The dietary inflammatory index (DII) has emerged as a promising tool associated with the development of cardiovascular risk factors. This systematic review and meta-analysis, developed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines (the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42022323267), aimed to synthesise observational studies that evaluated the association between the DII and indicators of body adiposity and blood pressure in children and adolescents. PubMed/MEDLINE, Embase, LILACS, CINAHL, Web of Science, Scopus and Google Scholar were searched, without time and language restrictions. The methodological quality of the studies and the certainty of the evidence were assessed using the Newcastle–Ottawa scale and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, respectively. The meta-analysis revealed that a higher DII (pro-inflammatory diet) was significantly associated with increased odds of body adiposity, as indicated by body mass index (BMI) (odds ratio [OR] = 1·62; 95% confidence interval [CI] 1·38–1·86), waist circumference (OR = 1·45; 95% CI 1·10–1·81) and the waist-to-height ratio (OR = 1·76; 95% CI 1·38–2·14) in adolescents, compared with those with a lower DII (anti-inflammatory diet). In addition, for every unit increase in the DII, there was a small but significant rise in mean BMI (β = 0·06 kg/m2). The children’s dietary inflammatory index (CDII) showed no association with cardiometabolic risk factors. There were no consistent associations between the DII or CDII and blood pressure. In conclusion, while a pro-inflammatory diet (based on the DII) is linked to body adiposity, additional longitudinal studies are needed to explore these associations, particularly regarding the CDII and blood pressure.

This study was designed to explore the mediating role of serum 25-hydroxyvitamin D (25(OH) D) in Triglyceride–glucose (TyG) index and hypertension (HTN). Study participants were selected from the 2001 to 2018 National Health and Nutrition Examination Survey. Firstly, we estimated the association between TyG index and serum 25(OH)D with HTN using a weighted multivariable logistic regression model and restricted cubic spline. Secondly, we used a generalised additive model to investigate the correlation between TyG index and serum 25(OH)D. Lastly, serum 25(OH)D was investigated as a mediator in the association between TyG index and HTN. There were 14 099 subjects in total. TyG index was positively and linearly associated with HTN risk, while serum 25(OH)D had a U-shaped relationship with the prevalence of HTN. When the serum 25(OH)D levels were lower than 57·464 mmol/l, the prevalence of HTN decreased with the increase of serum 25(OH)D levels. When serum 25(OH)D levels rise above 57·464 mmol/l, the risk of HTN increases rapidly. Based on the U-shaped curve, serum 25(OH)D concentrations were divided into two groups: < 57·464 and ≥57·464 mmol/l. According to the mediation analysis, when serum 25(OH)D levels reached < 57·464 mmol/l, the positive association between the TyG index and incident HTN was increased by 25(OH)D. When serum 25(OH)D levels reached ≥ 57·464 mmol/l, the negative association between the TyG index and incident HTN was increased by 25(OH)D. There was a mediation effect between the TyG index and HTN, which was mediated by 25(OH)D. Therefore, we found that the association between serum 25(OH)D levels and TyG index may influence the prevalence of HTN.

Wearable pressure sensors with high sensitivity, fast response time, and low detection limit have great potential for blood pressure monitoring and early diagnosis of hypertension. This article introduces a piezoresistive pressure sensor based on carbon nanotubes (CNTs), polyaniline (PAni), and fabric (CNT/PAni/fabric) for health monitoring applications. This sensor is made by using two layers of linen fabric coated with CNT and PAni. These layers are placed on a polyester fabric substrate. One of the coated layers has a mesh structure, which increases the sensitivity of the sensor and lowers its detection limit. The CNT/PAni/fabric sensor has a high sensitivity of 2.035 kPa−1 at pressures from 0 to 0.2 kPa, a response time of 290 ms, and a detection limit of 1.5 Pa. These features make it suitable for measuring blood pressure. The results obtained by measuring blood pressure using the pulse transit time method on four people, compared with the values obtained using the digital sphygmomanometer, show a discrepancy ranging between 0.019% and 1.62%. Also, the average error and standard deviation for the sensor measurement in systolic and diastolic pressures are 0.56 ± 0.33 and 0.57 ± 0.46, respectively, which shows that measurement with this sensor can be an alternative to existing devices.

Although research on the relationship between lean body mass and blood pressure (BP) has been inconsistent, most studies reported that measures of lean body mass are associated with a higher risk of hypertension. We explored relationships between body composition (fat and skeletal muscle mass) and BP in 1162 young adult African women. Dual-energy X-ray absorptiometry-derived measures of whole-body, central and arm fat mass were associated with higher systolic and diastolic BP, while leg fat percentage was associated with lower systolic and diastolic BP. However, only the associations with diastolic BP remained after adjusting for appendicular skeletal muscle mass (ASM). ASM was associated with higher systolic and diastolic BP, before and after adjusting for whole-body fat percentage and visceral adipose tissue. While there was no overlap in targeted proteomics of BP and body composition, REN was lower in the elevated BP than the normal BP group and was inversely associated with diastolic BP (false rate discovery adjusted P< 0·050). Several proteins were positively associated with both visceral adipose tissue and ASM (LEP, FABP4, IL6 and GGH) and negatively associated with both visceral adipose tissue and ASM (ACAN, CELA3A, PLA2G1B and NCAM1). NOTCH3, ART3, COL1A1, DKK3, ENG, NPTXR, AMY2B and CNTN1 were associated with lower visceral adipose tissue only, and IGFBP1 was associated with lower ASM only. While the associations between body fat and BP were not independent of skeletal muscle mass, the associations between muscle mass and BP were independent of overall and central adiposity in young adult African women. Future interventions targeting muscle mass should also monitor BP in this population.

Adherence to healthy diet principles and to cardiopreventive medication, both key behaviours in CVD prevention, is known to differ between women and men. Whether these adherence behaviours are differentially related among women and men has never been thoroughly assessed. The objective was to assess gender differences in the association between adherence to healthy diet principles and to cardiopreventive medication in adults free of CVD. This cross-sectional study included 268 women and 204 men from the CARTaGENE cohort (Québec, Canada) who were using antihypertensive and/or cholesterol-lowering medication. Adherence to healthy diet principles was assessed using the Alternate Healthy Eating Index (AHEI, %), calculated from a validated FFQ assessing diet in the 12-month preceding its completion. Medication adherence was assessed using the daily pharmacotherapy possession rate (DPPR, %), calculated from prescription claim data over the same 12-month period. In multivariable-adjusted analyses, an inverse association between AHEI and DPPR was observed among men (βAHEI for 10 % increment in DPPR = –0·65 %; 95 % CI −1·28 %, −0·03 %; P = 0·04), while it tended to be positive among women (β = 0·44 %; 95 % CI −0·11 %, 1·00 %; P = 0·12; Pgender×DPPR = 0·01). The negative association between AHEI and DPPR was stronger among men who never smoked or used cholesterol-lowering medication only. Among women, the positive association was stronger and statistically significant among those with obesity or using ≥ 3 medications simultaneously. Association between adherence to healthy diet principles and to cardiopreventive medication differs between women and men, with men potentially facing greater challenges in achieving optimal complementarity between these two behaviours.

This interventional single-centre prospective open-label study aims to evaluate the effects of a vegan diet, compared with a vegetarian and omnivorous diet, on metabolic parameters, insulin sensitivity, and liver and kidney steatosis in healthy adults. The study included fifty-three omnivorous participants aged 18–40 years, BMI 18–30 kg/m2, without any chronic disease, chronic medication use, active smoking or significant alcohol consumption. All participants were omnivorous at baseline and selected to continue an omnivorous diet or transition to a vegetarian or vegan diet, with follow-up over 6 months. Anthropometric measurements, biochemical parameters and liver and kidney steatosis were assessed at baseline and after six months using MRI-proton density fat fraction. Primary outcomes included changes in liver and kidney steatosis, while secondary outcomes were alterations in anthropometric and biochemical markers. Among fifty-three participants, eighteen followed an omnivorous diet, twenty-one adopted a vegetarian diet and fourteen transitioned to a vegan diet. Dietary interventions did not result in statistically significant changes in BMI, fat mass, fat percentage or muscle mass over 6 months. However, statistically significant improvements in systolic and diastolic blood pressure, favouring the vegan diet, were observed. We aimed to control for potentially confounding variables to ensure the reliability of these findings. We have demonstrated a better decline in steatosis at the lower kidney pole, the total hilus and the Liver 6 index in vegans. We demonstrated that a plant-based diet is associated with improvements in several metabolic parameters and may reduce liver and kidney steatosis.

Propolis, as a by-product of honey production, has shown several beneficial effects on cardiovascular risks in past randomised controlled trials, although the findings are not conclusive. In this review, we intend to evaluate the effects of propolis consumption on cardiovascular risk factors by conducting a meta-analysis. The Web of Science, Medline and Scopus databases were comprehensively searched until September 2023. Eligible studies were identified by screening, and their data were extracted. Weighted mean differences with a 95 % CI for each outcome were estimated using the random-effects model. This meta-analysis revealed that propolis consumption led to a significant decrease in the levels of TAG (weighted mean differences (WMD): –10·44 mg/dl 95 % CI: –16·58, –4·31; P = 0·001), LDL-cholesterol (WMD: –9·31 mg/dl; 95 % CI: –13·50, –5·12 mg; P < 0·001), fasting blood glucose (WMD: –7·30 mg/dl; 95 % CI: –11·58, –3·02; P = 0·001), HbA1c (WMD: –0·32 %; 95 % CI: –0·60, –0·05; P = 0·01), insulin (WMD: –1·36 μU/ml; 95 % CI: –2·36, –0·36; P = 0·007), homeostatic model assessment for insulin resistance (WMD: –0·39; 95 % CI: –0·74, –0·03; P = 0·020) and systolic blood pressure (WMD: –2·24 mmHg 95 % CI: –4·08, –0·39; P = 0·010), compared with the control groups. Furthermore, propolis consumption had a significant increasing effect on HDL-cholesterol levels (WMD: 2·03 mg/dl; 95 % CI: 0·24, 3·83; P = 0·020). In contrast, the consumption of propolis had no significant effect on total cholesterol and diastolic blood pressure levels. This systematic review and dose–response meta-analysis suggested that propolis intake may be effective in cardiometabolic improvement in adults. Further, well-designed studies are required to confirm and elucidate all aspects of these findings.

Perinatal malnutrition is a critical cause of diseases in offspring. Based on the different rates of organ development, we hypothesised that malnutrition at varying early life stages would have a differential impact on cardiovascular disease in middle-aged and older adults. This study sought to assess the long-term impact of exposure to the 1959–1961 Great Chinese Famine (GCF) during early developmental periods on risks of cardiovascular diseases in the late middle-aged offspring. A total 6, 662 individuals, born between 1958 and 1964, were divided into six groups according to the birth date. The generalised line model was used to control age and estimate differences with 95% confidence interval (CI) in blood pressure. Binary logistic regression was applied to evaluate the association between famine exposure and cardiovascular diseases. Compared to the unexposed late middle-aged persons, blood pressure was elevated in the entire gestation exposure group, regardless of postnatal exposure to GCF. Increased blood pressure was also found in the female offspring exposed to GCF during early and middle gestation. The early-childhood exposure was associated with the risk of bradycardia in the offspring. The risks of vertebral artery atherosclerosis were elevated in GCF famine-exposed groups except first trimester exposed group. The chronic influence of GCF in early life periods was specific to the developmental timing window, sexesand organs, suggesting an essential role of interactions among multiple factors and prenatal malnutrition in developmentally “programming” cardiovascular diseases.

The present systematic review and meta-analysis sought to evaluate the effects of conjugated linoleic acid (CLA) supplementation on cardiovascular risk factors in patients at risk of CVD. Relevant studies were obtained by searching the PubMed, SCOPUS and Web of Science databases (from inception to January 2023). Weighted mean differences (WMD) and 95% CI were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods. A pooled analysis of 14 randomised controlled trials (RCT) with 17 effect sizes revealed that CLA supplementation led to significant reductions in body weight (WMD: −0·72 kg, 95% CI: −1·11, −0·33, P < 0·001), BMI (WMD: −0·22 kg/m2, 95% CI: −0·44, −0·00, P = 0·037) and body fat percentage (BFP) (WMD: −1·32 %, 95% CI: −2·24, −0·40, P = 0·005). However, there was no effect on lipid profile and blood pressure in comparison with the control group. In conclusion, CLA supplementation may yield a small but significant beneficial effect on anthropometric indices in patients at risk of CVD. Moreover, CLA seems not to have adverse effects on lipid profiles and blood pressure in patients at risk of CVD. It should be noted that the favourable effects of CLA supplementation on anthropometric variables were small and may not reach clinical importance.

High dietary salt intake is a known risk factor for hypertension. However, Australians continue to consume excessive amounts of salt. The purpose of this study was to identify barriers, enablers and strategies to reduce salt in a sample of Australian adults with hypertension. This was a qualitative study. Participants were asked a set of open-ended questions during focus groups conducted between October 2020 and April 2021. Sessions were recorded and transcribed. Using an inductive approach, the transcript data from the focus groups were thematically analysed. This involved checking accuracy, becoming familiar with the data, coding responses based on questions, identifying themes through common patterns and validating themes by grouping similar questions that represented the data and study aim effectively. Thirty-one adults (55 % females) with high blood pressure participated in the focus group discussions. Participants demonstrated good knowledge of high blood pressure risk factors but lacked an understanding of recommended salt intake levels and sources of hidden salt. Challenges in reducing salt intake included the limited availability of low-salt commercial foods. Participants suggested improved food labelling and the use of technology-based interventions to promote healthier choices. Findings highlight the need for behavioural interventions, policy reforms and collaborations between the government, food industries and health organisations to address high salt intake in the population.

Diet is a contributing factor to CVD risk, but how diet quality changes over the long term and contributes to CVD risk is less well studied. Diet data were analysed from parents and offspring from the Princeton Lipid Research Study (24-h recall in the 1970s; Block FFQ in 1998). Diet quality was assessed using an 8-point Dietary Approaches to Stop Hypertension nutrient-based scoring index, including a new method for scoring in children, as well as examining twelve key macro/micronutrients. Outcomes included blood glucose, blood pressure, serum lipids and BMI. The analysis included 221 parents (39 % male, mean age 38·9 ± 6·5 at baseline and 66·6 ± 6·6 at follow-up) and 606 offspring (45 % male, 11·9 ± 3·2 at baseline and 38·5 ± 3·6 at follow-up). Parents’ Dietary Approaches to Stop Hypertension score increased slightly from baseline to follow-up (1·4 ± 1·0 and 2·1 ± 1·3, respectively, P < 0·001), while offspring remained consistent (1·6 ± 0·9 and 1·6 ± 1·1, respectively, P = 0·58). Overall, the Dietary Approaches to Stop Hypertension score, adjusted for age, race, sex and BMI, was not significantly associated with any examined outcomes. Of the macro/micronutrients at follow-up, saturated and total fat were associated with increased diabetes and dyslipidaemia in parents, while the inverse was seen with niacin. Among offspring, niacin was associated with lower rates of hypertension and dyslipidaemia. In conclusion, no relationship was detected between Dietary Approaches to Stop Hypertension adherence and disease outcomes. However, both saturated fat and niacin were associated with components of CVD risk, highlighting the need for improved diet quality overall.

The Dietary Approaches to Stop Hypertension (DASH) diet is highly effective in controlling blood pressure (BP). Although Na restriction is not a primary focus within the DASH diet, it is recommended that it be added to control BP. Therefore, we aimed to systematically review the characteristics and BP-lowering effects of Na-restricted DASH diet interventions. We searched thirteen databases, namely, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, KoreaMed, KISS, KMbase, RISS, CINAHL, Scopus, ClinicalTrials.gov, Grey Literature Report, OpenGrey and PQDT Global, for articles published through May 2023. The randomised controlled trials assessing the BP-lowering effect of the Na-restricted DASH diet in adults aged 18 years and older were included. The study protocol was registered in the PROSPERO registry (CRD42023409996). The risk of bias in the included studies was also assessed. Nine articles were included in this review. Interventions were categorised into three types: feeding, provision and education, and the study results were compared by intervention type. BP was significantly reduced in two of the three feeding studies, one of the three provisional studies and none of the educational studies. In eight studies, effect sizes varied among both systolic BP (–7·7 to −2·4) and diastolic BP (–8·3 to 0·1). Six studies showed an overall high risk of bias. In conclusion, Na-restricted DASH may have beneficial effects on BP control. Additionally, compared with control interventions, feeding interventions appeared to have a greater BP-lowering effect. Further high-quality studies are needed to improve the quality of the evidence.

Blood pressure (BP) is influenced by both genetics and diet. Dietary management of hypertension includes increasing potassium-rich foods while reducing sodium intakes. Dietary sodium and potassium intakes can be measured objectively using urinary sodium and urinary potassium, with lower urinary sodium to potassium ratios associated with lower BP(1). Understanding the interplay between diet and genetics may be useful in treating hypertension and determining which individuals may receive an outsized benefit from lowering their sodium potassium ratio. This study aims to investigate whether identifying genetic risk for hypertension could be utilised to identify individuals who may benefit most from lowering sodium intake and increasing potassium intake. UK Biobank cohort participants (n = 296,475) with data on genotype, BP and spot urinary sodium and potassium data were used. Diet quality was assessed using Oxford WebQ. Biologically directed genetic scores for BP were constructed for pathways related to sodium/potassium biology (pharmagenic enrichment scores [PES]), as well as traditional polygenic risk scores (PRS). A gene-by-environment effect between urinary electrolytes, diet quality and PRS on BP were tested. Genetic risk, diet quality and urinary electrolytes independently correlated with BP. Urinary sodium had larger BP increasing effects amongst individuals who had high genetic risk in sodium/potassium pathways than those with comparatively lower genetic risk. Higher diet quality had a small effect on reducing BP in baseline PRS models, but this did not remain significant in the full model. Polygenic scores for BP personalised to individual sodium/potassium biology (PES) could be used to identify individuals who may receive an outsized benefit from a personalised sodium/potassium dietary intervention. These findings may inform future precision and personalised dietary advice for the management of hypertension.

Hypertension, characterised by elevated blood pressure (BP), continues to be a major global public health problem. It is defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmH(1) and is the leading risk factor for cardiovascular diseases(2). Nutritional metabolomics (Nutrimetabolomics) presents an objective approach to explore the interplay between diet and health outcomes(3). Through analysis of intermediate molecules and metabolic byproducts, metabolomic profiles can objectively reflect an individual’s dietary intake and assess variations in metabolism(3). To date, no review has been conducted that investigates the relationship between diet, metabolites and BP regulation. This systematic review aimed to identify and synthesise findings of human dietary feeding intervention studies that have examined the role of metabolites in BP regulation. A comprehensive search was conducted in November 2022 across EMBASE, Medline, CINAHL, PsychINFO, Scopus and Cochrane databases. Search terms were defined using a combination of keywords, including “metabolome”, “diet”, and “blood pressure”. All included intervention studies explored the dietary metabolome from food provision, meals or supplements to a comparator or control intervention and, examined the relationship between dietary-related metabolites and BP in humans and published in English. The initial search identified 1,109 studies, with a final six studies meeting all eligibility criteria and included in the final review. Metabolites were identified in urine (n = 4), plasma (n = 2), or faeces (n = 1). Various analytical techniques were employed, including H-NMR, LC-MS, and GC-MS, while majority of studies used untargeted metabolomics (n = 4). Among included studies, five reported a significant association between individual metabolites and BP or change in BP. These investigations emphasised dietary patterns as the primary focus of analysis. In contrast, one study revealed no relationship between the investigated metabolites and BP. However, this particular study evaluated the impact of a single food product rather than dietary patterns. In total, 39 metabolites were linked to BP, with 36 associated with SBP and 25 with DBP. Several super-pathways involved in blood pressure regulation were identified, across metabolism of amino acids, carbohydrates, cofactors, vitamins, lipids, nucleotides, peptides, and xenobiotics. Within these, 17 distinct sub-pathways were delineated. The only metabolite found to have a significant relationship with BP measures across multiple studies was N-Acetylneuraminate. In one study, it showed a relationship with DBP, while another study linked it to a decrease in both 24-hour DBP and SBP. No other metabolites were consistently replicated between studies. Nutrimetabolomics appears to be a promising field in evaluation of diet and BP reduction. However, further research is required to understand which metabolites influence BP regulation.