What Can We Change in Diet and Behaviour in Order to Decrease Carotid Intima-Media Thickness in Patients with Obesity?

Abstract

Atherosclerosis—considered the major cause of cardiovascular diseases (CVDs)—is strongly associated with obesity, to which it strongly contributes. Moreover, atherosclerosis is characterised by a long asymptomatic phase, and its progression can lead to serious cardiovascular (CV) events. The carotid intima-media thickness (cIMT) has been determined as a predictor of CV events, as well as a marker of subclinical atherosclerosis, and has been used in clinical trials as an alternative assessment method or a surrogate endpoint. It should be noted that several behavioural approaches can directly influence the cIMT values, and decrease or increase the CV risk. In our paper, we aimed to summarize the current knowledge regarding IMT measurement among patients with obesity as a risk group—also in terms of the obesity paradox where the diagnosis of subclinical atherosclerosis is especially essential and implements the early therapeutic approach. We also summarized behavioural, modifiable factors, such as the Mediterranean diet, the Dietary Approach to Stop Hypertension Diets, body weight reduction or the intake of micro- and macronutrients, with a particular focus on the studies where the cIMT values were one of the outcomes. In order to collect the literature data related to the presented topic, the PubMed database was explored.

The Role of Physical Activity Status in the Relationship between Obesity and Carotid Intima-Media Thickness (CIMT) in Urban South African Teachers: The SABPA Study

“…Another limitation is that individual step test calibration of the ActiHeart device was not performed due to the vast number of participants, limited time, and the high-risk profiles of the participants; however, participants were thoroughly interviewed about their habitual PA patterns. An additional limitation of the study was the lack of menopausal status data given that some studies established that in obese women, significant differences in CIMT between pre-and post-menopausal women, and menopause exist [54][55][56]. The role of genetics factors in the physiological parameters of individuals to health is another limitation and should be considered in future similar studies.…”

The Interconnection between Carotid Intima–Media Thickness and Obesity: Anthropometric, Clinical and Biochemical Correlations

“…CIMT was measured according to the Mannheim protocol using a linear ultrasound transducer (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) [15]. Patients were in a supine position with their neck in extension and the probe was in an antero-lateral position.…”

“…The potential of CIMT measurement for the early detection of vascular remodeling was also demonstrated by the research of Lucas-Herald et al in a younger population [ 5 ]. CIMT was shown to be a convenient method for observing the reversibility of arterial wall thickness in individuals with obesity after the change in various variable factors, such as diet, nutrient intake, and weight loss [ 6 ]. Also, CIMT appears to be a simple method that can monitor the transition of a person with normal body mass to obesity as well as to a metabolically abnormal status [ 7 ].…”

Individualized Management of Patients with Coronary Artery Disease

“…In a review paper, Rychter et al summarized the knowledge on carotid intima media thickness (IMT) measurement among obese patients as well as options for an individualized approach to decrease IMT in this group, taking into consideration diet and behavioral changes [ 2 ].…”