Suchergebnisse

Sub-Saharan Africa (SSA) is experiencing a growing burden of cardiometabolic disorders, including diabetes, dyslipidemia, hypertension, obesity, coronary heart disease, and stroke. The increasing trends are expected to accelerate as SSA continues to experience economic progress, population growth, and the shift from communicable to noncommunicable diseases. These complex disorders are caused by multiple, potentially interacting, environmental, and genetic factors. While considerable progress has been made in the identification of the sociocultural, demographic, and lifestyle risk factors for cardiometabolic disorders, many genetic factors that underlie individual susceptibility to these diseases remain largely unknown. Although progress in genomic technologies has allowed for systematic characterization of genome-wide genetic diversity in health and disease in European and Asian ancestry populations, conduct of genetic studies in SSA has been underwhelming until recently. Here, we summarize recent understanding of the body of knowledge and highlight research opportunities on the genomics of cardiometabolic disorders in SSA. Published by S. Karger AG, Basel

By RICHARD FRANK By relying on virtual cardiometabolic solutions for continuous care, Medicare Advantage can produce better outcomes, curb costs, enhance member satisfaction — and improve Star ratings in the process. MedicareContinue reading...

Purpose To examine the associations between dietary intake as assessed by a rapid, image-based digital tool and biomarkers of cardiometabolic health. Design Retrospective analysis of adults with blood biomarkers performed by Boston Heart Diagnostics (BHD) between December 2020 and March 2022. Setting Outpatient centers serviced by BHD. Subjects 546 adults, excluding those taking relevant medications and/or supplements known to affect blood test results. Measures Laboratory assays of blood specimens were performed by Boston Heart Diagnostics. Nutrient intake and diet quality data were obtained using Diet Quality Photo Navigation (DQPN®; US Patent #11,328,810 B2) technique via Diet ID™ tool. Analysis Pearson correlation coefficients (for continuous variables) and Spearman coefficients (for ordinal variables) were used to evaluate associations between nutrient intake data and laboratory data for the full study sample. Two-sided P-values < .05 were considered statistically significant. Results Both continuous and ordinal measures of diet quality correlated significantly with HDL-C and triglycerides (n = 485; P < .0 01); with hs-CRP (n = 441; P < .001); with HgbA1c (n = 345; P < .01); with fasting insulin (n = 372; P < .001); and with HOMA-IR (n = 319; P < .001). Conclusion Findings affirm that rapid, digital diet quality and composition assessment by pattern recognition rather than recall tracks significantly with key biomarkers of cardiometabolic health.

This study was supported by the Spanish Ministry of Universities (FPU18/03357), Fulbright Spain and Junta de Andalucia, a postdoctoral grant from the Fundacion Alfonso Martin Escudero, a Nutrition Obesity Research Center (NORC) grant P30DK072476 and the Louisiana Clinical and Translational Science Center (U54 GM104940). ; This review summarizes the effects of different types of intermittent fasting (IF) on human cardiometabolic health, with a focus on energy metabolism. First, we discuss the coordinated metabolic adaptations (energy expenditure, hormonal changes and macronutrient oxidation) occurring during a 72 h fast. We then discuss studies investigating the effects of IF on cardiometabolic health, energy expenditure and substrate oxidation. Finally, we discuss how IF may be optimized by combining it with exercise. In general, IF regimens improve body composition, ectopic fat, and classic cardiometabolic risk factors, as compared to unrestricted eating, especially in metabolically unhealthy participants. However, it is still unclear whether IF provides additional cardiometabolic benefits as compared to continuous daily caloric restriction (CR). Most studies found no additional benefits, yet some preliminary data suggest that IF regimens may provide cardiometabolic benefits in the absence of weight loss. Finally, although IF and continuous daily CR appear to induce similar changes in energy expenditure, IF regimens may differentially affect substrate oxidation, increasing protein and fat oxidation. Future tightly controlled studies are needed to unravel the underlying mechanisms of IF and its role in cardiometabolic health and energy metabolism. ; Spanish Government FPU18/03357 ; Nutrition Obesity Research Center (NORC) P30DK072476 ; Louisiana Clinical and Translational Science Center U54 GM104940

The components of the metabolic syndrome, including prediabetes, prehypertension and dyslipidemia, represent prodromal stages of major cardiometabolic disorders. Lifestyle interventions have been shown to ameliorate or prevent the progression of individual components of the metabolic syndrome. The specific interventions utilized in randomized controlled studies often include dietary modification and physical activity. The effects of smoking cessation and the reduction of psychosocial stress on cardiometabolic risk factors need to be studied more. Because of the close concordance between the metabolic syndrome and multiple cardiometabolic diseases, the adoption of an effective lifestyle change upon initial recognition of the metabolic syndrome can be expected to delay or prevent the future development of sequelae such as diabetes, hypertension, and atherosclerotic cardiovascular and cerebrovascular diseases. Such a nonpharmacological approach to primary prevention and disease interruption carries enormous public health significance. Meeting the challenge of an implementation of effective lifestyle change at the community level requires (a) a system for the identification of at-risk populations, (b) an optimization of the knowledge base and practices of health care providers, and (c) a piloting of targeted biobehavioral intervention programs. Once identified, persons and communities at risk for cardiometabolic disorders can be empowered through increased health and nutritional literacy, the promotion of lifestyle interventions, provision of community resources, and pertinent legislative action that rewards preventive behavior. This paper reviews landmark studies that demonstrate the principles of nonpharmacological approaches to the reduction of cardiometabolic risk. We also discuss the physiological and emerging molecular genetic mechanisms that underlie the efficacy of lifestyle interventions.

Funding Information: This research has been conducted using the UK Biobank Resource (application 6818). We would like to thank the participants and researchers from the UK Biobank who contributed or collected data. We would also like to thank the research participants and employees of 23andMe for making this work possible. This work is supported by grants NIH-F32DK102323, NIH-4T32HL007901, NIH-R01DK107859, NIH-R35HL135818, NIH-K23DK114551 (M.S.U.), MGH Research Scholar Fund, Academy of Finland #309643 (H.M.O.), Instrumentarium Science Foundation (H.M.O.), Yrjö Jahnsson Foundation (H.M.O.), and Medical Research Council grant: MR/M005070/1. This work has been supported in part by The Spanish Government of Investigation, Development and Innovation (SAF2017-84135-R) including FEDER co-funding; The Autonomous Community of the Region of Murcia through the Seneca Foundation (20795/PI/18) and NIDDK R01DK105072 granted to M.G. The MEGASTROKE project received funding from sources specified at http://www.megastroke.org/acknowledgments.html. Publisher Copyright: © 2021, The Author(s). ; Daytime napping is a common, heritable behavior, but its genetic basis and causal relationship with cardiometabolic health remain unclear. Here, we perform a genome-wide association study of self-reported daytime napping in the UK Biobank (n=452,633) and identify 123 loci of which 61 replicate in the 23andMe research cohort (n=541,333). Findings include missense variants in established drug targets for sleep disorders (HCRTR1, HCRTR2), genes with roles in arousal (TRPC6, PNOC), and genes suggesting an obesity-hypersomnolence pathway (PNOC, PATJ). Association signals are concordant with accelerometer-measured daytime inactivity duration and 33 loci colocalize with loci for other sleep phenotypes. Cluster analysis identifies three distinct clusters of nap-promoting mechanisms with heterogeneous associations with cardiometabolic outcomes. Mendelian randomization shows potential causal links between more frequent daytime napping and higher blood pressure and waist circumference. The genetic basis of daytime napping and the directional effect of daytime napping on cardiometabolic health are unknown. Here, the authors perform a genome-wide association study on self-reported daytime napping in the UK Biobank and Mendelian randomization to explore causal associations. ; Peer reviewed

Abstract Background Rural men are known to have poor health behaviors, which contribute to their elevated burden of cardiometabolic disorders in the United States. Although regular physical activity, healthy eating, and avoiding tobacco can reduce cardiometabolic risk, little is known about how to engage rural men in health promotion programs. To bridge this gap in evidence, we investigate knowledge of modifiable cardiometabolic risk factors among rural men in the western United States, identify their concerns related to heart health and motivation to reduce risk, and explore individual, social, and community-level influences on heart-healthy behaviors, specifically diet, physical activity, and tobacco use. Methods We conducted seven focus groups with 54 sedentary, overweight/obese men (mean body mass index [BMI] = 31.3 ± 4.6) aged 43–88 residing in government-designated "medically underserved" rural Montana towns in September and October 2014. All sessions were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed thematically using Nvivo software. Participants also completed a brief questionnaire about personal characteristics and health behaviors. These data were explored descriptively. Results Despite being classified as overweight/obese and sedentary, no participants reported to be in poor health. Many men described health relative to self-reliance and the ability to participate in outdoor recreation; concern with health appeared to be related to age. Participants were generally knowledgeable of heart-healthy behaviors, but many felt fatalistic about their own risk. Catalysts for behavior change included a serious medical event in the household and desire to reduce aging-associated functional decline. Barriers to adopting and maintaining healthy eating and physical activity habits and abstaining from tobacco included normative beliefs around masculinity and individual liberty, the limited social universe of small towns, winter weather, time constraints, and preferences for unhealthy foods. Facilitators included behavioral self-monitoring, exercising with a partner, and opportunities for preferred activities, such as hunting and team sports. Conclusions These findings provide important insight about influences on rural men's health behaviors and provide guidance for possible intervention strategies to promote cardiometabolic health. Trial registration ClinicalTrials.gov NCT02499731 . Registered 1 July 2015.

<p class="Pa7">Cardiometabolic diseases, including diabetes and heart disease, account for &gt;12 million years of life lost annually among Black adults in the United States. Health disparities are geographically localized, with ~80% of health disparities occurring within ~6000 (16%) of all 38,000 US ZIP codes. Socio-economic status (SES), behavioral and environmental fac­tors (social determinants) account for ~80% of variance in health outcomes and cluster geographically. Neighborhood SES is inversely associated with prevalent diabetes and hyper­tension, and Blacks are four times more likely than Whites to live in lowest SES neighbor­hoods. In ZIP code 48235 (Detroit, 97% Black, 16.2% unemployed, income/capita $18,343, 23.6% poverty), 1082 Medicare fee-for service (FFS) beneficiaries received care for type 2 diabetes (T2D) and coronary artery disease (CAD) in 2012. Collectively, these beneficiaries had 1082 inpatient admissions and 839 emergency department visits, mean cost $27,759/beneficiary and mortality 2.7%. Nationally in 2011, 236,222 Black Medicare FFS beneficiaries had 213,715 inpatient admissions, 191,346 emergency department visits, mean cost $25,580/beneficiary and 2.4% mortality. In addition to more prevalent hypertension and T2D, Blacks appear more susceptible to clinical complications of risk fac­tors than Whites, including hypertension as a contributor to stroke. Cardiometabolic health equity in African Americans requires interven­tions on social determinants to reduce excess risk prevalence of risk factors. Social-medical interventions to promote timely access to, delivery of and adherence with evidence-based medicine are needed to counterbal­ance greater disease susceptibility. Place-based interventions on social and medical determi­nants of health could reduce the burden of life lost to cardiometabolic diseases in Blacks. <em>Ethn Dis. </em>2015;25(4):521-524; doi:10.18865/ ed.25.4.521</p>

Large differences in cardiovascular disease and diabetes prevalence exist between African American and European American adults. The US federal government has committed to reducing racial disparities in health; however, the precise mechanisms are not well understood. Sleep is one potential behavioral explanation for current racial differences in cardiometabolic conditions. We show that more than one-half of racial differences in cardiometabolic risk can be explained by sleep patterns—namely, less total sleep and lower sleep efficiency among African American than European American adults. Sleep is a malleable health behavior that is linked with characteristics of the social and physical environment and could be an effective target in national efforts to reduce racial health disparities.