'Green' Mediterranean Diet Linked to Aortic Stiffness Reversal

Has your doctor tested your aortic stiffness post stroke? And come up with a solution to reduce that stiffness?

Like this?

First-Time Marathoners Turn Back Clock on Vascular Aging

Maybe something in one of these?

• stiff arteries (11 posts to May 2013)

• Arterial stiffness (24 posts to April 2016) 

  • Aortic stiffness (3 posts to January 2016)

 

Since the Mediterranean Diet has zero specificity this doesn't help at all.

'Green' Mediterranean Diet Linked to Aortic Stiffness Reversal

All healthy diets helped, but one had the biggest impact in post hoc trial analysis

by Crystal Phend, Contributing Editor, MedPage Today April 17, 2023

Aortic stiffness regressed in overweight or dyslipidemic individuals who started a healthy diet, with the biggest benefit from a low-calorie "green" Mediterranean diet, post hoc analysis of a randomized trial showed.

The diet enriched with plant polyphenols and lower in red or processed meat and simple carbohydrates was better than a typical hypocaloric Mediterranean diet or following conventional healthy diet guidelines with regard to proximal aortic stenosis (PAS), reported Iris Shai, RD, PhD, of Ben-Gurion University of the Negev in Beer-Sheva, Israel, and colleagues.

After adjusting for other factors, PAS dropped by 15% over baseline with the green Mediterranean diet compared with 7.3% on the regular healthy Mediterranean diet and 4.8% with the guideline-based diet (-0.15 vs -0.08 and -0.05 raw natural logarithmic m/s, P=0.003 and P=0.032, respectively).

"This study, to our knowledge, is the first to show that PAS might be regressed by maintaining a healthy lifestyle," Shai's group wrote in a research letter in the Journal of the American College of Cardiologyopens in a new tab or window.

Beyond just weight loss, the green Mediterranean diet may have greater influence on PAS, which as a measure of "the aortic stiffness from the ascending to the proximal descending thoracic aorta, is a distinct marker of vascular aging and a sensitive early predictor of cardiovascular morbidity and mortality risk," they added. "Beyond aging, and similarly to atherosclerosis, PAS is sensitive to obesity-related metabolic conditions, specifically metabolic syndrome."

While lifestyle changes are the first line of treatment for obesity and metabolic syndrome, the prior data supporting its impact on PAS regression has rested on studies of intense physical activity.

Prior analyses of the group's DIRECT-PLUS trialopens in a new tab or window, showed greater success of the "green" Mediterranean diet for the primary endpoints of reductions in abdominal fatopens in a new tab or window, hepatic fatopens in a new tab or window, and waist circumferenceopens in a new tab or window over 18 months although the weight loss was similar to the regular Mediterranean diet (-3.9% and -2.7% over baseline).

The researchers thus analyzed the impact on PAS in the 281 participants with a valid baseline PAS. The overall trial included 294 adults age 30 and older with abdominal obesity or dyslipidemia (average age 51, BMI 31.3, 88% men) randomized to 18 months following healthy dietary guidelines, a hypocaloric Mediterranean diet, or hypocaloric "green" Mediterranean diet.

The two Mediterranean diets were to total the same 1,500-1,800 kcal/day for men and 1,200-1,400 kcal/day for women and to include 28 g of walnuts daily. The "green" version of the Mediterranean diet added consumption of 3-4 cups of green tea and a shake made of Wolffia globosa (Mankai, a high-protein aquatic plant also known as duckweed) each day, along with avoidance of processed red meat. All three groups got free gym memberships and instructions for moderate-intensity, largely aerobic physical activity.

PAS started out statistically similar between groups. Between-group differences in change in PAS were adjusted for age, sex, natural log of baseline PAS, change in weight, hypertension, dyslipidemia, diabetes, and baseline and change in mean arterial pressures.

The trial excluded people treated with warfarin because of the high level of vitamin K in the green plant-based shake that would interact with it.

Limitations of the trial included the post hoc exploratory nature of the analysis in a modest-sized trial with three primary and numerous secondary endpoints, which could have led to type I statistical error. The researchers acknowledged that the findings should be considered hypothesis-generating.

Another limitation was the largely male population studied, which the researchers attributed to the "unique" environment for the study. It was conducted among workers at an isolated nuclear research facility in Israel, where a monitored lunch was provided and which had a medical department where most of the clinical and medical measurements and lifestyle-intervention sessions were performed.

• 

  Crystal Phend is a contributing editor at MedPage Today. Follow

Disclosures

The study was funded by grants from the German Research Foundation, the Israel Ministry of Health, and the California Walnuts Commission.

The authors disclosed no relationships with industry.

Primary Source

Journal of the American College of Cardiology

Source Reference: opens in a new tab or windowTsaban G, et al "Effect of lifestyle modification and green Mediterranean diet on proximal aortic stiffness" J Amer Coll Cardiol 2023; DOI: 10.1016/j.jacc.2023.02.032.

First-Time Marathoners Turn Back Clock on Vascular Aging

You'll want this reversal but your doctor will look at the healthy individuals recruited and be able to successfully say this doesn't apply to stroke survivors. That 'get out of jail free' card should be laughed at and DEMAND your doctor provide protocols to get you running again.  Since you will get no help from your doctor you are completely on your own to learn running again. I'd suggest 'Teaching Me to Run' by Tommye-K. Mayer

First-Time Marathoners Turn Back Clock on Vascular Aging

Arterial stiffening cannot be helped by available medications

• by Nicole Lou, Staff Writer, MedPage Today January 07, 2020

Healthy individuals training for their first marathon saw a reversal in age-related aortic stiffening, a known cardiovascular risk factor, researchers found in a prospective study.
After 6 months of unsupervised training for the London Marathon, 138 people demonstrated improved distensibility on cardiac MRI in two levels of the thoracic aorta: the proximal descending aorta (average 9% increase from baseline, P=0.009) and the diaphragmatic descending aorta (16% increase, P=0.002).
This correlates with 4 years regained in "aortic age" given the amount of distensibility known to be lost over time due to aging, reported Charlotte Manisty, MD, of Barts Heart Centre in London, and colleagues in the Journal of the American College of Cardiology.
"If the observed effects of exercise on LAS [large artery stiffening] can be sustained, they could have major effects on the myocardium, kidney, brain, and various other organs, with a potentially broad impact on age-related conditions," commented Julio Chirinos, MD, PhD, of the Hospital of the University of Pennsylvania in Philadelphia.
"Despite its benefits, exercise remains underutilized and challenging to implement on a large scale, both in the general public and in clinical populations. Therefore, there is a need for implementation research aimed at overcoming common barriers to exercise and physical activity," he wrote in an accompanying editorial.
Study participants had no previous marathon experience and were running less than 2 hours a week at baseline. Half of the enrolled cohort were men. Mean age was 37.
Their recommended exercise training regimen consisted of 6 to 13 miles of weekly running before the 2016 and 2017 London Marathons. They had central blood pressure and aortic stiffness evaluated roughly 176 days before and 16 days after finishing the marathon.
Greater reversals in aortic stiffening were observed in older individuals, men, slower runners, and those with higher blood pressure.
"This study emphasizes the importance of lifestyle to modify the aging process, particularly as it appears 'never too late' to gain the benefit as seen in older, slower runners," Manisty's group noted.
Not all thoracic aortic segments showed improved elasticity with marathon training, however, as no change was seen in the ascending aorta in the study.
Marathon training reduced both brachial and aortic systolic blood pressures by 4 mm Hg -- in line with the magnitude achievable on first-line antihypertensive drugs, the investigators reported.
"The improvement in aortic stiffness was both functional due to blood pressure lowering, as well as intrinsic due to structural changes in the descending aorta. This is supported by wave separation analysis, which showed that reflection magnitude was unchanged," they stated.
That the increase in distal descending aortic distensibility was at least partially independent of the change in distending pressure suggests intrinsic changes in the material properties of the aortic wall, rather than changes in loading conditions alone, Chirinos agreed.
Manisty's team acknowledged that the study of healthy marathon-finishers precludes the generalizability of their results to hypertensive individuals and those who didn't complete the marathon.
They also had no information on the intensity, frequency, and type of exercise training undertaken.
A lack of controls also limits the interpretation of the findings, Chirinos said, noting that the finding of a more pronounced reduction in aortic stiffness among certain subgroups appears to be at odds with previous data suggesting less pronounced effects of exercise training on aortic stiffness among hypertensive and older adults.
"As a consequence of its key role in health and disease, LAS imposes a large global burden of age-related morbidity and mortality, which will become increasingly important as competing causes of death (such as atherosclerosis, cancer, and transthyretin amyloidosis) are addressed with more effective prevention and treatment strategies," the editorialist said.
"LAS therefore represents a high-priority therapeutic target that is not addressed by our current pharmacological approaches," he stated.

• Primary Source

  Journal of the American College of Cardiology

  Source Reference: Bhuva AN, et al "Training for a first-time marathon reverses age-related aortic stiffening" J Am Coll Cardiol 2020; DOI: 10.1016/j.jacc.2019.10.045.

• Secondary Source

  Journal of the American College of Cardiology

  Source Reference: Chirinos JA "The run against arterial aging" J Am Coll Cardiol 2020; DOI: 10.1016/j.jacc.2019.11.007.

Combination of physical fitness and aortic stiffness explains rate of memory decline in older people

You'll have to ask your doctor how to prevent aortic stiffness and the protocols needed to get to the levels of physical required for this. 

Combination of physical fitness and aortic stiffness explains rate of memory decline in older people

The rate of decline in certain aspects of memory may be explained by a combination of overall physical fitness and the stiffness of the central arteries, researchers from Swinburne's Centre for Human Psychopharmacology have found.
A study to be published in the Journal of Alzheimer's Disease considers the mechanisms underlying cognitive performance in older people living independently.
Lead author, PhD candidate Greg Kennedy, says that from early adulthood, memory and other aspects of cognition slowly decline, with an increasing risk of developing into dementia in later life.
"Exactly why this occurs is unclear, but research indicates that exercise and physical fitness are protective," Mr Kennedy says. "A healthier, more elastic aorta is also theorized to protect cognitive function, by reducing the negative effects of excessive blood pressure on the brain."

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The study investigated whether fitness was associated with better cognition through a healthier aorta.
Physical fitness and arterial stiffness assessment
One hundred and two people (73 females and 29 males), aged between 60 and 90 years, living independently in aged care communities, were recruited in Melbourne, Australia.
Their fitness was assessed with the Six-Minute Walk test which involved participants walking back and forth between two markers placed 10 meters apart for six minutes.
Only participants who completed the full six minutes were included in the analysis, which assessed the stiffness of their arteries and cognitive performance.
The researchers found that (along with Body Mass Index and sex) the combination of fitness and aortic stiffness explained a third of the variation in performance in working memory in older people.
"People generally are less fit and have stiffer arteries as they age, which seems to explain the difference in memory ability that is usually attributed to 'getting older'," Mr Kennedy says.
Interestingly, physical fitness did not seem to affect central arterial stiffness, however, Mr Kennedy points out that only current fitness was assessed - long-term fitness may be a better predictor of central arterial stiffness, however this has yet to be investigated.
"Unfortunately, there is currently no effective pharmacological intervention that has proven effective in the long term in reducing this decline or staving off dementia," Mr Kennedy says.
"The results of this study indicate that remaining as physically fit as possible, and monitoring central arterial health, may well be an important, cost-effective way to maintain our memory and other brain functions in older age."

Source:

https://www.iospress.nl/ios_news/better-physical-fitness-and-lower-aortic-stiffness-key-to-slower-brain-ageing/

Association of Aortic Stiffness With Cognition and Brain Aging in Young and Middle-Aged Adults

Has your doctor tested your aortic stiffness post stroke? And come up with a solution to reduce that stiffness?

The Framingham Third Generation Cohort Study

1. Matthew P. Pase,
2. Jayandra J. Himali,
3. Gary F. Mitchell,
4. Alexa Beiser,
5. Pauline Maillard,
6. Connie Tsao,
7. Martin G. Larson,
8. Charles DeCarli,
9. Ramachandran S. Vasan,
10. Sudha Seshadri

+ Author Affiliations

1. From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., J.J.H., A.B., S.S.); Framingham Heart Study, MA (M.P.P., J.J.H., G.F.M., A.B., M.G.L., R.S.V., S.S.); Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Victoria, Australia (M.P.P.); Cardiovascular Engineering Inc, Norwood, MA (G.F.M.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Department of Neurology, School of Medicine and Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California Davis, Sacramento (P.M., C.D.); and Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Centre, Boston, MA (C.T.).

1. Correspondence to Matthew P. Pase, Boston University School of Medicine and Framingham Heart Study, 72 E Concord St, B603, Boston, MA 02118. E-mail matthewpase@gmail.com

Abstract

Aortic stiffness is associated with cognitive decline and cerebrovascular disease late in life, although these associations have not been examined in young adults. Understanding the effects of aortic stiffness on the brain at a young age is important both from a pathophysiological and public health perspective. The aim of this study was to examine the cross-sectional associations of aortic stiffness with cognitive function and brain aging in the Framingham Heart Study Third Generation cohort (47% men; mean age, 46 years). Participants completed the assessment of aortic stiffness (carotid–femoral pulse wave velocity), a neuropsychological test battery assessing multiple domains of cognitive performance and magnetic resonance imaging to examine subclinical markers of brain injury. In adjusted regression models, higher aortic stiffness was associated with poorer processing speed and executive function (Trail Making B–A; β±SE, −0.08±0.03; P<0.01), larger lateral ventricular volumes (β±SE, 0.09±0.03; P<0.01) and a greater burden of white-matter hyperintensities (β±SE, 0.09±0.03; P<0.001). When stratifying by age, aortic stiffness was associated with lateral ventricular volume in young adults (30–45 years), whereas aortic stiffness was associated with white-matter injury and cognition in midlife (45–65 years). In conclusion, aortic stiffness was associated with cognitive function and markers of subclinical brain injury in young to middle-aged adults. Prospective studies are needed to examine whether aortic stiffening in young adulthood is associated with vascular cognitive impairment later in life.