Nutrition
-
Heart failure is a multifaceted pathophysiologic syndrome, with prevalent dysfunction of other vital organs and systems. The role of the liver in this disease has been little investigated, although up to 80% of patients with heart failure present with some form of liver dysfunction. In addition to its multiple metabolic functions, the liver has a crucial role in the removal of circulating endotoxins and in regulating immune responses and iron homeostasis. ⋯ However, the antioxidant capacity of the liver seems to be inadequate because there is evidence for selenium deficiency in patients with heart failure. The aim of this article was to summarize the various aspects of liver dysfunction in heart failure and to highlight the role of liver-derived factors in the development of specific nutritional deficiencies. Nutritional strategies opposing these deficiencies might present promising additive treatments of heart failure.
-
Cardiovascular disease (CVD) and type 2 diabetes mellitus have their roots in childhood, particularly in obese children and adolescents, raising important opportunities for early lifestyle intervention in at-risk individuals. However, not all obese individuals are at the same risk for disease progression. Accurate screening of obese adolescents may identify those in greatest need for intensive intervention to prevent or delay future disease. ⋯ However, long-term data linking increased hsCRP levels-and increased insulin or decreased adiponectin-in childhood to adult disease outcomes are lacking at this time. Future efforts continue to be needed to identify childhood clinical and laboratory characteristics that could be used as screening tests to predict adult disease progression. Such tests may have utility in motivating physicians and patients' families toward lifestyle changes, ultimately improving prevention efforts.
-
There is substantial evidence to show that consumption and increased blood levels of the very long-chain (VLC) ω-3 polyunsaturated fatty acids (ω-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with health benefits. The consumption of oily fish is an effective way of increasing EPA and DHA intake and status, but intake in most Western countries remains below the levels recommended for optimal health. The reasons for this include not liking the taste, a concern about sustainability of fish supplies, or potential chemical and heavy metal contamination. ⋯ Oil crops naturally rich in SDA or enriched through genetic modification may offer an alternative supplemental oil to boost the population status of VLC ω-3 PUFAs. This review discusses the currently available evidence that increased SDA consumption can increase red blood cell EPA content, although this is less than the effect of supplementation directly with EPA. There is now a need for trials specifically designed to assess whether an increased SDA consumption would translate into improved human health outcomes.