Andrew W Gardner1, Polly S Montgomery2, Ming Wang3, Biyi Shen3, Ana I Casanegra4, Federico Silva-Palacios5, Allen W Knehans6. 1. Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pa. Electronic address: agardner4@pennstatehealth.psu.edu. 2. Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pa. 3. Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pa. 4. Vascular Medicine Division, Cardiovascular Department, Mayo Clinic, Rochester, Minn. 5. Cardiovascular Section, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. 6. Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Okla.
Abstract
OBJECTIVE: The aims of this investigation were to determine whether the daily dietary intake of nutrients by patients with peripheral artery disease (PAD) and intermittent claudication (IC) met recommended levels for adults older than 50 years and to determine whether meeting recommended levels of nutrients was associated with ankle-brachial index (ABI), inflammation, and ambulation of patients with PAD and IC. METHODS: A total of 48 patients were assessed on their dietary intake of 20 nutrients during a 3-day period. Patients were further characterized on demographic variables, comorbid conditions, cardiovascular risk factors, ABI, 6-minute walk distance (6MWD), and high-sensitivity C-reactive protein (hsCRP) concentration. RESULTS: Few patients met the daily recommended intakes for calcium (4%), fiber (6%), vitamin E (6%), trans fatty acids (13%), vitamin A (15%), total sugars (19%), potassium (23%), sodium (29%), saturated fat (29%), and vitamin C (31%), and none of the patients met the daily recommended intake of vitamin D (0%). Overall, patients met few of the 20 dietary recommendations as the median score was seven recommendations. Only 17 of 48 patients met more than seven of the recommendations. For the ABI regression model adjusted for age, sex, race, smoking, hypertension, dyslipidemia, body mass index, and percentage body fat, the only significant predictor was total sugars (P < .001); patients who did not meet the recommendation had lower ABI values. For the hsCRP-adjusted regression model, the strongest significant predictor was omega-3 polyunsaturated fatty acids (P = .001), indicating that those who did not meet the recommendation had higher hsCRP values. Finally, for the 6MWD-adjusted regression model, folate (P = .011) and dietary score index (P = .014) were significant predictors; those who did not meet the recommendation for folate and those who met 5 or fewer of the 20 recommendations had shorter 6MWD. CONCLUSIONS: Patients with PAD and IC consume a low-nutrient-dense diet that is deficient in many vitamins, calcium, fruits, and vegetables and contains too much added sugar, saturated and trans fats, and processed foods. In addition, more severe PAD, greater inflammation, and ambulatory dysfunction are independently associated with aspects of a low-nutrient-dense diet, such as too much intake of added sugars, low intake of omega-3 polyunsaturated fatty acids and folate, and meeting the recommended intakes of only five or fewer nutrients.
OBJECTIVE: The aims of this investigation were to determine whether the daily dietary intake of nutrients by patients with peripheral artery disease (PAD) and intermittent claudication (IC) met recommended levels for adults older than 50 years and to determine whether meeting recommended levels of nutrients was associated with ankle-brachial index (ABI), inflammation, and ambulation of patients with PAD and IC. METHODS: A total of 48 patients were assessed on their dietary intake of 20 nutrients during a 3-day period. Patients were further characterized on demographic variables, comorbid conditions, cardiovascular risk factors, ABI, 6-minute walk distance (6MWD), and high-sensitivity C-reactive protein (hsCRP) concentration. RESULTS: Few patients met the daily recommended intakes for calcium (4%), fiber (6%), vitamin E (6%), trans fatty acids (13%), vitamin A (15%), total sugars (19%), potassium (23%), sodium (29%), saturated fat (29%), and vitamin C (31%), and none of the patients met the daily recommended intake of vitamin D (0%). Overall, patients met few of the 20 dietary recommendations as the median score was seven recommendations. Only 17 of 48 patients met more than seven of the recommendations. For the ABI regression model adjusted for age, sex, race, smoking, hypertension, dyslipidemia, body mass index, and percentage body fat, the only significant predictor was total sugars (P < .001); patients who did not meet the recommendation had lower ABI values. For the hsCRP-adjusted regression model, the strongest significant predictor was omega-3 polyunsaturated fatty acids (P = .001), indicating that those who did not meet the recommendation had higher hsCRP values. Finally, for the 6MWD-adjusted regression model, folate (P = .011) and dietary score index (P = .014) were significant predictors; those who did not meet the recommendation for folate and those who met 5 or fewer of the 20 recommendations had shorter 6MWD. CONCLUSIONS:Patients with PAD and IC consume a low-nutrient-dense diet that is deficient in many vitamins, calcium, fruits, and vegetables and contains too much added sugar, saturated and trans fats, and processed foods. In addition, more severe PAD, greater inflammation, and ambulatory dysfunction are independently associated with aspects of a low-nutrient-dense diet, such as too much intake of added sugars, low intake of omega-3 polyunsaturated fatty acids and folate, and meeting the recommended intakes of only five or fewer nutrients.
Authors: Andrea Kulezic; Sara Bergwall; Shahab Fatemi; Emily Sonestedt; Moncef Zarrouk; Anders Gottsäter; Stefan Acosta Journal: Vasc Med Date: 2019-08-20 Impact factor: 3.239
Authors: Jonathan Golledge; Anthony Leicht; Robert G Crowther; Paula Clancy; Warwick L Spinks; Francis Quigley Journal: J Vasc Surg Date: 2006-11-21 Impact factor: 4.268
Authors: John S Lane; Cheryl P Magno; Karen T Lane; Tyler Chan; David B Hoyt; Sheldon Greenfield Journal: J Vasc Surg Date: 2008-06-30 Impact factor: 4.268
Authors: Alan T Hirsch; Ziv J Haskal; Norman R Hertzer; Curtis W Bakal; Mark A Creager; Jonathan L Halperin; Loren F Hiratzka; William R C Murphy; Jeffrey W Olin; Jules B Puschett; Kenneth A Rosenfield; David Sacks; James C Stanley; Lloyd M Taylor; Christopher J White; John White; Rodney A White; Elliott M Antman; Sidney C Smith; Cynthia D Adams; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Raymond J Gibbons; Sharon A Hunt; Alice K Jacobs; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: Circulation Date: 2006-03-21 Impact factor: 29.690
Authors: F Gerald R Fowkes; Diana Rudan; Igor Rudan; Victor Aboyans; Julie O Denenberg; Mary M McDermott; Paul E Norman; Uchechukwe K A Sampson; Linda J Williams; George A Mensah; Michael H Criqui Journal: Lancet Date: 2013-08-01 Impact factor: 79.321
Authors: Judith G Regensteiner; William R Hiatt; Joseph R Coll; Michael H Criqui; Diane Treat-Jacobson; Mary M McDermott; Alan T Hirsch Journal: Vasc Med Date: 2008-02 Impact factor: 3.239