Most Read Articles
6 days ago
The choice between nonvitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) for stroke prevention appears to be complex and largely heterogenous across different, countries, a new study has found.
Yesterday
Monotherapy with tenofovir disoproxil fumarate increases virologic response for up to 240 weeks in pretreated patients with hepatitis B virus infection (HBV) who are resistant to entecavir and/or adefovir, a new study has found.
Elvira Manzano, 2 days ago
Long-term treatment with the interleukin-5 receptor alpha-directed cytolytic monoclonal antibody benralizumab led to long-term control of asthma, improvement in pulmonary function, and was safe in patients with severe eosinophilic asthma in the 2-year integrated analysis of the SIROCCO, CALIMA, and ZONDA pivotal studies plus the BORA extension study reported at ATS 2019.
Pearl Toh, 2 days ago
Emerging evidence is showing that the two major new classes of antidiabetic drugs — SGLT2* inhibitors and GLP-1** receptor agonists (RAs) — not only confer cardiovascular (CV) benefits to patients with type 2 diabetes (T2D), they also delay the loss of kidney function among these patients, potentially providing nephrologists with an additional tool in their armamentarium for managing patients with chronic kidney disease (CKD) in the future.

Mediterranean diet reduces pollution-related cardiovascular mortality

Jairia Dela Cruz
11 Feb 2019

Eating foods rich in antioxidant compounds, such as the Mediterranean diet, helps protect against the risk of cardiovascular disease (CVD) mortality associated with long-term exposure to air pollution, according to data from the NIH-AARP Diet and Health Study.

“Mediterranean diet has shown beneficial effects on cardiovascular health, improving blood pressure, endothelial function and lipid profiles while reducing inflammatory responses and oxidative stress. These benefits have been consistently observed in meta-analyses, cohort studies and randomized control trials,” the investigators pointed out. [N Engl J Med 2013:368;1279-1290; Adv Nutr 2014:5;330S-336S; Am J Med 2015:128;229-238]

“Attenuation of the CVD mortality risk associated with air pollution exposure by dietary patterns, as observed here, is therefore consistent with past evidence of oxidative stress as underlying mechanism for air pollution-induced health effects and suggests that a healthful dietary pattern enriched in antioxidant and anti-inflammatory compounds could interact with mechanisms underlying air pollution-induced health effects,” they added.

The current analysis included 548,845 individuals (mean age at study entry, 62.2 years; 59.1 percent male; 41.3 percent overweight). Over 17 years of follow-up, 126,817 participants (23.1 percent) died: 39,532 from all CVD, 22,329 from ischaemic heart disease (IHD), 5,592 from cerebrovascular diseases (CER) and 6,811 from cardiac arrests (CAR).

During the study period, the overall average concentrations of ambient air pollutants were 12.9 μg/m3 for particulate matter (PM2.5) and 13.3 ppb for nitrogen dioxide (NO2). Cox proportional hazards models revealed long-term exposure to PM2.5 to be significantly associated with elevated risks of the following cause-specific mortality outcomes: CVD (hazard ratio [HR], 1.13; 95 percent CI, 1.08–1.18), IHD (HR, 1.16; 1.10–1.23) and CAR (HR, 1.15; 1.03-1.28). [Circulation 2019;doi:10.1161/CIRCULATIONAHA.118.035742]

Long-term NO2 exposure likewise carried increased risks of CVD (HR, 1.06; 1.04–1.08) and IHD (HR, 1.08; 1.05–1.11) mortality.

Of note, following a Mediterranean-style diet modified the observed associations, such that individuals with higher alternative Mediterranean Diet Index scores were at lower risk of both PM2.5/NO2-related CVD and IHD mortality (p<0.01 for interaction).

When specific components of the diet were examined, higher consumption levels of vegetables conferred protective benefits for PM2.5-CVD, PM2.5-IHD, NO2-CVD and NO2-IHD deaths; whole grains for PM2.5-CVD and PM2.5-IHD death; and fruits for NO2-CVD death.

“These results add to a growing body of literature suggesting [that] dietary patterns may help reduce CV events due to air pollution exposure, potentially through augmenting antioxidants and reducing oxidative stress,” the investigators said.

More than 4.2 million people die from air pollution-related diseases every year, which by any measure is an immense global public health burden. According to the World Health Organization, exposure to ambient air pollution is the fifth leading mortality risk factor in the world. [https://www.who.int/newsroom/detail/02-05-2018-9-out-of-10-people-worldwide-breathe-polluted-air-but-morecountries-are-taking-action]

“Thus, in concert with air quality standards and emission control policies to protect … against the most harmful effects of air pollution, individual-level prevention strategies and population-wide policy efforts to promote healthier diets, aimed at countering the oxidative stress induced by air pollution exposure, may provide complementary approaches,” the investigators said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
6 days ago
The choice between nonvitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) for stroke prevention appears to be complex and largely heterogenous across different, countries, a new study has found.
Yesterday
Monotherapy with tenofovir disoproxil fumarate increases virologic response for up to 240 weeks in pretreated patients with hepatitis B virus infection (HBV) who are resistant to entecavir and/or adefovir, a new study has found.
Elvira Manzano, 2 days ago
Long-term treatment with the interleukin-5 receptor alpha-directed cytolytic monoclonal antibody benralizumab led to long-term control of asthma, improvement in pulmonary function, and was safe in patients with severe eosinophilic asthma in the 2-year integrated analysis of the SIROCCO, CALIMA, and ZONDA pivotal studies plus the BORA extension study reported at ATS 2019.
Pearl Toh, 2 days ago
Emerging evidence is showing that the two major new classes of antidiabetic drugs — SGLT2* inhibitors and GLP-1** receptor agonists (RAs) — not only confer cardiovascular (CV) benefits to patients with type 2 diabetes (T2D), they also delay the loss of kidney function among these patients, potentially providing nephrologists with an additional tool in their armamentarium for managing patients with chronic kidney disease (CKD) in the future.