Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature

Oskari Repo; Markus Juonala; Harri Niinikoski; Suvi Rovio; Juha Mykkänen; Hanna Lagström; Carol Y Cheung; Dawei Yang; Hanna Vaahtoranta-Lehtonen; Antti Jula; Jaakko Nevalainen; Tapani Rönnemaa; Jorma Viikari; Olli Raitakari; Robyn Tapp; Katja Pahkala

doi:10.1093/eurheartj/ehae423

Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature

Oskari Repo
, Markus Juonala
, Harri Niinikoski
, Suvi Rovio
, Juha Mykkänen
, Hanna Lagström
, Carol Y Cheung
, Dawei Yang
, Hanna Vaahtoranta-Lehtonen
, Antti Jula
, Jaakko Nevalainen
, Tapani Rönnemaa
, Jorma Viikari
, Olli Raitakari
, Robyn Tapp
, Katja Pahkala

Chinese University of Hong Kong
University of Melbourne
University of Turku
Turku University Hospital
Finnish Institute for Health and Welfare
University of Tampere

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

55 Downloads (Pure)

Abstract

Background and Aims: Retinal microvasculature characteristics predict cardiovascular morbidity and mortality. This study investigated associations of lifelong cardiovascular risk factors and effects of dietary intervention on retinal microvasculature in young adulthood.

Methods: The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years).

Results: The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles.

Conclusions: Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.

Original language	English
Article number	ehae423
Pages (from-to)	3072-3085
Number of pages	14
Journal	European Heart Journal
Volume	45
Issue number	33
Early online date	12 Jul 2024
DOIs	https://doi.org/10.1093/eurheartj/ehae423
Publication status	Published - 1 Sept 2024

Bibliographical note

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]

Funder

This work was supported by the Academy of Finland (grant nos. 206374, 294834, 251360, 275595, 307996, and 322112), the Juho Vainio Foundation, the Finnish Foundation for Cardiovascular Research, the Finnish Ministry of Education and Culture, the Finnish Cultural Foundation, the Sigrid Jusélius Foundation, Special Governmental grants for Health Sciences Research, the Yrjö Jahnsson Foundation, the Finnish Medical Foundation, and the Turku University Foundation.

Funding

This work was supported by the Academy of Finland (grant nos. 206374, 294834, 251360, 275595, 307996, and 322112), the Juho Vainio Foundation, the Finnish Foundation for Cardiovascular Research, the Finnish Ministry of Education and Culture, the Finnish Cultural Foundation, the Sigrid Jusélius Foundation, Special Governmental grants for Health Sciences Research, the Yrjö Jahnsson Foundation, the Finnish Medical Foundation, and the Turku University Foundation.

Funders	Funder number
Academy of Finland	206374, 294834, 251360, 275595, 307996, 322112
Juho Vainion Säätiö
Finnish Foundation for Cardiovascular Research
Ministry of Education and Culture
Suomen Kulttuurirahasto
Sigrid Juselius Foundation
Yrjö Jahnssonin Säätiö
Finnish Medical Foundation
Turku University Foundation

Keywords

Retinal microvasculature
Microvascular
Cardiovascular health
Nutrition
Childhood
Prevention

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Tapp2024VoRFinal published version, 1.11 MBLicence: CC BY-NC

Cite this

Repo, O., Juonala, M., Niinikoski, H., Rovio, S., Mykkänen, J., Lagström, H., Cheung, C. Y., Yang, D., Vaahtoranta-Lehtonen, H., Jula, A., Nevalainen, J., Rönnemaa, T., Viikari, J., Raitakari, O., Tapp, R., & Pahkala, K. (2024). Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature. European Heart Journal, 45(33), 3072-3085. Article ehae423. https://doi.org/10.1093/eurheartj/ehae423

Repo, O, Juonala, M, Niinikoski, H, Rovio, S, Mykkänen, J, Lagström, H, Cheung, CY, Yang, D, Vaahtoranta-Lehtonen, H, Jula, A, Nevalainen, J, Rönnemaa, T, Viikari, J, Raitakari, O, Tapp, R & Pahkala, K 2024, 'Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature', European Heart Journal, vol. 45, no. 33, ehae423, pp. 3072-3085. https://doi.org/10.1093/eurheartj/ehae423

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title = "Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature",

abstract = "Background and Aims: Retinal microvasculature characteristics predict cardiovascular morbidity and mortality. This study investigated associations of lifelong cardiovascular risk factors and effects of dietary intervention on retinal microvasculature in young adulthood. Methods: The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years). Results: The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles. Conclusions: Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.",

keywords = "Retinal microvasculature, Microvascular, Cardiovascular health, Nutrition, Childhood, Prevention",

author = "Oskari Repo and Markus Juonala and Harri Niinikoski and Suvi Rovio and Juha Mykk{\"a}nen and Hanna Lagstr{\"o}m and Cheung, \{Carol Y\} and Dawei Yang and Hanna Vaahtoranta-Lehtonen and Antti Jula and Jaakko Nevalainen and Tapani R{\"o}nnemaa and Jorma Viikari and Olli Raitakari and Robyn Tapp and Katja Pahkala",

note = "This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]",

year = "2024",

month = sep,

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doi = "10.1093/eurheartj/ehae423",

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volume = "45",

pages = "3072--3085",

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T1 - Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature

AU - Repo, Oskari

AU - Juonala, Markus

AU - Niinikoski, Harri

AU - Rovio, Suvi

AU - Mykkänen, Juha

AU - Lagström, Hanna

AU - Cheung, Carol Y

AU - Yang, Dawei

AU - Vaahtoranta-Lehtonen, Hanna

AU - Jula, Antti

AU - Nevalainen, Jaakko

AU - Rönnemaa, Tapani

AU - Viikari, Jorma

AU - Raitakari, Olli

AU - Tapp, Robyn

AU - Pahkala, Katja

N1 - This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]

PY - 2024/9/1

Y1 - 2024/9/1

N2 - Background and Aims: Retinal microvasculature characteristics predict cardiovascular morbidity and mortality. This study investigated associations of lifelong cardiovascular risk factors and effects of dietary intervention on retinal microvasculature in young adulthood. Methods: The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years). Results: The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles. Conclusions: Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.

AB - Background and Aims: Retinal microvasculature characteristics predict cardiovascular morbidity and mortality. This study investigated associations of lifelong cardiovascular risk factors and effects of dietary intervention on retinal microvasculature in young adulthood. Methods: The cohort is derived from the longitudinal Special Turku Coronary Risk Factor Intervention Project study. The Special Turku Coronary Risk Factor Intervention Project is a 20-year infancy-onset randomized controlled dietary intervention study with frequent study visits and follow-up extending to age 26 years. The dietary intervention aimed at a heart-healthy diet. Fundus photographs were taken at the 26-year follow-up, and microvascular measures [arteriolar and venular diameters, tortuosity (simple and curvature) and fractal dimensions] were derived (n = 486). Cumulative exposure as the area under the curve for cardiovascular risk factors and dietary components was determined for the longest available time period (e.g. from age 7 months to 26 years). Results: The dietary intervention had a favourable effect on retinal microvasculature resulting in less tortuous arterioles and venules and increased arteriolar fractal dimension in the intervention group when compared with the control group. The intervention effects were found even when controlled for the cumulative cardiovascular risk factors. Reduced lifelong cumulative intake of saturated fats, main target of the intervention, was also associated with less tortuous venules. Several lifelong cumulative risk factors were independently associated with the retinal microvascular measures, e.g. cumulative systolic blood pressure with narrower arterioles. Conclusions: Infancy-onset 20-year dietary intervention had favourable effects on the retinal microvasculature in young adulthood. Several lifelong cumulative cardiovascular risk factors were independently associated with retinal microvascular structure.

KW - Retinal microvasculature

KW - Microvascular

KW - Cardiovascular health

KW - Nutrition

KW - Childhood

KW - Prevention

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DO - 10.1093/eurheartj/ehae423

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VL - 45

SP - 3072

EP - 3085

JO - European Heart Journal

JF - European Heart Journal

IS - 33

M1 - ehae423

ER -

Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature

Abstract

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Funding

Keywords

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