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Dietary Factors and Hypertension in Adult Women in France and Mexico

  • Villaverde Montes de Oca, Paola
Publication Date
Oct 16, 2019
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Hypertension is the major risk factor for cardiovascular disease, the principal cause of mortality in the world, representing a significant health burden and is associated with both cardiovascular and renal outcomes. Modifiable risk factors, such as the diet, have been identified for hypertension; nonetheless some aspects of the role of the diet remain unclear.According to the evidence antioxidant intake could be an alternative against the detrimental effects of oxidative stress, thus to prevent hypertension. However, inconsistent results have been observed when the relation between the intake of individual antioxidants and hypertension risk has been assessed. The evaluation of individual antioxidants may not reflect the total antioxidant power from the diet as well as the possible synergistic effects of antioxidants, resulting in an inaccurate measure of antioxidant consumption.Dairy products have a complex nutritional content and are an important source of energy, protein, and can contribute significantly to meeting the required intakes of calcium, magnesium, selenium, riboflavin, and vitamin B12. The bioavailability of calcium from dairy products is high compared with other foods in the diet. Because of this, dairy products are widely consumed in different populations worldwide. However, recently, due to the appreciable amount of sodium and saturated fat in dairy products, its consumption has been questioned, as both nutrients have been associated with cardiovascular disease. However, the studies assessing the association between dairy products and hypertension have shown inconsistent results.Therefore, the main objective of this thesis was to evaluate the role and impact of dietary factors, particularly, the dietary total antioxidant capacity (TAC), and the consumption of dairy products and the risk of hypertension using data from both the French E3N and Mexican MTC cohort studies.For this work, I conducted three secondary analyses from data of two similar studies of women. The first study was the French E3N study, and included 98 995 teachers aged 40 - 65 years at the beginning of the study in 1990. The second, the Mexican Teachers’ Cohort study, is a prospective cohort of 115 314 teachers aged 25 years or older, initiated in 2006 - 2008. I used Cox regression models to estimate HR and 95% CI, data were analysed with the SAS program version 9.4.Dietary TAC was inversely associated with risk of hypertension in the E3N cohort study, after adjustment for the main risk factors of hypertension. The strength and direction of the association was consistent in fruit and vegetable consumers below the median population value. The spline regression curve demonstrated a steep inverse dose-effect relationship between dietary TAC and risk of hypertension, then leveled off, suggesting a maximal effect of TAC. In addition, the results suggest no association between total dairy intake or each type of dairy product consumed and hypertension risk in both the E3N and MTC cohort studies. Only processed cheese consumption was directly associated with hypertension. These are rich in lipids, sodium and sugar but has a lower content of proteins, magnesium and calcium, potential protective nutrients against hypertension.This research emphasizes the important and complex role that the diet plays in the development of hypertension. It confirms that hypertension is largely preventable and also illustrates the impact of a healthy lifestyle in the etiology of hypertension. Dietary TAC was inversely associated with the risk of hypertension. On contrary, dairy product was not associated to hypertension, the usefulness of replicating analyses in different populations where the patterns of consumption of foods and their correlated maybe different, thus the results are likely robust. Therefore, hypertension prevention should aim to reduce the impact of modifiable risk factors, such as the diet, by promoting varied and balanced diets.

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