Cardiovascular disease

Posted on Cancer, Cardiovascular disease, Diabetes, Diet

Identifying the hidden sources of saturated fat and added sugar in your diet is essential for maintaining a healthy lifestyle.

New research shows combined use of sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) is likely to offer additional protection against heart and kidney disease in patients with diabetes

A recently compiled list of foods and drinks commonly consumed in the United States suggests why many adults inadvertently consume excessive saturated fat and added sugar in their daily diet.

The study reveals that limiting fat and sugar to the recommended 10% of daily calories is challenging due to various popular sources, such as cheese for saturated fat and soft drinks for added sugar. Unexpected sources like chicken and ketchup contribute to overconsumption, posing risks for cairdiovascular disease, diabetes, and cancer.

The analysis of data from over 35,000 U.S. adults is part of a project to develop a research tool to streamline the assessment of these dietary downsides. The work also aims to raise awareness among consumers about the unexpected sources of fat and sugar that accumulate over the overesearchers hope this will encourage shoppers to read labels and identify these hidden sources.

“Chicken breast is often promoted as a low saturated fat food, but it still contains a small amount of saturated fat. It’s important to be aware that even foods with smaller amounts of saturated fat can contribute to the overall intake, gradually adding saturated fat into the diet,” explained Christopher Taylor, the first author of the study and a professor and director of medical dietetics at The Ohio State University’s School of Health and Rehabilitation Sciences.

“Meeting less than 10% helps identify major contributors, and allows us to recognize where saturated fat and added sugar might still be present in other food options. This doesn’t mean these are bad choices – it’s about being mindful of how the morning latte might be contributing.”

Lead author Susan Schembre, an associate professor of oncology at Georgetown University’s Lombardi Comprehensive Cancer Center, raised a public health policy concern about the abundant added sugar.

“It’s present in so many unexpected foods and often in surprising amounts,” she remarked.

The researchers examined information from 36,378 adults in the United States, aged 19 and older, who took part in the National Health and Nutrition Examination Survey from 2005 to 2018. This survey gathered 24-hour dietary recalls from each participant, providing detailed information on what and when all food and beverages were consumed over the preceding two days.

Here is the rewritten text:The main sources of saturated fat were cheese, pizza, ice cream, and eggs. The leading sources of added sugar were soft drinks, tea, fruit drinks, cakes, and pies. According to the USDA’s “What We Eat in America” food list, other categories contributing to saturated fat intake include cold cuts, cream substitutes, fried potatoes, and whole milk. Categories with added sugar include tomato-based condiments, cereal bars, energy drinks, and yeast breads.

The research team also analyzed variations in the primary sources of saturated fat and added sugar across different race/ethnicity groups and age brackets, which is crucial when evaluating diets for the purpose of developing tailored health interventions, Schembre explained.

“Before you understand what you can intervene on, you have to know what people are consuming,” she said.

The team is developing an app for focused assessment of “nutrients of concern.” They have shown that this analytical method generates a comprehensive list of foods that contribute to most of the saturated fat and added sugar intake. While NHANES data is important for understanding nutrition in the United States, identifying the specific food and beverage sources of fat, added sugar, and soon, sodium, is more efficient and effective for disease interventions.

The analysis revealed that saturated fat made up at least 12% of daily calories, while added sugar intake ranged from 14% to 16% of total calories. Although dietary recommendations often highlight common culprits like pizza and ice cream, this comprehensive list provides valuable and, for some, surprising insights, according to Taylor.

“There are foods that are high in saturated fat and added sugar which are frequently consumed and often targeted. However, there is also a smaller cumulative effect of things that are generally perceived as healthy, but still contribute a little bit,” he said. “When you top it off with some of those higher sources, it ends up taking you over the threshold for 10% of the day’s calories.”

“We’re aiming to find the right balance between addressing the major issues upfront while also recognizing the subtle contributors.”

Posted on Cardiovascular disease, Diabetes

Airplane noise exposure may increase the risk of chronic disease.

A new study found that people who were exposed to higher levels of noise from aircraft were more likely to have a higher body mass index, an indicator of obesity that can lead to stroke or hypertension.

Research has shown that noise from aeroplanes and helicopters flying overhead is far more bothersome to people than noise from other modes of transportation, and a growing body of research suggests that aircraft noise also contributes to negative health outcomes.

One of the latest studies indicates that aeroplane noise may increase one’s risk of developing cardiometabolic diseases, a cluster of conditions such as heart attack, stroke, diabetes, and hypertension.

The study found that people exposed to aeroplane noise levels at 45 dB or more were likelier to have higher self-reported body mass index (BMI), with the highest BMI measures linked to aircraft noise levels at 55 dB or above. Aeroplane noise exposure at 45 dB or above was also associated with having a higher BMI in middle to late adulthood from early adulthood. For comparison, the sound of a whisper is 30 dB, a library setting is 40 dB, and a typical conversation at home is 50 dB.

BMI is an indicator of general obesity, which can lead to cardiometabolic diseases, as well as a range of other health issues. The study is the first to explore a connection between aircraft noise exposure and obesity nationwide in the United States; past studies on this subject have focused on European populations, and results have varied.

“Prior research has shown that aircraft noise can elevate stress responses and disturb sleep, but there has been mixed evidence of any links with body mass index,” says study lead and corresponding author Dr. Matthew Bozigar, assistant professor of epidemiology at OSU. “We were surprised to see a fairly robust link between aircraft noise and higher body mass index among women across the US.”

These new findings underscore the role of the environment on one’s risk of chronic disease.

‘Obesity has become very stigmatized, but what is important to remember is that it is linked with poor cardiometabolic health outcomes, and that it has strong environmental drivers,” Dr. Bozigar says. “This is disheartening, but also promising, in the sense that we could potentially enact policies to mitigate these drivers of obesity.”

For the study, Dr Bozigar and colleagues examined aeroplane noise exposure and self-reported BMI and other individual characteristics among nearly 75,000 participants living around 90 of the major US airports. The participants were selected from the Nurses’ Health Studies (NHS), ongoing, prospective studies of US female nurses who have completed biennial questionnaires since the 1970s and 1980s. 

The team examined aircraft noise levels every five years from 1995 to 2010, using a day-night estimate (DNL) that captures the average noise level over a 24-hour period and applies a 10 dB adjustment for aircraft noise occurring at night, when background noise is low. The current policy-related threshold for significant noise impacts is above DNL 65 dB. The team assessed BMI measures at multiple thresholds below that (less than 45 dB, 45–54 dB, 55 dB and above, and continuous exposure at 45 dB or above) for the nurses’ geocoded residential addresses.

Although the team acknowledges that BMI is a suboptimal metric, the independent and strong association between more aircraft noise exposure and higher BMI that they observed is notable. There were also regional differences, with stronger associations among participants on the West Coast and those who live in arid conditions.

“We can only hypothesize about why we saw these regional variations, but one reason may relate to the era of regional development, building characteristics, and climate which may affect factors such as housing age, design, and level of insulation,” says study senior author Dr. Junenette Peters, associate professor of environmental health at BUSPH. “Regional differences in temperature and humidity may influence behaviors such as window opening, so perhaps study participants living in the West were more exposed to aircraft noise due to open windows or housing type, which allowed more noise to penetrate.”

Similarly, Dr. Peters says the stronger associations observed in arid climates, many of which are also in the Western US, may relate to the way noise travels under various atmospheric conditions. 

Future research should explore this link between aircraft noise exposure and obesity further, as well as broader inequities in environmental noise exposure, particularly among other populations. Previous data suggest that Black, Hispanic, and low-income populations are disproportionately exposed to aircraft noise. The participants in the NHS study groups were primarily White and of mid-level socioeconomic status. 

“We need to study the potential health impacts of environmental injustices in transportation noise exposures alongside other environmental drivers of poor health outcomes” Dr. Bozigar says. “There is a lot more to figure out, but this study adds evidence to a growing body of literature that noise negatively impacts health.”

Posted on Cardiovascular disease, Diabetes

Two medication classes reduced cardiovascular and liver events in people with type 2 diabetes.

Heart attack

GLP-1 receptor agonists (GLP-1s) and SGLT-2 inhibitors lower the risk of major cardiovascular events like heart attacks and severe liver complications compared to other diabetes treatments.

“Before this study, there was limited information about how these specific diabetes medications work in patients with both type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD),” said Alexander Kutz, M.D., M.P.H., M.Sc., a research fellow in the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, at Brigham and Women’s Hospital and Harvard Medical School in Boston, Mass. “Our study shows that GLP-1 receptor agonists and SGLT-2 inhibitors are more beneficial in preventing heart-related events compared to another group of drugs such as dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors), and GLP-1s also help reduce severe liver events.”

The researchers reviewed Medicare data documented from 2013 to 2020 and a large U.S. health insurance database from 2013 to 2022. They performed two analyses, including adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease who started GLP-1s, SGLT-2 inhibitors, or DPP-4is.

They analyzed the risk for acute heart attack, ischemic stroke, hospitalization for heart failure, or all-cause mortality. They also examined the incidence of serious liver events.

The people who used GLP-1s or SGLT-2 inhibitors had fewer cardiovascular events than those who were given DPP-4 inhibitors. The researchers also found that GLP-1s reduced severe liver events compared to DPP-4 inhibitors. Moreover, severe adverse events weren’t any more frequent than when people were treated with DPP-4 inhibitors.

Kutz said these findings suggest GLP-1 receptors and SGLT-2 inhibitors may be more beneficial than other diabetes medications for patients with type 2 diabetes and MASLD. In addition, using these drugs, which have become popular in recent years, reduces the risk of heart-related events and serious liver complications.

Kutz added that by introducing this treatment, patients with type 2 diabetes and MASLD may experience fewer hospitalizations despite complex medical needs.

“An increasing amount of people live with type 2 diabetes, and a significant proportion of these individuals also struggle with MASLD,” Kutz said. “Understanding which medications can effectively manage these conditions and prevent severe complications is crucial for their health and quality of life.”

Posted on Cancer, Cardiovascular disease, Diabetes, Obesity

Food’s Protective Power Against Inflammation

Inflammation can be good, signalling your body’s attempt to fight off infection or heal an injury. But when inflammatory cells soldier forth when you’re not sick or injured, chronic inflammation can ensue, contributing to obesity, cardiovascular disease, diabetes, and even autoimmune disease and cancer. The good—no, great—news is that the foods you eat can dramatically affect inflammation in your body, helping not only to prevent it but to fight it if it’s already started. Join Dr. Katsumoto as she discusses how foods can be anti-inflammatory—and how the ones you choose can also help the planet.