Food Pattern Analysis and Prevalence of Cardiovascular Disease Risk Factors Among Elderly People from Mediterranean Islands

Demosthenes Panagiotakos,Vassiliki Bountziouka,Akis Zeimbekis,Ioanna Vlachou,Evangelos Polychronopoulos 한국식품영양과학회 2007 Journal of medicinal food Vol.10 No.4

The effect of various foods on the development of cardiovascular disease (CVD) has already been investigated.prevalence of CVD risk factors among elderly people from Mediterranean islands (the MEDIS study). During 20052006,300 men and women from Cyprus, 142 from Mitilini, 100 from Samothraki, and 104 from Kefalonia islands (65100 yearsold) were enrolled. CVD risk factors (i.e., hypertension, diabetes, hypercholesterolemia, and obesity) were assessed throughstandard procedures. All participants were asked about their usual frequency of consumption of various foods through a semi-quantitative food frequency questionnaire, and food pattern analysis using the principal components analysis (PCA) methodi.e., a foodpattern (component 1) that was loaded mainly on low-fat products, a high glycemic index and high-fat pattern (component2), a pattern that included consumption of cereals and sweets (component 3), a pattern that was characterized by the intakeof dairy products and fruits (component 4), and a pattern that was characterized by the consumption of alcoholic beverages(component 5). Ordinal logistic regression analysis revealed that component 1, component 3, and component 5 were associ-ated with lower likelihood of having increased burden of CVD (P. .01), irrespective of various potential confounders. Foodburden of CVD risk factors among these people.

Estimating the 10-Year Risk of Cardiovascular Disease and Its Economic Consequences, by the Level of Adherence to the Mediterranean Diet: The ATTICA Study

Demosthenes Panagiotakos,Marietta Sitara,Christos Pitsavos,Christodoulos Stefanadis 한국식품영양과학회 2007 Journal of medicinal food Vol.10 No.2

In this study this traditional diet was assessed in relation to coronary heart disease risk and its economic con-sequences, in a cross-sectional study with economic analysis. From May 2001 to December 2002 we randomly enrolled 1,514adult men and 1,528 women, without any clinical evidence of cardiovascular disease. Adherence to the Mediterranean dietwas ascertained through a food-frequency questionnaire and a special diet score that incorporated the inherent characteristicsof this dietary pattern. The 10-year absolute risk for coronary heart disease was derived from the Framingham equations. Per-sons with a 10-year risk greater than 10% were considered as potential hospitalized patients. The health care cost of hospi-talization due to an event was estimated in 690A??per patient. Of the participants who were “closer” to the Mediterranean diet(i.e., above the median diet score) and of those “away” from this dietary pattern, 4.2% and 39.8%, respectively, had a 10-yearcoronary risk greater than 10% (P. .001). Moreover, participants “closer” to the Mediterranean diet had a 43% (odds ra-tio. 0.57, 95% confidence interval 0.38 to 0.86) lower likelihood of having a 10-year coronary risk greater than 10%, afteradjusting for potential confounders. Total health care cost was estimated to be 336.720A??in those who were “away” and 35.880A??in those who were closer to this diet pattern. Life-years lost due to disability was 6.8 in those who were “away” and0.9 in those “close” to this pattern. The incremental cost-effectiveness ratio was 50.989A??(i.e., the additive health care costdue to an unhealthy diet for each year lost). The implementation of the Mediterranean dietary pattern may lead to an im-provement in life expectancy, a net gain to health, and a reduction in total lifetime costs.

Long-Term Tea Intake is Associated with Reduced Prevalence of (Type 2) Diabetes Mellitus among Elderly People from Mediterranean Islands: MEDIS Epidemiological Study

Demosthenes B. Panagiotakos,Christos Lionis,Akis Zeimbekis,Kyriaki Gelastopoulou,Natassa Papairakleous,Undurti N. Das,Evangelos Polychronopoulos 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.1

Purpose: We sought to evaluate the link between long-term tea intake and prevalence of type 2 diabetes mellitus, in a sample of elderly adults. Materials and Methods: During 2005- 2007, 300 men and women from Cyprus, 142 from Mitilini, 100 from Samothraki, 114 from Kefalonia, 131 from Crete, 150 from Corfu and 103 from Zakynthos (aged 65 to 100 years) were enrolled. Dietary habits (including tea consumption) were assessed through a food frequency questionnaire. Among various factors, fasting blood glucose was measured and prevalence of (type 2) diabetes mellitus was estimated. Results: 54% of the participants reported that they consume tea at least once a week (mean intake 1.6±1.1cup/day). The majority of the participants (98%) reported green or black tea consumption. The participants reported that they consume tea for at least 30 years of their life. After adjusting for various confounders, tea intake was inversely associated with lower blood glucose levels (b±SEM per 1 cup: -5.9±2.6mg/dL, p=0.02). Moreover, multiple logistic regression revealed that moderate tea consumption (1-2 cups/day) was associated with 70% (95% CI 41% to 86%) lower odds of having (type 2) diabetes, irrespective of age, sex, body mass, smoking, physical activity status, dietary habits and other clinical characteristics. Conclusion: The presented findings suggest that long- term tea intake is associated with reduced levels of fasting blood glucose and lower prevalence of diabetes, in a cohort of elderly people living in Mediterranean islands.

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

Notara, Venetia,Panagiotakos, Demosthenes B.,Kogias, Yannis,Stravopodis, Petros,Antonoulas, Antonis,Zombolos, Spyros,Mantas, Yannis,Pitsavos, Christos The Korean Society for Preventive Medicine 2016 Journal of Preventive Medicine and Public Health Vol.49 No.4

Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

Venetia Notara,Demosthenes B. Panagiotakos,Yannis Kogias,Petros Stravopodis,Antonis Antonoulas,Spyros Zombolos,Yannis Mantas,Christos Pitsavos,GREECS Study Investigators 대한예방의학회 2016 Journal of Preventive Medicine and Public Health Vol.49 No.4

Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

Moderate Coffee Consumption Lowers the Likelihood of Developing Left Ventricular Systolic Dysfunction in Post-Acute Coronary Syndrome Normotensive Patients

Christina-Maria Kastorini,Christina Chrysohoou,Demosthenes Panagiotakos,Panagiotis Aggelopoulos,Catherine Liontou,Christos Pitsavos,Christodoulos Stefanadis 한국식품영양과학회 2009 Journal of medicinal food Vol.12 No.1

The aim of the present work was to evaluate the association between coffee consumption and the development of left ventricular systolic dysfunction (LVSD) in patients who had had an acute coronary syndrome. During 2006–2007, 144 male (65 ± 14 years) and 50 female (71 ± 12 years) post-acute coronary syndrome patients who developed LVSD (ejection fraction <40%) after the cardiac event and 129 male (64 ± 12 years) and 51 female (67 ± 10 years) post-acute coronary syndrome patients without LVSD (ejection fraction >50%) were included in the study. Participants were consequently selected. Detailed information regarding their medical records, sociodemographic and anthropometric data, and various psychological and lifestyle characteristics (physical activity, smoking habits, etc.) were recorded. In particular, nutritional habits, including coffee consumption, were evaluated using a semiquantitative food-frequency questionnaire. Multi-adjusted analysis revealed that in normotensive patients coffee consumption of 1–2 cups/day was associated with 88% (95% confidence interval, 0.02–0.84) lower likelihood of developing LVSD and consumption of >3 cups/day with 90% (95% confidence interval, 0.01–0.88) lower likelihood for LVSD, compared with no history of consumption of coffee and after adjusting for various confounders. In contrast, in hypertensive patients coffee consumption of >3 cups/day was associated with 4.5-fold higher likelihood for developing LVSD (95% confidence interval, 0.89–22.58) as compared with no history of coffee consumption. Coffee consumption has opposite effects on the likelihood of developing LVSD in post-acute coronary syndrome patients depending on their blood pressure levels.

The Mediterranean Diet in Cancer Prevention: A Review

Niki Kontou,Theodora Psaltopoulou,Demosthenes Panagiotakos,Meletios A. Dimopoulos,Athena Linos 한국식품영양과학회 2011 Journal of medicinal food Vol.14 No.10

The Mediterranean dietary pattern has a well-established beneficial role in health promotion. Epidemiologic studies reveal the protective role of adherence to this pattern on overall cancer incidence and mortality. This review examines results from prospective cohort, cross-sectional, and case-control studies assessing the role of the Mediterranean diet in cancer prevention. Original research studies that were published in English between 1985 and April 6, 2010, were selected through a computer-assisted literature search (i.e., PubMed and Scopus). From the initial search, 273 papers were selected. After the titles and the abstracts of these papers were read for relevance to this review, 17 studies were selected and are discussed here; 8 had a prospective design, 7 were case-control, 1 was a randomized screening study, and 1 was an interventional study. Although there is a lack of definitive evidence for the association of Mediterranean diet with various types of cancer, a dietary pattern emphasizing the consumption of fruits and vegetables, whole grains, legumes, nuts, seeds, and low-fat dairy products could be highly recommended for all people, and especially those at risk for cancer.

Moderate Coffee Consumption Lowers the Likelihood of Developing Left Ventricular Systolic Dysfunction in Post-Acute Coronary Syndrome Normotensive Patients

Kastorini, Christina-Maria,Chrysohoou, Christina,Panagiotakos, Demosthenes,Aggelopoulos, Panagiotis,Liontou, Catherine,Pitsavos, Christos,Stefanadis, Christodoulos The Korean Society of Food Science and Nutrition 2009 Journal of medicinal food Vol.12 No.1

The aim of the present work was to evaluate the association between coffee consumption and the development of left ventricular systolic dysfunction (LVSD) in patients who had had an acute coronary syndrome. During 2006.2007, 144 male ($65\;{\times}\;14$ years) and 50 female ($71\;{\times}\;12$ years) post-acute coronary syndrome patients who developed LVSD (ejecti fraction 40%) after the cardiac event and 129 male ($64\;{\times}\;12$ years) and 51 female ($67\;{\times}\;10$ years) post-acute coronary syndrome patients without LVSD (ejection fraction >50%) were included in the study. Participants were consequently selected. Detailed information regarding their medical records, sociodemographic and anthropometric data, and various psychological and lifestyle characteristics (physical activity, smoking habits, etc.) were recorded. In particular, nutritional habits, including coffee consumption, were evaluated using a semiquantitative food-frequency questionnaire. Multi-adjusted analysis revealed that in normotensive patients coffee consumption of 1-2 cups/day was associated with 88% (95% confidence interval, 0.02-0.84) lower likelihood of developing LVSD and consumption of >3 cups/day with 90% (95% confidence interval, 0.01-0.88) lower likelihood for LVSD, compared with no history of consumption of coffee and after adjusting for various confounders. In contrast, in hypertensive patients coffee consumption of >3 cups/day was associated with 4.5-fold higher likelihood for developing LVSD (95% confidence interval, 0.89-22.58) as compared with no history of coffee consumption. Coffee consumption has opposite effects on the likelihood of developing LVSD in post-acute coronary syndrome patients depending on their blood pressure levels.

Age-dependent dichotomous effect of superoxide dismutaseAla16Val polymorphism on oxidized LDL levels

George V. Dedoussis,Stavroula Kanoni,Eirini Louizou,Efi Grigoriou,Christina Chrysohoou,Christos Pitsavos,Christodoulos Stefanadis,Demosthenes B. Panagiotakos 생화학분자생물학회 2008 Experimental and molecular medicine Vol.40 No.1

We investigated the association between superoxide dismutase (SOD) Ala16Val polymorphism and the levels of oxidized LDL lipoprotein-C (ox-LDL-C) in two age-different Greek cohorts. Four hundred fifteen middle- aged (n = 147 females: 43.2 ± 13 years, n = 268 males: 43.3 ± 14 years) Caucasian Greek subjects consisted the middle aged cohort. One hundred seventy five elderly (n = 88 females: 79.9 ± 4 years; n = 87 males: 80.6 ± 4 years) were selected from the elderly cohort. Genotype data were obtained for all of them. Multiple linear regression analysis, stratified by gender and adjusted for age, smoking habits and body mass index as covariates, showed higher ox-LDL-C levels for the middle aged men with the Val/Val genotype, compared to the other allele (Ala/Ala and Ala/Val) carriers (65.9 ± 25.7 vs. 55.7 ± 20.5 mg/dl; standardized β coefficient = 0.192, P = 0.012). On the contrary, elderly women with the Val/Val genotype occurred with lower ox-LDL-C levels compared to the Ala/Ala or Ala/Val genotype (74.2 ± 22.1 vs. 86.5 ± 26.6 mg/dl; standardized β coefficient = -0.269, P = 0.015). The same trend was also recorded in elderly men, however without reaching statistical signifi significance (standardized β coefficient = -0.187, P = 0.077). Moreover, elderly men and women with the Ala/Ala or Ala/Val genotype presented higher triglycerides levels compared to Val/Val (women: 145.2 ± 68.7 vs. 114.3 ± 34.3 mg/dl, P = 0.027; men: 147.8 ± 72.4 vs. 103.7 ± 38.0 mg/dl, P = 0.002). Additionally, middle aged men with the Val/Val genotype had higher HDL-C levels compared to the Ala allele carriers. The results suggest that SOD Ala16Val polymorphism is an age-dependent modulator of ox-LDL-C levels in middle-aged men and elderly women. We investigated the association between superoxide dismutase (SOD) Ala16Val polymorphism and the levels of oxidized LDL lipoprotein-C (ox-LDL-C) in two age-different Greek cohorts. Four hundred fifteen middle- aged (n = 147 females: 43.2 ± 13 years, n = 268 males: 43.3 ± 14 years) Caucasian Greek subjects consisted the middle aged cohort. One hundred seventy five elderly (n = 88 females: 79.9 ± 4 years; n = 87 males: 80.6 ± 4 years) were selected from the elderly cohort. Genotype data were obtained for all of them. Multiple linear regression analysis, stratified by gender and adjusted for age, smoking habits and body mass index as covariates, showed higher ox-LDL-C levels for the middle aged men with the Val/Val genotype, compared to the other allele (Ala/Ala and Ala/Val) carriers (65.9 ± 25.7 vs. 55.7 ± 20.5 mg/dl; standardized β coefficient = 0.192, P = 0.012). On the contrary, elderly women with the Val/Val genotype occurred with lower ox-LDL-C levels compared to the Ala/Ala or Ala/Val genotype (74.2 ± 22.1 vs. 86.5 ± 26.6 mg/dl; standardized β coefficient = -0.269, P = 0.015). The same trend was also recorded in elderly men, however without reaching statistical signifi significance (standardized β coefficient = -0.187, P = 0.077). Moreover, elderly men and women with the Ala/Ala or Ala/Val genotype presented higher triglycerides levels compared to Val/Val (women: 145.2 ± 68.7 vs. 114.3 ± 34.3 mg/dl, P = 0.027; men: 147.8 ± 72.4 vs. 103.7 ± 38.0 mg/dl, P = 0.002). Additionally, middle aged men with the Val/Val genotype had higher HDL-C levels compared to the Ala allele carriers. The results suggest that SOD Ala16Val polymorphism is an age-dependent modulator of ox-LDL-C levels in middle-aged men and elderly women.

Acquisition of <i>in vitro</i> and <i>in vivo</i> functionality of Nurr1‐induced dopamine neurons

Park, Chang‐,Hwan,Kang, Jin Sun,Ho Shin, Yeon,Chang, Mi‐,Yoon,Chung, Seungsoo,Koh, Hyun‐,Chul,Zhu, Mei Hong,Bae Oh, Seog,Lee, Yong‐,Sung,Panagiotakos, Georgia,Tabar, Vivian,Stu Federation of American Society for Experimental Bi 2006 The FASEB Journal Vol.20 No.14

<P>Neural precursor cells provide an expandable source of neurons and glia for basic and translational applications. However, little progress has been made in directing naive neural precursors toward specific neuronal fates such as midbrain dopamine (DA) neurons. We have recently demonstrated that transgenic expression of the nuclear orphan receptor Nurr1 is sufficient to drive dopaminergic differentiation of forebrain embryonic rat neural precursors in vitro. However, Nurr1-induced DA neurons exhibit immature neuronal morphologies and functional properties and are unable to induce behavioral recovery in rodent models of Parkinson's disease (PD). Here, we report on the identification of key genetic factors that drive morphological and functional differentiation of Nurr1-derived DA neurons. We show that coexpression of Nurr1, Bcl-XL, and Sonic hedgehog (SHH) or Nurr1 and the proneural bHLH factor Mash1 is sufficient to drive naive rat forebrain precursors into neurons exhibiting the biochemical, electrophysiological, and functional properties of DA neuron in vitro. On transplantation into the striatum of Parkinsonian rats, precursor cells engineered with Nurr1/SHH/Bcl-XL or Nurr1/Mash1 survived in vivo and differentiated into mature DA neurons that can reverse the behavioral deficits in the grafted animals.</P>