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      A randomised controlled crossover trial investigating the short-term effects of different types of vegetables on vascular and metabolic function in middle-aged and older adults with mildly elevated blood pressure: the VEgetableS for vaScular hEaLth (VESSEL) study protocol

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          Abstract

          Background

          A diet rich in fruits and vegetables is recommended for cardiovascular health. However, the majority of Australians do not consume the recommended number of vegetable servings each day. Furthermore, intakes of vegetables considered to have the greatest cardiovascular benefit are often very low. Results from prospective observational studies indicate that a higher consumption of cruciferous vegetables (e.g. broccoli, cabbage, cauliflower) is associated with lower cardiovascular disease risk. This may be due to the presence of specific nutrients and bioactive compounds found almost exclusively, or at relatively high levels, in cruciferous vegetables. Therefore, the aim of this randomised controlled crossover trial is to determine whether regular consumption of cruciferous vegetables results in short-term improvement in measures related to cardiovascular disease risk, including ambulatory blood pressure, arterial stiffness, glycaemic control, and circulating biomarkers of oxidative stress and inflammation.

          Methods

          Twenty-five participants (50–75 years) with mildly elevated blood pressure (systolic blood pressure 120–160 mmHg) will complete two 2-week intervention periods in random order, separated by a 2-week washout period. During the intervention period, participants will consume 4 servings (~ 300 g) of cruciferous vegetables per day as a soup (~ 500–600 mL/day). The ‘control’ soup will consist of other commonly consumed vegetables (potato, sweet potato, carrot, pumpkin). Both soups will be approximately matched for energy, protein, fat, and carbohydrate content. All measurements will be performed at the beginning and end of each intervention period.

          Discussion

          The findings of this study will provide evidence regarding the potential cardiometabolic health benefits of cruciferous vegetables, which may contribute to the revision of dietary and clinical guidelines.

          Trial registration

          The trial was registered with the Australian New Zealand Clinical Trial Registry on 19th September 2019 ( ACTRN12619001294145).

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          Most cited references30

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          The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation.

          To assess the validity of the Anti Cancer Council of Victoria food frequency questionnaire (ACCVFFQ) relative to seven-day weighed food records (WFRs) in 63 women of child-bearing age. 63 women completed WFRs to assess iron intake as part of a study on iron deficiency. These women also completed the ACCVFFQ. Nutrient intakes were computed independently for the WFRs and FFQs. Intakes were compared as group means, by correlation and by quintile classification, adjusting for day-to-day variation in intakes, and for energy intake. Individual differences in results were also examined. The strongest associations between WFR and FFQ results were energy-adjusted, log-transformed and adjusted for day-to-day variability in intake. Correlation coefficients ranged from 0.28 for vitamin A to 0.78 for carbohydrate. Mean intakes from the WFRs and FFQs were within +/- 20% for 21 of 27 nutrients. Poor agreement between FFQs and WFRs for retinol intake was due to the inclusion of liver in two WFRs, an item which is not included in the FFQ. The ACCVFFQ performs as well as other FFQs for which validation data are available. The relatively poor measurement of retinol is consistent with other data, and with the limited number of foods in which this nutrient is abundant. The availability of an optically scannable valid instrument for assessing dietary intake will facilitate epidemiological studies of diet and disease, an area of current research priority.
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            Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer.

            First, to validate the LASA Physical Activity Questionnaire (LAPAQ) by a 7-day diary and a pedometer in older persons. Second, to assess the repeatability of the LAPAQ. Third, to compare the feasibility of these methods. The study was performed in a subsample (n=439, aged 69-92 years) of the Longitudinal Aging Study Amsterdam (LASA). The LAPAQ was completed twice (1998/1999, 1999/2000). Respondents completed a 7-day activity diary and wore a pedometer for 7 days (1999/2000). The LAPAQ was highly correlated with the 7-day diary (r=0.68, P<.001), and moderately with the pedometer (r=0.56, P<.001). The repeatability of the LAPAQ was reasonably good (weighted kappa: 0.65-0.75). The LAPAQ was completed in 5.7+/-2.7 min, and 0.5% of the respondents had missing values. The LAPAQ appears to be a valid and reliable instrument for classifying physical activity in older people. The LAPAQ was easier to use than the 7-day diary and pedometer.
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              Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation.

              Hypertension, myocardial infarction, atherosclerosis, arrhythmias and valvular heart disease, coagulopathies and stroke, collectively known as cardiovascular diseases (CVDs), contribute greatly to the mortality, morbidity and economic burden of illness in Canada and in other countries. It has been estimated that over four million Canadians have high blood pressure, a comorbid condition that doubles or triples the risk of CVD. According to the Heart and Stroke Foundation of Canada, CVDs caused 36% of deaths in 2001 and were responsible for 18% of the total hospital costs in Canada. The majority of Canadians exhibit at least one CVD-related risk factor, such as tobacco smoking, physical inactivity, diabetes, obesity, hypertension, a lack of daily fruit and vegetable consumption, and psychosocial factors, making these people more prone to developing a serious CVD-related illness in the future. It is therefore important that CVD-related causes and concerns be addressed. Given the scope and prevalence of CVDs, it is obvious that a population health approach - 'prevention is better than cure' - would be the most appropriate model to adopt to deal with this ubiquitous health problem and to reduce the costs of hospitalization, long-term medication and rehabilitation. The focus of the present review is to evaluate and compare the results of epidemiological, experimental and clinical studies, reporting on the influence of physical activity, dietary intervention, obesity and cigarette smoking on cardiovascular health and the prevention of CVDs. The prophylactic measures must be dealt with collectively because there is overwhelming evidence that the occurrence of CVDs can be reduced by approximately 80% by making lifestyle modifications. The preventive strategies against CVDs must be targeted at a primary health promotion level before some of the important underlying causes of CVD seriously afflict a person or a population at large. Such preventive approaches would help in reducing not only employee absenteeism but also the hospital and drug costs burdening the health care systems of both developed and developing countries.
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                Author and article information

                Contributors
                l.blekkenhorst@ecu.edu.au
                Journal
                Nutr J
                Nutr J
                Nutrition Journal
                BioMed Central (London )
                1475-2891
                12 May 2020
                12 May 2020
                2020
                : 19
                : 41
                Affiliations
                [1 ]GRID grid.1038.a, ISNI 0000 0004 0389 4302, School of Medical and Health Sciences, , Edith Cowan University, Royal Perth Hospital Research Foundation, ; Rear 50, Murray Street, Joondalup, Perth, WA 6000 Australia
                [2 ]GRID grid.1012.2, ISNI 0000 0004 1936 7910, Medical School, University of Western Australia, ; Perth, WA Australia
                [3 ]GRID grid.1038.a, ISNI 0000 0004 0389 4302, Centre for Integrative Metabolomics and Computational Biology, School of Science, , Edith Cowan University, ; Joondalup, WA Australia
                [4 ]GRID grid.1032.0, ISNI 0000 0004 0375 4078, School of Public Health, , Curtin University, ; Perth, WA Australia
                [5 ]GRID grid.1014.4, ISNI 0000 0004 0367 2697, Flinders Centre for Epidemiology and Biostatistics, , Flinders University, ; Adelaide, SA Australia
                [6 ]GRID grid.9654.e, ISNI 0000 0004 0372 3343, Liggins Institute, , University of Auckland, ; Auckland, New Zealand
                [7 ]GRID grid.1013.3, ISNI 0000 0004 1936 834X, Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, , The University of Sydney, ; Sydney, NSW Australia
                Author information
                http://orcid.org/0000-0003-1561-9052
                Article
                559
                10.1186/s12937-020-00559-3
                7218618
                32398091
                44884002-dc6c-4481-b557-1735af8c6a23
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 26 August 2019
                : 4 May 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001798, Edith Cowan University;
                Award ID: G1004405
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100006065, Department of Health, Government of Western Australia;
                Award ID: G1004519
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2020

                Nutrition & Dietetics
                blood pressure,cardiovascular disease,cruciferous vegetables,glycaemic control,inflammation,oxidative stress,arterial stiffness

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