Dietary Factors and Changes in Blood Pressure in Adult Kazakhs: A 3-year Follow-Up Study

Authors

  • Raushan Tuleuova Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan https://orcid.org/0000-0002-0964-3841
  • Lazzat Zhamaliyeva Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan https://orcid.org/0000-0003-3625-3651
  • Andrej Grjibovski Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan; Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia; Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia; Department of Health Policy and Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan https://orcid.org/0000-0002-5464-0498

DOI:

https://doi.org/10.3889/oamjms.2022.10287

Keywords:

Blood pressure, Dietary factors, Kazakh population

Abstract

BACKGROUND: As in the world and Kazakhstan’s clinical protocols for the treatment of AH, it is proposed to limit the intake of salt to <5 g/day and alcohol as a dietary therapy, as well as an increase in the consumption of vegetables, fresh fruits, fish, nuts, and sources of unsaturated fatty acids, to reduce the consumption of meat as a source of saturated fatty acids (SFA); consumption of low-fat dairy products. However, it remains unclear how the traditional diet of Kazakhs, which is dominated by sources of carbohydrates and fats with its subspecies, affects the development of AD in the Kazakh population. Local epidemiological and clinical data are required for the successful work of doctors with the population in the prevention of diseases of the blood circulatory system and the creation of clinical recommendations.

AIM: The aim of this investigation was to evaluate an influence of fats, its subspecies, and carbohydrates on BP change after 3-year observation of adult Kazakhs.

MATERIALS AND METHODS: There is described data of 96 individuals of the Kazakh population recruited by the cluster method, living in Aktobe, the Republic of Kazakhstan. Clusters were 14 polyclinics in Aktobe, of which three outpatient municipal polyclinics were randomly selected, each of which had one attached site. From the list of attached adults, also randomly selected 96 people without a history of cardiovascular events.

RESULTS: Average age of participants of the study was 61.9 ± 10.8. None of the participants had a special diets or food restrictions for health reasons or personal beliefs. Body mass index was 27.1 ± 8.4. The over half of the study participants practice on smoking. The average level of SBP in the study’s participants was initially 124.6 mmHg, after 3 years, it increased by an average of 8.6 mmHg and became 133.2, the average level of DBP was 82.2 mmHg, which became higher by 6.2 mmHg and became 88.4 mmHg. According to the regression analysis, higher consumption of carbohydrates, MUFAs, SFAs, and total fats increased SBP by 9.3, 12.3, 46.1, and 5.3 mmHg, respectively. However, with the use of PUFAs, an inverse relationship was found, an increase in PUFA sources in the diet by 100 g reduces SBP by 43.3 mmHg. An effect of all nutrients was not significantly reduced at 3 years on SBP when adjusted for age, sex, and waist circumference.

CONCLUSION: In accordance with the performed analysis in this cohort of subjects, that a significant percentage of these people are overweight or obese, the diet of the Kazakh population does not differ from the eating habits of residents of other countries. The examined individuals received an excess amount of energy from carbohydrates, fat, and SFA, an irrational diet was significantly correlated with an increase in blood pressure.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

World Health Organization. Hypertension. Geneva: World Health Organization; 2020. Available from: https://www.who.int/health-topics/hypertension/#tab=tab_1 [Last accessed on 2020 Nov 13].

Davletov K, McKee M, Berkinbayev S, Battakova Z, Vujnovic M, Rechel B. Regional differences in cardiovascular mortality in Kazakhstan: Further evidence for the ‘Russian mortality paradox’? Eur J Public Health. 2015;25(5):890-4. https://doi.org/10.1093/eurpub/ckv019 PMid:25745082

Mehlum MH, Liestol K, Kjeldsen SE, Julius S, Hua TA, Rothwell PM, et al. Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks. Eur Heart J. 2018;39(24):2243-51. https://doi.org/10.1093/eurheartj/ehx760 PMid:29365085

GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the global burden of disease study 2017. Lancet. 2018;392(10159):1789-858. https://doi.org/10.1016/S0140-6736(18)32279-7 PMid:30496104

Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl J. Effect of lower sodium intake on health outcomes: Systematic review and meta-analysis. Br Med J. 2013;346:f1326. https://doi.org/10.1136/bmj.f1326 PMid:23558163

Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010;91(3):535-46. https://doi.org/10.3945/ajcn.2009.27725 PMid:20071648

Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2020;8(8):CD011737. https://doi.org/10.1002/14651858.CD011737.pub3 PMid:32827219

Yarosh M, Klosevich-Latoshek L. Diagnosis of Eating Disorders in Medical and Nursing Practice. Warsaw: Kharzhevska; 2010. p. 1-25.

Li G, Zhang P, Wang J, An Y, Gong Q, Gregg EW, et al. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing diabetes prevention study: A 23-year follow-up study. Lancet Diabetes Endocrinol. 2014;2:474-80. https://doi.org/10.1016/s2213-8587(14)70057-9 PMid:24731674

Li J, Zheng H, Du HB, Tian XP, Jiang YJ, Zhang SL, et al. The multiple lifestyle modification for patients with prehypertension and hypertension patients: A systematic review protocol. BMJ Open. 2014;4(8):e004920. https://doi.org/10.1136/bmjopen-2014-004920 PMid:25125478

Tsao CW, Vasan RS. Cohort profile: The framingham heart study (FHS): Overview of milestones in cardiovascular epidemiology. Int J Epidemiol. 2015;44(6):1800-13. https://doi.org/10.1093/ije/dyv337 PMid:26705418

Taveras EM, Blaine RE, Davison KK, Gortmaker S, Anand S, Falbe J, et al. Design of the massachusetts childhood obesity research demonstration (MA-CORD) study. Child Obes. 2015;11(1):11-22. https://doi.org/10.1089/chi.2014.0031 PMid:25469676

Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: A meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77:1146-55. https://doi.org/10.1093/ajcn/77.5.1146 PMid:12716665

Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: A fresh look at the evidence. Lipids. 2010;45:893-905. https://doi.org/10.1007/s11745-010-3393-4 PMid:20354806

Mensink RP. Effects of stearic acid on plasma lipid and lipoproteins in humans. Lipids. 2005;40(12):1201-5. https://doi.org/10.1007/s11745-005-1486-x PMid:24129260

Kris-Etherton PM. AHA science advisory. Monounsaturated fatty acids and risk of cardiovascular disease. American heart association. Nutrition committee. Circulation. 1999;100:1253-8. https://doi.org/10.1161/01.cir.100.11.1253 PMid:10484550

Schwingshackl L, Strasser B, Hoffmann G. Effects of monounsaturated fatty acids on cardiovascular risk factors: A systematic review and meta-analysis. Ann Nutr Metab. 2011;59(2-4):176-86. https://doi.org/10.1159/000334071 PMid:22142965

Gillingham LG, Harris-Janz S, Jones PJ. Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors. Lipids. 2011;46(3):209-28. https://doi.org/10.1159/000334071 PMid:21308420

Huth PJ, Fulgoni VL, Keast DR, Park K, Auestad N. Major food sources of calories, added sugars, and saturated fat and their contribution to essential nutrient intakes in the U.S. diet: Data from the national health and nutrition examination survey (2003-2006). Nutr J. 2013;12:116. https://doi.org/10.1186/1475-2891-12-116 PMid:23927718

Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition. 2015;31(1):1-13. https://doi.org/10.1016/j.nut.2014.06.011 PMid:25287761

Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KH, MacLeod J, et al. Nutrition therapy for adults with diabetes or prediabetes: A consensus report. Diabetes Care. 2019;42(5):731-54. https://doi.org/10.2337/dci19-0014 PMid:31000505

Chakraborty S, Mandal J, Yang T, Cheng X, Yeo JY, McCarthy CG, et al. Metabolites and hypertension: Insights into hypertension as a metabolic disorder: 2019 harriet dustan award. Hypertension. 2020;75(6):1386-96. https://doi.org/10.1161/hypertensionaha.120.13896 PMid:32336227

Martinez-Martos JM, Ramirez-Exposito MJ. Dietary fat and hypertension: A novel approach through the proteolytic regulatory enzymes of the renin-angiotensin-system. Cardiovasc Hematol Agents Med Chem. 2006;4(3):263-76. https://doi.org/10.2174/187152506777698308 PMid:16842210

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2224-60. https://doi.org/10.3410/f.719894684.793533485 PMid:23245609

Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore H, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 2011;5(7):CD002137. https://doi.org/10.1002/14651858.cd002137.pub2 PMid:21735388

Imamura F, Micha R, Wu JH, de Oliveira Otto MC, Otite FO, Abioye AI, et al. Effects of saturated fat, polyunsaturated fat, monounsaturated fat, and carbohydrate on glucose-insulin homeostasis: A systematic review and meta-analysis of randomised controlled feeding trials. PLoS Med. 2016;13(7):e1002087. https://doi.org/10.1371/journal.pmed.1002087 PMid:27434027

Eckel RH, Jakicic JM, Ard JD, De Jesus JM, Miller NH, 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(24 pt B):2960-84. https://doi.org/10.1016/j.jacc.2013.11.003 PMid:24239922

Dietary Guidelines Advisory Committee. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service; Washington, DC, USA: 2020. p. 25. https://doi.org/10.52570/dgac2020

Irala-Estevez JD, Groth M, Johansson L, Oltersdorf U, Prattala R, Martinez-Gonzalez MA. A systematic review of socio-economic differences in food habits in Europe: Consumption of fruit and vegetables. Eur J Clin Nutr. 2000;54:706-14. https://doi.org/10.1038/sj.ejcn.1601080 PMid:11002383

Ebbeling CB, Swain JF, Feldman HA, Wong WW, Hachey DL, Garcia-Lago E, et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2012;307(24):2627-34. https://doi.org/10.1001/jama.2012.6607 PMid:22735432

Tahara Y. On the weighted-average relationship between plasma glucose and HbA1c: Response to Trevino. Diabetes Care. 2006;29(2):466-7. https://doi.org/10.2337/diacare.29.02.06.dc05-2104

Hanley JA, Negassa A, Edwardes MD, Forrester JE. Statistical analysis of correlated data using generalized estimating equations: An orientation. Am J Epidemiol. 2003;157(4):364-75. https://doi.org/10.1093/aje/kwf215 PMid:12578807

Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: A comprehensive review. Circulation. 2016;133(2):187-225. https://doi.org/10.1161/CIRCULATIONAHA.115.018585 PMid:26746178

McGuire S. U.S. department of agriculture and U.S. department of health and human services, dietary guidelines for Americans, 2010. 7th edition, Washington, DC: U.S. Government Printing Office, January 2011. Adv Nutr. 2011;2(3):293-4. https://doi.org/10.3945/an.111.000430 PMid:22332062

Pilipenko V, Isakov VA, Zejgarnik MV. A method of dietary assessment by comparison of eating patterns. Voprosy Dietologii. 2016;6(3):72-6.

Margerison C, Riddell LJ, McNaughton SA, Nowson CA. Associations between dietary patterns and blood pressure in a sample of Australian adults. Nutr J. 2020;19(1):5. https://doi.org/10.1186/s12937-019-0519-2 PMid:31937324

Eilat-Adar S, Mete M, Fretts A, Fabsitz RR, Handeland V, Lee ET, et al. Dietary patterns and their association with cardiovascular risk factors in a population undergoing lifestyle changes: The strong heart study. Nutr Metab Cardiovasc Dis. 2013;23(6):528-35. https://doi.org/10.1016/j.numecd.2011.12.005 PMid:22534653

Lee SA, Cai H, Yang G, Xu WH, Zheng W, Li H, et al. Dietary patterns and blood pressure among middle-aged and elderly Chinese men in Shanghai. Br J Nutr. 2010;104(2):265-75. https://doi.org/10.1017/S0007114510000383 PMid:20187997

Shin JY, Kim JM, Kim Y. Associations between dietary patterns and hypertension among Korean adults: The Korean national health and nutrition examination survey (2008-2010). Nutr Res Pract. 2013;7(3):224-32. https://doi.org/10.4162/nrp.2013.7.3.224 PMid:23766884

National Health and Nutrition Examination Survey. Available from: https://www.Cdc.gov [Last accessed on 2020 May 5].

Ndanuko RN, Tapsell LC, Charlton KE, Neale EP, Batterham MJ. Dietary patterns and blood pressure in adults: A systematic review and meta-analysis of randomized controlled trials. Adv Nutr. 2016;7(1):76-89. https://doi.org/10.3945/an.115.009753 PMid:26773016

Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. Primary prevention of cardio-vascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018;378(25):e34. https://doi.org/10.1056/NEJMoa1800389 PMid:24799608

Yu E, Malik VS, Hu FB. Cardiovascular disease prevention by diet modification: JACC health promotion series. J Am Coll Cardiol. 2018;72(8):914-26. https://doi.org/10.1016/j.jacc.2018.02.085 PMid:30115231

Pilipenko VI, Isakov VA, Vlasova AV, Naidenova MA. Features of the diet of patients with the syndrome of bacterial overgrowth in the intestine, resistant to antibiotic therapy. Vopr Pitan. 2019;88(5):31-8. https://doi.org/10.24411/0042-8833-2019-10051 PMid:31710785

Downloads

Published

2022-09-12

How to Cite

1.
Tuleuova R, Zhamaliyeva L, Grjibovski A. Dietary Factors and Changes in Blood Pressure in Adult Kazakhs: A 3-year Follow-Up Study. Open Access Maced J Med Sci [Internet]. 2022 Sep. 12 [cited 2024 Apr. 20];10(B):2146-52. Available from: https://oamjms.eu/index.php/mjms/article/view/10287

Most read articles by the same author(s)