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The triglyceride/high‐density cholesterol‐lipoprotein (TG/HDL‐c) is a biomarker of cardiovascular events and mortality. In hemodialysis patients, the evidence is controversial. A systematic review was carried out in the Medline, Scopus, Embase, Web of Science, and Pubmed databases to identify the relevant cohort studies on cardiovascular events and mortality in hemodialysis patients the role of TG/HDL‐c as a risk factor. Four cohort‐type studies were evaluated, with a total of 52,579 hemodialysis patients. Three studies conducted in Asian populations and one study in the United States had the highest percentage of the sample (50,673 patients). The elevated TG/HDL‐c ratio is associated with better survival, and there is a consistent gradual inverse association between TG/HDL‐c and mortality in all analysis subgroups. In the decile categorization of the exposure variable, a 21% decrease in the risk of cardiovascular mortality and a 15% decrease in all‐cause mortality in the highest decile compared to the reference group (D10 aHR = 0.79; 95% CI: 0.69–0.91 and D10 aHR = 0.85; 95%CI: 0.78–0.92). Our results show that the TG/HDL‐c ratio is a protective factor for cardiovascular outcomes and mortality in the American population and a risk factor for them in the population from Asia. [ABSTRACT FROM AUTHOR]

Background: South Asians are at higher risk for diabetes (DM) than many other racial/ethnic groups. Circulating metabolites are measurable products of metabolic processes that may explain the aetiology of elevated risk. We characterized metabolites associated with prevalent DM and glycaemic measures in South Asians. Methods: We included 717 participants from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, aged 40–84 years. We used baseline fasting serum for metabolomics and demographic, behavioural, glycaemic data from baseline and at 5 years. We performed LC‐MS untargeted metabolomic and lipidomic analysis with targeted integration of known signals. Individual linear and ordinal logistic regression models were adjusted for age, sex, BMI, diet, exercise, alcohol, smoking and family history of DM followed by elastic net regression to identify metabolites most associated with the outcome. Results: There were 258 metabolites with detectable signal in >98% of samples. Thirty‐four metabolites were associated with prevalent DM in an elastic net model. Predominant metabolites associated with DM were sphingomyelins, proline (OR 15.86; 95% CI 4.72, 53.31) and betaine (OR 0.03; 0.004, 0.14). Baseline tri‐ and di‐acylglycerols [DG (18:0/16:0) (18.36; 11.79, 24.92)] were positively associated with fasting glucose and long‐chain acylcarnitines [CAR 26:1 (−0.40; −0.54, −0.27)] were inversely associated with prevalent DM and HbA1c at follow‐up. Discussion: A metabolomic signature in South Asians may help determine the unique aetiology of diabetes in this high‐risk ethnic group. Future work will externally validate our findings and determine the effects of modifiable risk factors for DM. [ABSTRACT FROM AUTHOR]

Aim: Evidence of the effectiveness of dietetic consultation for the management of cardiovascular disease (CVD) risk factors has not been previously synthesised. A systematic review and four meta‐analyses evaluated the effectiveness of dietetic consultation for lowering blood lipid levels in high‐risk individuals in primary health‐care settings. Methods: Of the 4860 records identified, 10 eligible randomised controlled trials (RCTs, n = 1530) were evaluated for reporting blood lipid outcomes following dietetic consultation (DN)—defined as at least one exclusive individual face‐to‐face consultation with a dietitian and comparators (C)—defined as no nutrition intervention or usual or minimal care provided by physicians and/or nurses. Results: DN groups were effective for lowering blood lipid levels across nine studies reporting total cholesterol (TC) and LDL; and across five of six studies reporting triglycerides (TG). Between‐group differences were not consistently assessed, with significance levels reported in four studies all in favour of DN, P < 0.05. Meta‐analyses for TC and LDL (seven studies) confirmed DN and C groups were equally effective, P > 0.05; and for TG (six studies) DN groups were significantly more effective than C groups, P < 0.05). Conclusions: This review provides RCT evidence that dietetic counselling is effective for lowering TG levels and at least as effective as usual and minimal care for improving cholesterol levels in high‐risk individuals in primary health care. However, more adequate reporting of methods and greater consistency in timing interventions and data collection will enhance the quality of the evidence and increase confidence in the health benefits of dietetic counselling for the management of CVD risk. [ABSTRACT FROM AUTHOR]

Dyslipidaemia is a major risk factor for cardiovascular disease and is only detectable through blood testing, which may not be feasible in resource-poor settings. As dyslipidaemia is commonly associated with excess weight, it may be possible to identify individuals with adverse lipid profiles using simple anthropometric measures. A total of 222 975 individuals from 18 studies were included as part of the Obesity in Asia Collaboration. Linear and logistic regression models were used to assess the association between measures of body size and dyslipidaemia. Body mass index, waist circumference, waist : hip ratio (WHR) and waist : height ratio were continuously associated with the lipid variables studied, but the relationships were consistently stronger for triglycerides and high-density lipoprotein cholesterol. The associations were similar between Asians and non-Asians, and no single anthropometric measure was superior at discriminating those individuals at increased risk of dyslipidaemia. WHR cut-points of 0.8 in women and 0.9 in men were applicable across both Asians and non-Asians for the discrimination of individuals with any form of dyslipidaemia. Measurement of central obesity may help to identify those individuals at increased risk of dyslipidaemia. WHR cut-points of 0.8 for women and 0.9 for men are optimal for discriminating those individuals likely to have adverse lipid profiles and in need of further clinical assessment. [ABSTRACT FROM AUTHOR]

Food fortification is widely used to address the public health problem of nutrient deficiencies. This study's purpose is to assess the lipid profile and nutritional quality of 13 fortified infant flours (FI) collected "in the field" in Africa and Asia after different periods of storage. The lipid content, fatty acid profiles, lipophilic vitamin content, and lipid oxidation state (peroxide values, secondary oxidation products) are determined. Mycotoxins and packaging materials are also characterized. The lipid content averages 9.1 ± 3.5 g/100 g. Fatty acid profiles are dominated by linoleic (43.3 ± 8.8%), oleic (29.5 ± 7.4%), and palmitic acid (17.8 ± 6.7%) and result in an average ω6/ω3 ratio of 12.2 ± 5.9 but with high values for some FI. Very high overages in vitamins A, D, and E are observed in products stored for short periods (1–6 months), whereas FI stored for more than 12 months has insufficient vitamin content. Lipid oxidation is acceptable but for six products presenting excessive peroxide values. Most products are contaminated by low amounts of mycotoxins but only two FI do not abide by the regulation. A strong correlation between peroxide values, hexanal content, and time of storage is observed. Practical Applications: The expiration dates for FI commercialized in low‐income countries should be shortened from 36 to 12 months so as to guarantee their nutritional quality of these functional foods and to abide by the fortified infant flour legislation. Indeed, FI quality significantly decreases over time of storage. The use of high barrier packaging materials must be generalized, although it is a necessary criterion but not sufficient to ensure the long‐term stability of FI. Special attention should be given to reduce lipophilic vitamin overages and to improve their lipid profile, especially the ω6/ω3 ratio, which has to be lower than 15. [ABSTRACT FROM AUTHOR]