¿Son saludables los refrescos? Un par de cocacolas al día puede aumentar el riesgo cardíaco en más de un 20%

Higher Chocolate Intake May Lower Risk for CV Disease, Stroke in Healthy Adults

Deborah Brauser

June 16, 2015NEW YORK, NY — Rejoice, chocolate lovers: more findings suggest that regular consumption of the sweet stuff may decrease the risk of CV events and stroke in otherwise-healthy individuals^[1].
Analysis of almost 21,000 adults from the UK’s EPIC-Norfolk study showed that those who ate the most chocolate had an 11% lower risk of developing coronary heart disease (CHD) and a 25% lower risk of CV-related death over 12 years of follow-up when compared with those who ate no chocolate. In addition, the highest-consumption group had a 23% lower risk of stroke.
A separate meta-analysis of more than 155,000 participants in studies examining possible links between chocolate and CV outcomes showed similar findings.
The authors, led by Dr Chun Shing Kwok (University of Aberdeen, Scotland), note that although cause and effect could not be shown in these observational studies, cumulative evidence suggests that there is an association at play.
Interestingly, the participants in the cohort study ate more milk chocolate than dark chocolate, which may indicate that “not only flavonoids, but also other compounds, possibly related to milk constituents such as calcium and fatty acids, may provide an explanation for the observed association,” write the investigators.
The findings were published online June 15, 2015 in Heart.
More Chocolate, Less Risk
For the current analysis, the researchers examined records from 20,951 EPIC-Norfolk participants who filled out the food frequency questionnaire at baseline, which included questions about chocolate consumption. The participants were then divided into five “quintiles” based on their chocolate habits, with the highest group consuming 16 to 99 g/day of chocolate.
After a median of 11.9 years of follow-up, there were 2434 CHD events. Of these events, 13.8% occurred among those who ate the least amount of chocolate and 9.7% occurred among those in the highest quintile of chocolate consumption. There were also 848 strokes overall, including 5.4% and 3.1% of the lowest and highest quintiles, respectively.
Compared with those who didn’t eat any chocolate, the adjusted hazard ratio (HR) for the highest-consumption group was 0.89 (95% CI 0.79–1.00, P=0.02) for total CVD and 0.75 for CVD mortality (95% CI 0.62–0.92, P=0.01). This group also had significantly lower risk of CHD-related hospitalization or mortality in minimally adjusted models, but not in the fully adjusted models.
However, the highest-consumption group did have a significantly lower risk of stroke in both types of models (both HR 0.77, P<0.05).
In the systematic review of nine studies and 157,809 participants, the highest quintile of chocolate eaters vs the lowest quintile had significantly lower risk of CHD, stroke, composite CV adverse outcomes, and CV mortality—with pooled risk ratios (RRs) of 0.71, 0.79, 0.75, and 0.55, respectively.
Interestingly, the non–chocolate-eating group had the highest mean body-mass index, the highest percentage of participants with diabetes, and the highest levels of inactivity. On the other hand, “higher chocolate intake was associated with a higher energy intake, with lower contributions from protein and alcohol sources and higher contributions from fat and carbohydrates,” write the investigators.
Overall, they reiterate that their analyses do not show causation. However, “within the general context of existing recommendations for behaviors conductive to cardiovascular health, there does not appear to be evidence that chocolate should be avoided.”
EPIC-Norfolk was funded by grants from the Medical Research Council and Cancer Research UK. Kwok and the coauthors report they have no relevant financial relationships.

References

Kwok CS, Boekholdt SM, Lentjes MA, et al. Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart 2015; DOI:10.1136/heartjnl-2014-307050. Article

Los niveles bajos de vitamina D en menores elevarían el riesgo de enfermedad cardiovascular – correofarmacéutico.com

Los niveles bajos de vitamina D en menores elevarían el riesgo de enfermedad cardiovascular

Expertos han analizado los niveles de vitamina D en suero, glucosa sérica y triglicéridos de un grupo de 314 escolares de entre 8 y 13 años.
Los niveles bajos de vitamina D en menores elevarían el riesgo de enfermedad cardiovascular – correofarmacéutico.com

Los niveles bajos de vitamina D en menores aumentan los niveles de tensión y triglicéridos, principales responsables de la aparición de patologías cardiovasculares en el futuro, según ha mostrado un estudio dirigido por la Universidad Complutense de Madrid (UCM).
Para llevar a cabo el estudio, publicado en Nutrición Hospitalaria y en el que han participado la Universidad Alfonso X El Sabio y la Universidad Nacional de Tucumán (México), los expertos han analizado los niveles de vitamina D en suero, glucosa sérica y triglicéridos de un grupo de 314 escolares de entre 8 y 13 años pertenecientes a diez colegios de A Coruña, Barcelona, Madrid, Sevilla y Valencia.
Así, y a pesar de la importancia que tiene que la población infantil tenga unos niveles adecuados de esta vitamina, los datos de la investigación han reflejado que sólo el 17 por ciento de los menores tenían los valores adecuados, es decir, superiores a los 30 nanogramos por mililitros.
Además, el 35 por ciento de los escolares tenía valores inferiores a 20 nanogramos por mililitro de vitamina D en suero, lo que indica una deficiencia entre moderada y severa, y casi la mitad (47,1 por ciento), registró carencias, aunque menos agudas.

NIVELES SIMILARES A OTROS PAÍSES

“Los niveles de vitamina D sérica observados en este colectivo son similares a los encontrados en otros escolares españoles y de otros países. Esto confirma que la deficiencia en vitamina D es un problema prevalente en niños y adolescentes”, han subrayado los autores.
La vitamina D se adquiere a través de los alimentos como, por ejemplo, el pescado azul, la yema de huevo o los productos lácteos. Por ello, los investigadores achacan “gran parte” de las carencias de vitamina D presentadas por los menores a una dieta inadecuada.
Pero también, esta vitamina se adquiere de la propia síntesis que realiza el organismo con la luz solar aunque, tal y como ha advertido la investigadora de la Facultad de Farmacia de la UCM y autora principal de la investigación, Ana María López-Sobaler, la latitud de España “no es la óptima” y en los meses de invierno la inclinación de la Tierra “no es la más favorable” para la síntesis de la vitamina D. “Incluso en los meses de verano, los valores siguen siendo insuficientes”, ha concluido.

Los polifenoles de la granada prevendrían de la enfermedad coronaria – correofarmacéutico.com

Los polifenoles de la granada prevendrían de la enfermedad coronaria

Las propiedades de esta fruta rica en estos antioxidantes naturales, ayudaría contra la aparición de la disfunción endotelial, una de las primeras manifestaciones de la enfermedad vascular.
Los polifenoles de la granada prevendrían de la enfermedad coronaria – correofarmacéutico.com

La Sociedad Española del Corazón (SEC) ha anunciado este martes que un estudio publicado en la Revista Española de Cardiología (REC), señalaría que la ingesta de extracto de granada, alimento rico en polifenoles, prevendría de la disfunción endotelial coronaria, una de las primeras manifestaciones de enfermedades vasculares como la arterioesclerosis o la hipertensión (HTA).
Como informan desde la SEC, diversos estudios han evidenciado que la reducción en la incidencia de enfermedades cardiovasculares se produciría a través de una dieta rica en verduras pero, sobre todo, basada en un alto consumo de frutas, en especial debido a los polifenoles.
Los polifenoles son antioxidantes naturales que contribuyen a bloquear la formación de radicales libres, sustancias químicas muy nocivas responsables de un gran número de enfermedades, tales como trastornos degenerativos, enfermedades cardiovasculares u otras patologías metabólicas.
Estos antioxidantes se encontrarían en muchas especies vegetales y frutas típicas de la dieta mediterránea, como lentejas, uvas, frambuesas, arándanos, frutos secos, etc. Esto es gracias a las punicalaginas, un tipo de elagitaninos (polifenoles) que sólo se encuentran en la granada y que al metabolizarse en el intestino producirían urolitinas (metabolitos), las cuales los expertos creen que son las responsables de esta prevención.

ENSAYO CLÍNICO

El estudio llevado a cabo por el Hospital de la Santa Cruz y San Pablo de Barcelona, ha consistido en la alimentación de un grupo de animales durante diez días con un pienso estándar para cerdos y a otro grupo con una dieta rica en grasas saturadas y colesterol para poder obtener niveles de colesterol similares a los que se observan en la dislipemia humana y, que a su vez, inducirían a la disfunción endotelial, con una administración a la mitad de los animales de cada uno de los dos grupos con la dieta de un suplemento de 625mg/día con extracto de granada.
Los resultados señalaron que tras diez días y una hora después de ingerir la dieta, los investigadores demostraron que los animales con una dieta rica en grasas saturadas y colesterol presentaron una reducción de vasodilatación del 50 por ciento y que los animales que recibieron un suplemento con extracto de granada mostraron una capacidad de vasodilatación similar a la del grupo de animales con pienso estándar.
Asimismo, Gemma Vilahur, coautora del estudio e investigadora del Centro de Investigación Cardiovascular (CSIC-ICCC) del Hospital de la Santa Cruz y San Pablo de Barcelona, ha destacado que “otro dato observado ha sido que las lipoproteínas de alta densidad (HDL) mostraron mayor capacidad antioxidante y las lipoproteínas de baja densidad (LDL) fueron más resistentes a la oxidación después de la ingesta del suplemento de granada”.

Eating More Whole Grains May Extend Life, Decrease CV Deaths

Marlene Busko

January 06, 2015BOSTON, MA — Consuming more whole-grain foods was linked with a decreased risk of dying, mainly from cardiovascular disease (CVD), but not from cancer, in a long-term study of more than 100 000 American healthcare professionals^[1].
Each daily whole-grain serving was associated with a 5% lower risk of total mortality and a 9% lower risk of cardiovascular mortality, but no change in overall cancer mortality, during a follow-up of up to 26 years, Dr Hongyu Wu (Harvard School of Public Health, Boston, MA) and colleagues write. The study was published online January 5, 2015, in JAMA Internal Medicine.
The researchers also estimated that replacing one serving a day of refined grains with whole grains was tied to a 4% and 8% drop in total mortality and CVD mortality, respectively. Replacing a daily serving of red meat with whole grains was linked with a 10% and 20% lower risk of total mortality and CVD mortality, respectively.
Given that Americans fall far short of the recommended three daily servings of whole grains in their diet, “these findings further support current dietary guidelines that recommend increasing whole-grain consumption to facilitate primary and secondary prevention of chronic diseases and also provide promising evidence that suggests a diet enriched with whole grains may confer benefits toward extended life expectancy,” Wu and colleagues conclude.
“Patients [should be] encouraged to eat whole grains as their main source of carbohydrate on a daily basis,” senior author Dr Qi Sun (Harvard School of Public Health) told .
Typical American Diet Lacks Whole-Grain Foods
The 2010 American Dietary Guidelines recommend that people eat at least three to five servings of whole-grain foods a day, where a serving is 28 g (1 ounce), which is equivalent to a slice of whole-grain bread, a half-cup of cooked brown rice or whole-wheat pasta, or a cup of whole-grain cereal^[2]. However, only 5% of Americans currently eat the recommended minimum amount^[2].
Sun and colleagues previously reported that substituting whole grains for white rice may lower the risk for type 2 diabetes in this study population.
In the current study, they examined whole-grain intake and mortality in 74 341 women in the Nurses’ Health Study (1984–2010) and 43 744 men in the Health Professionals Follow-up Study (1986–2010).
The participants replied to food-frequency questionnaires asking about whole grains (intact and flour forms of wheat, corn, rye, oats, and brown rice, as well as barley, bulgur, buckwheat, popcorn, amaranth, and psyllium) as well as added bran or (wheat or other) germ.
At baseline, the participants had a mean body-mass index (BMI) of 24 to 25; the women had a mean age of 50 and the men a mean age of 53. They were divided into quintiles of median whole-grain consumption, which ranged from 4.2 g/day (quintile 1) to 33.0 g/day (quintile 5).
The authors documented 26 920 deaths during follow-up. There was a linear, significant, inverse relationship between whole-grain consumption and mortality, especially CV mortality, after adjustment for multiple confounders.
Mortality Risk (for Baseline Whole-Grain Intake vs Quintile 1*)

Quintile	Total mortality, HR (95% CI)	CVD mortality, HR (95% CI)
2	0.99 (0.95–1.02)	0.94 (0.88–1.01)
3	0.98 (0.95–1.02)	0.94 (0.87–1.01)
4	0.97 (0.93–1.01)	0.87 (0.80–0.94)
5	0.91 (0.88–0.95)	0.85 (0.78–0.92)

*Adjusted for age and other potential confounders, including physical activity, smoking, BMI, and diet (other than whole grains)

Whole-grain consumption was associated with reduced colorectal cancer in men, but this would need to be replicated in larger studies, Wu and colleagues write.
The beneficial effect of whole grains is likely related to its glycemic properties and nutrient content, Sun said. “Whole grains do not lead to rapid or dramatic changes in blood sugar and blood insulin levels, unlike refined grains or other carbohydrates, such as sugar, [and this] may explain why whole grains are associated with lower diabetes and cardiovascular disease risk,” he noted. Moreover, “whole grains contain many beneficial nutrients, including magnesium, vitamins, lignans, phenolic acids, and alkylresorcinols, and they may jointly lead to lower risk of developing heart disease and diabetes.”
The researchers found an inverse relationship between consumption of bran, but not germ, and mortality, which suggests that the bran component is key. “Bran is a rich source of fiber, B-group vitamins, vitamin E, magnesium, and phytochemicals, which may potentially explain whole grains’ favorable effects,” Wu and colleagues write. “For instance, fiber, primarily found in the bran, may reduce the risk of certain chronic diseases, in particular CVD, metabolic syndrome, diabetes, and certain cancers.”
The study was supported by grants from the National Institutes of Health and a career development award from the National Heart, Lung, and Blood Institute. The authors have reported no relevant financial relationships.

References

Wu H, Flint AJ, Qi Q, et al. Association between dietary whole-grain intake and risk of mortality two large prospective studies in US men and women. JAMA Intern Med 2015: DOI:10.1001/jamainternmed.2014.6283. Abstract
US Department of Agriculture, US Department of Health and Human Services. Dietary Guidelines for Americans 2010, 7th ed. Washington, DC: US Government Printing Office, December 2010. Available here.

Cite this article: Eating More Whole Grains May Extend Life, Decrease CV Deaths. Medscape. Jan 06, 2015.

Recomendar un estilo de vida saludable es eficaz frente al ictus – correofarmacéutico.com

Recomendar un estilo de vida saludable es eficaz frente al ictus

Se trata del primer trabajo que evalúa la relación entre algunos componentes de la dieta, los hábitos de vida y el accidente cerebrovascular en España.
Recomendar un estilo de vida saludable es eficaz frente al ictus – correofarmacéutico.com

Recomendar un estilo de vida saludable para reducir el riesgo de sufrir un ictus, que incluya actividad física, una mayor ingesta de frutas y verduras, reducción del peso y de la ingesta de sal, de grasa saturada y total, y moderación con el consumo de alcohol, son las pautas generales frente al ictus isquémico agudo, según un estudio realizado por neurólogos del Hospital del Mar que se publica en PLOS One.
El trabajo es el primero que evalúa la relación entre algunos componentes de la dieta, los hábitos de vida y el accidente cerebrovascular en España. “El asesoramiento conductual nutricional para promover un estilo de vida saludable en la prevención del ictus es una estrategia efectiva en poblaciones de riesgo”, ha dicho Ana Rodríguez Campello, una de las autoras del trabajo.
Para realizar el estudio se compararon los hábitos dietéticos de 300 pacientes que habían sido ingresados en Neurología del hospital por un ictus con un grupo control. Se analizaron diferentes nutrientes y formas de preparación de alimentos. Los pacientes que habían sufrido el ictus consumían más calorías y proteínas, y alimentos rebozados, y tenían más colesterol total; y estaban menos preocupados por mantener hábitos saludables.
“La dieta puede influir en el riesgo de ictus a través de varios mecanismos, pero los hábitos alimenticios óptimos para la prevención del ictus no están claramente establecidos. En nuestro medio, parece que uno de los mejores patrones dietéticos para la prevención es la dieta mediterránea, que incluye una ingesta de sal reducida y un mayor consumo de frutas y verduras, granos enteros, cereales con fibra, pescados grasos, legumbres y aceite de oliva”.

Sugar, Not Salt, May Be at Fault for Hypertension

Lara C. Pullen, PhD
December 11, 2014
A reduction in the consumption of added sugars and, in particular, processed foods may translate into decreased rates of hypertension as well as decreased cardiometabolic disease. In particular, a new review article suggests that sugar, not salt, appears to contribute to the majority of the hypertension risk associated with processed food.
James J. DiNicolantanio, PharmD, from Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, and Sean C. Lucan, MD, MPH, from Albert Einstein College of Medicine in Bronx, New York, published their review of epidemiological and experimental studies in Open Heart. The authors conclude that high-sugar diets may make a significant contribution to cardiometabolic risk. They also suggest that future dietary guidelines recommend that highly refined processed foods be replaced by natural whole foods.
“It is a little bit frightening that we have been focusing on salt for so long,” Richard Krasuski, MD, from the Cleveland Clinic in Ohio, told Medscape Medical News. Dr Krasuski was not affiliated with the research.
Dr Krasuski explained that the review article summarized the results from two types of studies: epidemiological studies and small interventional studies. Although both types of studies have limitations, together they make a rather strong case.
“[W]hen you do these types of epidemiological studies, you are not really controlling for confounding factors.” Thus, Dr Krasuski described the epidemiological studies as primarily hypothesis-generating.
In contrast, the small interventional studies test a hypothesis through manipulation of a single factor, intensely, over a short period of time. In this type of study, the limitation is that “we don’t know if these acute effects transmit into long-lasting effects,” he explained.
The bottom line, Dr Krasuski said, is that although the science is not perfect, it is, in its entirety, good. He cautioned readers, however, to understand the research context when reading the conclusions.
The conclusion that sugar represents a greater danger to the heart than salt, Dr Krasuski said, was an “eye opener.” He acknowledged, though, that he should have anticipated it. He and other cardiologists have noticed that the recommendations to increasingly lower salt intake have not resulted in the expected positive cardiovascular outcomes.
The article by Dr DiNicolantanio and Dr Lucan will likely be controversial because it contradicts current assumptions about the relationship between diet and cardiovascular disease. “The controversy here is whether it is the salt or the sugar…. It probably is, at least partially, if not more, related to sugar consumption,” Dr Krasuski concluded after reading the paper.
Nevertheless, the bottom line of the article’s recommendation should be familiar and comfortable to most physicians: Eat less processed food.
When asked about what he tells his patients, Dr Krasuski stated that his recommendations are consistent with those of the authors of the current article. He recommends a diet that is full of whole grains and fruits and vegetables, and he also recommends that his patients try to avoid processed foods.
Dr Krasuski added that regular exercise, not smoking, and maintaining weight at a level close to target are also all important for cardiovascular health, although these recommendations are beyond the scope of the current review.
Dr DiNicolantanio, Dr Lucan, and Dr Krasuski have disclosed no relevant financial relationships.
Open Heart. 2014;1;e000167. Full text

Diet Rich in Antioxidants Lowers Postop AF Risk, Suggests European Study

Michael O’Riordan
November 28, 2014
POZZILLI, ITALY – A diet rich in foods with antioxidants appears to provide protection against the development of atrial fibrillation (AF) following cardiac surgery, according to the results of a new observational study^[1].
Assessing the total antioxidant intake of diets using a food-frequency questionnaire, investigators found that patients with greater consumption of antioxidant-rich foods had a significantly lower incidence of postoperative AF compared with individuals who ate less of such foods.
“The food items that contributed the most to dietary [total antioxidant capacity] TAC variance in this population were wine, coffee, and fruit, which altogether explained more than 85% of the total antioxidant intake,” write Dr Simona Constanzo (IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy) and colleagues November 21, 2014 in the Journal of Thoracic and Cardiovascular Surgery.
Red wine, they add, was the major contributor to dietary intake of antioxidants. “It indeed contains a wide variety of polyphenols with antioxidant and anti-inflammatory properties,” they note.
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The study included 217 consecutive Italian patients, average age 68 years, undergoing cardiac surgery (mainly CABG and/or valve replacement or repair). Total antioxidant levels of their diets were assessed using the European Prospective Investigation into Cancer and Nutrition (EPIC) food frequency questionnaire. The total antioxidant levels of individual foods was assessed using an antioxidant-capacity assay validated in previous studies.
The overall incidence of AF following surgery was 38.2%. In a multivariate-adjusted analysis that stratified patients into tertiles based on dietary antioxidant consumption, those in the highest tertile had a 54% lower risk of postoperative AF compared with the two lowest tertiles. The results were consistent when the analysis was restricted to patients undergoing CABG alone or CABG plus valve replacement/repair.
Researchers note the relationship between antioxidant consumption and postoperative AF was nonlinear; a lower intake of antioxidants was not associated with reduced risk.
“Recommendations on dietary habits in coronary artery disease patients at high risk to undergo an open-heart surgery are uncommon,” write Costanzo and colleagues. “Considering our results, dietary habits may be of a particular relevance in preventing the arrhythmia, besides the traditional antiarrhythmic therapy.”

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