Total Antioxidant Capacity from Diet and Risk of Myocardial Infarction

Pentingnya asupan bahan makanan kaya anti-oksidan untuk pencegahan penyakit jantung koroner

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Total Antioxidant Capacity from Diet and Risk of Myocardial Infarction: A Prospective Cohort of Women

Susanne Rautiainen, MSc, Emily B. Levitan, DrPh, Nicola Orsini, PhD et al

The American Journal of Medicine
Volume 125, Issue 10 , Pages 974-980, October 2012

Abstract

Background
There are no previous studies investigating the effect of all dietary antioxidants in relation to myocardial infarction. The total antioxidant capacity of diet takes into account all antioxidants and synergistic effects between them. The aim of this study was to examine how total antioxidant capacity of diet and antioxidant-containing foods were associated with incident myocardial infarction among middle-aged and elderly women.

Methods
In the population-based prospective Swedish Mammography Cohort of 49-83-year-old women, 32,561 were cardiovascular disease-free at baseline. Women completed a food-frequency questionnaire, and dietary total antioxidant capacity was calculated using oxygen radical absorbance capacity values. Information on myocardial infarction was identified from the Swedish Hospital Discharge and the Cause of Death registries. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard models.

Results
During the follow-up (September 1997-December 2007), we identified 1114 incident cases of myocardial infarction (321,434 person-years). In multivariable-adjusted analysis, the HR for women comparing the highest quintile of dietary total antioxidant capacity to the lowest was 0.80 (95% CI, 0.67-0.97; P for trend=0.02). Servings of fruit and vegetables and whole grains were nonsignificantly inversely associated with myocardial infarction.

Conclusions
These data suggest that dietary total antioxidant capacity, based on fruits, vegetables, coffee, and whole grains, is of importance in the prevention of myocardial infarction.

Vegetarian Diets: Five Things to Know

Vegetarian nutrition (VN) evidence based nutrition practice guideline.

Assessing Biochemical Data of Adult, Child and Adolescent Vegetarians

Assessing Vitamin B-12 Status of Adult, Child and Adolescent Vegetarians

• For adult, child and adolescent vegetarians, the RD should assess for dietary adequacy of vitamin B-12 intake. If dietary intake of vitamin B-12 is inadequate, then the RD may recommend using MMA if available, as a functional indicator of deficiency. Two research studies measuring MMA levels showed that LOV/LV [lacto-ovo vegetarian/lacto-vegetarian] or omnivorous adolescents (9 to 15 years) who had followed a very restrictive vegetarian diet (macrobiotic) early in life, may be at risk for vitamin B-12 deficiency (41% of adolescents had MMA >290nmol/L and 21% had MMA >410nmol/L). In addition, research studies showed that the prevalence of vitamin B-12 deficiency among healthy, non-pregnant adult vegetarians ranged from 30% to 86%. When vegans and LOV/LV vegetarians were analyzed separately, vegans had even higher proportions of vitamin B-12 deficiency (43% to 88%). Among children (10 months to 11.7 years) and older adults (>55 years), the prevalence of vitamin B-12 deficiency was 55% to 85% and 46.9% to 68%, respectively.
• Fair, Imperative
• Recommendation Strength Rationale. Conclusion statements are Grades I, III, and Consensus

Assessing Food and Nutrient Intake of Adult Vegetarians

Assessing Micronutrient Intake of Adult Vegetarians

• For adult vegetarians, the RD should assess micronutrient intake, particularly vitamin B-12. Research studies measuring MMA levels showed that the prevalence of vitamin B-12 deficiency among healthy, non-pregnant adult vegetarians ranged from 30% to 86%. When vegans, LOV/LV were analyzed separately, vegans had even higher proportions of vitamin B-12 deficiency (43% to 88%). Among older adults (>55 years), the prevalence of vitamin B-12 deficiency was 46.9% to 68%.
• Fair, Imperative

Micronutrient Intake in Adolescent and Adult Vegetarians During Pregnancy

Micronutrient Intake in Pregnant Adolescent and Adult Vegetarians

• For pregnant adolescent and adult vegetarians, the RD should design a nutrition prescription to ensure the DRI for all micronutrients are met. If unable to meet the DRI for recommended levels of micronutrients, particularly iron, folate and zinc, the RD should recommend supplementation to ensure adequate intake. Research indicates that pregnant vegetarians did not meet dietary requirements for at least one of these micronutrients.
• Fair, Conditional

Vitamin B-12 Intake in Pregnant Adolescent and Adult Vegetarians

• For pregnant adolescent and adult vegetarian or vegan patients or clients, the RD should design a nutrition prescription to ensure vitamin B-12 requirements are met by diet and/or supplementation, including prenatal supplements. Two high quality studies report that lacto-ovo vegetarian pregnant women are less likely than non-vegetarian pregnant women to meet dietary requirements for vitamin B-12 intake, and two high quality studies report that pregnant vegetarians had significantly lower serum B-12 concentrations than pregnant non-vegetarians. In addition, twelve studies measuring MMA levels showed that the prevalence of vitamin B-12 deficiency among healthy, non-pregnant adult vegetarians ranged from 30% to 86%. When vegans and LOV/LV were analyzed separately, vegans had even higher proportions of vitamin B-12 deficiency (43% to 88%).
• Fair, Imperative
• Recommendation Strength Rationale. Conclusion statements are Grades I and III

Hyperlipidemia Treatment with a Vegetarian Diet for Adults

Treating Hyperlipidemia with a Vegetarian Diet for Adults

• If consistent with patient or client preference, the RD may recommend and educate on the benefits of a vegetarian diet for adults seeking treatment to lower total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels, or if appropriate, to reduce weight. Research shows that various types of vegetarian diets (e.g., vegetarian Ornish, Portfolio diet, ovo-lacto vegetarian and vegan) lower TC from 7.2% to 26.6% and lower LDL-C from 8.7% to 35% (with five of the eight studies that provided comparison data showing a decrease between 10% and 20% for both TC and LDL-C). Vegan diets lower both TC and LDL-C more than other types of vegetarian diets.
• Strong, Conditional
• Recommendation Strength Rationale. Conclusion statement is Grade I

Overweight and Obesity Treatment with a Vegetarian Diet for Adults

Treating Overweight and Obesity with a Vegetarian Diet for Adults

• If consistent with patient or client preference, the RD may recommend and educate on the benefits of the therapeutic use of a vegetarian diet for adults seeking treatment for overweight or obesity. Research indicates that the therapeutic use of a vegetarian diet is effective for treating overweight and obesity in both the short term (less than one year) and longer term (greater than one year), and may perform better than alternative omnivorous diets for the same purpose. Percent weight loss ranged from 3.2% to 9.3% at 12 months across studies.
• Strong, Conditional
• Recommendation Strength Rationale. Conclusion statements are Grades I and III

Type 2 Diabetes Treatment with a Vegetarian Diet for Adults

Treating Type 2 Diabetes with a Vegetarian Diet for Adults

• If consistent with patient or client preference, the RD may recommend and educate on the benefits of the therapeutic use of a vegetarian diet for adults seeking treatment for type 2 diabetes. Research indicates that a vegetarian diet may decrease or maintain blood glucose levels; a vegan diet may decrease hemoglobin A1c (A1c) as well as, or better than, an omnivorous diet. Additionally, a vegetarian diet may reduce diabetes-related co-morbidities (e.g., cardiovascular disease, obesity, and hypertension).
• Fair, Conditional
• Recommendation Strength Rationale. Conclusion statements are Grades II and III