Nutrition, Cardiometabolic and Vascular Health Tracker
Last updated on 04/05/2022
Current Highlights
Building on years of expertise in the nutrition, vascular and cardiometabolic domains, NNEdPro has established a group of interdisciplinary researchers with the aim to produce cutting-edge research to support the achievement of the Global Development Goals to reduce by one-third premature mortality from chronic diseases by 2030, in particular, cardiometabolic and cardiovascular diseases.
The Nutrition and cardiometabolic and vascular health evidence tracker represents a living collection of published original research and reviews which underpins research related to cardiometabolic and vascular health. The evidence is organised by thematic area based on different known pathways linking diet, cardiometabolic and vascular health.
Recent Resources include
Vimaleswaran KS, Zhou A, Cavadino A and Hyppönen E. Evidence for a causal association between milk intake and cardiometabolic disease outcomes using a two-sample Mendelian Randomization analysis in up to 1,904,220 individuals. International Journal of Obesity, 2021.
Recent BMJ Nutrition Articles include
Huang M, Lo K, Li J, Allison M, Wu WC and Liu S. Pasta meal intake in relation to risks of type 2 diabetes and atherosclerotic cardiovascular disease in postmenopausal women: findings from the Women’s Health Initiative. BMJ Nutrition, Prevention & Health, 2021.
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Healthy vs unhealthy dietary patterns
A systematic review and meta-analysis showed that an unhealthy dietary pattern, characterised by an intake of fast food, snacks, sugared drinks, candies, trans-fat and saturated fat sources, fried foods, sugar intake and others, was associated with poor mean values of cardiometabolic risk factors among adolescents. Moreover, they found no evidence of a protective effect of healthier dietary patterns. Dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean body mass index and waist circumference compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean body mass index and waist circumference. De Magalhães Cunha, et al. 2018.
Meta-analysis investigating observational studies; including cross-sectional and case-control studies, found that the ‘Healthy/Prudent’ dietary pattern, characterised by high factor loadings for fruit and vegetables, fish and whole grains, was inversely associated with risk of Metabolic syndrome. In contrast, the ‘Unhealthy/Western’ dietary pattern had a significant positive association with risk of Metabolic syndrome. Shab-Bidar, et al. 2018.
Another, systematic review and meta-analysis found that a ‘Healthy’ diet, characterised by a high loading of vegetables and fruit, poultry, fish, and whole grains, was associated with reduced risk of Metabolic syndrome and significantly decreased the risk in both sexes and in Eastern countries, particularly in Asia. Whereas, a ‘Meat/Western’ dietary pattern, characterised by a high loading of red meat, processed meat, animal fat, eggs and sweets, was associated with an increased risk of Metabolic syndrome, and this association persisted in stratified analysis by geographic area and study design. Fabiani et al., 2019.
Vegetarian or vegan diets
A systematic review and meta-analysis investigating the association of vegan and vegetarian diets with inflammatory biomarkers, found that a vegan diet was associated with lower levels of C-reactive protein compared to omnivores. This association was less pronounced in vegetarians. In patients with impaired kidney function, the association between vegetarian nutrition and CRP was much stronger. No substantial effects were observed for all other inflammatory biomarkers. Menzel, et al., 2020.
Dietary inflammatory index (DII)
Another meta-analysis investigating vegan and vegetarian with cardiovascular biomarkers found that compared to controls vegans had a lower body mass index, waist circumference, low density lipoprotein cholesterol, triglycerides, fasting blood glucose, and systolic and diastolic blood pressure. Benatar and Stewart, 2018.
A systematic review and meta-analysis of cross-sectional, case–control and cohort stdueis found that higher dietary inflammatory index scores were associated with higher odds of hypertension, systolic blood pressure, fasting blood sugar, insulin, HbA1c and homeostatic model assessment of insulin resistance values compared with lowest dietary inflammatory index categories. Farhangi et al., 2020.
Breakfast frequency or breakfast skipping
Meta-analysis of Prospective Cohort Studies provides evidence that breakfast skipping is associated with an increased risk of type 2 diabetes, and the association is partly mediated by BMI. Skipping breakfast 4–5 days a week was associated with 55% increased risk of type 2 diabetes. Ballon et al., 2019.
Another review found that skipping breakfast increases the risk of overweight/obesity and abdominal obesity. Analysis of cross-sectional and cohort studies found a positive association between skipping breakfast and prevalence of overweight/obesity. Ma, et al. 2020.
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Coffee consumption
Meta-analysis of cohort studies found the risk of hypertension was reduced by 2% with each cup per day increment of coffee consumption. However, they found no evidence of a nonlinear dose–response association of coffee consumption and hypertension. Xie, et al. 2018.
Moreover, a dose–response meta-analysis of prospective studies showed a non-linear relationship between coffee consumption and risk of hypertension (D'Elia et al., 2019). Although, they found that a habitual intake of one or two cups of coffee per day, compared with non-drinking, was not associated with risk of hypertension, a significantly protective effect of coffee consumption was found starting from the consumption of three cups of coffee per day, and was confirmed for greater consumption. D'Elia et al., 2019.
Meta-analysis of prospective studies found that the relative risk of developing type 2 diabetes was 0.71 for the highest category of coffee consumption vs the lowest category. The risk of type 2 diabetes decreased by 6% for each cup-per-day increase in coffee consumption. These results were similar for caffeinated coffee consumption and decaffeinated coffee consumption. Carlström, and Larsson, 2018.
Caffeine
A systematic review of observational studies found a significant influence of recent caffeine intake on cardiac perfusion measurements during adenosine and dipyridamole induced hyperemia in healthy subjects or patients with known or suspected coronary artery disease. Van Dijk, et al. 2018 .
Alcohol intake
Meta-analysis of cohort studies found an association between average alcohol consumption of 1 to 2 drinks per day and risk of hypertension with men showing an increased risk, whereas women showed no difference in risk compared with abstainers. Additionally, alcohol intake beyond 2 drinks per day was associated with increased incidence of hypertension in both men and women. Roerecke, et al. 2018
Meta-analysis of prospective cohort studies and case-control studies found that among Asian men, there was a significantly elevated risk of hypertension observed even in the low alcohol dose group in comparison with the group with no alcohol consumption, and the risk increased in a dose-dependent manner. Among Western men, a similar dose-response relationship was noted in general, but a significantly elevated risk was evident only in the high-dose group. Jung et al. 2020.
Dairy foods
A systematic review and a meta-analysis of prospective cohort studies and cross-sectional studies found an inverse relationship between specific types of dairy food consumption and incidence or prevalence of the Metabolic syndrome. Total dairy food consumption was associated with lower risk of Metabolic syndrome components, including hyperglycaemia, elevated blood pressure, hypertriacylglycerolaemia and low HDL- cholesterol. Dose–response analysis found a one-serving increment of total dairy food consumption was associated with a 9% lower risk of the Metabolic syndrome. Additionally, a one-serving increment per day of milk and yogurt consumption was related to a 13 and 18% lower risk of the Metabolic syndrome, respectively. A one-serving per day increment of milk was related to a 12 % lower risk of abdominal obesity, and a one-serving per day increment of yogurt was associated with a 16 % lower risk of hyperglycaemia. Lee, et al. 2018 .
Red meat, poultry, and egg consumption
Meta-analysis of the prospective cohort studies showed a positive association between red meat consumption and the risk of hypertension. Subgroup analysis showed that both processed and unprocessed red meat were associated with a higher risk of hypertension. Moreover, poultry consumption was also associated with a higher risk of hypertension. Additionally, egg consumption was associated with a lower risk of hypertension. Zhang, and Zhang, 2018.
Another, meta-analysis of prospective cohort studies found that moderate egg consumption was associated with higher risk of type 2 diabetes among US studies, but not among European or Asian studies. Drouin-Chartier etal., 2020.
Sugar-sweetened beverages (SSBs) and food sources of fructose-containing sugars
A systematic review and dose-response meta-analysis of prospective cohort studies found that sugar‐sweetened beverages were associated with an increased incidence of hypertension, whereas fruit and yogurt showed protective associations with incident hypertension throughout the dose range. In addition, one hundred percent fruit juice showed a protective association only at moderate doses (U-shaped association). Moreover, no association was found between dairy desserts, fruit drinks or sweet snacks with hypertension. Liu et al., 2019.
This was supported by another meta-analysis, which found high consumption of sugar‐sweetened beverages was associated with an increase in systolic blood pressure in children and adolescents. However, there was no significant difference in diastolic blood pressure. Additionally, high sugar‐sweetened beverages consumers were more likely to develop hypertension compared with low sugar‐sweetened beverages consumers. Farhangi, et al. 2020.
Another Meta-analysis found an adverse association of sugar-sweetened beverages with the incident of metabolic syndrome, however this association did not extend to other major food sources of fructose-containing sugars; yogurt, fruit, 100% fruit juice, and mixed fruit juice all had a protective association with incident metabolic syndrome. Semnani-Azad et al., 2020.
Legume consumption (Legumes and soy products)
Meta-analysis of cross-sectional, cohort and case–control studies found legume consumption was not associated with the odds of Metabolic Syndrome. Jiang et al., 2020.
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Fibre intake
Meta-analysis of observational studies found the highest versus lowest fibre intake was associated with a reduced risk of Metabolic syndrome, with moderate heterogeneity across studies. The benefit of fibre intake was significant among cross-sectional studies but not among cohort studies. Dose–response analysis found a curvilinear relationship between fibre consumption and prevalence of Metabolic syndrome. Wei, et al. 2018.
A systematic review of cohort studies found improvements in body weight, blood lipids, blood pressure, glycaemia and other outcomes, with higher intakes of dietary fibre and high-fibre foods. However, large differences between studies precluded formal synthesis and meta-analysis of the data. Reynolds, et al. 2020.
Carbohydrate intake
The highest versus the lowest carbohydrate intake values were associated with increased risk of Metabolic syndrome. Dose-response analysis found a linear association between carbohydrate consumption and Metabolic syndrome risk. Liu et al., 2019.
Dietary Fat intake
A systematic review found that the data suggested that replacing carbohydrates with any fat, but particularly polyunsaturated fat, will lower triglycerides, increase high-density lipoprotein cholesterol, and lower blood pressure, but have no effects on fasting glucose in normal volunteers or insulin sensitivity. Additionally, monounsaturated fat was preferable to polyunsaturated fat for fasting insulin and glucose-lowering. The addition of 3–4 g of omega-3 will lower triglycerides and blood pressure and reduce the proportion of subjects with metabolic syndrome. Moreover, cohort studies suggested that dairy fat was related to a lower incidence of metabolic syndrome. Clifton, 2019.
A systematic review and dose-response meta-analysis of prospective observational studies found no association between total fat intake and the incidence of type 2 diabetes. Dose–response curves provided insights for significant associations between specific fats and fatty acids with type 2 diabetes. In particular, a high intake of vegetable fat was inversely associated with type 2 diabetes incidence. Neuenschwander et al., 2020.
Meta-analysis of case-control, cross-sectional and prospective cohort studies found that higher omega-3 polyunsaturated fat levels in diets or blood were associated with a reduction in the risk of Metabolic syndrome. An inverse association was found among studies with Asian populations, but not among those with American/European populations. No association was found between circulating/dietary omega-6 polyunsaturated fats and Metabolic syndrome. Jang & Park, 2020.
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Serum Vitamin D
A meta-analysis and systematic review found that serum vitamin D level was negatively associated with carotid atherosclerosis, with substantial heterogeneity among the individual studies. Furthermore, subgroup analysis suggested that hypovitaminosis D was associated with an 0.85-fold decrease in the odds of having a higher carotid intima-media thickness. Additionally, the pooled analysis also indicated that the serum vitamin D level was a protective factor against increased carotid plaque. Chen, et al. 2018
In both diabetic and non-diabetic subjects, meta-analyses found a significant inverse relationship of vitamin D status with glycemic level (Rafiq and Jeppesen, 2018) and an overall inverse relationship between serum vitamin D status and body mass index. Rafiq and Jeppesen, 2018.
Calcium intake
Higher dietary calcium intake, independent of adiposity and intake of other blood pressure-related minerals, is slightly associated with a lower risk of developing hypertension. Jayedi, and Zargar, 2019.
Vitamin B12, vitamin B6, folate and homocysteine
A systematic review did not establish an inverse association (or J-curve) between serum or plasma B12 concentrations and body mass index. However, based on the results of the meta-regression, in an exploratory sub-network meta-analysis, showed lower levels of B12 in people with higher body mass indices. Wiebe, et al. 2018
Meta-analysis of Prospective cohort studies found a higher intake of folate and vitamin B6, but not vitamin B12, was associated with a lower risk of coronary heart disease in the general population. Jayedi & Zargar, 2019.
Sodium
Meta-analysis of observational studies showed that subjects with the metabolic syndrome had significantly higher levels of sodium compared to healthy controls. They found that body sodium level increases with the number of metabolic syndrome components. Also, participants with highest dietary/urinary or serum sodium levels had 37% higher chance of developing metabolic syndrome when compared with participants with the lowest sodium levels. Soltani et al., 2019.
Serum vitamin C
Meta-analysis of observational articles including cross-sectional studies, case-control studies, and cohort studies found that individuals with hypertension had lower levels of serum vitamin C when compared with normotensive individuals. Additionally, serum vitamin C was inversely associated with both systolic blood pressure and diastolic blood pressure. Ran, et al. 2020.
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Nutrition, Vascular and Cardiometabolic Team
Prof Sumantra Ray
Dr Rajna Golubic
Dr Marjorie Lima do Vale
Dr Claudia Trammont
Dr Claudia-Gabriela Mitrofan
Dr Federica Amati
Dr Harry Jarrett
Dr Luigi Palla
Kai Sento Kargbo, BSc
Mayara de Paula, MSc
Dr Saad Mouti
Dr Xiaowu Dai
Prof Lisa Goldberg
Dr Jeffrey Bohn
Dr Christoph Nabholz
Nate Jansen
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