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Examinando por Autor "Wentzel-Viljoen, Edelweiss"

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  • Publicación
    Acceso abierto
    Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries
    (BMJ Journals, 2020-05-18) Bhavadharini, Balaji; Dehghan, Mahshid; Mente, Andrew; Rangarajan, Sumathy; Sheridan, Patrick; Mohan, Viswanathan; Iqbal, Romaina; Gupta, Rajeev; Lear, Scott; Wentzel-Viljoen, Edelweiss; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Mony, Prem; Prasad Varma, Ravi; Kumar, Rajesh; Chifamba, Jephat; Alhabib, Khalid F; Mohammadifard, Noushin; Oguz, Aytekin; Lanas, Fernando; Rozanska, Dorota; Bengtsson Bostrom, Kristina; Yusoff, Khalid; Tsolkile, Lungiswa P; Dans, Antonio; Yusufali, Afzalhussein; Orlandini, Andres; Poirier, Paul; Khatib, Rasha; Hu, Bo; Wei, Li; Yin, Lu; Deeraili, Ai; Yeates, Karen; Yusuf, Rita; Ismail, Noorhassim; Mozaffarian, Dariush; Teo, Koon; Anand, Sonia S; Yusuf, Salim; Everest
    Objective Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study. Methods The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes). Results In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake; OR 0.76, 95% CI 0.71 to 0.80, p-trend<0.0001) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone (OR 0.72, 95% CI 0.66 to 0.78, p-trend<0.0001), or consumed jointly with low fat dairy (OR 0.89, 95% CI 0.80 to 0.98, p-trend=0.0005), were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS (OR 1.03, 95% CI 0.77 to 1.38, p-trend=0.13). In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension (HR 0.89, 95% CI 0.82 to 0.97, p-trend=0.02) and diabetes (HR 0.88, 95% CI 0.76 to 1.02, p-trend=0.01). Directionally similar associations were found for whole fat dairy versus each outcome. Conclusions Higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.
  • Publicación
    Acceso abierto
    Association of nut intake with risk factors, cardiovascular disease, and mortality in 16 countries from 5 continents
    (American Society for Nutrition, 2020-05-20) De Souza, Russell J; Dehghan, Mahshid; Mente, Andrew; Bangdiwala, Shrikant I; Ahmed, Suad Hashim; Alhabib, Khalid F; Altuntas, Yuksel; Basiak-Rasała, Alicja; Dagenais, Gilles-R; Diaz, Rafael; Amma, Leela Itty; Kelishadi, Roya; Khatib, Rasha; Lear, Scott A; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Poirier, Paul; Rangarajan, Sumathy; Rosengren, Annika; Ismail, Rosnah; Swaminathan, Sumathi; Wentzel-Viljoen, Edelweiss; Yeates, Karen; Yusuf, Rita; Teo, Koon; Anand, Sonia S; Yusuf, Salim; PURE Study Investigators; Everest
    Background: The association of nuts with cardiovascular disease and deaths has been investigated mostly in Europe, the USA, and East Asia, with few data available from other regions of the world or from low- and middle-income countries. Objective: To assess the association of nuts with mortality and cardiovascular disease (CVD). Methods: The Prospective Urban Rural Epidemiology study is a large multinational prospective cohort study of adults aged 35–70 y from 16 low-, middle-, and high-income countries on 5 continents. Nut intake (tree nuts and ground nuts) was measured at the baseline visit, using country-specific validated FFQs. The primary outcome was a composite of mortality or major cardiovascular event [nonfatal myocardial infarction (MI), stroke, or heart failure]. Results: We followed 124,329 participants (age = 50.7 y, SD = 10.2; 41.5% male) for a median of 9.5 y. We recorded 10,928 composite events [deaths (n = 8,662) or major cardiovascular events (n = 5,979)]. Higher nut intake (>120 g per wk compared with <30 g per mo) was associated with a lower risk of the primary composite outcome of mortality or major cardiovascular event [multivariate HR (mvHR): 0.88; 95% CI: 0.80, 0.96; P-trend = 0.0048]. Significant reductions in total (mvHR: 0.77; 95% CI: 0.69, 0.87; Ptrend <0.0001), cardiovascular (mvHR: 0.72; 95% CI: 0.56, 0.92; Ptrend = 0.048), and noncardiovascular mortality (mvHR: 0.82; 95% CI: 0.70, 0.96; P-trend = 0.0046) with a trend to reduced cancer mortality (mvHR: 0.81; 95% CI: 0.65, 1.00; P-trend = 0.081) were observed. No significant associations of nuts were seen with major CVD (mvHR: 0.91; 95% CI: 0.81, 1.02; P-trend = 0.14), stroke (mvHR: 0.98; 95% CI: 0.84, 1.14; P-trend = 0.76), or MI (mvHR: 0.86; 95% CI: 0.72, 1.04; P-trend = 0.29). Conclusions: Higher nut intake was associated with lower mortality risk from both cardiovascular and noncardiovascular causes in low-, middle-, and high-income countries. Am J Clin Nutr 2020;112:208–219.
  • Publicación
    Acceso abierto
    Associations of Fish Consumption with Risk of Cardiovascular Disease and Mortality among Individuals with or without Vascular Disease from 58 Countries
    (JAMA Network, 2021-03-08) Mohan, Deepa; Mente, Andrew; Dehghan, Mahshid; Rangarajan, Sumathy; O’Donnell, Martin; Hu, Weihong; Dagenais, Gilles; Wielgosz, Andreas; Lear, Scott; Wei, Li; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Swaminathan, Sumathi; Kaur, Manmeet; Vijayakumar, K.; Mohan, Viswanathan; Gupta, Rajeev; Szuba, Andrzej; Iqbal, Romaina; Yusuf, Rita; Mohammadifard, Noushin; Khatib, Rasha; Yusoff, Khalid; Gulec, Sadi; Rosengren, Annika; Yusufali, Afzalhussein; Wentzel-Viljoen, Edelweiss; Chifamba, Jephat; Dans, Antonio; Alhabib, Khalid F.; Yeates, Karen; Teo, Koon; Gerstein, Hertzel C.; Yusuf, Salim; The PURE, ONTARGET, TRANSCEND, and ORIGIN investigators; Masira
    Importance Cohort studies report inconsistent associations between fish consumption, a major source of long-chain ω-3 fatty acids, and risk of cardiovascular disease (CVD) and mortality. Whether the associations vary between those with and those without vascular disease is unknown. Objective To examine whether the associations of fish consumption with risk of CVD or of mortality differ between individuals with and individuals without vascular disease. Design, Setting, and Participants This pooled analysis of individual participant data involved 191 558 individuals from 4 cohort studies—147 645 individuals (139 827 without CVD and 7818 with CVD) from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study and 43 413 patients with vascular disease in 3 prospective studies from 40 countries. Adjusted hazard ratios (HRs) were calculated by multilevel Cox regression separately within each study and then pooled using random-effects meta-analysis. This analysis was conducted from January to June 2020. Exposures Fish consumption was recorded using validated food frequency questionnaires. In 1 of the cohorts with vascular disease, a separate qualitative food frequency questionnaire was used to assess intake of individual types of fish. Main Outcomes and Measures Mortality and major CVD events (including myocardial infarction, stroke, congestive heart failure, or sudden death). Results Overall, 191 558 participants with a mean (SD) age of 54.1 (8.0) years (91 666 [47.9%] male) were included in the present analysis. During 9.1 years of follow-up in PURE, compared with little or no fish intake (≤50 g/mo), an intake of 350 g/wk or more was not associated with risk of major CVD (HR, 0.95; 95% CI, 0.86-1.04) or total mortality (HR, 0.96; 0.88-1.05). By contrast, in the 3 cohorts of patients with vascular disease, the HR for risk of major CVD (HR, 0.84; 95% CI, 0.73-0.96) and total mortality (HR, 0.82; 95% CI, 0.74-0.91) was lowest with intakes of at least 175 g/wk (or approximately 2 servings/wk) compared with 50 g/mo or lower, with no further apparent decrease in HR with consumption of 350 g/wk or higher. Fish with higher amounts of ω-3 fatty acids were strongly associated with a lower risk of CVD (HR, 0.94; 95% CI, 0.92-0.97 per 5-g increment of intake), whereas other fish were neutral (collected in 1 cohort of patients with vascular disease). The association between fish intake and each outcome varied by CVD status, with a lower risk found among patients with vascular disease but not in general populations (for major CVD, I2 = 82.6 [P = .02]; for death, I2 = 90.8 [P = .001]). Conclusions and Relevance Findings of this pooled analysis of 4 cohort studies indicated that a minimal fish intake of 175 g (approximately 2 servings) weekly is associated with lower risk of major CVD and mortality among patients with prior CVD but not in general populations. The consumption of fish (especially oily fish) should be evaluated in randomized trials of clinical outcomes among people with vascular disease.
  • Publicación
    Acceso abierto
    White rice intake and incident diabetes: A study of 132,373 participants in 21 countries
    (Diabetes Care, 2020-09-01) Bhavadharini, Balaji; Mohan, Viswanathan; Dehghan, Mahshid; Rangarajan, Sumathy; Swaminathan, Sumathi; Rosengren, Annika; Wielgosz, Andreas; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Dans, Antonio; Yeates, Karen; Poirier, Paul; Chifamba, Jephat; Alhabib, Khalid F.; Mohammadifard, Noushin; Zatonska, Katarzyna; Khatib, Rasha; Keskinler, Mirac Vural; Wei, Li; Wang, Chuangshi; Liu, Xiaoyun; Iqbal, Romaina; Yusuf, Rita; Wentzel-Viljoen, Edelweiss; Yusufali, Afzalhussein; Diaz, Rafael; Kien Keat, Ng; Lakshmi, P.V.M.; Ismail, Noorhassim; Gupta, Rajeev; Palileo-Villanueva, Lia M.; Sheridan, Patrick; Mente, Andrew; Yusuf, Salim; Masira
    OBJECTIVE Previous prospective studies on the association of white rice intake with incident diabetes have shown contradictory results but were conducted in single countries and predominantly in Asia. We report on the association of white rice with risk of diabetes in the multinational Prospective Urban Rural Epidemiology (PURE) study. RESEARCH DESIGN AND METHODS Data on 132,373 individuals aged 35–70 years from 21 countries were analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice = 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a multivariable Cox frailty model. RESULTS During a mean follow-up period of 9.5 years, 6,129 individuals without baseline diabetes developed incident diabetes. In the overall cohort, higher intake of white rice (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02–1.40; P for trend = 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13–2.30; P for trend = 0.02), followed by other regions of the world (which included South East Asia, Middle East, South America, North America, Europe, and Africa) (HR 1.41; 95% CI 1.08–1.86; P for trend = 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77–1.40; P for trend = 0.38). CONCLUSIONS Higher consumption of white rice is associated with an increased risk of incident diabetes with the strongest association being observed in South Asia, while in other regions, a modest, nonsignificant association was seen.
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