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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.05.038 Byline: Anne Kavanagh (a), Rebecca J. Bentley (a), Gavin Turrell (b), Jonathan Shaw (c), David Dunstan (c), S.V. Subramanian (d) Abstract: Socio-economic gradients in cardiovascular disease (CVD) and diabetes have been found throughout the developed world and there is some evidence to suggest that these gradients may be steeper for women. Research on social gradients in biological risk factors for CVD and diabetes has received less attention and we do not know the extent to which gradients in biomarkers vary for men and women. We examined the associations between two indicators of socio-economic position (education and household income) and biomarkers of diabetes and cardiovascular disease (CVD) for men and women in a national, population-based study of 11,247 Australian adults. Multi-level linear regression was used to assess associations between education and income and glucose tolerance, dyslipidaemia, blood pressure (BP) and waist circumference before and after adjustment for behaviours (diet, smoking, physical activity, TV viewing time, and alcohol use). Measures of glucose tolerance included fasting plasma glucose and insulin and the results of a glucose tolerance test (2 h glucose) with higher levels of each indicating poorer glucose tolerance. Triglycerides and High Density Lipoprotein (HDL) Cholesterol were used as measures of dyslipidaemia with higher levels of the former and lower levels of the later being associated with CVD risk. Lower education and low income were associated with higher levels of fasting insulin, triglycerides and waist circumference in women. Women with low education had higher systolic and diastolic BP and low income women had higher 2 h glucose and lower HDL cholesterol. With only one exception (low income and systolic BP), all of these estimates were reduced by more than 20% when behavioural risk factors were included. Men with lower education had higher fasting plasma glucose, 2 h glucose, waist circumference and systolic BP and, with the exception of waist circumference, all of these estimates were reduced when health behaviours were included in the models. While low income was associated with higher levels of 2-h glucose and triglycerides it was also associated with better biomarker profiles including lower insulin, waist circumference and diastolic BP. We conclude that low socio-economic position is more consistently associated with a worse profile of biomarkers for CVD and diabetes for women. Author Affiliation: (a) Centre for Women's Health, Gender & Society, Melbourne School of Population Health, The University of Melbourne, Australia (b) School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia (c) Baker IDI Heart and Diabetes Institute, Caufield, Victoria, Australia (d) Department of Society, Human Development and Health, Harvard School of Public Health, Harvard University, MA, United States

Epidemiologic studies have shown that a low level of high-density lipoprotein (HDL) cholesterol is a risk factor for cardiovascular diseases. The purpose of this study was to determine the contribution of isolated low HDL cholesterol to endothelial function. Thirty-nine subjects with low HDL cholesterol who had no other cardiovascular risk factors were selected from the 5,417 participants from our population. We evaluated flow-mediated vasodilation (FMD) before and after 4 wk of treatment with the HMG-CoA reductase inhibitor pravastatin in 29 of the 39 subjects with isolated low HDL cholesterol. FMD was lower in the low-HDL-cholesterol group (n = 29) than in the control group (n = 29), whereas NTG-induced vasodilation was similar in the two groups. Pravastatin increased HDL cholesterol, urinary excretion of nitrite/nitrate, circulating levels of progenitor cells, and cell migration response to vascular endothelial growth factor in 15 subjects with low HDL cholesterol but not in 14 placebo control subjects. FMD increased in the pravastatin treatment group but not in the control group. NTG-induced vasodilation was similar before and after 4 wk of treatment in the two groups. Multiple regression analysis revealed that changes in HDL cholesterol, the number of progenitor cells, and migration of progenitor cells were independent predictors of augmentation of FMD with pravastatin. These findings suggest that low HDL cholesterol is an independent risk factor for endothelial dysfunction and that pravastatin improves endothelial function in individuals with isolated low HDL cholesterol through, at least in part, an increase in circulating progenitor cells. high-density lipoprotein; 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor doi: 10.1152/ajpendo.00394.2009

Marital status has been recognized as a significant health-influencing factor, including cardiovascular disease (CVD) risk. The aim of the present paper was to evaluate whether eating habits mediate the relationship between marital status and levels of CVD risk factors among apparently healthy men and women from the ATTICA Study. During 2001-2002, we randomly enrolled 1514 men (18-87 years old) and 1528 women (18-89 years old) from the Attica area, Greece; the sampling was stratified by the age-gender distribution of the region. Participants underwent clinical, anthropometric and psychological assessment. Food consumption was assessed through a semi-quantitative food frequency questionnaire. Participants were classified as never married, married, divorced and widowed. Discriminant analysis revealed that vegetable consumption, followed by red meat, potatoes, poultry, and soft drinks were the factors with the higher discriminating ability among the food groups studied. In particular, dietary patterns of never married participants were characterized by the consumption of potatoes and red meat, those of married participants by nuts, legumes and fish, those of divorced participants by fruits, cereals and soft drinks, whereas those of widowed participants by dairy, vegetables, sweets and poultry. In addition, never married and divorced participants reported eating fast-foods more frequently and drink less alcohol compared to married or widowed participants. After controlling for potential confounders (i.e., age, gender, physical activity, anxiety score and smoking habits), the reported marital status of the participants was associated only with body mass index and total serum cholesterol levels. When the analysis was repeated after taking into account the information on dietary habits by creating four 'new' dietary-adjusted marital status groups, no significant association was revealed between marital status and body mass index and blood cholesterol levels. This finding implies that, in our population, eating patterns may explain the observed differences between marital status and selected CVD risk factors. Keywords: Marital status; Cardiovascular disease risk; Eating patterns; Diet; Food groups' consumption; Greece; BMI

Cocoa powder is rich in polyphenols, such as catechins and procyanidins, and has been shown in a variety of subject models to inhibit oxidized LDL and atherogenesis. Our study evaluated plasma LDL cholesterol and oxidized LDL concentrations following the intake of different levels of cocoa powder (13, 19.5, and 26 g/d) in normocholesterolemic and mildly hypercholesterolemic humans. In this comparative, double-blind study, we examined 160 subjects who ingested either cocoa powder containing low-polyphenolic compounds (placebo-cocoa group) or 3 levels of cocoa powder containing high-polyphenolic compounds (13, 19.5, and 26 g/d for low-, middle-, and high-cocoa groups, respectively) for 4 wk. The test powders were consumed as a beverage after the addition of hot water, twice each day. Blood samples were collected at baseline and 4 wk after intake of the test beverages for the measurement of plasma lipids. Plasma oxidized LDL concentrations decreased in the low-, middle-, and high-cocoa groups compared with baseline. A stratified analysis was performed on 131 subjects who had a LDL cholesterol concentrations of [greater than or equal to] 3.23 mmol/L at baseline. In these subjects, plasma LDL cholesterol, oxidized LDL, and apo B concentrations decreased, and the plasma HDL cholesterol concentration increased, relative to baseline in the low-, middle-, and high-cocoa groups. The results suggest that polyphenolic substances derived from cocoa powder may contribute to a reduction in LDL cholesterol, an elevation in HDL cholesterol, and the suppression of oxidized LDL.

Objective: The aim of the study was to evaluate the impact of a low glycaemic index (GI) breakfast on glucose tolerance and lipaemia at a subsequent lunch meal. Design: A low GI spaghetti meal and a high-GI white wheat bread (WWB) reference meal were served in the morning after an overnight fast in random order. Four hours after the breakfast, the subjects were given a second meal--a standardized high-GI lunch--and the blood glucose, insulin and lipid responses were measured after the lunch meal. Setting: The study was performed at the Department of Applied Nutrition and Food Chemistry, Lund University, Sweden. Subjects: Ten healthy volunteers, eight women and two men, aged 25-51 y, with normal body mass indices, were recruited. Results: Lowered glucose and insulin responses and reduced serum triglyceride (TG) level were found at the subsequent lunch meal when the low-GI spaghetti meal was given as a breakfast. No differences in total serum cholesterol or HDL cholesterol were seen after lunch, when preceded by the WWB reference breakfast or the spaghetti breakfast, respectively. Conclusions: Improved glucose tolerance and lowered serum TG levels can appear in the course of a single day. As insulin resistance and raised postprandial TG concentration are known risk factors for cardiovascular disease, the present study adds evidence for a beneficial role of a low-GI diet. Sponsorship: Cerealia Foundation for Research and Development (project no. 232) and the Swedish Council for Forestry and Agricultural Research. Descriptors: second-meal tolerance; glucose and insulin responses; triglycerides; glycaemic index; spaghetti; humans, Introduction Low-glycaemic index (GI) food items that reduce glucose and insulin concentrations over the course of the day are increasingly being discussed as favourable in relation to disorders with the [...]

Byline: Fernando Civeira, Ana Cenarro, Juan Ferrando, Jose Puzo, Angel L. Garcia-Otin, Pilar Mozas, Miguel Pocovi Abstract: Background Type III hyperlipoproteinemia is characterized by the accumulation of chylomicron and very low density lipoprotein (VLDL) remnants. Individuals with this disorder have a high risk of premature atherosclerosis, and hypolipidemic drugs are useful in their management. Methods We compared, in a double-blind, placebo-controlled, randomized crossed study, the effects of gemfibrozil (1200 mg/day) and simvastatin (20 mg/day) on lipids, apolipoprotein AI, apolipoprotein B, and apolipoprotein E and on lipids and apolipoprotein B content in VLDL, intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) in 10 patients with type III hyperlipoproteinemia. Results Levels of total cholesterol, VLDL cholesterol, IDL cholesterol, and apolipoprotein B decreased with both drugs. Larger reductions in triglycerides (109 [+ or -] 28.2 mg/dL, P = .005), VLDL cholesterol (24.7 [+ or -] 10.9 mg/dL, P = .05), and VLDL triglycerides (86.3 [+ or -] 20.2 mg/dL, P = .003) were obtained with gemfibrozil compared with simvastatin. LDL cholesterol reduction was more effective with simvastatin than with gemfibrozil (44.3 [+ or -] 17.1 mg/dL, P = .03). HDL cholesterol after gemfibrozil was 5.71 [+ or -] 2.37 mg/dL higher than after simvastatin. Conclusions In patients with type III hyperlipoproteinemia gemfibrozil is more effective in reducing total triglyceride and VLDL lipid levels than simvastatin, and simvastatin is better in reducing LDL cholesterol than gemfibrozil is. IDL and apolipoprotein E levels were reduced similarly with both drugs. (Am Heart J 1999;138:156-62.) Author Affiliation: Zaragoza and Huesca, Spain From the.sup.aHospital Miguel Servet and.sup.bHospital Royo Villanova,Zaragoza; the Departments of.sup.cMedicine and.sup.dBiochemistry and Molecular Biology, University of Zaragoza; and.sup.eHospital San Jorge, Huesca Article History: Received 13 April 1998; Accepted 24 June 1998 Article Note: (footnote) [star] Supported by Merck, Sharp & Dohme, Spain and grants FIS 97/0010-02 and SAF 96/0264-C02-01 from Spain., [star][star] Reprint requests: Fernando Civeira, MD, Servicio de Medicina Interna, Hospital Miguel Servet, Av. Isabel La Catolica 1-3, 50009, Zaragoza, Spain.E-mail: civeira@posta.unizar.es , a 0002-8703/99/$8.00 + 0 4/1/95068

A randomized, placebo-controlled study was conducted to evaluate the effects of long-term consumption of reduced fat products on blood levels of cholesterol, hemostasis variables, antioxidants and indicators of immune functions among healthy subjects. The results confirmed that regular intake of reduced fat products has no positive nor adverse effects on the blood parameters measured.

The consumption of even five cups of instant coffee in a day raises the levels of cholesterol by only marginal amounts, suggesting that the drinking of coffee has little effect on the cholesterol levels in the serum. High cholesterol in the serum is the major cause of heart disease. The levels of high density lipoprotein cholesterol remain unaffected, indicating that the effect of drinking coffee affects only low and very low density lipoproteins.