Efeito da Dieta Cardioprotetora Brasileira suplementada ou não com amendoins (Arachis hypogaea) sobre parâmetros cardiometabólicos no pós-infarto agudo do miocárdio
Introduction: cardiovascular diseases (CVD) are responsible for almost 18 million deaths a year worldwide, and acute myocardial infarction (AMI) affects approximately 300,000 Brazilians annually.The Brazilian Cardioprotective Diet (DICA-BR) was designed to facilitate nutritional guidance to the Brazilian population based on national clinical guidelines and the backdrop of the Mediterranean diet and the American Heart Association guidelines.Peanut has components such as fiber, proteins, arginine, phenolic compounds, niacin, folate, magnesium, manganese, and monounsaturated and polyunsaturated fatty acids, whose nutritional composition has the potential to modulate cardiovascular risk.Objective: to evaluate the effect of DICA-BR, supplemented or not with peanuts, on cardiometabolic parameters in patients with recent AMI.Methods: the study was a randomized clinical trial, with 100 individuals allocated into two groups (allocation ratio 1:1).Inclusion criteria are age over 40 years and having an AMI episode between the last 60 and 180 days.Group 1 received DICA-BR-aligned guidance while group 2 received DICA-BR-aligned guidance and peanut supplementation of 30 g/day.Patients were followed for four months, with visits occurring at 30, 60, 90, and 120 days after the start of the experimental protocol.Throughout the study, anthropometric assessment, 24hour recalls, assessment of medication used and physical exercise and smoking habits, socioeconomic questionnaire, and blood collection for biochemical tests were performed.The primary outcome of the present study was the plasma concentration of cholesterol associated with low-density lipoprotein (LDL-c), and the secondary outcomes were characterized as other indicators of lipid profile and glycemic control, food intake, anthropometric indices, malondialdehyde concentration (MDA), and total antioxidants (TAOC), catalase enzyme activity and fatty acid profile in the plasma membrane of erythrocytes.For statistical analysis, paired t-tests were performed.Results: there was no significant difference regarding the variation of plasma LDL-c concentration in groups 1 and 2 throughout the protocol.A significant reduction in the plasma concentration of triacylglycerols was observed in individuals in group 1 (191 mg/dL [t=0] vs 160 mg/dL [t=1]; p = 0.03), as well as a significant increase in the concentration plasma HDL-c in group 2 (40.3 mg/dL [t=0] vs 42.8 mg/dL [t=1]; p = 0.003).Group 2 showed a reduction in total energy consumption (1772 Kcal/day [t=0] vs 1374 Kcal/day [t=1]; p = 0.002) and both groups showed a decrease in MDA concentrations (Group 1: 0, 63 Mol/mL [t=0] vs 0.4 Mol/mL [t=1]; p = 0.007 and group 2: 0.81 Mol/mL vs 0.4 Mol/mL; p = 0.038).The other biomarkers showed no significant difference.Conclusion: after 16 weeks of follow-up, the results show that in isolation, DICA-BR promotes an improvement in cardiovascular risk by reducing plasma biomarkers, such as triacylglycerol concentration and the triacylglycerol/HDL ratio, and reduction in anthropometric indices, such as BMI and waist circumference.However, when supplemented with peanuts, DICA-BR has a positive impact on plasma HDL-c concentration, suggesting a potential benefit of this intervention concerning reverse cholesterol transport.
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