Nutritional assessment in Polish men with cardiovascular diseases

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Objectives. To assess nutrition in male subjects suffering from cardiovascular disease.

Materials and methods. 6XEMHFWVZHUHPHQZLWKFDUGLRYDVFXODUGLVHDVHDJHG\HDUV1XWULWLRQZDVDVVHVVHGE\ ZHLJKHGIRRGUHFRUGVRYHUGD\V7KHFDORULILFGLHWDU\LQWDNHDVZHOODVWKHSURSRUWLRQVRIFDORULHVGHULYHGIURPGLHWDU\ SURWHLQFDUERK\GUDWHVDQGIDWZHUHDOVRFDOFXODWHGWKLVLQFOXGHGYLWDPLQVDQGPLQHUDOV Results. 2QO\VXEMHFWVKDGDQRUPDO%RG\0DVV,QGH[%0,WKHUHVWIDOOLQJLQWRWKHRYHUZHLJKWRUREHVLW\UDQJHV 7KHDYHUDJHGLHWDU\FDORULILFGDLO\LQWDNHVZHUHDEQRUPDOO\ORZDWNFDOSHUVRQKRZHYHUWKHSURSRUWLRQVRIIDWDQG SURWHLQPDNLQJXSWKLVYDOXHZHUHWRRKLJKUHVSHFWLYHO\DWDQG7KHDYHUDJHGDLO\FRQVXPSWLRQSHUSHUVRQRI FKROHVWHUROILEUHDQGYHJHWDEOHVZHUHUHVSHFWLYHO\PJJDQGJ$VLJQLILFDQWQXPEHUZHUHGHILFLHQWLQGLHWDU\ PLQHUDOVHJFDOFLXPSRWDVVLXPDQGPDJQHVLXPDVZHOODVYLWDPLQVHVSHFLDOO\$%₁DQG%.

Conclusions. Persons suffering from cardiovascular disease require a diet with sufficient calories for their body needs. It is DOVRYLWDOWKDWWKHGLHWDU\VRXUFHVRIHQHUJ\DUHSURSHUO\EDODQFHGEHWZHHQSURWHLQFDUERK\GUDWHVDQGIDWVDVZHOODVKDYLQJ DSSURSULDWHLQWDNHVRIERWKYLWDPLQVDQGPLQHUDOVHJFDOFLXPPDJQHVLXPDQGSRWDVVLXP Key wordsFDUGLRYDVFXODUGLVHDVHVQXWULWLRQERG\PDVVLQGH[%0, 675(6=&=(1,( :SURZDG]HQLH&KRURE\VHUFRZRQDF]\QLRZHWRQDMF]ĊVWV]DSU]\F]\QD]JRQyZZ3ROVFH1DUR]ZyMW\FKVFKRU]HĔZSá\ZD ZLHOHF]\QQLNyZPLQRW\áRĞüSDOHQLHSDSLHURVyZF]\EUDNDNW\ZQRĞFLIL]\F]QHM6SRĞUyGF]\QQLNyZĪ\ZLHQLRZ\FKGR QDMZDĪQLHMV]\FKSU]\F]\QQDOHĪąLORĞüLURG]DMHNZDVyZWáXV]F]RZ\FK]E\WQLVNLHVSRĪ\FLHEáRQQLNDSRNDUPRZHJRRUD] RZRFyZLZDU]\ZDSU]H]WRSU]HGHZV]\VWNLPZLWDPLQDQW\RNV\GDF\MQ\FK Cel. &HOHPEDGDĔE\áDRFHQDVSRVREXĪ\ZLHQLDJUXS\PĊĪF]\]Q]FKRUREDPLVHUFRZRQDF]\QLRZ\PL 0DWHULDáLPHWRG\%DGDQLHSU]HSURZDG]RQRZĞUyGPĊĪF]\]Q]FKRUREDPLVHUFRZRQDF]\QLRZ\PLZZLHNXRGGR ODW2FHQ\VSRVREXĪ\ZLHQLDGRNRQDQRQDSRGVWDZLHGQLRZHJRELHĪąFHJRQRWRZDQLD2EOLF]RQRZDUWRĞüHQHUJHW\F]-QąFDáRG]LHQQ\FKUDFMLSRNDUPRZ\FKEDGDQ\FKDWDNĪHXG]LDáELDáHNZĊJORZRGDQyZLWáXV]F]XZGRVWDUF]DQLXHQHUJLL 2NUHĞORQRWDNĪHZLHONRĞüVSRĪ\FLDZ\EUDQ\FKVNáDGQLNyZPLQHUDOQ\FKLZLWDPLQ :\QLNL=DOHGZLHXEDGDQ\FKVWZLHUG]RQRSUDZLGáRZąZDUWRĞüZVNDĨQLNDPDV\FLDáD%0,XSR]RVWDá\FKRVyE VWZLHUG]RQRQDGZDJĊOXERW\áRĞü3RGDĪHQHUJLL]FDáRG]LHQQąUDFMąSRNDUPRZąE\áD]E\WQLVNDLZ\QRVLáDĞUHGQLRNFDO RVGDXG]LDáWáXV]F]XLELDáNDZGRVWDUF]DQLXHQHUJLLE\á]E\WZ\VRNLĝUHGQLHVSRĪ\FLHFKROHVWHUROXEáRQQLND RUD]RZRFyZLZDU]\ZZ\QRVLáRPJRVGJRVGRUD]JRVG=QDF]ąFDOLF]EDRVyEEDGDQ\FKVSRĪ\ZDáDQLHZ\-VWDUF]DMąFHLORĞFLVNáDGQLNyZPLQHUDOQ\FKJáyZQLHZDSQLDSRWDVXLPDJQH]XRUD]ZLWDPLQSU]HGHZV]\VWNLP$%₁L%). :QLRVNL6]F]HJyOQąXZDJĊZĞUyGRVyE]FKRUREDPLVHUFRZRQDF]\QLRZ\PLQDOHĪ\]ZUyFLüQDSUDZLGáRZHVSRĪ\FLHHQHUJLL RUD]XG]LDáHQHUJLL]ELDáHNZĊJORZRGDQyZLWáXV]F]XZGLHFLHMDNWHĪQDSUDZLGáRZHVSRĪ\FLHVNáDGQLNyZPLQHUDOQ\FK WDNLFKMDN&D0JL.RUD]ZLWDPLQZW\PDQW\RNV\GDF\MQ\FK 6áRZDNOXF]RZHFKRURE\VHUFRZRQDF]\QLRZHVSRVyEĪ\ZLHQLDZVNDĨQLNPDV\FLDáD%0,

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The study aims were to determine and assess the nutrition of a subject group of men with cardiovascular disease.

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7KHVWXG\KDGEHHQSHUIRUPHGGXULQJ RQPDOHVXEMHFWV\HDUVROGUHFUXLWHGLQRQH of Warsaw’s hospitals suffering from coronary heart GLVHDVHDUWHULDOVFOHURVLVRUKDYLQJSUHYLRXVHSLVRGHV of cardiac infarction or stroke. The survey posed the IROORZLQJTXHVWLRQVDJHOHYHORIHGXFDWLRQH[WHQWRI SK\VLFDODFWLYLW\KHLJKWDQGZHLJKWZKHUHLQWKHODWWHU

WZRFDVHVWKLVDSSOLHGWRYDOXHVUHFRUGHGGXULQJWKH day trial before subsequent assessment visits which were XVHGWRFDOFXODWHWKH%0,'DWDZDVREWDLQHGGXULQJ two week days and one from the weekend. Portion sizes were based on a photograph album of relevant foodstuffs DQGGLVKHV>@$FRPSXWHUSURJUDPPHDQGGDWDEDVH ‘ZYWIENIE’ was used to determine daily calorific values in a given diet that also allowed the proportio-QDOFRQWULEXWLRQRIFDORULHVGHULYHGIURPSURWHLQIDWV and carbohydrates to be made as well as estimating the DPRXQWVRIYLWDPLQVDQGPLQHUDOVFRQVXPHG>@7KH calculated totals were adjusted for technological and serving losses where individual results were referenced WRYDULRXVQXWULWLRQVWDQGDUGVVXFKDVWKH5'$5HFRP-mended Daily Allowance) or AI (Adequate Intake) from >@GLHWDU\UHFRPPHQGDWLRQVPDGHE\WKH1DWLR-QDO&KROHVWHURO(GXFDWLRQ3URJUDPPH*UDGH1&(3 regarding persons suffering from cardiovascular disease together with those of the Adult Treatment Panel III $73,,,>@$OOVXEMHFWVKDGEHHQWDNLQJPHGLFLQHV as primary prevention measures. The presented studies ZHUHDSSURYHGE\WKH%LRHWKLFDO&RPPLVVLRQIURPWKH Cardiology Institute in Warsaw.

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The average age of the subjects with cardiovascular GLVHDVHZDV\HDUVRIZKLFKDQGKDGKLJKHU RUVHFRQGDU\HGXFDWLRQUHVSHFWLYHO\WKHUHPDLQLQJ were educated to primary or basic vocational levels. Low physical activity levels (PAL) were noted in over Table 1. ,QWDNHVRIIRRGVWXIIFRPSRQHQWVIUXLWDQGYHJHWDEOHVLQPDOHVXEMHFWVQ 

Foodstuffs/components x ± sd median min ÷ max

&DORULHV>NFDO@ ± 933 ÷ 'LHWDU\¿EUH>J@ 19 ± 7 19 6 ÷ 39 &KROHVWHURO>PJ@ ± 95 ÷ 569 &DOFLXP>PJ@ ± ÷ 1583 3KRVSKRUXV>PJ@ 1335 ± 366 656 ÷ 3RWDVVLXP>PJ@ ± 1313 ÷ 0DJQHVLXP>PJ@ ± 133 ÷ ,URQ>PJ@ ± 3.1 ÷ &RSSHU>PJ@ ± ÷ =LQF>PJ@ 11.3 ± 5.7 ÷ 9LWDPLQ$>JUHWLQRO@ ± ÷ 1867 9LWDPLQ(>PJĮWRFRSKHUROHTXLYDOHQW@ ± 11.8 ÷ 9LWDPLQ&>PJ@ 58 ± 35 51 6 ÷ 188 9LWDPLQ%₁>PJWKLDPLQH@ 1.3 ± ÷ 9LWDPLQ%>PJULERÀDYLQ@ ± 1.3 ÷ 9LWDPLQ%₆>PJS\ULGR[LQH@ ± ÷ 1LDFLQ>PJQLDFLQHTXLYDOHQW@ ± 7 9 ÷ )UXLWDQGYHJHWDEOHV>J@ ± 389 55 ÷

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Nutritional assessment in Polish men with cardiovascular diseases Nr 3

RQH WKLUG RI VXEMHFWV 3$/ ZKHUHDV WKH UHPD LQLQJGLGPRGHUDWHDPRXQWVZLWKD3$/RI $FFRUGLQJWRWKH%0,DSSURSULDWHERG\PDVVHVZHUH REVHUYHGLQRQO\VXEMHFWVLQFRQWUDVWWRRYHUZHLJKW DQGREHVLW\,QUHSO\WRWKHTXHVWLRQRQ ZKHWKHUQXWULWLRQDIIHFWVKHDOWKDQVZHUHGSRVLWL YHO\GLVDJUHHGDQGVLPSO\GLGQ¶WNQRZ7KH average calorific values of daily diets were found to EHORZDWNFDOSHUSHUVRQ7DEOHZKLFKZHUH FRQVLVWHQW ZLWK WKH ILQGLQJV RI WKH :2%$6= VWXG\ FRQGXFWHGRQPHQDJHGZLWKDYHUDJHGLHWDU\ FDORULILFLQWDNHVRINFDOGDLO\>@

The dietary proportions of energy/calories derived IURP SURWHLQ IDWV DQG FDUERK\GUDWH ZHUH DEQRUPDO )LJXUH)RUWKHIRUPHUWZRUHFRPPHQGHGYDOXHV ZHUHUHVSHFWLYHO\H[FHHGHGE\DQGZKHUHDV FDUERK\GUDWHVZHUHORZHUWKDQUHFRPPHQGHG7KH presented findings for protein and fats were approxima-tely similar to other studies on the inhabitants of Warsaw >@EXWVKRZHGDJUHDWHUDEQRUPDOLW\FRPSDUHGWR WKH:2%$6=VWXG\DOWKRXJKWKHFRQWULEXWLRQRIIDWV to the total dietary calorific value remained around the VDPHDW>@ Figure 1. 3URSRUWLRQVRIFDORULHVGHULYHGIURPGLHWDU\SURWHLQ FDUERK\GUDWHVIDWV6)$08)$DQG38)$RIPDOH VXEMHFWVFRPSDUHGWRUHFRPPHQGHGYDOXHV>@ 'LHWDU\VDWXUDWHGIDWW\DFLGV6)$PDGHXS RIWKHFDORULILFLQWDNHZKLFKLVKLJKHUWKDQWKDWUH FRPPHQGHGKRZHYHURWKHUVWXGLHVVKRZHGHYHQKLJKHU OHYHOVRI>@7KHSURSRUWLRQRIVDWXUDWHGIDWW\ acids to polyunsaturated (PUFA) and monounsaturated (MUFA) ones were nevertheless acceptable (Figure 1). Daily consumption of cholesterol ranged between WRPJSHUSHUVRQZKHUHWKHUHFRPPHQGHGGDLO\ GRVHRIPJZDVH[FHHGHGE\RIVXEMHFWV7KH DYHUDJHGDLO\LQWDNHRIFKROHVWHUROZDVKRZHYHUPJ ORZHUFRPSDUHGWRWKH:2%$6=VWXG\RQPDOHVXEMHFWV >@7KHUHZDVLQVXIILFLHQWGLHWDU\ILEUHFRQVXPSWLRQLQ VXEMHFWVUDQJLQJIURPWRJGDLO\SHUSHUVRQ average being 19 g. Almost half the subjects ate average

JSHUVRQGD\RIIUXLWDQGYHJHWDEOHVWKDWZDVPRUH WKDQ WKH UHFRPPHQGHG DPRXQWV JSDUVRQGD\ (Table 1). The presented findings also demonstrated that WKHGDLO\IUXLWDQGYHJHWDEOHFRQVXPSWLRQZDVJSHU SHUVRQKLJKHUWKDQWKHUHVXOWVRIWKH:2%$6=VWXG\ LQVXEMHFWVDJHG\HDUV>@0DQ\RWKHUVWXGLHV demonstrate that higher fruit and vegetable consump-tion are linked to reduced cardiovascular disease risk >@

Intakes of the vitamins and minerals studied were IRXQGWREHLQDGHTXDWH&DOFLXPSRWDVVLXPDQGPD gnesium intakes were found to be higher than reference/ UHFRPPHQGHGOHYHOVLQRQO\VXEMHFWVFRPSDUHG WRDQGIRU]LQFDQGLURQUHVSHFWLYHO\)LJXUH 'DLO\FDOFLXPLQWDNHVZHUHQHDUO\PJSHUSHUVRQ ORZHUWKDQLQDVWXG\RQWKHLQKDELWDQWVRI:DUVDZZLWK potassium and magnesium levels following a similar WUHQG>@7KHREVHUYHGFRQVXPSWLRQRIFDOFLXPDQG SRWDVVLXPZDVPXFKKLJKHUFRPSDUHGWRWKH:2%$6= VWXG\IRUPDJQHVLXPWKLVDPRXQWHGWRPJGDLO\SHU SHUVRQPRUH>@'LHWDU\GHILFLHQFLHVRIWKHVHDIRUH mentioned elements are also risk factors for developing FDUGLRYDVFXODUGLVHDVHZKHUHWKH\SOD\LPSRUWDQWUROHV LQSUHYHQWLRQDQGWUHDWPHQW>@

)LJXUH. The proportions of male subjects fulfilling adequate dietary intakes according to recommended values. The fewest subjects with higher than recommended YLWDPLQLQWDNHVZHUHIRXQGIRUYLWDPLQ$DQG YLWDPLQ%₁IRUWKHRWKHUYLWDPLQVVWXGLHGWKH QXPEHUVFRQVWLWXWHGWR)LJXUH7KHREVH UYHGGDLO\YLWDPLQ$LQWDNHZDVRYHUJSHUSHUVRQ lower than in studies conducted on the inhabitants of :DUVDZ>@ZKHUHDVREVHUYHGYLWDPLQ(OHYHOV ZHUH VXEVWDQWLDOO\ KLJKHU ZKLOVW YLWDPLQ & LQWDNHV were similar in all instances. The consumption of the DQWLR[LGDQWYLWDPLQV$&DQG(LVHVSHFLDOO\VLJQLIL cant in those subjects with a history of cardiovascular incidents where a reduction of harmful free radicals can WKXVEHDFKLHYHG>@

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Figure 3. The percentage of men fulfilling recommended intakes for vitamins

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1. Subjects with cardiovascular disease consumed nutritionally inadequate diets where a rather high %0,ZDVREVHUYHGLQFDVHV

7KHGDLO\GLHWRIWKHVWXGLHGPDOHVGHPRQVWUDWHG insufficient calorie intake and that the proportions of FDORULHVGHULYHGIURPSURWHLQIDWVDQGFDUERK\GUDWHV were unbalanced.

3. Even though fruit and vegetable consumption was VLJQLILFDQWO\KLJKHUWKDQUHFRPPHQGHGOHYHOVGLH tary fibre intake was insufficient.

'HILFLHQFLHV LQ PLQHUDO LQWDNHV ZHUH REVHUYHG LQ VLJQLILFDQW QXPEHUV RI VXEMHFWV PDLQO\ FDOFLXP potassium and magnesium) as well as for vitamins $%₁DQG%.

5. Consuming a nutritionally adequate diet for pre-venting cardiovascular disease forms an important part for decreasing its risk. It is therefore necessary to ensure that an the dietary intake of calories is sufficient and that this is correctly balanced between WKHIRRGGHULYHGIURPVRXUFHVRISURWHLQIDWVDQG FDUERK\GUDWHV,QDGGLWLRQWKHUHVKRXOGEHDGHTXDWH LQWDNHVRIPLQHUDOVVXFKDVFDOFLXPSRWDVVLXPDQG magnesium together with the antioxidant vitamins.

Acknowledgement

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1. $VSOXQG..: Antioxidant vitamins in the prevention of FDUGLRYDVFXODU GLVHDVH D V\VWHPDWLF UHYLHZ - ,QWHUQ 0HG

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