PMID- 32122735 OWN - NLM STAT- MEDLINE DCOM- 20210311 LR - 20211002 IS - 1097-6809 (Electronic) IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 72 IP - 4 DP - 2020 Oct TI - Diet is associated with ankle-brachial index, inflammation, and ambulation in patients with intermittent claudication. PG - 1375-1384 LID - S0741-5214(20)30146-4 [pii] LID - 10.1016/j.jvs.2019.12.038 [doi] AB - OBJECTIVE: The aims of this investigation were to determine whether the daily dietary intake of nutrients by patients with peripheral artery disease (PAD) and intermittent claudication (IC) met recommended levels for adults older than 50 years and to determine whether meeting recommended levels of nutrients was associated with ankle-brachial index (ABI), inflammation, and ambulation of patients with PAD and IC. METHODS: A total of 48 patients were assessed on their dietary intake of 20 nutrients during a 3-day period. Patients were further characterized on demographic variables, comorbid conditions, cardiovascular risk factors, ABI, 6-minute walk distance (6MWD), and high-sensitivity C-reactive protein (hsCRP) concentration. RESULTS: Few patients met the daily recommended intakes for calcium (4%), fiber (6%), vitamin E (6%), trans fatty acids (13%), vitamin A (15%), total sugars (19%), potassium (23%), sodium (29%), saturated fat (29%), and vitamin C (31%), and none of the patients met the daily recommended intake of vitamin D (0%). Overall, patients met few of the 20 dietary recommendations as the median score was seven recommendations. Only 17 of 48 patients met more than seven of the recommendations. For the ABI regression model adjusted for age, sex, race, smoking, hypertension, dyslipidemia, body mass index, and percentage body fat, the only significant predictor was total sugars (P < .001); patients who did not meet the recommendation had lower ABI values. For the hsCRP-adjusted regression model, the strongest significant predictor was omega-3 polyunsaturated fatty acids (P = .001), indicating that those who did not meet the recommendation had higher hsCRP values. Finally, for the 6MWD-adjusted regression model, folate (P = .011) and dietary score index (P = .014) were significant predictors; those who did not meet the recommendation for folate and those who met 5 or fewer of the 20 recommendations had shorter 6MWD. CONCLUSIONS: Patients with PAD and IC consume a low-nutrient-dense diet that is deficient in many vitamins, calcium, fruits, and vegetables and contains too much added sugar, saturated and trans fats, and processed foods. In addition, more severe PAD, greater inflammation, and ambulatory dysfunction are independently associated with aspects of a low-nutrient-dense diet, such as too much intake of added sugars, low intake of omega-3 polyunsaturated fatty acids and folate, and meeting the recommended intakes of only five or fewer nutrients. CI - Copyright (c) 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Gardner, Andrew W AU - Gardner AW AD - Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pa. Electronic address: agardner4@pennstatehealth.psu.edu. FAU - Montgomery, Polly S AU - Montgomery PS AD - Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pa. FAU - Wang, Ming AU - Wang M AD - Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pa. FAU - Shen, Biyi AU - Shen B AD - Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pa. FAU - Casanegra, Ana I AU - Casanegra AI AD - Vascular Medicine Division, Cardiovascular Department, Mayo Clinic, Rochester, Minn. FAU - Silva-Palacios, Federico AU - Silva-Palacios F AD - Cardiovascular Section, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. FAU - Knehans, Allen W AU - Knehans AW AD - Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. LA - eng GR - M01 RR014467/RR/NCRR NIH HHS/United States GR - R01 AG024296/AG/NIA NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20200228 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aged MH - Aged, 80 and over MH - *Ankle Brachial Index MH - Feeding Behavior/*physiology MH - Female MH - Humans MH - Inflammation/complications/*diagnosis/immunology MH - Intermittent Claudication/diagnosis/*diet therapy/immunology MH - Male MH - Middle Aged MH - Nutrients/standards MH - Peripheral Arterial Disease/complications/diagnosis/*diet therapy/immunology MH - Recommended Dietary Allowances MH - Walk Test MH - Walking/*physiology PMC - PMC7483568 MID - NIHMS1569803 OTO - NOTNLM OT - Antioxidants OT - Exercise OT - Nutrition OT - Peripheral artery disease OT - Sugars OT - Vitamins EDAT- 2020/03/04 06:00 MHDA- 2021/03/12 06:00 PMCR- 2021/10/01 CRDT- 2020/03/04 06:00 PHST- 2019/09/17 00:00 [received] PHST- 2019/12/17 00:00 [accepted] PHST- 2020/03/04 06:00 [pubmed] PHST- 2021/03/12 06:00 [medline] PHST- 2020/03/04 06:00 [entrez] PHST- 2021/10/01 00:00 [pmc-release] AID - S0741-5214(20)30146-4 [pii] AID - 10.1016/j.jvs.2019.12.038 [doi] PST - ppublish SO - J Vasc Surg. 2020 Oct;72(4):1375-1384. doi: 10.1016/j.jvs.2019.12.038. Epub 2020 Feb 28.