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Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 5 June 2025 | Viewed by 11256

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Special Issue Editors

Prof. Dr. Manuel A. Gomez-Marcos

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Guest Editor

Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
Interests: diet; obesity; vascular function; cardiovascular disease
Special Issues, Collections and Topics in MDPI journals

Dr. Marta Gómez-Sánchez

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Guest Editor

Marqués Valdecilla University Hospital, Avda. Valdecilla s/n, 39008 Santander, Spain
Interests: diet; obesity; vascular function; cardiovascular disease

Dr. Leticia Gómez Sánchez

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Guest Editor

Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
Interests: arterial stiffness; vascular aging; lifestyles
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Special Issue Information

Dear Colleagues,

The increase in obesity over the last few decades has become a pandemic in developed countries. This accretion of excess body weight has been related to, in part, the increase in the consumption of micro-processed foods and a decrease in natural foods such as fruits and vegetables. A consequence of this is an elevation in cardiovascular disease, type 2 diabetes and cancer risk. In fact, these chronic diseases are the most common causes of mortality across industrialized countries. Alterations in vascular function are thought to be a primary factor related to poor diet raising cardiovascular morbidity and mortality. Vascular function can be measured non-invasively in several ways, but assessment of pulse wave velocity, aortic waveforms and endothelial function have been recognized as related to obesity-mediated disease risk. However, not all forms of measurement of vascular function, such as CAVI are related to obesity-induced cardiovascular disease. Thus, this Special Issue will collect work that analyzes the relationship between diet and obesity on vascular function in an effort to provide evidence about the role that diet has on raising chronic disease risk. Specifically, this Special Issue will focus on research that analyzes different dietary patterns or components of the diet (macronutrient, micronutrients and vitamins) that are related to vascular function among people with obesity across their lifespan.

Prof. Dr. Manuel A. Gomez-Marcos
Dr. Marta Gómez-Sánchez
Dr. Leticia Gómez Sánchez
Guest Editors

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Keywords

nutrition
diet
cholesterol
lipids
cardiovascular disease
atherosclerosis
heart disease
vascular inflammation
endothelial dysfunction
inflammation
heart disease prevention
dietary interventions
heart-healthy diets
Mediterranean diet
DASH diet in contemporary context
gut microbiota and heart health
nutrients and heart health
dietary patterns
clinical trials in nutrition
diabetes
CVD

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Published Papers (6 papers)

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Research

17 pages, 1646 KiB

Open AccessArticle

Relationship Between Alcohol Consumption and Vascular Structure and Arterial Stiffness in Adults Diagnosed with Persistent COVID: BioICOPER Study

by Silvia Arroyo-Romero, Leticia Gómez-Sánchez, Nuria Suárez-Moreno, Alicia Navarro-Cáceres, Andrea Domínguez-Martín, Cristina Lugones-Sánchez, Olaya Tamayo-Morales, Susana González-Sánchez, Ana B. Castro-Rivero, Marta Gómez-Sánchez, Emiliano Rodríguez-Sánchez, Luis García-Ortiz, Elena Navarro-Matías and Manuel A. Gómez-Marcos

Nutrients 2025, 17(4), 703; https://doi.org/10.3390/nu17040703 - 16 Feb 2025

Viewed by 837

Abstract

Background: The relationship between alcohol consumption and vascular structure and arterial stiffness is not clear, especially in people diagnosed with persistent COVID. The aim of this study was to evaluate how alcohol use is related to vascular structure and arterial stiffness in adults with persistent COVID. Methods: A descriptive cross-sectional study was conducted involving 305 individuals (97 men and 208 women) diagnosed with persistent COVID according to the WHO criteria. Arterial stiffness was assessed by measuring the cardio-ankle vascular index (CAVI) and the brachial-ankle pulse wave velocity (ba-PWV) with a VaSera VS-1500 device, and the carotid-femoral pulse wave velocity (cf-PWV) with a Sphygmocor device. Vascular structure was assessed by measuring carotid intima-media thickness (c-IMT) with a Sonosite Micromax ultrasound unit. Alcohol intake was calculated using a standardized questionnaire and quantified in g/week. Results: Mean alcohol intake was 29 ± 53 g/week (men 60 ± 76 g/w and women 15 ± 27 g/w; p < 0.001). Heavy drinkers showed higher levels of c-IMT, cf-PWV, ba-PWV and CAVI than non-drinkers (p < 0.05). The multinomial regression analysis adjusted for sex and lifestyles showed a positive association between heavy drinking and c-IMT and cf-PWV values (β = 1.08 (95% CI 1.01–1.17); β = 1.37 (95% CI 1.04–1.80); ba-PWV and CAVI figures showed a similar trend, without reaching statistical significance. Conclusions: The results of this study indicate that high alcohol use in patients with persistent COVID is linked to higher c-IMT and cf-PWV figures than in non-drinkers. Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

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11 pages, 527 KiB

Open AccessArticle

Heterogeneity in Health Outcomes in the Strong Hearts, Healthy Communities-2.0 Multilevel Intervention in a Community-Randomized Trial: An Exploratory Study of Moderators

by Chad D. Rethorst, Margaret M. Demment, Seungyeon Ha, Sara C. Folta, Meredith L. Graham, Galen D. Eldridge and Rebecca A. Seguin-Fowler

Nutrients 2024, 16(24), 4353; https://doi.org/10.3390/nu16244353 - 17 Dec 2024

Viewed by 1017

Abstract

Background/Objectives: Multilevel interventions have demonstrated efficacy in improving obesity and other related health outcomes. However, heterogeneity in individual responses indicates the need to identify the factors associated with responses and non-responses to multilevel interventions. The objective of this report is to identify the potential sources of heterogeneity through the exploration of the moderation effects of participant characteristics (sociodemographic and baseline physical/mental health) in the Strong Hearts, Healthy Communities-2.0 (SHHC-2.0) intervention. Methods: SHHC-2.0 is a 24-week multilevel intervention to improve people’s diet and physical activity evaluated using a cluster-randomized, controlled trial design conducted with women aged 40 and older living in rural communities with an elevated risk of cardiovascular disease, defined as having a BMI > 30, or a BMI 25–30 plus < 1 weekly occurrence of 30 min of physical activity during leisure time. Linear mixed models were used to compare the between-group changes in the outcomes (weight, systolic blood pressure, hemoglobin A1c [HbA1c], and triglycerides), with an interaction term included for each potential moderator. Results: Within the sociodemographic characteristics, there were no differences in effectiveness by age, income, or baseline BMI status, but the participants with a high school education or less experienced less weight loss. Among their health history, only a history of hypertension was associated with differential outcomes; those with a history of hypertension demonstrated a greater reduction in systolic blood pressure. The participants with elevated depressive symptoms demonstrated greater weight loss and a greater reduction in the HbA1c level. Conclusions: SHHC-2.0 was effective across a wide range of participants. The identified moderators (i.e., education level) may inform the future tailoring of the SHHC intervention to optimize the outcomes among participant subgroups, while more broadly, our findings can serve to inform the development and dissemination of multilevel interventions. Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

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10 pages, 715 KiB

Open AccessArticle

High Meat Intake and Ferritin Levels in Relation to Cardiovascular Risk Among Individuals with Diabetes in Mongolia

by Narkhajid Galsanjigmed, Munkhuchral Nordog, Altaisaikhan Khasag, Odgerel Tsogbadrakh, Oyuntugs Byambasukh and Otgonbat Altangerel

Nutrients 2024, 16(23), 4245; https://doi.org/10.3390/nu16234245 - 9 Dec 2024

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Abstract

Background/Objectives: Mongolian diets are characterized by high meat consumption, which may contribute to dietary iron intake and influence ferritin levels and cardiovascular risk. Elevated ferritin levels have been associated with inflammation and cardiovascular disease (CVD) risk in various populations; however, the specific effects of high meat intake and ferritin levels on CVD risk in Mongolian individuals with diabetes remain unclear. This study aimed to assess the relationship between meat intake, ferritin levels, and cardiovascular risk markers in a diabetic Mongolian population. Methods: A cross-sectional study was conducted involving 171 Mongolian adults with diabetes. Meat intake was assessed using 24 h dietary recall interviews, and participants were categorized into tertiles of low, medium, and high intake. Blood samples were collected to measure ferritin, lipid profiles, and other CVD markers. The Framingham Risk Score was calculated for each participant. Results: Participants in the highest tertile of meat intake exhibited significantly elevated ferritin levels compared to those in the lower tertiles (275.6 ng/mL vs. 119.6 ng/mL, p = 0.001). Elevated ferritin levels were observed in 40% of participants and were associated with higher LDL cholesterol (3.75 vs. 3.22 mmol/L, p = 0.002), total cholesterol (5.63 vs. 5.2 mmol/L, p = 0.012), and Framingham Risk Scores (13.97 vs. 11.4, p = 0.0001). However, ferritin levels showed no significant association with other cardiovascular or inflammatory markers, including BMI, HbA1c, CRP, and IL-6 (p > 0.05). Mediation analysis revealed that ferritin partially mediated the relationship between meat intake and cardiovascular risk (beta coefficient = 0.539, p = 0.001), though the indirect effect was not statistically significant. Interaction analysis indicated no significant effect modification of meat intake and ferritin levels on cardiovascular risk (p = 0.844). Conclusions: In this diabetic Mongolian population, high meat intake was associated with elevated ferritin levels, which may have reflected dietary iron intake rather than systemic inflammation or increased CVD risk. Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

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10 pages, 288 KiB

Open AccessArticle

Validation of the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in Spanish University Students

by Miguel López-Moreno, Carlos Marchena-Giráldez, Marta Garcés-Rimón, Marta Miguel-Castro and María Teresa Iglesias-López

Nutrients 2024, 16(20), 3492; https://doi.org/10.3390/nu16203492 - 15 Oct 2024

Viewed by 2074

Abstract

Objective: The aim of this study was to explore the factorial structure, psychometric properties and association with anthropometric and clinical variables of the Modified Yale Addiction Scale 2.0 (mYFAS 2.0) in a Spanish university population. Methods: A cross-sectional study of n = 270 university students in Spain was conducted. Variables measured: mYFAS 2.0, Emotional Eater Questionnaire (EEQ), Alcohol Use Disorder Identification Test (AUDIT), Pittsburg Sleep Quality index (PSQI) and Perceived Stress Scale (PSS). In mYFAS 2.0 were performed an Exploratory Factor Analysis (EFA), an Unweight Least Square (ULS), a model fit using comparative fit index (CFI) and nomological validity. Results: EFA revealed that a two-factor structure is the most appropriate in a non-clinical population of Spanish university students. The factors accounted for 18.54% and 16.33% of the variance, and the correlation between them was moderate—0.487 (p < 0.001). This different structure from that reported in the original scale could be derived from the cultural characteristics and intrinsic eating habits of the study population. The correlation matrix reported an inverse association of mYFAS 2.0 with Body Mass Index (BMI). In addition, participants with a BMI below 25 showed a higher mYFAS 2.0 and EEQ score. Conclusions: These results suggest some changes in the psychometric assessment structure of the mYFAS 2.0 in a non-clinical population of university students, as well as the usefulness of this questionnaire to identify individuals with an adequate BMI but with compensatory behaviours that predispose to different eating disorders. Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

18 pages, 1125 KiB

Open AccessArticle

Relationship between the Mediterranean Diet and Vascular Function in Subjects with and without Increased Insulin Resistance

by Marta Gómez-Sánchez, Leticia Gómez-Sánchez, Rocío Llamas-Ramos, Emiliano Rodríguez-Sánchez, Luis García-Ortiz, Ruth Martí-Lluch, María Cortés Rodríguez, Inés Llamas-Ramos and Manuel A. Gómez-Marcos

Nutrients 2024, 16(18), 3106; https://doi.org/10.3390/nu16183106 - 14 Sep 2024

Cited by 1 | Viewed by 1644

Abstract

(1) The main aim of this study was to analyze the relationship of the Mediterranean diet (MD) with vascular function in participants with and without increased insulin resistance (IR) in the Spanish population. A secondary aim was to study differences by gender. (2) Methods: Data were analyzed from 3401 subjects in the EVA, MARK, and EVIDENT studies (mean age = 60 years and 57% men). IR was evaluated with the triglyceride and glucose index (TyG index). TyG index = Ln [(fasting triglyceride mg/dL × fasting glucose mg/dL)/2]. The MD was measured against the MEDAS questionnaire, with the 14 items used in the PREDIMED study. Vascular stiffness was estimated with the brachial–ankle pulse wave velocity (baPWV) and the cardio ankle vascular index (CAVI) using the Vasera VS-1500^®. (3) Results: The mean MEDAS value was 5.82 ± 2.03; (men: 5.66 ± 2.06; women: 6.04 ± 1.99; p < 0.001). MD adherence was 36.8% (men: 34.2%; women: 40.3%; p < 0.001). The mean baPWV value was 14.39 ± 2.78; (men: 14.50 ± 2.65; women: 14.25 ± 2.93; p = 0.005). A baPWV value ≥ 14.5 m/s was found in 43.4% (men: 43.6%; women: 40.0%; p = 0.727). The mean CAVI value was 8.59 ± 1.28; (men: 8.75 ± 1.28; women: 8.37 ± 1.26; p < 0.001). CAVI values ≥ 9 were present in 39.0% (men: 44.4%; women: 31.7%; p < 0.001). The mean value of the TGC/G index was 10.93 ± 1.39; (men: 11.08 ± 1.33; women: 10.73 ± 1.43; p < 0.001). IR was found in 49.9%. The average value of the MD score value was negatively associated with baPWV and CAVI in all groups analyzed (<0.05), except in the group of women with insulin resistance. (4) Conclusions: The results suggest that MD adherence is negatively associated with the vascular stiffness parameters analyzed in all the groups studied except the group of women with insulin resistance. Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

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17 pages, 1392 KiB

Open AccessArticle

No Difference between the Efficacy of High-Nitrate and Low-Nitrate Vegetable Supplementation on Blood Pressure after 16 Weeks in Individuals with Early-Stage Hypertension: An Exploratory, Double-Blinded, Randomized, Controlled Trial

by Dandan Li, Elena Jovanovski, Andreea Zurbau, John Sievenpiper, Davor Milicic, Ahmed El-Sohemy and Vladimir Vuksan

Nutrients 2024, 16(17), 3018; https://doi.org/10.3390/nu16173018 - 6 Sep 2024

Viewed by 3530

Abstract

Dietary inorganic nitrate lowers blood pressure (BP) in healthy individuals through improved nitric oxide (NO) bioavailability. However, there is limited evidence examining the long-term effects of dietary nitrate for managing hypertension. We aimed to determine whether the sustained intake of dietary nitrate improved BP and cardiovascular disease (CVD) risk factors in individuals with early-stage hypertension. The Dietary Nitrate (NO₃) on BP and CVD Risk Factors (DINO₃) Trial was a multi-center, double-blinded, parallel, randomized, controlled trial in participants with elevated BP. Participants were supplemented with high-nitrate (HN) (~400 mg nitrate) or low-nitrate (LN) vegetable powder (~50 mg nitrate) on top of their usual diets for 16 weeks. The primary outcome was office systolic BP at 16 weeks. The secondary outcomes were 24 h ambulatory BP, central BP, heart-rate-corrected augmentation index (AIx75), carotid–femoral pulse wave velocity (cf-PWV), lipids, and high-sensitivity C-reactive protein (hs-CRP). Sixty-six participants were randomized at baseline (39M:27F, age: 51.5 ± 10.8 years, BMI:27.9 ± 3.2 kg/m²). In an intention-to-treat analysis, no differences were observed between HN and LN groups in terms of office systolic BP at 16 weeks (3.91 ± 3.52 mmHg, p = 0.27) or secondary outcomes. In this exploratory study, sustained HN vegetable supplementation did not exhibit more favorable vascular effects than LN vegetable supplementation in individuals with elevated BP. Full article

(This article belongs to the Special Issue Diet, Obesity and Type 2 Diabetes in Cardiovascular Disease)

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