a low level of PA, both during school and in leisure time (41.67 vs. 6.06%; p = 0.0001 and 32.79 vs. 5.71%; p = 0.003, respectively). The PCOS group had also significantly higher waist circumference (WC), C-reactive protein (CRP) (p = 0.01), LDL cholesterol (p = 0.01), fasting insulin (p = 0.002) and HOMA-IR (p = 0.006) levels. There was an inverse correlation between fiber intake and fasting insulin, (p = 0.0002, r = −0.37), HOMA-IR (p = 0.0004, r = −0.35), WC (p = 0.029; r = −0.222) and a positive relationship between high and medium GI diet and insulin concentration (p = 0.003; r = 0.3). An increase of 10 g/day in total fat intake per day increases the probability of PCOS by 1.4 times. If the SFA or MUFA intakes increase by 10 g, the probability of PCOS increase 1.7-fold and 2.5-fold, respectively. The consumption of foods with a medium GI raises the probability of PCOS by more than 3 times, after adjusting for age. The odds ratio decreased for the moderate and high PA at school/work and in leisure time. Further research in girls with PCOS is needed to test whether low GI and dietary fatty acid reduction combined with increased PA is effective in the nonpharmacological treatment and prevention of PCOS complications. ClinicalTrial.gov Identifier: NCT04738409. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

12 pages, 272 KiB

Open AccessArticle

Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?—A 12-Month Follow-Up

by Jakub Pobłocki, Tamara Pańka, Małgorzata Szczuko, Arkadiusz Telesiński and Anhelli Syrenicz

J. Clin. Med. 2021, 10(15), 3240; https://doi.org/10.3390/jcm10153240 - 22 Jul 2021

Cited by 14 | Viewed by 10678

Abstract

Elimination diets have recently become extremely popular among people with autoimmune diseases. A gluten-free diet is indicated in celiac disease (CD), but some studies show its effectiveness in cases of autoimmunity. The aim of this study was to assess whether the use of [...] Read more.

Elimination diets have recently become extremely popular among people with autoimmune diseases. A gluten-free diet is indicated in celiac disease (CD), but some studies show its effectiveness in cases of autoimmunity. The aim of this study was to assess whether the use of a gluten-free diet is also effective in patients with chronic autoimmune thyroid disease (cAITD), which is the most common thyroid autoimmune pathology associated with chronic inflammation, over-reactivity of the immune system, auto-destruction of thyrocytes and hypothyroidism. The final analysis of the study included 62 Caucasian women randomized into a control group (CG: n = 31) and an experimental group on a gluten-free diet (GFDG: n = 31), were subject to a 12-month follow-up, during which the concentrations of thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were assessed at baseline and after 3, 6 and 12 months. During the 12-month follow-up between the CG and the GFDG, no differences were found in anti-TPO and anti-TG antibodies, fT3 or fT4 levels, except a significant reduction in TSH levels in the GFDG. Additionally, performed analysis between individual appointments presented no significant differences in changes in the median concentrations of anti-TPO, anti-TG or fT3, but confirmed a significant decrease in TSH and showed accessory an increase in fT4 after 12 months in GFDG. Statistical analyses performed separately for both groups indicated a constant reduction of anti-TG concentrations in the GFDG. In conclusion, a GFD may be administered in cAITD after ruling out celiac disease, but it is necessary to perform more studies to assess if cAITD patients achieve the benefits of following a GFD. Patients with cAITD should be offered proper nutrition education combined with a healthy lifestyle promotion. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

10 pages, 724 KiB

Open AccessArticle

Application of a Lifestyle-Based Score to Predict Cardiovascular Risk in African Americans: The Jackson Heart Study

by Mercedes Sotos-Prieto, Songzhu Zhao, David Kline, Guy Brock, Holly Gooding, Josiemer Mattei, Fernando Rodriguez-Artalejo, Yuan-I Min, Eric B. Rimm, Katherine L. Tucker and Joshua J. Joseph

J. Clin. Med. 2021, 10(11), 2252; https://doi.org/10.3390/jcm10112252 - 22 May 2021

Cited by 3 | Viewed by 2120

Abstract

Cardiovascular disease (CVD) primordial prevention tools applicable to diverse populations are scarce. Our aim was to assess the performance of a lifestyle-based tool to estimate CVD risk in an African American population. The Jackson Heart Study is a prospective cohort including 5306 African [...] Read more.

Cardiovascular disease (CVD) primordial prevention tools applicable to diverse populations are scarce. Our aim was to assess the performance of a lifestyle-based tool to estimate CVD risk in an African American population. The Jackson Heart Study is a prospective cohort including 5306 African American participants in Jackson, Mississippi (2000–2004), with a mean follow up of 12 years. The Healthy Heart Score is a lifestyle-based CVD risk prediction model based on nine components: body mass index (BMI), physical activity, smoking, and a 5-component diet score. Gender-specific beta coefficients from its derivation cohorts were used to assess the performance of the Healthy Heart Score. Model discrimination was assessed using Harrell’s C-Index for survival data and time dependent Area Under the Curve. Model calibration was evaluated through calibration plots. A total of 189 CVD events occurred. The Healthy Heart Score showed high-moderate discrimination for CVD events (C-statistic 0.75 [95% CI, 0.71–0.78]) but with little improvement over the age-only model. Both the age-only and Healthy Heart Score models had better performance in participants without diabetes at baseline and showed good calibration. In African Americans, the Healthy Heart Score does not improve prediction of mid-life CVD events beyond what is obtained by age alone. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

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Review

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23 pages, 1490 KiB

Open AccessReview

Alzheimer’s Disease, Mild Cognitive Impairment and Mediterranean Diet. A Systematic Review and Dose-Response Meta-Analysis

by Natalia García-Casares, Paloma Gallego Fuentes, Miguel Ángel Barbancho, Rosa López-Gigosos, Antonio García-Rodríguez and Mario Gutiérrez-Bedmar

J. Clin. Med. 2021, 10(20), 4642; https://doi.org/10.3390/jcm10204642 - 10 Oct 2021

Cited by 33 | Viewed by 7269

Abstract

Alzheimer’s Disease (AD) is a pathology with increasing prevalence in the context of a more long-lived society and it is the first cause of dementia in western countries. It is important to investigate factors that can be protective and may influence its development, [...] Read more.

Alzheimer’s Disease (AD) is a pathology with increasing prevalence in the context of a more long-lived society and it is the first cause of dementia in western countries. It is important to investigate factors that can be protective and may influence its development, in order to act on them trying to reduce AD incidence and its progression. The aim of this study was to conduct a systematic review and meta-analysis to determine the effects of a higher adherence to Mediterranean diet (MD) on Mild Cognitive Impairment (MCI) and AD. A literature search in PubMed, The Cochrane Library Plus and Scopus was conducted, selecting articles that analyzed associations between MD adherence and AD biomarkers (Volumetry assessed by MRI and betamiloide and Tau deposits by PET); cognitive performance in patients at risk or presenting MCI and AD; and incidence or progression from MCI to AD. Out of the 589 studies screened, 22 studies met eligibility criteria for the systematic review and qualitative synthesis. Finally, 11 studies were included in the meta-analysis (12,458 participants). Higher adherence to MD was associated with a significantly lower risk of MCI (RR = 0.91, 95%CI = 0.85–0.97) and lower risk of AD (RR = 0.89, 95% CI = 0.84–0.93). Our results enhance the importance of taking health-promoting lifestyle measures like following Mediterranean dietary patterns in order to reduce AD risk. Full article

(This article belongs to the Special Issue Clinical Research on Nutritional Epidemiology)

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