Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors

Background: Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors. Methods: Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA). Results: Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: −3.28, 95% C.I.: −5.7 to −0.86), diastolic blood pressure (b: −1.85, 95% C.I.: −3.34 to −0.36), augmentation index (b: −3.17, 95% C.I.:−4.98 to 1.35) and left carotid intima media thickness (b: −0.03, 95% C.I.:−0.06 to −0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10–20% of daily total energy intake (dTEI) was inversely associated with Aix (b: −2.31, 95% C.I.:−4.05 to −0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90). Conclusion: SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health

Dietary Sodium Consumption and 3-Year Progression of Subclinical Arterial Damage in Adults with Cardiovascular Risk Factors

Background/Objectives: Available data regarding associations between sodium (Na) intake and biomarkers of subclinical arterial damage (SAD) are scarce. This study aimed to investigate the possible associations between Na intake and the 3-year progression of SAD in subjects with cardiovascular disease (CVD) risk factors. Methods: Participants underwent CVD risk assessment, vascular assessment [arterial stiffness by pulse wave velocity (PWV), and atheromatosis, as the existence of carotid and/or femoral plaques], anthropometric measurements [at baseline and 3-year follow-up (FU)], and dietary assessment at FU. Results: A total of 675 adults (47.9% males, 55.02 ± 13.79 years) were included. Na daily consumption quartiles (Qs) ranged from very low consumption in Q1 (811.72 ± 241.81 mg) up to twice the recommendations in Q4 (3487.92 ± 1025.92 mg). No statistically significant associations were observed between Na intake and changes in SAD biomarkers, after adjustment for age, sex, presence of hypertension, presence of dyslipidemia, smoking, mean arterial pressure, BMI, chronic inflammatory diseases, and energy intake. The results remained the same, even after the assessment of misreporting and the correction of Na intake. Conclusions: Dietary Na intake was not significantly associated with changes in PWV and carotid or femoral plaques, even in the high Q that was twice as high as the recommended intake. Research in different additional adult cohorts is needed to further investigate whether Na consumption independently affects vascular health. © 2025 by the authors

Current Data on Dietary Sodium, Arterial Structure and Function in Humans: A Systematic Review

Background: Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Worldwide, sodium (Na) intake is almost double international recommendations and has been linked with CVD and death, although in a J-shape manner. Studies regarding dietary Na and major types of SAD may provide pathophysiological insight into the association between Na and CVD. Objectives: Systematic review of data derived from observational and interventional studies in humans, investigating the association between dietary Na with (i) atheromatosis (arterial plaques); (ii) arteriosclerosis (various biomarkers of arterial stiffness); (iii) arterial remodeling (intima–media thickening and arterial lumen diameters). Data sources: Applying the PRISMA criteria, the PubMed and Scopus databases were used. Results: 36 studies were included: 27 examining arteriosclerosis, four arteriosclerosis and arterial remodeling, three arterial remodeling, and two arterial remodeling and atheromatosis. Conclusions: (i) Although several studies exist, the evidence does not clearly support a clinically meaningful and direct (independent from blood pressure) effect of Na on arterial wall stiffening; (ii) data regarding the association of dietary Na with arterial remodeling are limited, mostly suggesting a positive trend between dietary Na and arterial hypertrophy but still inconclusive; (iii) as regards to atheromatosis, data are scarce and the available studies present high heterogeneity. Further state-of-the-art interventional studies must address the remaining controversies

Current Data on Dietary Sodium, Arterial Structure and Function in Humans: A Systematic Review

Background: Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Worldwide, sodium (Na) intake is almost double international recommendations and has been linked with CVD and death, although in a J-shape manner. Studies regarding dietary Na and major types of SAD may provide pathophysiological insight into the association between Na and CVD. Objectives: Systematic review of data derived from observational and interventional studies in humans, investigating the association between dietary Na with (i) atheromatosis (arterial plaques); (ii) arteriosclerosis (various biomarkers of arterial stiffness); (iii) arterial remodeling (intima–media thickening and arterial lumen diameters). Data sources: Applying the PRISMA criteria, the PubMed and Scopus databases were used. Results: 36 studies were included: 27 examining arteriosclerosis, four arteriosclerosis and arterial remodeling, three arterial remodeling, and two arterial remodeling and atheromatosis. Conclusions: (i) Although several studies exist, the evidence does not clearly support a clinically meaningful and direct (independent from blood pressure) effect of Na on arterial wall stiffening; (ii) data regarding the association of dietary Na with arterial remodeling are limited, mostly suggesting a positive trend between dietary Na and arterial hypertrophy but still inconclusive; (iii) as regards to atheromatosis, data are scarce and the available studies present high heterogeneity. Further state-of-the-art interventional studies must address the remaining controversies.</jats:p

Dietary sodium estimation methods: accuracy and limitations of old and new methods in individuals at high cardiovascular risk

AbstractObjective:Accurate and easy to use methods for dietary Na intake estimation in population level are lacking. We aimed at (i) estimating the mean Na intake in the group level using a variety of dietary methods (DM) and urinary methods (UM) and correlating them with 24-h urine collection (24UCol) and (ii) improving the accuracy of the existing DM.Design:The most common DM (three 24-h dietary recalls (24DR) and FFQ) and UM (24UCol and spot urine collection using common equations) were applied. To improve the existing: (i) 24DR, discretionary Na was quantified using salt-related questions or adding extra 15 % in total Na intake and (ii) FFQ, food items rich in Na and salt-related questions were added in the standard questionnaire (NaFFQ).Setting:National and Kapodistrian University of Athens, Greece.Participants:Totally, 122 high cardiovascular risk subjects (56·0 ± 12·6 years; 55·7 % males).Results:Mean 24 h Na excretion (24UNa) was 2810 ± 1304 mg/d. Spot urine methods overestimated the 24UNa (bias range: −1781 to −492 mg) and were moderately correlated to 24UCol (r = 0·469–0·596, P ≤ 0·01). DM underestimated the 24UNa (bias range: 877 to 1212 mg) and were weakly correlated with 24UCol. The improved DM underestimated the 24UNa (bias range: 877 to 923 mg). The NaFFQ presented the smallest bias (−290 ± 1336 mg) and the strongest correlation with 24UCol (r = 0·497, P ≤ 0·01), but wide limits of agreement in Bland–Altman plots (−2909 mg; 2329 mg), like all the other methods did.Conclusions:The existing methods exhibit poor accuracy. Further improvement of the newly developed NaFFQ could be promising for more accurate estimation of mean dietary Na intake in epidemiological studies. Additional validation studies are needed.</jats:sec

Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors

Background: Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors. Methods: Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA). Results: Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: −3.28, 95% C.I.: −5.7 to −0.86), diastolic blood pressure (b: −1.85, 95% C.I.: −3.34 to −0.36), augmentation index (b: −3.17, 95% C.I.:−4.98 to 1.35) and left carotid intima media thickness (b: −0.03, 95% C.I.:−0.06 to −0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10–20% of daily total energy intake (dTEI) was inversely associated with Aix (b: −2.31, 95% C.I.:−4.05 to −0.57) compared to &lt;10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90). Conclusion: SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.</jats:p