Diyet Özellikleri Kardiyovasküler Hastalık İçin Bir Risk Faktörü Olabilir Mi?

Yıl 2023, Cilt: 45 Sayı: 3, 382 - 394, 23.05.2023

Hande Bakırhan , Serap İncedal Irgat

Öz

Diyet paterni kardiyovasküler hastalıklarla ilişkili olabilir. Bu çalışma, diyet örüntüsünün kardiyovasküler hastalıklar için bir risk faktörü olup olmadığını araştırma amacı ile yürütülmüştür. Kardiyovasküler hastalık riskin belirlenmesinde SCORE (Systematic Coronary Risk Evaluation) ve ASCVD (Atherosclerotic Cardiovascular Disease) risk değerlendirme sistemleri kullanılmıştır. Katılımcıların fiziksel aktivite seviyelerinin değerlendirilmesi amacıyla kısa fiziksel aktivite değerlendirme aracı karşılıklı görüşme yolu ile uygulanmıştır. Mevcut diyetin örüntüsünün belirlenmesinde 24 saatlik besin tüketim kayıtları kullanılmış ve enerji ve besin ögeleri alımları değerlendirilmiştir. Çalışmanın bulgularına odaklanıldığında; inaktif olan bireylerin yeterli fiziksel aktivite yapanlara göre yüksek/çok yüksek KVH riskinin 1,46 kat daha yüksek olduğu bulunmuştur (p=0,04). Enerji alımının bir birim artması yüksek/çok yüksek KVH riskini ve 10 yıllık orta/yüksek KVH riskini 1,02 kat (p<0,001), doymuş yağ alımının bir birimlik artması ise 10 yıllık orta/yüksek KVH riskini 1,02 kat artırmaktadır (p=0,04). Karbonhidrat alım yüzdesindeki her bir birimlik artış yüksek/çok yüksek KVH riskini 1,01 kat (p=0,03), 10 yıllık orta/yüksek KVH riskini 1,02 kat artırmakta (p=0,005) iken, protein alım yüzdesindeki her bir birimlik artış yüksek/çok yüksek KVH riskini 0,96 kat azaltmaktadır (p=0,02). Bu çalışma, Türk toplumunda dengeli ve sağlıklı beslenme özelliklerini barındıran diyetin daha düşük KVH riski ile ilişkili olabileceğini ortaya koyan ve diyet özelliklerini bütüncül olarak değerlendiren ilk çalışmadır.

Anahtar Kelimeler

Diyet özellikleri, Kardiyovasküler hastalık riski, Enerji alımı, Besin ögeleri, Dietary characteristics, Cardiovascular disease risk, Energy intake, Nutrients

Can Dietary Characteristics Be a Risk Factor for Cardiovascular Disease?

Öz

Dietary patterns may be related to cardiovascular diseases. This study was conducted with the aim of investigating whether dietary pattern is a risk factor for cardiovascular diseases. SCORE (Systematic Coronary Risk Evaluation) and ASCVD (Atherosclerotic Cardiovascular Disease) risk assessment systems were used to determine cardiovascular disease risk. In order to evaluate the physical activity levels, a short physical activity assessment tool was applied by mutual interview. 24-hour food consumption records were used to determine the pattern of the current diet and energy and nutrients intakes were evaluated. When focusing on the findings; It was found that individuals who are inactive have a 1.46 times higher risk of high/very high CVD than those who do adequate physical activity (p=0.04). One unit increase in energy intake increases the risk of high/very high CVD and 10-year moderate/high CVD risk 1.02 times (p<0.001), while a one-unit increase in saturated fat intake increases the risk of moderate/high CVD at 10 years 1.02 times (p=0.04). Each unit increase in the percentage of carbohydrate intake increases the risk of high/very high CVD by 1.01 times (p=0.03) and the 10-year risk of moderate/high CVD by 1.02 times (p=0.005), while each unit in the percentage of protein intake increases the risk of high/very high CVD by 1.01 times (p=0.03), reduces the risk of high/very high CVD by 0.96 times (p=0.02). This is the first study to holistically evaluate dietary characteristics in a Turkish population and demonstrate that a balanced diet may be associated with a lower CVD risk.

Anahtar Kelimeler

Dietary characteristics, Cardiovascular disease risk, Energy intake, Nutrients

Kaynakça

• 1. Shahdadian F, Saneei P, Milajerdi A, et al. Dietary glycemic index, glycemic load, and risk of mortality from all causes and cardiovascular diseases: a systematic review and dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr 2019; 110:921-937.
• 2. Edwards MK, Crush E, Loprinzi PD. Dietary behavior and predicted 10-year risk for a first atherosclerotic cardiovascular disease event using the pooled cohort risk equations among US adults. Am J Health Promot 2018; 32:1447-1451.
• 3. World Health Organization. “-Fact Sheets-Cardiovascular diseases”, 2021. http://www.who.int/mediacentre/factsheets/fs317/en/ [accessed: 20 Nov 2022].
• 4. Lakka TA, Bouchard C. Physical activity, obesity and cardiovascular diseases. Handb Exp Pharmacol 2005; 170:137-163.
• 5. Milte CM, Thorpe MG, Crawford D, et al. Associations of diet quality with health-related quality of life in older Australian men and women. Exp Gerontol 2015; 64:8-16.
• 6. Jenkins DJA, Dehghan M, Mente A, et al. Glycemic index, glycemic load, and cardiovascular disease and mortality. N Engl J Med 2021; 384:1312-1322.
• 7. Göktaş Z, Dikmen D, Rakıcıoğlu N. Validation of MEDFICTS dietary assessment questionnaire in Turkish population. Public Health Nutr 2022;25:13-17.
• 8. Wong ND, Budoff MJ, Ferdinand K, et al. Atherosclerotic cardiovascular disease risk assessment: An American Society for Preventive Cardiology clinical practice statement. Am J Prev Cardiol 2022; 10:100335
• 9. Ural D. A perspective to lipid lowering therapy after ESC/EAS guidelines for the management of dyslipidaemias and the European guidelines on cardiovascular disease prevention in clinical practice. Arch Turk Soc Cardiol 2012;40:293-297.
• 10. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019; 140:e596-e646
• 11. Marshall AL, Smith BJ, Bauman AE, et al. Reliability and validity of a brief physical activity assessment for use by family doctors. Br J Sports Med 2005;39:294-297.
• 12. World Health Organization. Waist circumference and waist-hip ratio. Report of a WHO Expert Consultation. Geneva, 8-11 December 2008. Web: https://www.who.int/nutrition/publications/obesity/WHO_report_waistcircumference_and_waisthip_ratio/en/. [accessed: 14.06.2022].
• 13. Ben‐Noun LL, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obesity 2001;9:470-477.
• 14. Ashwell M, Gibson S. Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’based on BMI and waist circumference. BMJ Open 2016;6(3): e010159.
• 15. Akman M, Civek S. Dünyada ve Türkiye’de kardiyovasküler hastalıkların sıklığı ve riskin değerlendirilmesi. Jour Turk Fam Phy 2022;13: 21-28
• 16. Saeed A, Saeed A, Abaalkhail B. Estimate patient's 10-years cardiovascular risk using Arteriosclerotic Cardiovascular Disease Tool a cross-sectional study in Al-Harja, Asser, Saudi Arabia, 2021. Am Heart J 2022; 254:238.
• 17. Zibaeenejad F, Mohammadi SS, Sayadi M, et al. Ten-year atherosclerosis cardiovascular disease (ASCVD) risk score and its components among an Iranian population: a cohort-based cross-sectional study. BMC Cardiovasc Disord 2022; 22:1-8.
• 18. Piwońska A, Piotrowski W, Broda G. Ten-year risk of fatal cardiovascular disease in the Polish population and medical care. Results of the WOBASZ study. Kardiol Pol 2010; 68: 677-682.
• 19. Uçar E, Alim NE. Kardiyovasküler hastalıklarda diyet posasının rolü. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi, 2020;3:1-10.
• 20. Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al. Effect of a lifestyle intervention program with energy-restricted Mediterranean diet and exercise on weight loss and cardiovascular risk factors: one-year results of the PREDIMED-Plus Trial. Diabetes Care 2019; 42:777-788.
• 21. Sofi F, Dinu M, Pagliai G, et al. Low-calorie vegetarian versus Mediterranean diets for reducing body weight and improving cardiovascular risk profile: CARDIVEG Study (Cardiovascular Prevention with Vegetarian Diet). Circulation 2018;137:1103-1113.
• 22. Yu E, Malik VS, Hu FB. Cardiovascular disease prevention by diet modification: JACC Health Promotion Series. J Am Coll Cardiol 2018; 72:914-926.
• 23. Bernstein AM, Sun Q, Hu FB, et al. Major dietary protein sources and risk of coronary heart disease in women. Circulation 2010;122:876-883.
• 24. George SM, Ballard-Barbash R, Manson JE, et al. Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance. Am J Epidemiol 2014;180:616-625.
• 25. Wang H, Ye J. Regulation of energy balance by inflammation: common theme in physiology and pathology. Rev Endocr Metab Disord 2015;16:47-54.
• 26. Alfaddagh A, Martin SS, Leucker TM, et al. Inflammation and cardiovascular disease: From mechanisms to therapeutics. Am J Prev Cardiol 2020; 4:100130.
• 27. Guasch-Ferré M, Babio N, Martínez-González MA, et al. Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease. Am J Clin Nutr 2015;102:1563-1573.
• 28. Tuttolomondo A, Simonetta I, Daidone M, et al. Metabolic and vascular effect of the Mediterranean diet. Int J Mol Sci 2019;20:4716.