J Lipid Atheroscler.  2019 Sep;8(2):192-203. 10.12997/jla.2019.8.2.192.

Nutritional Therapy for Asian Patients at Risk for Atherosclerotic Cardiovascular Disease

• Lim H
• Kim J
• Kim DY

• KMID: 2458384
• DOI: http://doi.org/10.12997/jla.2019.8.2.192

Abstract

The burden of atherosclerotic cardiovascular disease (ASCVD) remains high worldwide, and its prevalence has increased in Asian countries over the last two decades. The increase in ASCVD may arise from complex interactions between genetic and lifestyle/environmental factors. Abnormal blood cholesterol levels, elevated blood glucose, obesity, elevated blood pressure, smoking, and family history are common risk factors of ASCVD. There is an increased burden of ASCVD in Asian countries, maybe due to rapid economic development and lifestyle changes in these countries. Nutrition is one of the major modifiable risk factors for ASCVD. Despite this, there are insufficient nutritional therapies for prevention and management of ASCVD in Asian patients. There is also a lack of relevant research in Asian populations. In this review, we describe the current nutritional guidelines and the findings from previous landmark studies regarding management and/or prevention of ASCVD. We also summarize the recommendations regarding evidence-based nutrition therapy/management strategies that may be effective in Asian subjects to prevent onset and/or to treat ASCVD.

Keyword

Atherosclerosis; Nutrition therapy; Nutritional management; Asians

MeSH Terms

Asian Continental Ancestry Group*
Atherosclerosis
Blood Glucose
Blood Pressure
Cardiovascular Diseases*
Cholesterol
Economic Development
Humans
Life Style
Nutrition Therapy
Obesity
Prevalence
Risk Factors
Smoke
Smoking
Blood Glucose
Cholesterol
Smoke

Reference

1. Yusuf S, Islam S, Chow CK, Rangarajan S, Dagenais G, Diaz R, et al. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE study): a prospective epidemiological survey. Lancet. 2011; 378:1231–1243.

2. Gopal DP, Usher-Smith JA. Cardiovascular risk models for South Asian populations: a systematic review. Int J Public Health. 2016; 61:525–534.

3. Dodani S. Coronary artery diseases in South Asian immigrants: an update on high density lipoprotein role in disease prevention. J Immigr Minor Health. 2009; 11:415–421.

4. O'Donnell CJ, Elosua R. Cardiovascular risk factors. Insights from Framingham Heart Study. Rev Esp Cardiol. 2008; 61:299–310.

5. Ustulin M, Rhee SY, Chon S, Ahn KK, Lim JE, Oh B, et al. Importance of family history of diabetes in computing a diabetes risk score in Korean prediabetic population. Sci Rep. 2018; 8:15958.

6. Bianchi C, Penno G, Daniele G, Benzi L, Del Prato S, Miccoli R. Optimizing management of metabolic syndrome to reduce risk: focus on life-style. Intern Emerg Med. 2008; 3:87–98.

7. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006; 84:289–298.

8. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 385:117–171.

9. Torres N, Guevara-Cruz M, Velázquez-Villegas LA, Tovar AR. Nutrition and atherosclerosis. Arch Med Res. 2015; 46:408–426.

10. Wang Z, Klipfell E, Bennett BJ, Koeth R, Levison BS, Dugar B, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature. 2011; 472:57–63.

11. Fan J, Song Y, Wang Y, Hui R, Zhang W. Dietary glycemic index, glycemic load, and risk of coronary heart disease, stroke, and stroke mortality: a systematic review with meta-analysis. PLoS One. 2012; 7:e52182.

12. Ravera A, Carubelli V, Sciatti E, Bonadei I, Gorga E, Cani D, et al. Nutrition and cardiovascular disease: finding the perfect recipe for cardiovascular health. Nutrients. 2016; 8:363.

13. Eilat-Adar S, Sinai T, Yosefy C, Henkin Y. Nutritional recommendations for cardiovascular disease prevention. Nutrients. 2013; 5:3646–3683.

14. Abiemo EE, Alonso A, Nettleton JA, Steffen LM, Bertoni AG, Jain A, et al. Relationships of the Mediterranean dietary pattern with insulin resistance and diabetes incidence in the Multi-Ethnic Study of Atherosclerosis (MESA). Br J Nutr. 2013; 109:1490–1497.

15. Nettleton JA, Steffen LM, Ni H, Liu K, Jacobs DR Jr. Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2008; 31:1777–1782.

16. Miller ER 3rd, Erlinger TP, Appel LJ. The effects of macronutrients on blood pressure and lipids: an overview of the DASH and OmniHeart trials. Curr Atheroscler Rep. 2006; 8:460–465.

17. Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L, Lin PH, et al. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med. 2010; 170:126–135.

18. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014; 63:2960–2984.

19. Van Horn L, Carson JA, Appel LJ, Burke LE, Economos C, Karmally W, et al. Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) guidelines: a scientific statement from the American Heart Association. Circulation. 2016; 134:e505–e529.

20. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346:393–403.

21. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344:1343–1350.

22. Orchard TJ, Temprosa M, Barrett-Connor E, Fowler SE, Goldberg RB, Mather KJ, et al. Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP outcomes study. Diabet Med. 2013; 30:46–55.

23. Swain JF, McCarron PB, Hamilton EF, Sacks FM, Appel LJ. Characteristics of the diet patterns tested in the optimal macronutrient intake trial to prevent heart disease (OmniHeart): options for a heart-healthy diet. J Am Diet Assoc. 2008; 108:257–265.

24. Ueshima H, Sekikawa A, Miura K, Turin TC, Takashima N, Kita Y, et al. Cardiovascular disease and risk factors in Asia: a selected review. Circulation. 2008; 118:2702–2709.

25. Eriksen A, Tillin T, O'Connor L, Brage S, Hughes A, Mayet J, et al. The impact of health behaviours on incident cardiovascular disease in Europeans and South Asians--a prospective analysis in the UK SABRE study. PLoS One. 2015; 10:e0117364.

26. Kandula NR, Dave S, De Chavez PJ, Bharucha H, Patel Y, Seguil P, et al. Translating a heart disease lifestyle intervention into the community: the South Asian Heart Lifestyle Intervention (SAHELI) study; a randomized control trial. BMC Public Health. 2015; 15:1064.

27. Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V, et al. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006; 49:289–297.

28. Zhang Y, Mei S, Yang R, Chen L, Gao H, Li L. Effects of lifestyle intervention using patient-centered cognitive behavioral therapy among patients with cardio-metabolic syndrome: a randomized, controlled trial. BMC Cardiovasc Disord. 2016; 16:227.

29. Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet. 2015; 115:1447–1463.

30. Kim D, Yoon SJ, Lim DS, Gong YH, Ko S, Lee YH, et al. The preventive effects of lifestyle intervention on the occurrence of diabetes mellitus and acute myocardial infarction in metabolic syndrome. Public Health. 2016; 139:178–182.

31. Martiniuk AL, Lee CM, Lawes CM, Ueshima H, Suh I, Lam TH, et al. Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. J Hypertens. 2007; 25:73–79.

32. Enas EA, Yusuf S, Mehta J. Meeting of the international working group on coronary artery disease in South Asians. 24 March 1996, Orlando, Florida, USA. Indian Heart J. 1996; 48:727–732.

33. Garvey WT, Garber AJ, Mechanick JI, Bray GA, Dagogo-Jack S, Einhorn D, et al. American Association of Clinical Endocrinologists and American College of Endocrinology position statement on the 2014 advanced framework for a new diagnosis of obesity as a chronic disease. Endocr Pract. 2014; 20:977–989.

34. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2019; 74:1376–1414.

35. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019; 28:40–45.

36. Kinoshita M, Yokote K, Arai H, Iida M, Ishigaki Y, Ishibashi S, et al. Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017. J Atheroscler Thromb. 2018; 25:846–984.

37. Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D, et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet. 2009; 373:1765–1772.

38. Boussageon R, Bejan-Angoulvant T, Saadatian-Elahi M, Lafont S, Bergeonneau C, Kassaï B, et al. Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials. BMJ. 2011; 343:d4169.

39. Korean Diabetes Association. 2015 Treatment Guidelines for Diabetes. 5th ed. Seoul: Korean Diabetes Association;2015.

40. Korean Society of Hypertension. 2018 Korean Society of Hypertension guidelines for the management of hypertension. Seoul: Korean Society of Hypertension;2018.

41. Alshamiri M, Ghanaim MM, Barter P, Chang KC, Li JJ, Matawaran BJ, et al. Expert opinion on the applicability of dyslipidemia guidelines in Asia and the Middle East. Int J Gen Med. 2018; 11:313–322.

42. Thompson KL, Davidson P, Swan WI, Hand RK, Rising C, Dunn AV, et al. Nutrition care process chains: the “missing link” between research and evidence-based practice. J Acad Nutr Diet. 2015; 115:1491–1498.

43. Academy of Nutrition and Dietetics. Nutrition terminology reference manual (eNCPT): dietetics language for nutrition care [Internet]. Cleveland (OH): Academy of Nutrition and Dietetics;2016. accessed on 26 July 2019. Available from: http://ncpt.webauthor.com.

44. Committee for the Korean Guidelines for the Management of Dyslipidemia. 2015 Korean guidelines for the management of dyslipidemia: executive summary (English translation). Korean Circ J. 2016; 46:275–306.

45. Korea Centers for Disease Control and Prevention. Evidence-based recommendations for dyslipidemia in primary care. Osong: Korea Centers for Disease Control and Prevention;2018.

46. Joint committee for guideline revision. 2016 Chinese guidelines for the management of dyslipidemia in adults. J Geriatr Cardiol. 2018; 15:1–29.

47. Li YH, Ueng KC, Jeng JS, Charng MJ, Lin TH, Chien KL, et al. 2017 Taiwan lipid guidelines for high risk patients. J Formos Med Assoc. 2017; 116:217–248.

48. Ministry of Health Malaysia. Management of dyslipidaemia guidelines 2017. 5th ed. Putrajaya: Ministry of Health Malaysia;2017.