diet – IH CONNECT

This is the second part of a IH Blog series on Cardiovascular Disease.

By Brianna Koenick MPH (c) MMS (c) and Dr. Heather F. McClintock PhD MSPH MSW

More than 670 million people have been infected with COVID-19 worldwide. The pandemic exacerbated health disparities between high-income countries (HICs) and low-income and middle-income countries (LMICs), and the global community is continuing to grapple with the immediate and long-term implications of COVID-19. Long COVID is loosely defined as having symptoms at least two months after the initial infection and lasting for at least four weeks. A longitudinal cohort study conducted in South Africa found 39% of participants showed significant symptoms 6 months after a COVID-19 infection. In the United States, approximately 1 in 7 people have suffered from long COVID according to survey data. Cardiovascular disease (CVD) is a leading cause of death in the U.S. and globally, and substantial evidence suggests that the COVID-19 increases risk for poor cardiovascular outcomes. Researchers suggest that biological, social/psychological, and systemic factors underlie the complex relationship between CVD and COVID-19. Biologically, chronic inflammation and other physiological changes may contribute to increased CVD risk. Impaired social, behavioral and psychological well-being related to contextual influences related to the pandemic exacerbate CVD risk. Further, systemic breakdowns and infrastructure challenges lead to poor access to high quality care and services.

Several systematic literature reviews and meta-analyses have documented a relationship between long COVID-19 and CVD. One of these investigations reviewed 150 studies focused on 57 cardiac complications published between January 2020 to July 2023 that persisted for at least 1 month after a COVID-19 infection. Their meta-analysis included 137 studies that identified 17 complications. They found a high prevalence of many complications, particularly chest pain and abnormal heart rhythms (arrhythmias). The authors noted that there were many CVD complications identified that lasted for years post COVID-19. The World Heart Federation has conducted “the largest global effort to reflect geographic spread” of COVID-19 and CVD aiming to determine the short-and long-term clinical sequelae among COVID-19 hospitalized patients across 16 low-middle-,upper-middle and high-income countries. Findings were presented at the 2023 European Society of Cardiology Conference indicating high post-discharge mortality for persons with COVID-19 in LMICs. Future predictions for CVD in the U.S. from 2025 to 2060 indicate that stroke will increase 33.8%, heart failure will increase 33.4%, ischemic heart disease will increase 30.7%, and heart attack will increase 16.9%. These CVD rate increases are expected to have the biggest impact on Black and Hispanic communities in the U.S. Globally, predictions indicate there will be a 50.2% increase in cardiovascular mortality rates between 2025 and 2050 with an increased burden on LMICs.

Many initiatives and interventions have been implemented to try to reduce the CVD burden in the context of COVID-19. For instance, the U.S. Centers for Disease Control and Prevention developed the Community Health Workers for COVID Response and Resilient Communities initiative (CCR) to “strengthen the public health workforce, slow the spread of COVID-19, and move toward health equity.” Regarding long COVID, the NIH RECOVER Initiative was launched in 2021 and included the largest, most diverse study group to learn more about long COVID in hopes to treat and prevent it moving forward. The World Heart Federation has information and resources related to COVID-19 and CVD including those with practical applications for practicing professionals. While many effective and impactful projects have been implemented, further research and initiatives are needed to understand and address the complex relationship between CVD and COVID-19.

Brianna Koenick MPH (c) MMS (c)

Brianna Koenick is a current student in Arcadia University’s Dual Master of Public Health/Master of Medical Science in Physician Assistant Program. As an MPH student, her capstone research explored the relationship between lifestyle factors and cognitive health outcomes related to dementia. She completed an internship at the Jewish Relief Agency, a hunger-relief organization working to inspire volunteerism across the greater Philadelphia region, where she assisted the client services team with community outreach and developed communication materials for both clients and volunteers. Her public health interests include preventative health, environmental health, and health equity. After graduating, she plans to continue practicing evidence-based public health and advocating for the communities she will serve as a Physician Assistant.

Dr. Heather F. McClintock PhD MSPH MSW

Dr. McClintock is an IH Section Member and Associate Professor in the Department of Public Health, College of Health Sciences at Arcadia University. She earned her Master of Science in Public Health from the Department of Global Health and Population at the Harvard School of Public Health. Dr. McClintock received her PhD in Epidemiology from the University of Pennsylvania with a focus on health behavior and promotion. Her research broadly focuses on the prevention, treatment, and management of chronic disease and disability globally. Recent research aims to understand and reduce the burden of intimate partner violence in Sub-Saharan Africa. Prior to completing her doctorate she served as a Program Officer at the United States Committee for Refugees and Immigrants and a Senior Project Manager in the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania. At the University of Pennsylvania she led several research initiatives that involved improving patient compliance and access to quality healthcare services including the Spectrum of Depression in Later Life Study and Integrating Management for Depression and Type 2 Diabetes Mellitus Study.

October 10 was World Mental Health Day.
October 15 was Global Handwashing Day.

POLITICS AND POLICY

The U.S. Army has proposed major cuts to its work on HIV, especially in the vaccine field. Leaders of the Infectious Diseases Society of America and other biomedical research organizations oppose the cuts.
The WHO plans to recommend tighter nutritional standards in food aid for young children, a move activists say is necessary to improve donations from countries such as the United States.
The US Department of Defense is funding platforms that will completely rethink how malaria drugs are developed.
Former Bush Administration official Andrew Natsios argues the case for foreign aid: “Singling out foreign aid for disproportionate cuts—which is exactly what has happened—is a serious mistake the United States as a world leader will pay for in the future.”
A survey of 507 Americans at the end of September sought to capture what, exactly, Americans know about the foreign aid budget. Particpiants were asked four questions about their impressions of foreign aid and opinions on why it is important to American interests. Go here to read the full fact sheet that also includes more details about the study’s methods and see below to review the results in more detail.
The World Health Organization’s chief on Monday urged governments to unite against “big tobacco”, as she accused the industry of dirty tricks, bullying and immorality in its quest to keep people smoking.

PROGRAMS

Berk Ozler examines some recent reports about the challenges surrounding male circumcision. In the World Bank Development Impact blog, he offers two suggestions for how to improve the programs.
A partnership between Pampers and UNICEF to deliver neonatal tetanus vaccines is on track to eliminate the disease by 2015.
A $258 million initiative sponsored by the Bill & Melinda Gates Foundation aimed at preventing AIDS in India appears to have paid off overall, researchers say, resulting in more than 100,000 fewer new HIV infections over five years. Many aren’t quite ready to judge this project, Avahan, a success, however. The project failed in three of the six Indian states where it was tested.
Are the Millennium Villages an intervention that can reach scale? Supporters say yes and detractors are skeptical. Madeline Bunting covers the debate in the Guardian Development.
A report on the MGDS by United Nations Development Program, the UN Economic Commission for Africa, the African Development Bank and the African Union Commission says that social protection programs can have a wide positive impact.

RESEARCH

A cancer diagnosis can leave lasting psychological scars akin to those inflicted by war, according to a new survey. More than decade after being told they had the disease, nearly four out of 10 cancer survivors said they were still plagued by symptoms of post-traumatic stress disorder, or PTSD.
Researchers have found that vitamin D can be used to activate the immune system’s response to TB.
The Paul G Allen Family Foundation is supporting the Infectious Disease Research Institute phase I TB vaccine trial with a two-year $300,000 grant.
We know that eating lots of fruits and vegetables is good for the heart, but can a healthy diet really overcome the effect of genes that boost your risk for heart problems?
Vitamin E supplements significantly increased the risk of prostate cancer in healthy men even after they stopped taking them, scientists reported Tuesday. Given the popularity of vitamin E for those 60 and over, the researchers wrote, “the implications of our observations are substantial.” Those studied took 400 international units (IUs) a day.
New studies find that young people diagnosed with HIV will now likely survive for close to 46 years thanks to improved antiretrovirals
A Norwegian study found that pregnant women who took folic acid supplements in the first two months of pregnancy were less likely to have children with severe language delays.
“Tobacco Control is Tuberculosis Control,” says a new study in the British Medical Journal.
The NIH has announced that it is providing University of California San Francisco $718,136 to support its anti-malaria research.
A study by the Institute for Health Metrics and Evaluation, University of Washington, University of Hong Kong and the Public Health Foundation of India and published in the Lancet shows that an Indian program to focus HIV intervention projects in high risk groups has dramatically reduced infection rates.

DISEASES AND DISASTERS

Primitive cooking stoves are used throughout half the world and kill more people per year — about two million — than malaria, researchers say. Three billion people worldwide cook indoors by burning solid fuels such as wood, charcoal or dung and are at high risk for lung diseases.
Over the past three years, 1.5 million children deaths from malaria were averted, said the chief of Roll Back Malaria, downgrading malaria from the leading cause of infant mortality in Africa to the third leading cause of child mortality.
The world has become more vulnerable to outbreaks of disease caused by contaminated food because of growing global trade and tracking them down is also difficult due to the global food supply chain, health officials said.
For the first time, tuberculosis rates are declining worldwide. World Health Organization officials reported case numbers have gone down and death rates have plummeted 40% from 1990 to 2010. China has seen death rates decline almost 80% from 1990 to 2010.
Mental illness drives a surprising amount of disability and death around the planet. The World Health Organization says investing just $3 to $4 per person to improve mental health in poor countries would significantly reduce the health and economic losses from mental illness.

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Cardiovascular Disease and COVID-19

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