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Peter Kokkinos

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Prevention and Management of Cardiovascular and Metabolic Disease Provides accurate and well-documented information on the impact of diet and physical activity in the prevention and management of cardiovascular and metabolic diseases and healthy aging. This authoritative textbook examines the independent and combined impact of diet and physical activity in the prevention and management of cardiovascular and metabolic diseases, with special emphasis on the elderly populations. In this book the authors: * Provide the latest data on the association between a suboptimal diet and physical inactivity and chronic disease. * Examine the role of epigenetics on longevity. * Discuss the fundamentals of healthy aging. * Highlight the role of well-known dietary patterns such as the Mediterranean diet and the Nordic diet in favorable health outcomes, including cardiovascular, metabolic health, and healthy aging. * Discuss the health outcomes of physical activity and healthy aging. * Present the most recent evidence-based data on the independent and synergistic impact of diet and exercise on disease prevention and management including, heart disease, diabetes mellitus, hypertension, dyslipidemia, kidney failure, cancer and other conditions. Prevention and Management of Cardiovascular and Metabolic Disease: Diet, Physical Activity and Healthy Aging is an excellent textbook for upper-level undergraduate and graduate students in medical and health-related disciplines and for health professionals, including dietitians and nutritionists, exercise physiologists, athletic trainers, nurses, physicians, geriatricians, and other health professionals with a special focus in older adults. This book is also a highly useful reference for health professionals interested in introducing diet and physical activity as an intervention for healthy aging as well as the prevention and management of cardiovascular and other metabolic diseases that are prevalent in aging populations.

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Veröffentlichungsjahr: 2023

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Prevention and Management of Cardiovascular and Metabolic Disease

Diet, Physical Activity and Healthy Aging

Peter Kokkinos

Rutgers University, 295 Halsey road, Annapolis, MD, US, 21401

Christina N. Katsagoni

Agia Sofia Children's Hospital, Thivon 1 & Papadiamantopoulou Str, Athens, GR, 11527

Labros S. Sidossis

Rutgers University, 70 Lipman Drive, New Brunswick, NJ, US, 08901‐8525

This edition first published 2023© 2023 John Wiley & Sons Ltd

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Peter Kokkinos, Christina N. Katsagoni, and Labros S. Sidossis to be identified as the authors of this work has been asserted in accordance with law.

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Library of Congress Cataloging‐in‐Publication Data

Names: Kokkinos, Peter, author. | Katsagoni, Christina, N., author.| Sidossis, Labros S., author.Title: Prevention and management of cardiovascular and metabolic disease : diet, physical activity and healthy aging / Peter Kokkinos, Christina N. Katsagoni, Labros S. Sidossis.Description: First edition. | Chichester, West Sussex, UK ; [Hoboken] : Wiley‐Blackwell, 2023. | Includes bibliographical references and index.Identifiers: LCCN 2023013406 (print) | LCCN 2023013407 (ebook) | ISBN 9781119833444 (cloth) | ISBN 9781119833451 (adobe pdf) | ISBN 9781119833468 (epub)Subjects: MESH: Cardiovascular Diseases–prevention & control | Metabolic Diseases–prevention & control | Exercise | Healthy AgingClassification: LCC RC684.D5 (print) | LCC RC684.D5 (ebook) | NLM WG 120 | DDC 616.1/0654–dc23/eng/20230323LC record available at https://lccn.loc.gov/2023013406LC ebook record available at https://lccn.loc.gov/2023013407

Cover Design: WileyCover Image: © Science Photo Library/Alamy Stock Photo, Simone van den Berg/Adobe Stock Photos, Explode/Shutterstock

Preface

Approximately 2500 years ago, the Greek physician and father of medicine Hippocrates wrote: “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” In more recent years, a plethora of scientific evidence supports this concept.

In this book, we present strong scientific evidence that supports the important role of proper diet and physical activity on the prevention and management of cardio‐metabolic diseases and mortality. Our focus is on older adults and healthy aging, as the aging population is increasing globally and is expected to nearly double by 2050. Millions of deaths worldwide are attributed to some of today’s most common diseases such as cardiovascular disease, obesity, type 2 diabetes mellitus, and others.

It is now well‐accepted that individuals who follow a healthy lifestyle live longer and are in better health. Key health behaviors such as physical activity and healthy diet are among the factors that contribute to reducing the risk of chronic diseases, improving quality of life, and promoting healthy aging.

The main aim of this book is to provide health professionals, clinicians, and students in medical and health‐related disciplines with the most recent scientific evidence on the impact of diet and physical activity in the prevention and management of several chronic diseases that are prevalent in aging populations. Our goal is to provide accurate and well‐established knowledge and to identify gaps in our knowledge as well as new challenges for current and future health professionals in our quest to find the safest way to healthy aging via proper diet and physical activity.

This book can serve as a primer for all health‐care professionals involved in the prevention and management of cardiovascular and metabolic conditions with a special focus on older adults, or in a research lab that studies some aspects of lifestyle in relation to healthy aging.

The book is divided into five units. In every chapter, readers are provided with the latest, in‐depth scientific evidence in specific areas.

Unit 1: Diet and Physical Activity as Determinants of Human Health. In Unit 1, we discuss the dual role of lifestyle, e.g., the negative (unhealthy lifestyle) or positive (healthy lifestyle) effects on health. We first describe the link between a suboptimal diet and physical inactivity with non‐communicable diseases. Next, we discuss the concept and mechanisms of epigenetics, presenting how lifestyle stimuli can change our gene expression. We finish this unit by describing the beneficial role of healthy/prudent diets on health.

Unit 2: Basic Concepts of Physical Activity and Fitness. Unit 2 begins with an introduction to the fundamental knowledge needed for both basic and more complex definitions of physical activity, exercise, and fitness. We then describe the implications and health benefits of physical activity in adults.

Unit 3: Determinants of Healthy Aging. In Unit 3, we begin with a discussion on aging and age‐related disease (e.g., the definition of healthy aging, the interface between healthy aging, longevity, and disease, the physiological changes in multiple organ systems through aging, measuring and monitoring tools). Next, we emphasize the role of nutrients, foods, and healthy dietary patterns on aging. For example, we discuss in detail the Mediterranean dietary pattern, the Nordic diet, the Dietary Approaches to Stop Hypertension (DASH) diet, the vegetarian diet, and the Okinawan diet by presenting the latest evidence‐based data on this topic. We finish this unit by including the applicability of metrics used in physical activity for older adults as well as mechanisms to reduce sarcopenia and frailty, common health issues in older adults. We hope that this section will be a useful guide in the hands of health professionals and clinicians who manage older‐adult patients by acknowledging the instrumental role of diet and physical activity as determinants of healthy aging.

Unit 4: Cardiovascular Health, Diet, and Physical Activity. Unit 4 is devoted to specific cardiovascular diseases common in older adults, e.g., heart failure and atrial/flutter fibrillation as well as the loss of normal endothelial function as a hallmark of vascular diseases. We discuss the challenges faced in the assessment and management of these diseases in adults and older adults. We also present specific exercise training and dietary interventions for these populations.

Unit 5: Cardio‐metabolic Health, Diet, and Physical Activity. In Unit 5, we describe the most common metabolic diseases, which include diabetes mellitus, hypertension, dyslipidemia, obesity, metabolic syndrome, obstructive sleep apnea, chronic kidney disease, and obesity‐induced cancers. Most of these conditions require a weight‐loss intervention as part of the strategy to prevent and manage the disease. We provide evidence on the impact of diet‐ or exercise‐alone interventions on muscle physiology in these patients and older adults. We also discuss the synergistic effects of diet and physical activity in achieving optimal health.

Some of the distinctive features of the book are:

Well‐established knowledge related to cardiovascular and metabolic diseases that affect human health.

Applicability to those interested in studying or working with older‐adult patients.

An easy‐to‐use and read format that can be used for undergraduate and graduate teaching.

The latest evidence‐based data to describe some of the healthiest dietary patterns according to the 2015 Dietary Guidelines for Americans: the Mediterranean‐style eating pattern, the DASH diet, the Nordic dietary pattern, and the vegetarian‐type dietary pattern.

Highlighted main messages (key points) at the end of each chapter.

Over 200 “Self‐assessment Questions” and answers that offer readers the most comprehensive, and up‐to‐date coverage in relation to the material presented in the book.

Useful links and related bibliographies at the end of each chapter with patent‐related information and services.

A collection of clinical “Case scenarios” at the end of each chapter in

Units 4

and

5

, for students and health professionals to enhance their knowledge and practice skills relevant to each clinical condition.

We hope that this book can serve as a valuable tool to students in medical and health‐related disciplines and to health professionals, including dietitians and nutritionists, exercise physiologists, athletic trainers, nurses, physicians, geriatricians, and other health professionals. We hope that the information included in this book will advance the implementation of non‐pharmacological strategies that include proper dietary and exercise interventions to better manage cardiovascular and metabolic diseases in adults and older adults, ultimately leading to healthy aging.

We are grateful to Ioanna Katsaroli MSc, Mara Alepoudea cMMedSci, Athanasia Kyrkili ΜSc, Alexandros Tsigkas MSc, Michael Georgoulis PhD, Natasha Kolomvotsou PhD, Eleftheria Papachristou MSc, Despoina Chaloutsi, and Alexandra Foskolou PhD. These passionate young scientists contributed tremendously to completing this book with thorough literature reviews, drafting and editing chapters, and helping during the final stages of book editing. Last, but not least we would like to thank the Wiley team for their dedication and professionalism; Mandy Collison, Tom Marriott, Ranjith Kumar Thanigasalam, Anitha Jasmine Stanley, and Ada Hagan, PhD.

We would like also to thank our families for their continuous love and support.

Peter Kokkinos, PhDAnnapolis, Maryland, USA

Christina N. Katsagoni, PhDAthens, Greece

Labros S. Sidossis, PhDPrinceton, New Jersey, USA

AUTHORS

Peter Kokkinos, PhD, FACSM, FAHA is a Professor in the Department of Kinesiology and Health at Rutgers University, New Brunswick, NJ, USA; Professor of Medicine at George Washington University School of Medicine and Health Sciences; and Physiologist in the Cardiology Department at the Veterans Affairs Medical Center, Washington DC, USA.

Christina N. Katsagoni, PhD is a Clinical Dietitian at Agia Sofia Children's Hospital; Research Associate at the Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece; and post‐doctoral researcher at the Department of Kinesiology and Health at Rutgers University, NJ, USA

Labros S. Sidossis, PhD is a Distinguished Professor at the Department of Kinesiology and Health at Rutgers University, NJ, USA; Professor of Medicine at Robert Wood Johnson Medical School; and President of the Mediterranean Lifestyle Medicine Institute.

List of Contributors

Alepoudea Maria, cMMedSciNutritionist‐Dietitian, Sfantos and PartnerscMMedSci in General Pediatrics and Pediatric Subspecialties, National and Kapodistrian University of AthensResearch Associate, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

Foscolou Alexandra, PhDDietitian‐Nutritionist, EpidemiologistPhD in Nutritional Epidemiology, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

Katsaroli Ioanna, MScClinical Dietitian‐Nutritionist, MSc in Sport Science, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

Kolomvotsou Natasha, PhDChief Clinical Dietitian, Polyclinic of Olympic Village, Athens, Greece PhD in the Department of Food Science & Human Nutrition at the Agricultural University of Athens‐Greece

Kyrkili Athanasia, MScDietitian‐Nutritionist, MSc in Clinical Nutrition, Research Associate, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

Georgoulis Michael, PhDDietitian‐NutritionistPost Doctoral Researcher, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

Pantelis‐Tsigkas Alexandros, MScDietitian‐Nutritionist, MSc in Clinical Nutrition, Research Associate, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

Papachristou Eleftheria, MScClinical Dietitian‐Nutritionist, MSc in Clinical Nutrition, Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Greece

UNIT 1Diet and Physical Activity as Determinants of Human Health