Examinando por Autor "Kabagambe, Edmond K."
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Ítem Adipose tissue biomakers of fatty acid intake(American Journal of Clinical Nutrition, No.76, 2002) Baylin, Ana; Kabagambe, Edmond K.; Siles, Xinia; Campos, HanniaThe use of biomarkers to assess dietary intake has increased dramatically in the past few years (1-7). Biomarkers may provide a more accurate and objective measure of long-term intake than dietary questionnaires provide because biomarkers do not rely on memory, self-reported information, or interviewer bias. However, nutrient concentrations in tissue or blood do not always reflect dietary intake because they can be affected by genetic factors, smoking, obesity, physical activity, and metabolism.Ítem Alcohol intake, drinking patterns and risk of nonfatal acute myocardial infarction in Costa Rica(The American Journal of Clinical Nutrition, vol. 82, no. 6, 2005) Kabagambe, Edmond K.; Baylin, Ana; Rimm, Eric B.; Campos, HanniaModerate consumption of alcohol in developed countries has been associated with a reduced risk of myocardial infarction (MI) (1–3). This evident protection is thought to be due to improved plasma lipid profiles, particularly an increase in HDL cholesterol (4–6), increased adiponectin (7), reduced plasma fibrinogen (8), viscosity (9), platelet activity (10, 11), C-reactive protein (8, 12), and improved insulin sensitivity (13). However, the protective effect of alcohol is not uniform across sex and populations or socioeconomic classes (14, 15), which raises doubts as to whether alcohol per se is truly protective or instead is a marker for another protective factor associated with alcohol consumption (4). Others have suggested that certain types of alcohol, eg, wine, may be more protective than others (16 –18). Growing evidence (2, 6, 14) suggests that the amount and pattern of intake, rather than the type of alcohol (19, 20), are more important in explaining the effects of alcohol in populations. Other studies suggest that sex (14) and genetic diversity of alcohol users (6, 21) may also play an important role in explaining the observed protection and differences across studies. For instance, in a recent prospective study, alcohol was inversely related to MI in white Americans but was hazardous for hypertension and MI in African Americans (14, 22). These disparities could be due to differences in alcohol intake patterns or the prevalence of functional genetic polymorphisms in genes encoding alcoholmetabolizing enzymes that have been reported across races (23–26). Polymorphisms in the alcohol dehydrogenase gene have been associated with changes in bothHDLcholesterol and risk of MI in moderate drinkers (6). Apart from one multicountry study (3) in which consumption of alcohol was marginally associated with a reduced risk of MI, to date, no large case-control studies have investigated the association between alcohol intake, patterns, and risk of MI in developing countries where diet and lifestyles differ from those in Western cultures. We conducted a large (n = 4548), matched, incident casecontrol study of residents of the Central Valley of Costa Rica, a country with low wine intake, to determine whether alcohol users, compared with self-reported lifelong abstainers, are less likely to have an MI. We also determined whether the pattern of alcohol drinking is associated with the risk of MI or intermediate phenotypes such as plasma lipid concentrations.Ítem Decreased Consumption of Dried Mature Beans Is Positively Associated with Urbanization and Nonfatal Acute Myocardial Infarction(J Nutr, Vol. 135, no. 7, 2005) Kabagambe, Edmond K.; Baylin, Ana; Ruiz Narvaez, Edward; Siles, Xinia; Campos, HanniaLegumes may protect against myocardial infarction (MI). The objective of this study was to determine whether consumption of dried mature beans (referred to as beans), the main legume in Latin America, is associated with MI. The cases (n = 2119) were survivors of a first acute MI and were matched by age, sex, and area of residence to randomly selected population controls (n = 2119) in Costa Rica. Dietary intake was assessed with a validated FFQ. Of the population, 69% consumed 1 serving of beans/d (1 serving = one-third cup of cooked beans, 86 g). Consumption of 1 serving/d was significantly higher (P 0.001) in rural (81%) than in urban (65%) areas. Individuals who never eat dried beans or whose consumption was 1 time/mo were classified as nonconsumers. Compared with nonconsumers, intake of 1 serving of beans/d was inversely associated with MI in analyses adjusted for smoking, history of diabetes, history of hypertension, abdominal obesity, physical activity, income, intake of alcohol, total energy, saturated fat, trans fat, polyunsaturated fat, and cholesterol [odds ratio (OR) 0.62; 95% CI: 0.45–0.88]. No further protection was observed with increased number of servings/d (OR 0.73; 95% CI: 0.52–1.03 for 1 serving/d). In summary, we found that consumption of 1 serving of beans/d is associated with a 38% lower risk of MI. No additional protection was observed at intakes 1 serving/d. These findings are timely given the trend toward increased obesity, cardiovascular disease, and a reduction in the intake of beans in Latin American countries.Ítem Decreased consumption of dried mature beans is positively associated with urbanization and nonfatal acute myocardial infarction(The Journal of Nutrition, vol 35, no. 7, 2005) Kabagambe, Edmond K.; Baylin, Ana; Ruiz Narváez, Edward A.; Siles, Xinia; Campos, HanniaBeans, Phaseolus vulgaris, are legumes that are thought to have originated from southern Mexico and Central America over 7000 y ago (1); they still form an important part of the staple diet in those regions. For many centuries, beans have remained part of the human diet in several countries on all continents. Black beans or black Spanish beans are the commonest variety in Latin America; they are usually consumed as dried mature beans together with rice. The combination of rice and dried mature black beans (later referred to as beans) supplies various nutrients including essential amino acids, folate, soluble fiber, copper, magnesium, iron, potassium, calcium, zinc, and _-linolenic acid (2–10). Although there are several varieties of beans that occur in different sizes, shapes, and colors, their nutrient composition is quite similar to that of black beans (Table 1). Legumes including beans may protect against cardiovascular disease (CVD)3 through various mechanisms (2,5,10,11). However, epidemiologic data on the association between individual legumes such as beans and peas and CVD are lacking. Beans form the core of the Latin American staple diet and contribute significantly to energy and micronutrient intakes (5–7,12). Despite the recommendation to increase the intake of beans by health organizations (8), their consumption, as well as that of other legumes, has decreased with urbanization (13). This is probably because of the increased availability and advertising of relatively cheap simple carbohydrate diets such as pasta and white bread (7,13). As expected, these trends are likely to be responsible for the increased obesity and the slow emergence of cardiovascular and other chronic diseases in many Latin American countries, including Costa Rica, where myocardial infarction (MI) accounts for 47.2% of CVD (14,15). Some of the few studies that have investigated the nutrients in beans [e.g., fiber (16 –18), folate (19), magnesium (20,21), and copper (22)], suggest inverse associations with CVD. Unlike soybeans and peanuts, the role of other legumes (e.g., beans) in CVD has not been reported. We therefore investigated, in a large incident case-control study in Costa Rica, whether eating beans is associated with risk of MI and explored potential mechanisms for such an association.Ítem Nonfatal acute myocardial infarction in Costa Rica: modifiable risk factors, population-attributable risks, and adherence to dietary guidelines(Circulation Journal of the American Heart Association, Vol. 115, no. 9, 2007) Kabagambe, Edmond K.; Baylin, Ana; Campos Núñez, HanniaDisability and mortality resulting from cardiovascular disease (CVD) are on the rise in many developing countries, partly because of the nutritional transition and westernization of lifestyles. Developing countries account for 80% of the global CVD burden. In 2002, the number of health-years of life lost to heart disease including myocardial infarction (MI) per 1000 people in developing countries was between 6 and 20 for countries such as Costa Rica, Uganda, Croatia, Nigeria, Indonesia, and India, whereas for developed countries, they were 5 for Australia, 5 for Canada, 7 for the United Kingdom, and 8 for the United States. These numbers suggest poor quality of secondary prevention and lack of primary CVD prevention in developing countries. Recent data show that primary prevention could reduce CVD deaths by 4 times the reduction achieved through secondary prevention.Ítem Transient exposure to coffee as a trigger of a first nonfatal myocardial infarction(Epidemiology, Vol. 17, No.5, 2006) Baylin, Ana; Hernández Díaz, Sonia; Kabagambe, Edmond K.; Siles, Xinia; Campos, HanniaCoffee is one of the most popular beverages worldwide, with an average consumption of 6.7 million tons per year. Prepared from the seed of the coffee plant Coffea arabica originated in Ethiopia and domesticated in Yemen, this beverage has been part of the diet for the past 5 centuries. Coffee contains many biologically active compounds, including caffeine, diterpenes, and polyphenols, with numerous metabolic properties and diverse health effects. Because of the potential adverse effects of coffee on blood cholesterol, homocysteine, and hypertension, the effects of coffee intake on heart disease have been extensively studied for decades. Findings are still controversial, with most case–control studies showing increased heart disease risk for heavy drinkers and cohort studies showing both negative and positive results. Some authors have suggested that this discrepancy is the result of a more acute effect of coffee on the risk of myocardial infarction that could be better assessed using a case–control design. More recent studies have observed a J-shaped association between coffee drinking and heart disease, which suggests that people with light or occasional intake could be at higher myocardial infarction risk because coffee may act as a trigger of myocardial infarction. The transient effects of coffee intake on increased blood pressure and sympathetic tone support this hypothesis. It has also been suggested that the disruption of a vulnerable atherosclerotic plaque in response to hemodynamic stress could trigger a myocardial infarction.Ítem Triggers of nonfatal myocardial infarction in Costa Rica : heavy physical exertion, sexual activity, and infection(Annals of epidemiology, Vol. 17, no. 2, 2007) Baylin, Ana; Hernández Díaz, Sonia; Siles, Xinia; Kabagambe, Edmond K.; Campos, HanniaThe incidence of coronary heart disease is increasing in developing countries undergoing socioeconomic transition(1). Lifestyles in many of these countries are dramatically different from those in Europe and the United States. For ex-ample, vigorous physical activity is more likely to be related to work than to recreational activities(2). The pattern of acute infections also is distinct, with a greater incidence than in developed countries. In addition, because transition countries are characterized by the presence of both infectious and chronic disease (3), the study of gastroenteritis episodes as a trigger of myocardial infarction (MI) is of particular interest in these countries. Cardiovascular disease (CVD) as a major health problem was established only recently in transition societies, and very few studies examined factors affecting CVD in the context of these different lifestyles(4).Ítem The type of oil used for cooking is associated with the risk of nonfatal acute myocardial infarction in Costa Rica(The Journal of Nutrition, Vol. 135, no 11, 2005) Kabagambe, Edmond K.; Baylin, Ana; Ascherio, Alberto; Campos Núñez, HanniaPalm oil and soybean oil are the 2 most widely used cooking oils in the world. Palm oil is consumed mainly in developing countries, where morbidity and mortality due to cardiovascular disease (CVD) are on the rise. Although claims about adverse or protective effects of these oils are commonly made, there are no epidemiologic studies assessing the association between these oils and cardiovascular disease endpoints. We examined whether consumption of palm oil relative to soybean oil and other unsaturated oils (predominantly sunflower) is associated with myocardial infarction (MI) in Costa Rica. The cases (n = 2111) were survivors of a first acute MI and were matched to randomly selected population controls (n = 2111). Dietary intake was assessed with a validated semiquantitative FFQ. Adipose tissue profiles of essential fatty acids were assessed to validate cooking oil intake and found to be consistent with self-reported major oils used for cooking. The data were analyzed using conditional logistic regression. Palm oil users were more likely to have an MI than users of soybean oil [odds ratio (OR) = 1.33; 95% CI: 1.08–1.63] or other cooking oils (OR = 1.23; CI: 0.99–1.52), but they did not differ from users of soybean oil with a high trans-fatty acid content (OR = 1.14; CI: 0.84–1.56). These data suggest that as currently used in Costa Rica, and most likely in many other developing countries, the replacement of palm oil with a polyunsaturated nonhydrogenated vegetable oil would reduce the risk of MI.