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PhD project participating in the National Research School in General Medicine.
Cardiovascular disease is the leading cause of death globally (1). The underlying mechanisms of cardiovascular diseases are complex and multifactorial. The overall aim of this thesis is to study health factors and behaviors in relation to inflammation and cardiovascular disease in the general population, as well as in patients with type 2 diabetes.
Inflammation is suggested to play an important role in the development of cardiovascular disease (2). An aim of the project is to investigate the association of low-grade inflammation and cardiovascular health (3).
Type 2 diabetes is a major risk factor for cardiovascular disease (4). Diet is an important part of the prevention and treatment of type 2 diabetes (5). An aim of this project is to study the effect of a mobile health application for dietary advice on HbA1c, blood lipids, and low-grade inflammation in patients with type 2 diabetes. This application is used in several other countries and may be helpful to patients but is not yet available in Sweden.
Methods
Data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), a national cohort study of 30 000 participants, will be analyzed in first and second study. The first study will include an analysis of the association between health behaviors (diet, physical activity, nicotine exposure and sleep), health factors (body mass index, blood lipids, glucose and blood pressure) and the inflammatory marker high sensitivity C-reactive protein.
The second study, a pilot study, including 100 participants from the SCAPIS cohort, is a preparation of the randomized controlled implementation trial of a mobile health dietary application. The pilot study will include digital questionnaires about symptoms, functions and quality of life. Self-administered home blood tests will be used for measurement of average blood sugar levels (HbA1c). Participants will be interviewed regarding their experiences of the digital systems used in the study and self-administered home blood tests.
The third study, a randomized controlled trial, including 900 patients with type 2 diabetes, will examine the effect of an application for healthier food choices on HbA1c, blood lipids and low-grade inflammation. The application will show an interpretive nutritional information about packaged food and suggest healthier options.
The burden of cardiovascular diseases on public health and health care is significant. The prevention of cardiovascular diseases reduces costs and is of importance to individuals’ health and quality of life. Studying health factors and behaviors may support the promotion of cardiovascular health in the general population as a tool for cardiovascular disease prevention. Furthermore, a mobile health application for dietary advice is easily accessible and may be helpful for patients with type 2 diabetes.
References
1. WHO. Topic on cardiovascular diseases. World Health Organization.
2. Libby P.: Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr 2006 Feb; 83: pp. 456S-460S.
3. Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W; American Heart Association. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022 Aug 2;146(5):e18-e43. doi: 10.1161/CIR.0000000000001078. Epub 2022 Jun 29. PMID: 35766027.
4. Einarson, T.R., Acs, A., Ludwig, C. et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol 17, 83 (2018).
5. Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet. 2014 Jun 7;383(9933):1999-2007. doi: 10.1016/S0140-6736(14)60613-9.
Linköping University
Karin Rådholm, Associate Professor
