ORCID Profile
0000-0002-4449-9304
Current Organisation
Northumbria University
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Publisher: Elsevier BV
Date: 10-2014
Abstract: Several studies tested the effects of supplementation with antioxidant vitamins on arterial stiffness, but the results were contradictory. The aim of our study was to conduct a systematic review and meta-analysis investigating the effect of antioxidant vitamins on arterial stiffness and to determine whether the effects on arterial stiffness vary according to dose, duration of intervention, and health or nutritional status of the included participants. We searched 3 databases (Medline, Embase, and Scopus) for articles that potentially met the following eligibility criteria: 1) randomized controlled trials comparing antioxidant vitamins (vitamins C, E, and A and β-carotene) to either placebo or no active control in 2) adult participants aged ≥18 y 3) antioxidant vitamins administered alone or in combination, irrespective of dose, duration, and route of administration and 4) changes in arterial stiffness or arterial compliance. Data were pooled as standardized mean differences (SMDs) and analyzed using fixed- and random-effects models. Data synthesis showed that antioxidant vitamins reduced arterial stiffness significantly (SMD: -0.17 95% CI: -0.26, -0.08 P < 0.001). This effect was significant in experimental (SMD: -1.02 95% CI: -1.54, -0.49 P < 0.001) and primary prevention (SMD: -0.14 95% CI: -0.24, -0.04 P < 0.01) studies, whereas a trend for reduced arterial stiffness was observed in studies including participants with diseases (SMD: -0.19 95% CI: -0.40, 0.02 P = 0.08). Vitamin supplementation improved arterial stiffness irrespective of age group and duration of intervention. Antioxidant vitamins were more effective in participants with low baseline plasma concentrations of vitamins C (SMD: -0.35 95% CI: -0.62, -0.07 P < 0.016) and E (SMD: -0.79 95% CI: -1.23, -0.33 P < 0.01). Supplementation with antioxidant vitamins has a small, protective effect on arterial stiffness. The effect may be augmented in those with lower baseline plasma vitamin E and C concentrations. This trial was registered at PROSPERO as CRD42014007260.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2014
DOI: 10.1007/S40520-013-0169-8
Abstract: This study evaluated the agreement of novel anthropometric equations and established indirect methods (skinfold thickness and bioimpedance analysis) with reference methods [dual X-ray absorptiometry (DXA) and air displacement plethysmography (ADP)] for fat mass assessment (FM) in older subjects. Forty subjects (M/F = 15/25, age = 61-84 years, BMI = 18-37 kg/m(2)) were recruited. The agreement of the following predictive equations was evaluated: body adiposity index (BAI), BAI-Fels and Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE). BAI estimates were comparable to DXA (Δ ± 2SD = 0.4 ± 6.0 kg, p > 0.05) but not to ADP (Δ ± 2SD = -2.8 ± 7.2 kg, p 0.05) but not to ADP (Δ ± 2SD = -4.0 ± 6.9 kg, p 0.05), whereas it significantly overestimated DXA (Δ ± 2SD = 2.8 ± 5.4 kg, p < 0.001). ADP significantly overestimated FM compared to DXA (Δ ± 2SD = 3.2 ± 5.4 kg, p < 0.001) and the measurement bias was significantly correlated with BMI in men (p = 0.004). The accuracy of the three anthropometric indexes is dependent on the choice of the reference method. The variability of the FM estimates was large and these indexes cannot be recommended for the assessment of FM in older subjects.
Publisher: Public Library of Science (PLoS)
Date: 15-10-2014
Publisher: Springer Science and Business Media LLC
Date: 19-10-2014
DOI: 10.1007/S40519-013-0077-0
Abstract: Body adiposity index (BAI) is a novel index for the assessment of percentage fat mass (FM%). We tested the association between BAI and metabolic outcomes in overweight and obese women of different ages. 260 young women (24.7 ± 5.3 years, 31.0 ± 5.0 kg/m(2)) and 328 older women (66.9 ± 4.6 years, 34.8 ± 4.7 kg/m(2)) were recruited. BAI was calculated using hip circumference and height. Bioimpedance analysis was used to measure FM%. Metabolic risk was assessed using a composite z score integrating standardised measurements of fasting glucose, total cholesterol, liver enzymes and triglycerides. The association between BAI and FM% was modest in both young (r = 0.56, p < 0.001) and older (r = 0.49, p < 0.001) groups. BAI was directly associated with metabolic risk in young women (r = 0.29, p < 0.001), whereas it showed a weak, inverse association in the older group (r = -0.14, p = 0.01). BAI validity needs to be re-assessed in older in iduals for better definition of its predictive accuracy.
Publisher: Springer Science and Business Media LLC
Date: 02-08-2016
DOI: 10.1007/S00394-015-0993-Z
Abstract: Ageing is directly associated with visceral fat (VAT) deposition and decline of metabolically active cellular mass, which may determine age-related shifts in substrate oxidation and increased cardiometabolic risk. We tested whether VAT and fasting respiratory quotient (RQ, an index of macronutrient oxidation) changed with age and if they were associated with increased risk of metabolic syndrome (MetSyn). A total of 2819 adult participants (age range: 18-81 years men/women: 894/1925) were included we collected history, anthropometric measures, biochemistry, smoking habits, and physical activity. The body mass index range was 18.5-60.2 kg/m(2). Gas exchanges (VO2 and VCO2) were measured by indirect calorimetry in fasting conditions, and RQ was calculated. Body composition was measured by bioelectrical impedance. Abdominal subcutaneous fat and VAT were measured by ultrasonography. MetSyn was diagnosed using harmonised international criteria. Multivariate linear and logistic regression models were utilised. VAT increased with age in both men (r = 0.31, p < 0.001) and women (r = 0.37, p < 0.001). Basal RQ was not significantly associated with age (p = 0.49) and VAT (p = 0.20) in addition, basal RQ was not a significant predictor of MetSyn (OR 3.31, 0.57-19.08, p = 0.27). VAT was the primary predictor of MetSyn risk in a fully adjusted logistic model (OR 4.25, 3.01-5.99, p < 0.001). Visceral adiposity remains one of the most important risk factors for cardiometabolic risk and is a significant predictor of MetSyn. Post-absorptive substrate oxidation does not appear to play a significant role in age-related changes in body composition and cardiometabolic risk, except for a correlation with triglyceride concentration.
Publisher: Public Library of Science (PLoS)
Date: 29-07-2016
Publisher: BMJ
Date: 20-09-2016
DOI: 10.1136/BMJ.I4707
Abstract: To assess the effect of the FTO genotype on weight loss after dietary, physical activity, or drug based interventions in randomised controlled trials. Systematic review and random effects meta-analysis of in idual participant data from randomised controlled trials. Ovid Medline, Scopus, Embase, and Cochrane from inception to November 2015. Randomised controlled trials in overweight or obese adults reporting reduction in body mass index, body weight, or waist circumference by FTO genotype (rs9939609 or a proxy) after dietary, physical activity, or drug based interventions. Gene by treatment interaction models were fitted to in idual participant data from all studies included in this review, using allele dose coding for genetic effects and a common set of covariates. Study level interactions were combined using random effect models. Metaregression and subgroup analysis were used to assess sources of study heterogeneity. We identified eight eligible randomised controlled trials for the systematic review and meta-analysis (n=9563). Overall, differential changes in body mass index, body weight, and waist circumference in response to weight loss intervention were not significantly different between FTO genotypes. Sensitivity analyses indicated that differential changes in body mass index, body weight, and waist circumference by FTO genotype did not differ by intervention type, intervention length, ethnicity, s le size, sex, and baseline body mass index and age category. We have observed that carriage of the FTO minor allele was not associated with differential change in adiposity after weight loss interventions. These findings show that in iduals carrying the minor allele respond equally well to dietary, physical activity, or drug based weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions. PROSPERO CRD42015015969.
Publisher: Wiley
Date: 28-05-2015
DOI: 10.1111/OBR.12290
Abstract: Risk variants of fat mass and obesity-associated (FTO) gene have been associated with increased obesity. However, the evidence for associations between FTO genotype and macronutrient intake has not been reviewed systematically. Our aim was to evaluate the potential associations between FTO genotype and intakes of total energy, fat, carbohydrate and protein. We undertook a systematic literature search in OVID MEDLINE, Scopus, EMBASE and Cochrane of associations between macronutrient intake and FTO genotype in adults. Beta coefficients and confidence intervals (CIs) were used for per allele comparisons. Random-effect models assessed the pooled effect sizes. We identified 56 eligible studies reporting on 213,173 adults. For each copy of the FTO risk allele, in iduals reported 6.46 kcal day(-1) (95% CI: 10.76, 2.16) lower total energy intake (P = 0.003). Total fat (P = 0.028) and protein (P = 0.006), but not carbohydrate intakes, were higher in those carrying the FTO risk allele. After adjustment for body weight, total energy intakes remained significantly lower in in iduals with the FTO risk genotype (P = 0.028). The FTO risk allele is associated with a lower reported total energy intake and with altered patterns of macronutrient intake. Although significant, these differences are small and further research is needed to determine whether the associations are independent of dietary misreporting.
Publisher: Wiley
Date: 07-05-2004
Publisher: Springer Science and Business Media LLC
Date: 04-12-2015
DOI: 10.1038/JHH.2014.114
Publisher: Canadian Science Publishing
Date: 08-2014
Abstract: The 4-component (4-C) model is the reference method to measure fat mass (FM). Simpler 2-component (2-C) models are widely used to assess FM. We hypothesised that an aggregate 2-C model may improve accuracy of FM assessment during weight loss (WL). One hundred and six overweight and obese men and women were enrolled in different WL programs (fasting, very low energy diet, low energy diet). Body density, bone mineral content, and total body water were measured. FM was calculated using 2-C, 3-C, and 4-C models. Aggregate equations for 2-C, 3-C, and 4-C models were calculated, with the aggregate 4-C model assumed as the reference method. The aggregate approach postulates that the average of the in idual estimates obtained from each model is more accurate than the best single measurement. The average WL was −7.5 kg. The agreement between 3-C and 4-C models for FM change was excellent (R 2 = 0.99). The aggregate 2-C equation was more accurate than in idual 2-C estimates in measuring changes in FM. The aggregate model was characterised by a lower measurement error at baseline and post-WL. The relationship between the aggregate 3-C and 4-C component models was highly linear (R 2 = 0.99), whereas a lower linearity was found for the aggregate 2-C and 4-C model (R 2 = 0.72). The aggregate 2-C model is characterised by a greater accuracy than commonly applied 2-C equations for the measurement of FM during WL in overweight and obese men and women.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.NIOX.2015.04.007
Abstract: Abnormal circadian oscillations of blood pressure (BP) and nocturnal-diurnal BP differences (i.e., dipping) increase cardiovascular risk. Whether inorganic nitrate supplementation influences 24-hr BP variability is currently unknown. We studied the effects of high-nitrate beetroot juice supplementation on BP variability measured by 24-hr ambulatory BP monitoring (24-hr ABPM) in older subjects. Data from four independent randomised clinical trials were collated. Eighty-five older participants (age range: 55-76 years) were included in the final database. Two trials had an open-label, parallel design and two trials had a cross-over, double-blind design. Participants were randomised to either beetroot juice or placebo. Changes in 24-hr ABPM (daily, diurnal, nocturnal), variability (weighted-SDs), night-dipping, morning surge for systolic and diastolic BP were measured. Meta-analysis was conducted to obtain pooled estimates of the effect size for each BP outcome. Sub-group analyses were conducted to evaluate the influence of age, BMI, gender, BP status and changes in nitrite concentrations on the effect size. The pooled effect of beetroot juice on all BP outcomes was not significant. Beetroot juice ingestion determined a significant decrease in nocturnal systolic BP variability in subjects aged less than 65 y (2.8 mmHg, -4.5 -1.0, p = 0.002) compared to the older group (≥ 65 y 1.0 mmHg, -2.2 4.2, p = 0.54). A greater change in NO2(-) concentrations after beetroot supplementation was associated with significant differences for nocturnal mean (-3.4 mmHg, -0.6 -2.4, p = 0.02) and variability (-0.8 mmHg, -1.5 -0.06, p = 0.03) of systolic BP. The vascular responsiveness to inorganic nitrate may be modified by mechanisms of vascular ageing influencing the reducing capacity to convert inorganic nitrate into nitrite and tissue-specific responses to dietary nitrate supplementation.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.NUMECD.2014.05.005
Abstract: The worldwide epidemiology of diabetes is rapidly changing as a result of the spreading of westernised nutritional and lifestyle habits. We conducted an ecological analysis to identify dietary, lifestyle and socio-economic factors associated with global diabetes prevalence. Country-specific estimates of diabetes prevalence were obtained. Data were then matched to year- and country-specific food and energy availability for consumption, and to year-specific information on obesity, physical inactivity, urbanisation, gross domestic product (GDP), and smoking. Data were obtained from publicly available databases compiled by the Food Agricultural Organisation (FAO), World Health Organisation (WHO) and World Bank. Cluster analysis was used to derive dietary patterns of global food consumption. The association with diabetes prevalence was evaluated. Stepwise multiple regression analysis was conducted to identify predictors associated with worldwide diabetes prevalence. 96 countries were eligible for inclusion in the analysis. The average diabetes prevalence was 7.0% and the highest rate was observed in the Middle-Eastern region (13.1%). The worldwide prevalence of obesity and physical inactivity was 15.1% and 36.1%, respectively. Diabetes prevalence was associated with age and physical inactivity prevalence in a fully adjusted multiple regression model. Three dietary patterns (agricultural, transitional and westernised) were identified by the cluster analysis. Diabetes prevalence showed a direct dose-response association with the degree of exposure to a westernised dietary pattern. The adoption of sedentary lifestyle and westernised dietary patterns appears to be closely linked to the global rise in diabetes prevalence.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.CLNU.2018.01.022
Abstract: There is no consensus on the definition of sarcopenic obesity (SO), resulting in inconsistent associations of SO with mortality risk. We aim to evaluate association of dual energy x-ray absorptiometry (DXA) SO models with mortality risk in a US adult population (≥50 years). The study population consisted of 3577 participants aged 50 years and older from the 1999-2004 National Health and Nutrition and Examination Survey with mortality follow-up data through December 31, 2011. Difference in survival time in people with and without SO defined by three body composition DXA models (Model 1: body composition phenotype model Model 2: Truncal Fat Mass (TrFM)/Appendicular Skeletal Muscle Mass (ASM) ratio model Model 3: Fat Mass (FM)/Fat Free Mass (FFM) ratio). The differences between the models were assessed by the acceleration failure time model, and expressed as time ratios (TR). Participants age 50-70 years with SO had a significantly decreased survival time, according to the body composition phenotype model (TR: 0.92 95% CI: 0.87-0.97), and TrFM/ASM ratio model (TR: 0.88 95% CI: 0.81-0.95). The FM/FFM ratio model did not detect significant differences in survival time. Participants with SO aged 70 years and older did not have a significantly decreased survival time, according to all three models. A SO phenotype increases mortality risk in people of age 50-70 years, but not in people aged 70 years and older. The application of the body composition phenotype and the TrFM/ASM ratio models may represent useful diagnostic approaches to improve the prediction of disease and mortality risk.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: Cambridge University Press (CUP)
Date: 28-11-2015
DOI: 10.1017/S0007114514003341
Abstract: The Dietary Approach to Stop Hypertension (DASH) is recommended to lower blood pressure (BP), but its effects on cardiometabolic biomarkers are unclear. A systematic review and meta-analysis of randomised controlled trials (RCT) was conducted to determine the effects of the DASH diet on cardiovascular risk factors. Medline, Embase and Scopus databases were searched from inception to December 2013. Inclusion criteria were as follows: (1) DASH diet (2) RCT (3) risk factors including systolic and diastolic BP and glucose, HDL, LDL, TAG and total cholesterol concentrations (4) control group. Random-effects models were used to determine the pooled effect sizes. Meta-regression analyses were carried out to examine the association between effect sizes, baseline values of the risk factors, BMI, age, quality of trials, salt intake and study duration. A total of twenty articles reporting data for 1917 participants were included in the meta-analysis. The duration of interventions ranged from 2 to 24 weeks. The DASH diet was found to result in significant decreases in systolic BP ( − 5·2 mmHg, 95 % CI − 7·0, − 3·4 P 0·001) and diastolic BP ( − 2·6 mmHg, 95 % CI − 3·5, − 1·7 P 0·001) and in the concentrations of total cholesterol ( − 0·20 mmol/l, 95 % CI − 0·31, − 0·10 P 0·001) and LDL ( − 0·10 mmol/l, 95 % CI − 0·20, − 0·01 P = 0·03). Changes in both systolic and diastolic BP were greater in participants with higher baseline BP or BMI. These changes predicted a reduction of approximately 13 % in the 10-year Framingham risk score for CVD. The DASH diet improved cardiovascular risk factors and appeared to have greater beneficial effects in subjects with an increased cardiometabolic risk. The DASH diet is an effective nutritional strategy to prevent CVD.
Publisher: Cambridge University Press (CUP)
Date: 31-03-2015
DOI: 10.1017/S0007114515000227
Abstract: Randomised controlled trials (RCT) testing the effects of antioxidant supplements on endothelial function (EF) have reported conflicting results. We aimed to investigate the effects of supplementation with antioxidant vitamins C and E on EF and to explore factors that may provide explanations for the inconsistent results. We searched four databases (MEDLINE, Embase, Cochrane Library and Scopus) from inception until May 2014 for RCT involving adult participants aged ≥ 18 years who were supplemented with vitamins C and E alone or in combination for more than 2 weeks and reporting changes in EF measured using flow mediated dilation or forearm blood flow. Data were pooled as standardised mean difference (SMD) and analysed using a random-effects model. Significant improvements in EF were observed in trials supplementing with vitamin C alone (500–2000 mg/d) (SMD: 0·25, 95 % CI 0·02, 0·49, P = 0·043) and vitamin E alone (300–1800 IU/d 1 IU vitamin E = 0·67 mg natural vitamin E) (SMD: 0·48, 95 % CI 0·23, 0·72, P = 0·0001), whereas co-administration of both vitamins was ineffective (vitamin C: 500–2000 mg/d vitamin E: 400–1200 IU/d) (SMD: 0·12, 95 % CI − 0·18, 0·42, P = 0·428). The effect of vitamin C supplementation on EF increased significantly with age (β 0·023, 95 % CI 0·001, 0·05, P = 0·042). There was a significant negative correlation between baseline plasma vitamin E concentration and the effect of vitamin E supplementation on EF (β − 0·03, 95 % CI − 0·06, − 0·001, P = 0·029). Supplementation with either vitamin C or vitamin E alone improves EF. However, subgroup analysis emphasises the importance of careful characterisation and selection of a population group which may benefit from such supplementation.
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.NIOX.2016.08.001
Abstract: Nitrate-rich beetroot juice (BRJ) increases plasma nitrite concentrations, lowers the oxygen cost (V⋅O2) of steady-state exercise and improves exercise performance in sedentary and moderately-trained, but rarely in well-trained in iduals exercising at sea-level. BRJ supplementation may be more effective in a hypoxic environment, where the reduction of nitrite into nitric oxide (NO) is potentiated, such that well-trained and less well-trained in iduals may derive a similar ergogenic effect. We conducted a randomised, counterbalanced, double-blind placebo controlled trial to determine the effects of BRJ on treadmill running performance in moderate normobaric hypoxia (equivalent to 2500 m altitude) in participants with a range of aerobic fitness levels. Twelve healthy males (V⋅O2max ranging from 47.1 to 76.8 ml kg(-1) min(-1)) ingested 138 ml concentrated BRJ (∼15.2 mmol nitrate) or a nitrate-deplete placebo (PLA) (∼0.2 mmol nitrate). Three hours later, participants completed steady-state moderate intensity running, and a 1500 m time-trial (TT) in a normobaric hypoxic chamber (FIO2 ∼ 15%). Plasma nitrite concentration was significantly greater following BRJ versus PLA 1 h post supplementation, and remained higher in BRJ throughout the testing session (p < 0.01). Average V⋅O2 was significantly lower (BRJ: 18.4 ± 2.0, PLA: 20.4 ± 12.6 ml kg(-1) min(-1) p = 0.002), whilst arterial oxygen saturation (SpO2) was significantly greater (BRJ: 88.4 ± 2.7, PLA: 86.5 ± 3.3% p < 0.001) following BRJ. BRJ improved TT performance in all 12 participants by an average of 3.2% (BRJ: 331.1 ± 45.3 vs. PL: 341.9 ± 46.1 s p 0.05). These findings suggests that a high nitrate dose in the form of a BRJ supplement may improve running performance in in iduals with a range of aerobic fitness levels conducting moderate and high-intensity exercise in a normobaric hypoxic environment.
Publisher: Cambridge University Press (CUP)
Date: 12-06-2019
Publisher: Informa UK Limited
Date: 25-09-2017
DOI: 10.1080/10408398.2017.1362630
Abstract: Worldwide, cardiovascular diseases (CVDs) remains as the main cause of mortality. Observational studies supports an association between intake of tomato products or lycopene with a reduced CVDs risk. Our aim was to undertake a systematic review and meta-analysis of the evidence on the topic. Medline, Web of Science, and Scopus were searched from inception until July 2017. We included longitudinal and cross-sectional studies reporting associations between lycopene and tomato consumption and cardiovascular morbidity and mortality among adult subjects. Random-effects models were used to determine the pooled effect sizes. Twenty-eight publications met our inclusion criteria and 25 studies provided quantitative data for meta-analysis. Results showed that in iduals in the highest consumption category of, or with the highest serum concentration of, lycopene had significantly lower risk of stroke (hazard ratio (HR) 0.74, 0.62-0.89, p = 0.02 I This comprehensive meta-analysis suggests that high-intakes or high-serum concentration of lycopene are associated with significant reductions in the risk of stroke (26%), mortality (37%) and CVDs (14%).
Publisher: Springer Science and Business Media LLC
Date: 13-03-2016
DOI: 10.1007/S00394-015-0872-7
Abstract: Diets rich in inorganic nitrate are associated with lower blood pressure, an effect that may be mediated by an improvement of endothelial function (EF). Therefore, a systematic review and meta-analysis of randomised controlled trials (RCTs) were conducted to examine the effects of inorganic nitrate and beetroot supplementation on measures of EF. MEDLINE, EMBASE and Scopus databases were searched from inception until November 2014. Specific inclusion criteria were as follows: (1) RCTs (2) trials comparing inorganic nitrate or beetroot supplementation with placebo control groups and (3) trials reporting effects of these interventions on outcomes of vascular function. Random-effect models were used to assess the pooled effect sizes showed as standardised mean differences (SMD). Nine crossover trials and three parallel trials met our inclusion criteria. The trials were conducted between 2008 and 2014 and included a total of 246 participants with 10-64 participants per study. The duration of each intervention ranged from 1.5 h to 28 days. Inorganic nitrate and beetroot consumption was associated with an improvement in vascular function (SMD 0.36 95 % CI 0.16, 0.56 P < 0.001). The effect on EF was significantly associated with the dose of inorganic nitrate (β = 0.04, SE = 0.01, P < 0.001), age (β = -0.01, SE = 0.004, P = 0.02), baseline BMI (β = -0.04, SE = 0.02, P = 0.05) and systolic BP (β = -0.01, SE = 0.005, P = 0.02). Inorganic nitrate and beetroot supplementation was associated with beneficial effects on EF. These effects appear to be reduced in older subjects and in subjects with greater cardiometabolic risk.
Publisher: Wiley
Date: 21-11-2016
DOI: 10.1111/COB.12165
Abstract: The ratio between fat mass (FM) and fat-free mass (FFM) has been used to discriminate in idual differences in body composition and improve prediction of metabolic risk. Here, we evaluated whether the use of a visceral adipose tissue-to-fat-free mass index (VAT:FFMI) ratio was a better predictor of metabolic risk than a fat mass index to fat-free mass index (FMI:FFMI) ratio. This is a cross-sectional study including 3441 adult participants (age range 18-81 men/women: 977/2464). FM and FFM were measured by bioelectrical impedance analysis and VAT by ultrasonography. A continuous metabolic risk Z score and harmonised international criteria were used to define cumulative metabolic risk and metabolic syndrome (MetS), respectively. Multivariate logistic and linear regression models were used to test associations between body composition indexes and metabolic risk. In unadjusted models, VAT:FFMI was a better predictor of MetS (OR 8.03, 95%CI 6.69-9.65) compared to FMI:FFMI (OR 2.91, 95%CI 2.45-3.46). However, the strength of association of VAT:FFMI and FMI:FFMI became comparable when models were adjusted for age, gender, clinical and sociodemographic factors (OR 4.06, 95%CI 3.31-4.97 OR 4.25, 95%CI 3.42-5.27, respectively). A similar pattern was observed for the association of the two indexes with the metabolic risk Z score (VAT:FFMI: unadjusted b = 0.69 ± 0.03, adjusted b = 0.36 ± 0.03 FMI:FFMI: unadjusted b = 0.28 ± 0.028, adjusted b = 0.38 ± 0.02). Our results suggest that there is no real advantage in using either VAT:FFMI or FMI:FFMI ratios as a predictor of metabolic risk in adults. However, these results warrant confirmation in longitudinal studies.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.NUTRES.2014.09.007
Abstract: Although inorganic nitrate and beetroot juice supplementation are associated with decreased systolic blood pressure (BP), these results have primarily been obtained from short-term trials that focused on healthy young adults. Therefore, we hypothesized that oral supplementation of beetroot juice concentrate would decrease systolic BP in overweight older participants but that the decline in BP would not be sustained after a 1-week interruption of the beetroot juice supplementation. For 3 weeks, 24 participants were randomized to either the beetroot juice concentrate or blackcurrant juice group, with a 1-week postsupplementation phase (week 4). Changes in systolic and diastolic BP were assessed during the supplementation and postsupplementation phases. Blood pressure was measured using 3 different methods: (1) resting clinic BP, (2) 24-hour ambulatory BP monitoring, and (3) home monitoring of daily resting BP. The first 2 methods were applied at baseline and after weeks 3 and 4. Daily measurements were conducted throughout the study, with 21 subjects completing the study (beetroot/blackcurrant = 10/11 male/female = 12/9 age = 62.0 ± 1.4 years body mass index = 30.1 ± 1.2 kg/m(2)). After 3 weeks, beetroot juice supplementation was not associated with significant changes in resting clinic BP or 24-hour ABPM. Conversely, beetroot juice concentrate reduced daily systolic BP after 3 weeks (-7.3 ± 5.9 mm Hg, P = .02) however, the effect was not maintained after the interruption of the supplementation (week 4, 2.8 ± 6.1 mm Hg, P = .09). In overweight older subjects, beetroot juice concentrate supplementation was associated with beneficial effects on daily systolic BP, although the effects were not significant when measured by 24-hour ABPM or resting clinic BP.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.ATHEROSCLEROSIS.2017.01.009
Abstract: Epidemiological evidence suggests an association between consumption of tomato products or lycopene and lower risk for cardiovascular diseases (CVD). Our aim was to evaluate the state of the evidence from intervention trials on the effect of consuming tomato products and lycopene on markers of cardiovascular (CV) function. We undertook a systematic review and meta-analysis on the effect of supplementing tomato and lycopene on CV risk factors. Three databases including Medline, Web of science, and Scopus were searched from inception to August 2016. Inclusion criteria were: intervention trials reporting effects of tomato products and lycopene supplementation on CV risk factors among adult subjects >18 years of age. The outcomes of interest included blood lipids (total-, HDL-, LDL-cholesterol, triglycerides, oxidised-LDL), endothelial function (flow-mediated dilation (FMD), pulse wave velocity (PWV)) and blood pressure (BP) inflammatory factors (CRP, IL-6) and adhesion molecules (ICAM-1). Random-effects models were used to determine the pooled effect sizes. Out of 1189 publications identified, 21 fulfilled inclusion criteria and were meta-analysed. Overall, interventions supplementing tomato were associated with significant reductions in LDL-cholesterol (-0.22 mmol/L p = 0.006), IL-6 (standardised mean difference -0.25 p = 0.03), and improvements in FMD (2.53% p = 0.01) while lycopene supplementation reduced systolic-BP (-5.66 mmHg p = 0.002). No other outcome was significantly affected by these interventions. The available evidence on the effects of tomato products and lycopene supplementation on CV risk factors supports the view that increasing the intake of these has positive effects on blood lipids, blood pressure and endothelial function. These results support the development of promising in idualised nutritional strategies involving tomatoes to tackle CVD.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2014
Publisher: Springer Science and Business Media LLC
Date: 04-10-2015
DOI: 10.1007/S40279-014-0272-9
Abstract: Regular exercise is associated with enhanced nitric oxide (NO) bioavailability. Flow-mediated dilation (FMD) is used widely to assess endothelial function (EF) and NO release. The aims of this systematic review and meta-analysis were to (i) investigate the effect of exercise modalities (aerobic, resistance or combined) on FMD and (ii) determine which exercise and participant characteristics are most effective in improving FMD. We searched the MEDLINE, Embase, Cochrane Library, and Scopus databases for studies that met the following criteria: (i) randomized controlled trials of exercise with comparative non-exercise, usual care or sedentary groups (ii) duration of exercise intervention ≥4 weeks (iii) age ≥18 years and (iv) EF measured by FMD before and after the intervention. Weighted mean differences (WMDs) with 95% confidence interval were entered into a random effect model to estimate the pooled effect of the exercise interventions. All exercise modalities enhanced EF significantly: aerobic (WMD 2.79, 95% CI 2.12-3.45, p = 0.0001), resistance (WMD 2.52, 95% CI 1.11-3.93, p = 0.0001) and combined (WMD 2.07, 95% CI 0.70-3.44, p = 0.003). A dose-response relationship was observed between aerobic exercise intensity and improvement in EF. A 2 metabolic equivalents (MET) increase in absolute exercise intensity or a 10% increase in relative exercise intensity resulted in a 1% unit improvement in FMD. There was a positive relationship between frequency of resistance exercise sessions and improvement in EF (β 1.14, CI 0.16-2.12, p = 0.027). All exercise modalities improve EF significantly and there was a significant, positive relationship between aerobic exercise intensity and EF. Greater frequency, rather than intensity, of resistance exercise training enhanced EF.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.MATURITAS.2014.12.023
Abstract: Aging is associated with changes in resting energy expenditure (REE) and body composition. We investigated the association between age and changes in REE in men and women stratified by body mass index (BMI) categories (normal weight, overweight and obesity). We also examined whether the age-related decline in REE was explained by concomitant changes in body composition and lifestyle factors. Cross-sectional. 3442 adult participants (age range: 18-81 y men/women: 977/2465) were included. The BMI range was 18.5-60.2 kg/m(2). REE was measured by indirect calorimetry in fasting conditions and body composition by bioelectrical impedance. Regression models were used to evaluate age-related changes in REE in subjects stratified by sex and BMI. Models were adjusted for body composition (fat mass, fat free mass), smoking, disease count and physical activity. In unadjusted models, the rate of decline in REE was highest in obese men (slope=-8.7±0.8 kcal/day/year) whereas the lowest rate of decline was observed in normal weight women (-2.9±0.3 kcal/day/year). Gender differences were observed for the age of onset of REE adaptive changes (i.e., not accounted by age related changes in body composition and lifestyle factors). In women, adaptive changes appeared to occur in middle-age (∼47 y) across all BMI groups whereas changes seemed to be delayed in obese men (∼54 y) compared to overweight (∼43 y) and normal weight (∼39 y) men. Sex and BMI influenced the rate and degree of the age-related decline in REE. Critical age windows have been identified for the onset of putative mechanisms of energy adaptation. These findings require confirmation in prospective studies.
Publisher: Springer Science and Business Media LLC
Date: 15-03-2017
DOI: 10.1038/EJCN.2017.24
Abstract: Randomised controlled trials (RCTs) have observed contrasting results on the effects of vitamin C on circulating biomarkers of glycaemic and insulin regulation. We conducted a systematic review and meta-analysis of RCTs testing the effect of vitamin C administration on glucose, HbA1c and insulin concentrations. Four databases (PubMed, Embase, Scopus and Cochrane Library) were used to retrieve RCTs published from inception until April 2016 and testing the effects of vitamin C in adult participants. The screening of 2008 articles yielded 22 eligible studies (937 participants). Overall, vitamin C did not modify glucose, HbA1c and insulin concentrations. However, subgroup analyses showed that vitamin C significantly reduced glucose concentrations (-0.44 mmol/l, 95% CI: -0.81, -0.07, P=0.01) in patients with type 2 diabetes and in interventions with a duration greater than 30 days (-0.53%, 95% CI: -0.79, -0.10, P=0.02). Vitamin C administration had greater effects on fasting (-13.63 pmol/l, 95% CI: -22.73, -4.54, P<0.01) compared to postprandial insulin concentration. Meta-regression analyses showed that age was a modifier of the effect of vitamin C on insulin concentration. Furthermore, the effect size was associated with baseline BMI and plasma glucose levels, and with the duration of the intervention. In conclusion, greater reduction in glucose concentrations observed in patients with diabetes, older in iduals and with more prolonged supplementation. Personalised interventions with vitamin C may represent a feasible future strategy to enhance benefits and efficacy of interventions. Nevertheless, results need to be interpreted cautiously due to limitations in the primary studies analysed.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.ATHEROSCLEROSIS.2014.04.004
Abstract: Observational studies indicate that higher vitamin C intake is associated with reduced risk for cardiovascular diseases. However, randomised controlled trials (RCT) examining the effect of vitamin C on endothelial function (EF) have reported inconsistent results. The aims of this systematic review and meta-analysis were to determine the effect of vitamin C supplementation on EF and to investigate whether the effect was influenced by health status, study duration, dose and route of vitamin C administration. We searched the Medline, Embase, Cochrane Library, and Scopus databases from inception to May 2013 for studies that met the following criteria: 1) RCT with adult participants, 2) vitamin C administered alone, 3) studies that quantified EF using commonly applied methods including ultrasound, plethysmography and pulse wave analysis. Pooling the data from 44 clinical trials showed a significant positive effect of vitamin C on EF (SMD: 0.50, 95% CI: 0.34, 0.66, P < 0.001). Stratification of the analysis by health outcome revealed improved EF in atherosclerotic (SMD: 0.84, 95% CI: 0.41, 1.26, P < 0.001), diabetic (SMD: 0.52, 95% CI: 0.21, 0.82, P < 0.001) and heart failure patients (SMD: 0.48, 95% CI: 0.08, 0.88, P < 0.02) after vitamin C supplementation. The effect size appeared to be unaffected by study design, duration, baseline plasma vitamin C concentration or route of administration of vitamin C. The meta-regression showed a significant positive association between vitamin C dose and improvement in EF (β: 0.00011, 95% CI: 0.00001, 0.00021, P = 0.03). Vitamin C supplementation improved EF. The effect of vitamin C supplementation appeared to be dependent on health status, with stronger effects in those at higher cardiovascular disease risk. PROSPERO Database registration: CRD42013004567, www.crd.york.ac.uk rospero/
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.METABOL.2015.03.011
Abstract: Weight loss (WL) is associated with a decrease in total and resting energy expenditure (EE). We aimed to investigate whether (1) diets with different rate and extent of WL determined different changes in total and resting EE and if (2) they influenced the level of adaptive thermogenesis, defined as the decline in total or resting EE not accounted by changes in body composition. Three groups of six, obese men participated in a total fast for 6 days to achieve a 5% WL and a very low calorie (VLCD, 2.5 MJ/day) for 3 weeks or a low calorie (LCD, 5.2 MJ/day) diet for 6 weeks to achieve a 10% WL. A four-component model was used to measure body composition. Indirect calorimetry was used to measure resting EE. Total EE was measured by doubly labelled water (VLCD, LCD) and 24-hour whole-body calorimetry (fasting). VLCD and LCD showed a similar degree of metabolic adaptation for total EE (VLCD = -6.2% LCD = -6.8%). Metabolic adaptation for resting EE was greater in the LCD (-0.4 MJ/day, -5.3%) compared to the VLCD (-0.1 MJ/day, -1.4%) group. Resting EE did not decrease after short-term fasting and no evidence of adaptive thermogenesis (+0.4 MJ/day) was found after 5% WL. The rate of WL was inversely associated with changes in resting EE (n = 30, r = 0.-42, p=0.01). The rate of WL did not appear to influence the decline in total EE in obese men after 10% WL. Approximately 6% of this decline in total EE was explained by mechanisms of adaptive thermogenesis.
Publisher: Springer Science and Business Media LLC
Date: 07-10-2014
Publisher: Informa UK Limited
Date: 03-07-2015
DOI: 10.1080/17437199.2015.1012177
Abstract: Content, delivery and effects of physical activity (PA) interventions are heterogeneous. There is a need to identify intervention features (content and delivery) related to long-term effectiveness. Behaviour change techniques (BCTs) and modes of intervention delivery were coded in 19 randomised controlled trials included in a systematic review of PA interventions for adults aged 55-70 years, published between 2000 and 2010, with PA outcomes ≥ 12 months after randomisation protocol registration: PROSPERO CRD42011001459. Meta-analysis, moderator analyses and meta-regression were conducted. Meta-analysis revealed that interventions were effective in promoting PA compared with no/minimal intervention comparators [d = 0.29, 95% CI = 0.19-0.40, I(2) = 79.8%, Q-value = 89.16 (df = 18, p < 0.01)]. Intervention features often concurred and goal setting was the most commonly used BCT. Subgroup analyses suggested that interventions using the BCT feedback may be more effective, whilst interventions using printed materials or the BCTs information on where and when to perform the behaviour and information on consequences of behaviour to the in idual may be less effective. Meta-regression revealed that neither the number of BCTs nor self-regulatory BCTs significantly related to effect size. Feedback appears to be a potentially effective candidate BCT for future interventions promoting long-term PA. Considering concurrence of intervention features alongside moderator analyses is important.
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.CLNU.2013.09.009
Abstract: The measurement of resting energy expenditure (REE) is important to assess in idual total energy requirements in older subjects. The validity of REE prediction equations in this population has not been thoroughly evaluated and therefore the main aim of this analysis was to assess the accuracy of REE prediction equations in older subjects. Weight, height and body mass index (BMI) were measured. REE was measured by indirect calorimetry (IC) in 68 older subjects (age: 60-94 years, M/F: 13/55, BMI: 26.3 ± 5.0 kg/m(2)). Measured REE was compared to 14 equations for the calculation of REE estimates. In addition, two novel approaches (Aggregate model and meta-regression equations) for the prediction of REE were evaluated. Paired t test and Bland-Altman method were used to assess the agreement of the equations. The average measured REE was 1298 ± 264 kcal/day. The equation with the smallest bias was proposed by Muller (Bias ± 2SD = +3 ± 294 kcal/day) whereas the Mifflin equation was associated with the largest error (Bias ± 2SD = -172 ± 282 kcal/day). The Aggregate, Muller, Harris-Benedict and Fredrix equations were characterised by a prediction within ±10% of measured REE in more than 60% of subjects. Of the four algorithms, only the Aggregate equation did not show a significant association of the measurement bias with age, BMI and gender. The Aggregate algorithm was characterised by a higher, overall accuracy for the prediction of REE in older subjects and its use should be advocated in older subjects. However, due to the large variability of the estimates, the measurement of REE by IC is still recommended for an accurate assessment of in idual REE.
Publisher: Springer Science and Business Media LLC
Date: 2015
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jose Lara.