Nutrition, metabolism, and cardiovascular diseases : NMCD
-
Nutr Metab Cardiovasc Dis · Jul 2008
ReviewTrans fatty acids and cardiovascular health: translation of the evidence base.
The recent interest in the development of evidence-based nutrition recommendations has resulted in the development of frameworks which enable a more structured evaluation of the link between diet and chronic disease. This paper examines the application of the frameworks produced by the Scottish Intercollegiate Guidelines Network (SIGN) and the World Cancer Research Fund (WCRF), by using as a case study the association between trans unsaturated fatty acids (TFAs) and coronary heart disease. TFAs arise during industrial hydrogenation of vegetable or fish fats and oils and the natural digestion process in ruminant animals. ⋯ While the evidence is sufficient to suggest a probable positive association between TFAs and coronary heart disease, and thus to justify a firm recommendation for a reduction in dietary TFA intake, the evaluation of the data underlines the difficulties in extrapolating the principles of evidence-based medicine to evidence-based nutrition. Furthermore, there is a paucity of research into the effects of animal-derived TFAs in amounts typically consumed in a western diet and their association with adverse lipid profiles or cardiovascular outcomes.
-
Nutr Metab Cardiovasc Dis · Mar 2007
ReviewObstructive sleep apnea: an update on mechanisms and cardiovascular consequences.
There is growing recognition of the widespread incidence and health consequences of obstructive sleep apnea (OSA). This review examines the evidence linking sleep apnea with cardiovascular disease and discusses potential mechanisms underlying this link. ⋯ Patients with OSA are at increased risk for cardiovascular disease. OSA should be considered in the differential diagnosis of hypertensive patients who are obese. In particular, OSA should be excluded in patients with hypertension resistant to conventional drug therapy.
-
Over the last few years, weight loss has been recognised as a key factor in the control and prevention of coronary heart disease, hypertension, type 2 diabetes, hyperlipidaemia, cardiorespiratory failure and other chronic degenerative diseases. It has been shown that even a modest loss of 5% of initial body weight can reduce, eliminate or prevent these disorders in a large proportion of overweight patients. The early benefits of weight loss can be explained by the direct effects of a low calorie diet, but the long-term effects can only partially be attributed to diet, physical exercise or behavioural modifications. ⋯ These complications include cholelithiasis and the subsequent risk of cholecystitis, lean body mass loss and a stable decrease in energy expenditure with a high probability of regaining weight (weight cycling syndrome). In conclusion, a large number of obese patients may be sensitive to a modest weight loss even without the achievement of ideal body weight. Sustained moderate weight loss by itself is definitely beneficial in obesity (especially "malignant" and "morbid" obesity), but also in diabetes, hypertension, hyperlipidaemia, cardiorespiratory diseases and other chronic degenerative diseases associated with any degree of excess body fat.