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Influence of the Mediterranean Diet on 25- Hydroxyvitamin D Levels in Adults. Nutrients 2020; 12:nu12051439. [PMID: 32429342 PMCID: PMC7284708 DOI: 10.3390/nu12051439] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/26/2020] [Accepted: 05/14/2020] [Indexed: 02/07/2023] Open
Abstract
The Mediterranean diet (MD) is a dietary pattern effective in terms of prevention of obesity-related diseases, and represents the gold standard in preventive medicine, due to the synergistic action of many nutrients with antioxidant and anti-inflammatory properties. In addition, excess body weight significantly increases the risk of hypovitaminosis D, a well-recognized common feature of individuals with obesity. It is well-known that there is a clear gender difference in the adherence to the MD. The aim of this study was to investigate the association between adherence to the MD and 25-hydroxyvitamin D (25OHD) levels in adults, according to gender. Study population consisted of 617 participants; 296 were males and 321 were females, matched by age and body mass index (BMI). A validated 14-item questionnaire PREDIMED (Prevención con dieta Mediterránea) was used for the assessment of adherence to the MD. The 25OHD levels were determined by a direct competitive chemiluminescence immunoassay. Females have a higher PREDIMED score than males (7.4 ± 2.8 vs. 6.7 ± 3.1 score, p = 0.001), and according to PREDIMED categories, a greater percentage of males had low adherence to the MD compared to their female counterparts (40.2% vs. 37.1%; χ2 = 8.94, p = 0.003). The 25OHD levels were higher in males than in females (18.3 ± 7.3 vs. 16.8 ± 7.8 ng/mL, p = 0.01), and a higher percentage of males had sufficient 25OHD levels (>30 ng/mL) than their female counterparts (10.5% vs. 3.4%, χ2 = 10.96, p < 0.001). Stratifying the sample population according to 25OHD categories, BMI decreased and PREDIMED score increased significantly along with the increased 25OHD levels, in both males and females, respectively (p < 0.001). Looking at the bivariate correlations, PREDIMED score was positively correlated with 25OHD levels after adjusting for age and BMI, in both males (r = 0.21, p < 0.001) and females (r = 0.30, p < 0.001). At the bivariate proportional odds ratio (OR) model, 25OHD levels presented the highest OR values in the category low adherence vs. high adherence to the MD, in both genders (OR 1.21 and OR 1.31, in males and females, respectively). Receiver operator characteristic (ROC) analysis was performed to determine the cut-off values of PREDIMED scores predictive of 25OHD levels: PREDIMED score >5 in males (p < 0.001) and >7 in females (p < 0.001) could serve as thresholds for 25OHD levels above the median. The results of our study highlighted a novel positive association between adherence to the MD and 25OHD levels in both genders. Although 25OHD levels were higher in males than females, 69.7% were deficient. To the best of our knowledge, this is the first study to show that high adherence to the MD is associated with low BMI and high 25OHD levels in both genders, probably through the anti-inflammatory and anti-oxidant effects that are synergistically exerted by either MD or vitamin D on body weight.
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González-García S, Green RF, Scheelbeek PF, Harris F, Dangour AD. Dietary recommendations in Spain -affordability and environmental sustainability? JOURNAL OF CLEANER PRODUCTION 2020; 254:120125. [PMID: 33897918 PMCID: PMC7610673 DOI: 10.1016/j.jclepro.2020.120125] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Global food demand is increasing due to population growth and dietary transitions, resulting from rising incomes, are associated with increased prevalence of non-communicable diseases. Improving the sustainability of the food sector is also critical for achieving the Sustainable Development Goals. This study assesses for the first time the greenhouse gases emissions (Carbon Footprint - CF), the water footprint (WF) and the cost of three omnivorous diets recommended in Spain due to their health benefits: the Mediterranean diet (MD), the Southern European Atlantic diet (SEAD) and the Spanish dietary guidelines (NAOS). Analysis was conducted using standard Life Cycle Assessment and WF methods together with current Spanish food price data. The dietary energy recommendation of the SEAD is greater than that of MD and NAOS (11 and 15% respectively), and SEAD also has greater animal source food content than the other two diets. SEAD has a concomitantly higher CF, WF and cost scores in comparison with MD (+30%, +23% and +21% respectively) and NAOS (+15%, +9% and +21% respectively). Adjusting recommendations to meet the suggested Spanish adult dietary energy of 2228 kcal.capita-1.day-1 changed the environmental profiles of the diets and the NAOS has the highest environmental impact. However, the isocaloric diets had approximately the same cost. Analysis of the WF of the diets identified the major contribution of precipitation (the green WF) to the overall WF (88% of the total) and the significant contribution of animal-source foods to dietary WF. Regardless of the dietary scenario, better scores were identified for the Spanish recommendations analysed than those reported for other healthy diets identified in Europe. Differences in the recommended intake levels of certain food groups, cooking techniques and the origin of food products are behind these results. Environmental indicators should be considered alongside nutrition and health metrics when defining national dietary guidelines. Supporting citizens to follow healthy and environmentally-friendly dietary recommendations through, among other things, information campaigns and nutritional education programmes is essential. It is recommended the incorporation not only of health, but also of environmental indicators of these dietary options in the national dietary guidelines, as well as implementation of information campaigns and nutritional education programs among citizens to promote their adhesion since balanced dietary habits rich on plant-based products and low on animal-based ones involve multiple health and environmental benefits.
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Affiliation(s)
- Sara González-García
- CRETUS Institute, Department of Chemical Engineering, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain
| | - Rosemary F. Green
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Pauline F. Scheelbeek
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Francesca Harris
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Alan D. Dangour
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
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González-García S, Green RF, Scheelbeek PF, Harris F, Dangour AD. Dietary recommendations in Spain -affordability and environmental sustainability? JOURNAL OF CLEANER PRODUCTION 2020; 254:120125. [PMID: 33897918 DOI: 10.1016/j.jclepro.2020.120122] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Global food demand is increasing due to population growth and dietary transitions, resulting from rising incomes, are associated with increased prevalence of non-communicable diseases. Improving the sustainability of the food sector is also critical for achieving the Sustainable Development Goals. This study assesses for the first time the greenhouse gases emissions (Carbon Footprint - CF), the water footprint (WF) and the cost of three omnivorous diets recommended in Spain due to their health benefits: the Mediterranean diet (MD), the Southern European Atlantic diet (SEAD) and the Spanish dietary guidelines (NAOS). Analysis was conducted using standard Life Cycle Assessment and WF methods together with current Spanish food price data. The dietary energy recommendation of the SEAD is greater than that of MD and NAOS (11 and 15% respectively), and SEAD also has greater animal source food content than the other two diets. SEAD has a concomitantly higher CF, WF and cost scores in comparison with MD (+30%, +23% and +21% respectively) and NAOS (+15%, +9% and +21% respectively). Adjusting recommendations to meet the suggested Spanish adult dietary energy of 2228 kcal.capita-1.day-1 changed the environmental profiles of the diets and the NAOS has the highest environmental impact. However, the isocaloric diets had approximately the same cost. Analysis of the WF of the diets identified the major contribution of precipitation (the green WF) to the overall WF (88% of the total) and the significant contribution of animal-source foods to dietary WF. Regardless of the dietary scenario, better scores were identified for the Spanish recommendations analysed than those reported for other healthy diets identified in Europe. Differences in the recommended intake levels of certain food groups, cooking techniques and the origin of food products are behind these results. Environmental indicators should be considered alongside nutrition and health metrics when defining national dietary guidelines. Supporting citizens to follow healthy and environmentally-friendly dietary recommendations through, among other things, information campaigns and nutritional education programmes is essential. It is recommended the incorporation not only of health, but also of environmental indicators of these dietary options in the national dietary guidelines, as well as implementation of information campaigns and nutritional education programs among citizens to promote their adhesion since balanced dietary habits rich on plant-based products and low on animal-based ones involve multiple health and environmental benefits.
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Affiliation(s)
- Sara González-García
- CRETUS Institute, Department of Chemical Engineering, Universidade de Santiago de Compostela, 15782, Santiago de Compostela, Spain
| | - Rosemary F Green
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Pauline F Scheelbeek
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Francesca Harris
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Alan D Dangour
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
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Tobore TO. Towards a comprehensive theory of obesity and a healthy diet: The causal role of oxidative stress in food addiction and obesity. Behav Brain Res 2020; 384:112560. [DOI: 10.1016/j.bbr.2020.112560] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 02/06/2023]
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Barnaba L, Intorre F, Azzini E, Ciarapica D, Venneria E, Foddai MS, Maiani F, Raguzzini A, Polito A. Evaluation of adherence to Mediterranean diet and association with clinical and biological markers in an Italian population. Nutrition 2020; 77:110813. [PMID: 32450332 DOI: 10.1016/j.nut.2020.110813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/22/2020] [Accepted: 03/07/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the overall diet quality of an Italian population through the use of the Mediterranean Diet Serving Score (MDSS) and its relation to clinical and biochemical nutritional markers. METHODS The study was conducted on healthy participants ages 18 to 86 y living in central Italy. Adherence to the Mediterranean food pattern was evaluated by a semiquantitative food frequency, using the MDSS. Anthropometric measurements and biochemical analyses of nutritional interest were performed according to the standardized procedure. RESULTS The sample included a total of 349 participants (121 men and 228 women) with an average age of 54 ± 15 y and a body mass index of 27.4 ± 4.8 kg/m2, underlining an overweight status in both men and women. The mean educational level was medium-high in both sexes, whereas the occupation level was higher in women than in men (P = 0.001). The mean MDSS score was 14.4 ± 4.1 out of a total of 24 points. The adherence was higher in women (score 14.7 ± 3.9) than men (score 13.9 ± 4.4), although there were no significant differences (P = 0.25). No statistical differences in MDSS were found in relation to body mass index and educational level, whereas a higher MDSS score was observed in the older age group (P < 0.05). A positive correlation among MDSS, high-density lipoprotein cholesterol, and vitamin C has been found (P < 0.05), whereas there was a negative correlation with uric acid and triacylglycerols (P < 0.05). A logistic regression analysis highlighted smoking habit as the only predictive factor for a high adherence to MDSS (P < 0.05). CONCLUSIONS MDSS has a low adherence to the Mediterranean diet, particularly in the youngest age group and smokers. The index shows a correlation with some parameters of nutritional interest and further larger cohorts studies are needed to confirm our findings.
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Affiliation(s)
- Lorenzo Barnaba
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy.
| | - Federica Intorre
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Elena Azzini
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Donatella Ciarapica
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Eugenia Venneria
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Maria Stella Foddai
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Francesca Maiani
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Anna Raguzzini
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
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Saugo E, Lasalvia A, Bonetto C, Cristofalo D, Poli S, Bissoli S, Bertani M, Lazzarotto L, Gardellin F, Ceccato E, Pavanati M, Tosato S, Ruggeri M. Dietary habits and physical activity in first-episode psychosis patients treated in community services. Effect on early anthropometric and cardio-metabolic alterations. Schizophr Res 2020; 216:374-381. [PMID: 31806524 DOI: 10.1016/j.schres.2019.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/27/2019] [Accepted: 11/05/2019] [Indexed: 01/08/2023]
Abstract
People with psychosis often develop metabolic and cardiovascular disorders, due to several factors including unhealthy lifestyle and antipsychotic treatment. This study aims to evaluate in a sample of first episode psychosis (FEP) patients lifestyle factors, with a specific emphasis on dietary habits and physical activity, and cardio-metabolic and anthropometric profile at illness onset and at 9 months. Moreover, this study aims to evaluate the impact of lifestyle factors on short term changes in cardio-metabolic and anthropometric profile. A 9-month follow-up study was conducted on a sample of 96 FEP patients recruited within the context of the GET UP program. Standardised assessments of dietary habits (EPIC) and physical activity (IPAQ) were retrospectively performed at 9 months; cardiovascular measures (blood pressure, heart rate), metabolic parameters (glucose, cholesterol, triglycerides), BMI and antipsychotic treatment were assessed at illness onset and at 9 months. We found that most FEP patients (60%) displayed poor dietary habits, as defined in terms of adherence to the Mediterranean diet. A significant increase for both BMI and cholesterol levels was found in the overall sample over 9 months. However, when considering the effect of lifestyle factors, BMI and total cholesterol were specifically raised in patients with low adherence to Mediterranean diet. The association with antipsychotic medication was found for SGA only, with a significant increase in both BMI and total cholesterol overtime. Our findings confirm the need to implement specific and early strategies to promote healthy lifestyle in people with FEP, since metabolic alterations occur within the first months of treatment.
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Affiliation(s)
- Elena Saugo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy.
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Doriana Cristofalo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Sara Poli
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Sarah Bissoli
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Mariaelena Bertani
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | - Lorenza Lazzarotto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy
| | | | - Enrico Ceccato
- Dipartimento di Salute Mentale, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Michele Pavanati
- Dipartimento di Salute Mentale e Dipendenze Patologiche, AUSL Ferrara, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Italy
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Petrenya N, Rylander C, Brustad M. Dietary patterns of adults and their associations with Sami ethnicity, sociodemographic factors, and lifestyle factors in a rural multiethnic population of northern Norway - the SAMINOR 2 clinical survey. BMC Public Health 2019; 19:1632. [PMID: 31801498 PMCID: PMC6894324 DOI: 10.1186/s12889-019-7776-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 10/14/2019] [Indexed: 01/22/2023] Open
Abstract
Background Few population-based studies have assessed dietary behaviors in the rural multiethnic population of Northern Norway. The present study determined dietary patterns and investigated their association with Sami ethnicity, sociodemographic factors, and lifestyle factors in a multiethnic population in rural Northern Norway. Methods This cross-sectional study included 4504 participants of the SAMINOR 2 Clinical Survey (2012–2014) aged 40–69 years. All participants completed a lifestyle and food frequency questionnaire. Dietary patterns were determined using principal component analysis. Associations between food patterns and ethnicity, sociodemographic factors, and lifestyle factors were examined by multiple linear regression. Results Six dietary patterns were identified that accounted for 28% of the variability in food intake in the study sample: ‘processed meat/westernized’, ‘fish/traditional’, ‘fruit/vegetables’, ‘reindeer/traditional’, ‘bread and sandwich spreads’, and ‘sweets and bakery goods’. The ‘reindeer/traditional’ pattern was most common among the inland Sami population. The ‘fish/traditional’ pattern was most common among costal multiethnic Sami and least common among inland Sami and among women independent of ethnicity. The ‘fish/traditional’ pattern was also positively associated with older age, high education level, small household size, and smoking. Adherence to the ‘processed meat/westernized’ pattern was lower among inland Sami than inland/coastal non-Sami; no ethnic differences in adherence to this pattern were found between costal multiethnic Sami and inland/coastal non-Sami. Unhealthy lifestyle factors, like low physical activity level and smoking, and younger age were mainly associated with the ‘processed meat/westernized’ pattern, whereas socioeconomic factors like low education, low gross annual household income, and large household size were related to the ‘sweets and bakery goods’ pattern. Male gender, low education level, and smoking were associated with the ‘bread and sandwich spreads’ pattern. The ‘fruit/vegetables’ pattern was characterized by healthy dietary choices and a health-conscious lifestyle, and was more common in women with a high education level and income. Conclusions Adherence to the six identified dietary patterns was characterized by different sociodemographic and lifestyle factors. Ethnicity, in combination with geographical region of residence, was associated with dietary behaviors. This study provides knowledge that will be useful in future studies on dietary patterns related to chronic diseases in the rural population of Northern Norway.
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Affiliation(s)
- Natalia Petrenya
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø The Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway. .,The Public Dental Health Service Competence centre of Northern Norway, TkNN, Tromsø, Norway.
| | - Charlotta Rylander
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø The Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway
| | - Magritt Brustad
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø The Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway
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Santulli G, Pascale V, Finelli R, Visco V, Giannotti R, Massari A, Morisco C, Ciccarelli M, Illario M, Iaccarino G, Coscioni E. We are What We Eat: Impact of Food from Short Supply Chain on Metabolic Syndrome. J Clin Med 2019; 8:E2061. [PMID: 31771147 PMCID: PMC6947359 DOI: 10.3390/jcm8122061] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
Food supply in the Mediterranean area has been recently modified by big retail distribution; for instance, industrial retail has favored shipments of groceries from regions that are intensive producers of mass food, generating a long supply chain (LSC) of food that opposes short supply chains (SSCs) that promote local food markets. However, the actual functional role of food retail and distribution in the determination of the risk of developing metabolic syndrome (MetS) has not been studied hitherto. The main aim of this study was to test the effects of food chain length on the prevalence of MetS in a population accustomed to the Mediterranean diet. We conducted an observational study in Southern Italy on individuals adhering to the Mediterranean diet. We examined a total of 407 subjects (41% females) with an average age of 56 ± 14.5 years (as standard deviation) and found that being on the Mediterranean diet with a SSC significantly reduces the prevalence of MetS compared with the LSC (SSC: 19.65%, LSC: 31.46%; p: 0.007). Our data indicate for the first time that the length of food supply chain plays a key role in determining the risk of MetS in a population adhering to the Mediterranean diet.
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Affiliation(s)
- Gaetano Santulli
- Dept. of Medicine, Division of Cardiology, and Dept. of Molecular Pharmacology, Montefiore University Hospital, Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine (AECOM), New York, NY 10461, USA
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
- International Translational Research and Medical Education Consortium (ITME), 80131 Naples, Italy
| | - Valeria Pascale
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Rosa Finelli
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Valeria Visco
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Rocco Giannotti
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Angelo Massari
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84131 Salerno, Italy; (A.M.); (E.C.)
| | - Carmine Morisco
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
| | - Michele Ciccarelli
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Maddalena Illario
- Health’s Innovation, Campania Regional Government, 80132 Naples, Italy;
- Dept. of Public Health, Federico II University, 80131 Naples, Italy
| | - Guido Iaccarino
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
- International Translational Research and Medical Education Consortium (ITME), 80131 Naples, Italy
| | - Enrico Coscioni
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84131 Salerno, Italy; (A.M.); (E.C.)
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Schanuel FS, Saguie BO, Monte-Alto-Costa A. Olive oil promotes wound healing of mice pressure injuries through NOS-2 and Nrf2. Appl Physiol Nutr Metab 2019; 44:1199-1208. [PMID: 30901524 DOI: 10.1139/apnm-2018-0845] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The pressure injury environment is characterized by overproduction of reactive oxygen species and exacerbated inflammation, which impair the healing of these lesions. Mediterranean-like diet may be a good intervention to improve the healing of pressure injury owing to its anti-inflammatory and antioxidant components. Thus, this study evaluated the hypothesis that olive oil, as a main source of lipid in Mediterranean diet, could improve cutaneous wound healing of pressure injury in mice. Male Swiss mice were randomly divided into standard, olive oil, or soybean oil plus olive oil groups and fat represented 10% of total calories in all groups. Four weeks after the beginning of diet administration, 2 cycles of ischemia-reperfusion (IR) by external application of 2 magnets disks were performed in the dorsal skin to induce pressure injury formation. Fourteen days after the end of the second IR cycle, olive oil-based diet reduced neutrophils cells and cyclooxygenase-2 protein expression and increased nitric oxide synthase-2 and protein and lipid oxidation. Olive oil based-diet also increased nuclear factor erythroid 2-related factor 2 protein expression and collagen type I precursor protein expression. In addition, administration of olive oil-based diet promoted wound closure at 7, 10, and 14 days after the end of the second IR cycle. These findings support the hypothesis that olive oil-based diet improves cutaneous wound healing of pressure injury in mice through the reduction of inflammation and stimulation of redox equilibrium.
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Affiliation(s)
- Fernanda Seabra Schanuel
- Rio de Janeiro State University (UERJ), Histology and Embryology Department - Tissue Repair Laboratory, Av. Marechal Rondon, 381/HLA, RJ 20950-003, Brazil
- Rio de Janeiro State University (UERJ), Histology and Embryology Department - Tissue Repair Laboratory, Av. Marechal Rondon, 381/HLA, RJ 20950-003, Brazil
| | - Bianca Oliveira Saguie
- Rio de Janeiro State University (UERJ), Histology and Embryology Department - Tissue Repair Laboratory, Av. Marechal Rondon, 381/HLA, RJ 20950-003, Brazil
- Rio de Janeiro State University (UERJ), Histology and Embryology Department - Tissue Repair Laboratory, Av. Marechal Rondon, 381/HLA, RJ 20950-003, Brazil
| | - Andréa Monte-Alto-Costa
- Rio de Janeiro State University (UERJ), Histology and Embryology Department - Tissue Repair Laboratory, Av. Marechal Rondon, 381/HLA, RJ 20950-003, Brazil
- Rio de Janeiro State University (UERJ), Histology and Embryology Department - Tissue Repair Laboratory, Av. Marechal Rondon, 381/HLA, RJ 20950-003, Brazil
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Food Consumption during Pregnancy and Post-Partum. ECLIPSES Study. Nutrients 2019; 11:nu11102447. [PMID: 31615024 PMCID: PMC6836140 DOI: 10.3390/nu11102447] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 11/16/2022] Open
Abstract
Inadequate maternal diet can adversely affect mother and child. Our aim was to assess adherence to the Spanish dietary guidelines and to the Mediterranean diet, to analyze changes in diet during pregnancy and post-partum, and to identify maternal factors associated with food consumption. A total of 793 healthy pregnant women were recruited during the first prenatal visit and followed until the post-partum period. Data from the clinical history, anthropometric measurements, and lifestyle habits were collected. Food consumption was evaluated using a food frequency questionnaire. The results show that in pregnant women the consumption of healthy foods did not meet recommendations, whereas consumption of red and processed meat and sweet food exceeded recommendations. The results also show a medium adherence to the Mediterranean diet that remained unchanged throughout pregnancy. A significant decrease was observed in the consumption of fruits, followed by vegetables and then salted and sweet cereals from pregnancy to post-partum. A better adherence to the Mediterranean diet has been reported by pregnant women that are older, of higher social class, and higher education level, and who do not smoke nor drink (p < 0.005). In conclusion, the diet of pregnant women from Spain departs from recommendations, medium adherence to the Mediterranean diet was maintained throughout the pregnancy and post-partum, and a decreasing consumption of healthy food from the first trimester to the post-partum period was observed. Maternal factors such as age, social class, education, and smoking influence diet quality.
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61
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Cano-Ibáñez N, Bueno-Cavanillas A, Martínez-González MÁ, Salas-Salvadó J, Corella D, Freixer GL, Romaguera D, Vioque J, Alonso-Gómez ÁM, Wärnberg J, Martínez JA, Serra-Majem L, Estruch R, Tinahones FJ, Lapetra J, Pintó X, Tur JA, García-Ríos A, García-Molina L, Delgado-Rodríguez M, Matía-Martín P, Daimiel L, Martín-Sánchez V, Vidal J, Vázquez C, Ros E, Bartolomé-Resano J, Palau-Galindo A, Portoles O, Torres L, Miquel-Fiol, Sánchez MTC, Sorto-Sánchez C, Moreno-Morales N, Abete I, Álvarez-Pérez J, Sacanella E, Bernal-López MR, Santos-Lozano JM, Fanlo-Maresma M, Bouzas C, Razquin C, Becerra-Tomás N, Ortega-Azorin C, LLimona R, Morey M, Román-Maciá J, Goicolea-Güemez L, Vázquez-Ruiz Z, Barrubés L, Fitó M, Gea A. Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study. Eur J Nutr 2019; 59:2395-2409. [PMID: 31523780 DOI: 10.1007/s00394-019-02087-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/30/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The prevalence of overweight/obesity and related manifestations such as metabolic syndrome (MetS) is increasing worldwide. High energy density diets, usually with low nutrient density, are among the main causes. Some high-quality dietary patterns like the Mediterranean diet (MedDiet) have been linked to the prevention and better control of MetS. However, it is needed to show that nutritional interventions promoting the MedDiet are able to improve nutrient intake. OBJECTIVE To assess the effect of improving MedDiet adherence on nutrient density after 1 year of follow-up at the PREDIMED-Plus trial. METHODS We assessed 5777 men (55-75 years) and women (60-75 years) with overweight or obesity and MetS at baseline from the PREDIMED-Plus trial. Dietary changes and MedDiet adherence were evaluated at baseline and after 1 year. The primary outcome was the change in nutrient density (measured as nutrient intake per 1000 kcal). Multivariable-adjusted linear regression models were fitted to analyse longitudinal changes in adherence to the MedDiet and concurrent changes in nutrient density. RESULTS During 1-year follow-up, participants showed improvements in nutrient density for all micronutrients assessed. The density of carbohydrates (- 9.0%), saturated fatty acids (- 10.4%) and total energy intake (- 6.3%) decreased. These changes were more pronounced in the subset of participants with higher improvements in MedDiet adherence. CONCLUSIONS The PREDIMED-Plus dietary intervention, based on MedDiet recommendations for older adults, maybe a feasible strategy to improve nutrient density in Spanish population at high risk of cardiovascular disease with overweight or obesity.
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Affiliation(s)
- Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, 18016, Granada, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. .,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, 18016, Granada, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Jordi Salas-Salvadó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Dolores Corella
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Gal-la Freixer
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Dora Romaguera
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Nutritional Epidemiology Unit, Miguel Hernández University, ISABIAL-FISABIO, Alicante, Spain
| | - Ángel M Alonso-Gómez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Nursing, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Alfredo Martínez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Lluis Serra-Majem
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Ramón Estruch
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Endocrinology, Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain
| | - José Lapetra
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain
| | - Xavier Pintó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep A Tur
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Antonio García-Ríos
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, 18016, Granada, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Health Sciences, University of Jaen, Jaen, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Vicente Martín-Sánchez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain.,CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Clotilde Vázquez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Emilio Ros
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Lipid Clinic Department of Endocrinology and Nutrition, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Javier Bartolomé-Resano
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Health Service-Osasunbidea, Pamplona, Spain
| | - Antoni Palau-Galindo
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,ABS Reus V. Centre d'Assistència Primària Marià Fortuny, SAGESSA, Reus, Spain
| | - Olga Portoles
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Laura Torres
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Miquel-Fiol
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | | | - Carolina Sorto-Sánchez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Noelia Moreno-Morales
- Department of Physiotherapy, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Itziar Abete
- Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Jacqueline Álvarez-Pérez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Emilio Sacanella
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - María Rosa Bernal-López
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Internal Medicine, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Malaga (IBIMA), Malaga, Spain
| | - José Manuel Santos-Lozano
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain.,Department of Medicine, Facultad de Medicina, University of Sevilla, Seville, Spain
| | - Marta Fanlo-Maresma
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Bouzas
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Nerea Becerra-Tomás
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Carolina Ortega-Azorin
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Regina LLimona
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Marga Morey
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | | | - Leire Goicolea-Güemez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Zenaida Vázquez-Ruiz
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Laura Barrubés
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Montse Fitó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
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62
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H Al Wattar B, Dodds J, Placzek A, Beresford L, Spyreli E, Moore A, Gonzalez Carreras FJ, Austin F, Murugesu N, Roseboom TJ, Bes-Rastrollo M, Hitman GA, Hooper R, Khan KS, Thangaratinam S. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): A pragmatic multicentre randomised trial. PLoS Med 2019; 16:e1002857. [PMID: 31335871 PMCID: PMC6650045 DOI: 10.1371/journal.pmed.1002857] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pregnant women with metabolic risk factors are at high risk of complications. We aimed to assess whether a Mediterranean-style diet reduces adverse pregnancy outcomes in high-risk women. METHODS AND FINDINGS We conducted a multicentre randomised trial in 5 maternity units (4 in London and 1 in Birmingham) between 12 September 2014 and 29 February 2016. We randomised inner-city pregnant women with metabolic risk factors (obesity, chronic hypertension, or hypertriglyceridaemia) to a Mediterranean-style diet with high intake of nuts, extra virgin olive oil, fruits, vegetables, nonrefined grains, and legumes; moderate to high consumption of fish; low to moderate intake of poultry and dairy products; low intake of red and processed meat; and avoidance of sugary drinks, fast food, and food rich in animal fat versus usual care. Participants received individualised dietary advice at 18, 20, and 28 weeks' gestation. The primary endpoints were composite maternal (gestational diabetes or preeclampsia) and composite offspring (stillbirth, small for gestational age, or admission to neonatal care unit) outcomes prioritised by a Delphi survey. We used an intention-to-treat (ITT) analysis with multivariable models and identified the stratification variables and prognostic factors a priori. We screened 7,950 and randomised 1,252 women. Baseline data were available for 593 women in the intervention (93.3% follow-up, 553/593) and 612 in the control (95.6% follow-up, 585/612) groups. Over a quarter of randomised women were primigravida (330/1,205; 27%), 60% (729/1,205) were of Black or Asian ethnicity, and 69% (836/1,205) were obese. Women in the intervention arm consumed more nuts (70.1% versus 22.9%; adjusted odds ratio [aOR] 6.8, 95% confidence interval [CI] 4.3-10.6, p ≤ 0.001) and extra virgin olive oil (93.2% versus 49.0%; aOR 32.2, 95% CI 16.0-64.6, p ≤ 0.001) than controls; increased their intake of fish (p < 0.001), white meat (p < 0.001), and pulses (p = 0.05); and reduced their intake of red meat (p < 0.001), butter, margarine, and cream (p < 0.001). There was no significant reduction in the composite maternal (22.8% versus 28.6%; aOR 0.76, 95% CI 0.56-1.03, p = 0.08) or composite offspring (17.3% versus 20.9%; aOR 0.79, 95% CI 0.58-1.08, p = 0.14) outcomes. There was an apparent reduction in the odds of gestational diabetes by 35% (aOR 0.65, 95% CI 0.47-0.91, p = 0.01) but not in other individual components of the composite outcomes. Mothers gained less gestational weight (mean 6.8 versus 8.3 kg; adjusted difference -1.2 Kg, 95% CI -2.2 to -0.2, p = 0.03) with intervention versus control. There was no difference in any of the other maternal and offspring complications between both groups. When we pooled findings from the Effect of Simple, Targeted Diet in Pregnant Women With Metabolic Risk Factors on Pregnancy Outcomes (ESTEEM) trial with similar trials using random effects meta-analysis, we observed a significant reduction in gestational diabetes (odds ratio [OR] 0.67, 95% CI 0.53-0.84, I2 = 0%), with no heterogeneity (2 trials, 2,397 women). The study's limitations include the use of participant reported tools for adherence to the intervention instead of objective biomarkers. CONCLUSIONS A simple, individualised, Mediterranean-style diet in pregnancy did not reduce the overall risk of adverse maternal and offspring complications but has the potential to reduce gestational weight gain and the risk of gestational diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT02218931.
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Affiliation(s)
- Bassel H Al Wattar
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Julie Dodds
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Anna Placzek
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Lee Beresford
- Pragmatic Clinical Trials Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Eleni Spyreli
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Amanda Moore
- Diabetes & Nutritional Sciences Division, Faculty of Life Sciences & Medicine, King's College, London, United Kingdom
| | - Francisco J Gonzalez Carreras
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Frances Austin
- Maternity Dietetic Service, Women's and Children's Services, Barts NHS Trust, London, United Kingdom
| | - Nilaani Murugesu
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Tessa J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, the Netherlands.,Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.,CIBERobn, Instituto de Salud Carlos III, Madrid, Spain.,IDISNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Graham A Hitman
- Barts Diabetes and Obesity Research Group, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Richard Hooper
- Pragmatic Clinical Trials Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Khalid S Khan
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Multidisciplinary Evidence Synthesis Hub (mEsh), Blizard Institute, Barts and the London School of Medicine, Queen Mary University London, London, United Kingdom
| | - Shakila Thangaratinam
- BARC (Barts Research Centre for Women's Health), Women's Health Research Unit, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Multidisciplinary Evidence Synthesis Hub (mEsh), Blizard Institute, Barts and the London School of Medicine, Queen Mary University London, London, United Kingdom
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63
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Kim H, Kwon O. Higher Diet Quality is Associated with Lower Odds of Low Hand Grip Strength in the Korean Elderly Population. Nutrients 2019; 11:E1487. [PMID: 31261920 PMCID: PMC6683249 DOI: 10.3390/nu11071487] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 12/16/2022] Open
Abstract
Single nutrients or food groups have been associated with physical performance. However, little is known about the association of overall diet quality with hand grip strength (HGS), a predictive parameter in the prognosis of chronic disease morbidity and mortality, or quality of life. This study examined the association between HGS and three indices-the Korean Healthy Eating Index (KHEI), the Alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH)-using data obtained on Korean elderly persons aged ≥65 years (n = 3675) from a nationally representative database. The cross-sectional data was collected as part of the Korea National Health and Nutrition Examination Survey (KNHANES, 2014-2016). Dietary intake data from the 24-h recall method were used to calculate diet quality scores. The cutoff value for low HGS was defined as the value corresponding to the lowest 20th percentile of HGS of the study population (men, 28.6 kg; women, 16.5 kg). Higher index scores for diet quality were associated with 32%-53% lower odds of low HGS. Better overall diet quality may be associated with higher HGS in the elderly Korean population.
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Affiliation(s)
- Hyesook Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea.
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64
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Alvarez-Alvarez I, Toledo E, Lecea O, Salas-Salvadó J, Corella D, Buil-Cosiales P, Zomeño MD, Vioque J, Martinez JA, Konieczna J, Barón-López FJ, López-Miranda J, Estruch R, Bueno-Cavanillas A, Alonso-Gómez ÁM, Tur JA, Tinahones FJ, Serra-Majem L, Martín V, Ortega-Calvo M, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, González JI, Díaz-López A, Paz-Graniel I, Muñoz MA, Fito M, Pertusa-Martinez S, Abete I, García-Ríos A, Ros E, Ruiz-Canela M, Martínez-González MÁ. Adherence to a priori dietary indexes and baseline prevalence of cardiovascular risk factors in the PREDIMED-Plus randomised trial. Eur J Nutr 2019; 59:1219-1232. [PMID: 31073885 DOI: 10.1007/s00394-019-01982-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/26/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Cardiovascular disease remains the global leading cause of death. We evaluated at baseline the association between the adherence to eight a priori high-quality dietary scores and the prevalence of individual and clustered cardiovascular risk factors (CVRF) in the PREDIMED-Plus cohort. METHODS All PREDIMED-Plus participants (6874 men and women aged 55-75 years, with overweight/obesity and metabolic syndrome) were assessed. The prevalence of 4 CVRF (hypertension, obesity, diabetes, and dyslipidaemia), using standard diagnoses criteria, were considered as outcomes. The adherence to eight a priori-defined dietary indexes was calculated. Multivariable models were fitted to estimate differences in mean values of factors and prevalence ratios for individual and clustered CVRF. RESULTS Highest conformity to any dietary pattern did not show inverse associations with hypertension. The modified Mediterranean Diet Score (PR = 0.95; 95% CI 0.90-0.99), Mediterranean Diet Adherence Score (MEDAS) (PR = 0.94; 95% CI 0.89-0.98), the pro-vegetarian dietary pattern (PR = 0.95; 95% CI 0.90-0.99) and the Alternate Healthy Eating Index 2010 (PR = 0.92; 95% CI 0.87-0.96) were inversely associated with prevalence of obesity. We identified significant inverse trend among participants who better adhered to the MEDAS and the Prime Diet Quality Score (PDQS) in the mean number of CVRF across categories of adherence. Better adherence to several high-quality dietary indexes was associated with better blood lipid profiles and anthropometric measures. CONCLUSIONS Highest adherence to dietary quality indexes, especially Mediterranean-style and PDQS scores, showed marginal associations with lower prevalence of individual and clustered CVRF among elderly adults with metabolic syndrome at high risk of cardiovascular disease.
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Affiliation(s)
- Ismael Alvarez-Alvarez
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Oscar Lecea
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,Atención Primaria, Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Pilar Buil-Cosiales
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Atención Primaria, Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain
| | - María Dolores Zomeño
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Blanquerna School of Life Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Nutritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - J Alfredo Martinez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain.,Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Jadwiga Konieczna
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain
| | | | - José López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Ángel M Alonso-Gómez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Cardiology Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain.,University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco J Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, Hospital Virgen de la Victoria (IBIMA), University of Málaga, Málaga, Spain
| | - Lluís Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Manuel Ortega-Calvo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Family Medicine, Healthcare centre Las Palmeritas, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Division of Preventive Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - José I González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Andrés Díaz-López
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Indira Paz-Graniel
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Miguel A Muñoz
- Gerencia territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Montse Fito
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Salvador Pertusa-Martinez
- Nutritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain.,Healthcare centre Cabo Huertas, Alicante, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Antonio García-Ríos
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology and Nutrition, Lipid Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Á Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. .,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA.
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65
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Effect of Adherence to Mediterranean Diet during Pregnancy on Children's Health: A Systematic Review. Nutrients 2019; 11:nu11050997. [PMID: 31052443 PMCID: PMC6566280 DOI: 10.3390/nu11050997] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 12/17/2022] Open
Abstract
The traditional Mediterranean diet has been shown to be a healthy eating pattern that protects against the development of many diseases in adults and children. Pregnancy is a critical period of plasticity during which foetal development may be significantly influenced by different environmental factors, including maternal nutrition. In this context, several studies have examined the potential benefits of adherence to a Mediterranean diet during pregnancy on birth outcomes, considering the Mediterranean diet as a whole rather than focusing on the effect of its individual components. In this review, we systematically summarized and discussed results of studies investigating the protective role of Mediterranean diet against foetal growth, prematurity, neural tube defects and other congenital pathologies, asthma and allergy, body weight and metabolic markers. Although current data are insufficient and randomized control trials are needed, growing evidence suggests the beneficial effect of the Mediterranean diet during pregnancy on children's health. In this sense, strategies aiming to promote adherence to this dietary pattern might be of considerable importance to public health.
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66
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Konieczna J, Yañez A, Moñino M, Babio N, Toledo E, Martínez-González MA, Sorlí JV, Salas-Salvadó J, Estruch R, Ros E, Alonso-Gómez A, Schröder H, Lapetra J, Serra-Majem L, Pintó X, Gutiérrez-Bedmar M, Díaz-López A, González JI, Fitó M, Forga L, Fiol M, Romaguera D. Longitudinal changes in Mediterranean diet and transition between different obesity phenotypes. Clin Nutr 2019; 39:966-975. [PMID: 31053509 DOI: 10.1016/j.clnu.2019.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/19/2019] [Accepted: 04/03/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND & AIMS Little is known about the impact of specific dietary patterns on the development of obesity phenotypes. We aimed to determine the association of longitudinal changes in adherence to the traditional Mediterranean diet (MedDiet) with the transition between different obesity phenotypes. METHODS Data of 5801 older men and women at high cardiovascular risk from PREDIMED trial were used. Adherence to MedDiet was measured with the validated 14p-Mediterranean Diet Adherence Screener (MEDAS). Using the simultaneous combination of metabolic health- and body size-related parameters participants were categorized into one of four phenotypes: metabolically healthy and abnormal obese (MHO and MAO), metabolically healthy and abnormal non-obese (MHNO and MANO). Cox regression models with yearly repeated measures during 5-year of follow-up were built with use of Markov chain assumption. RESULTS Each 2-point increase in MEDAS was associated with the following transitions: in MAO participants, with a 16% (95% CI 3-31%) greater likelihood of becoming MHO; in MHO participants with a 14% (3-23%) lower risk of becoming MAO; in MHNO participants with a 18% (5-30%) lower risk of becoming MHO. In MANO women, but not in men, MEDAS was associated with 20% (5-38%) greater likely of becoming MHNO (p for interaction by gender 0.014). No other significant associations were observed. CONCLUSIONS Better adherence to the traditional MedDiet is associated with transitions to healthier phenotypes, promoting metabolic health improvement in MAO, MANO (only in women), and MHO, as well as protecting against obesity incidence in MHNO subjects.
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Affiliation(s)
- J Konieczna
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - A Yañez
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; Department of Nursing and Physiotheraphy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - M Moñino
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - N Babio
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Rovira i Virgili University Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - E Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra-Navarra Institute for Health Research, Department of Preventive Medicine and Public Health, Pamplona, Spain
| | - M A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra-Navarra Institute for Health Research, Department of Preventive Medicine and Public Health, Pamplona, Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - J V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - J Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Rovira i Virgili University Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - R Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E Ros
- Lipid Clinics. Department of Endocrinology, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - A Alonso-Gómez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, University Hospital Araba, Vitoria, Spain
| | - H Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), Institut Hospital del Mar d' Investigacions Mèdiques (IMIM), Barcelona Biomedical Research Park, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - J Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Familiy Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Ll Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Service of Preventive Medicine, Complejo Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canary Health Service, Las Palmas de Gran Canaria, Spain
| | - X Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Bellvitge Hospital, Barcelona, Spain
| | - M Gutiérrez-Bedmar
- Department of Preventive Medicine and Public Health, University of Malaga, Malaga, Spain
| | - A Díaz-López
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Rovira i Virgili University Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - J I González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - M Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN), Institut Hospital del Mar d' Investigacions Mèdiques (IMIM), Barcelona Biomedical Research Park, Barcelona, Spain
| | - L Forga
- Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - M Fiol
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - D Romaguera
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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67
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Eslami O, Shidfar F, Dehnad A. Inverse association of long-term nut consumption with weight gain and risk of overweight/obesity: a systematic review. Nutr Res 2019; 68:1-8. [PMID: 31151081 DOI: 10.1016/j.nutres.2019.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 03/13/2019] [Accepted: 04/04/2019] [Indexed: 12/27/2022]
Abstract
Nuts contain a variety of nutrients and bioactive compounds that are capable of promoting metabolic health. However, due to their high energy density, concerns have been raised that nut consumption in the long term may contribute to weight gain. This systematic review summarizes the findings of prospective studies regarding the relationship between long-term nut consumption and obesity. Searches were conducted up through February 2018, using the PUBMED, EMBASE, and SCOPUS databases with the relevant MeSH terms and phrases. This systematic review included prospective cohort studies investigating the relationship between consumption of total nut and/or nut subtypes with changes in weight, body mass index (BMI), and waist circumference (WC), as well as the risk of overweight/obesity, with follow-up duration ≥1-year. Out of a total of 1580 papers that were initially examined, 6 met the inclusion criteria. Four out of the 6 studies showed an inverse association between nut consumption (typically at the dosages of ≥1 to 2 servings per week) and weight gain and risk of overweight/obesity. The remaining 2 studies evaluated the association between nut intake and changes in WC. From these 2 studies, only one study reported a significant inverse association. Overall, evidence from limited cohort studies demonstrated that long-term nut intake was associated with less weight gain and reduced risk of overweight/obesity. Whether such findings are generalizable to racially diverse ethnic groups, individuals of low socioeconomic status, and populations in developing countries should be addressed in future studies.
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Affiliation(s)
- Omid Eslami
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Afsaneh Dehnad
- Department of English Language, School of Health Management and Information Sciences, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
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68
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Aljabri MK, Al-Raddadi R, Bahijri SM, Al Ahmadi J, Ajabnoor G, Jambi HA. Factors associated with adherence to Mediterranean diet among Saudi non-diabetic patients attending primary health care centers: A cross-sectional study. J Taibah Univ Med Sci 2019; 14:139-148. [PMID: 31435404 PMCID: PMC6694985 DOI: 10.1016/j.jtumed.2019.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 02/07/2023] Open
Abstract
Objectives To investigate the degree and factors responsible for adherence to a Mediterranean diet among non-diabetic patients attending primary health care centres (PHCCs). Methods A cross-sectional study was conducted in Jeddah PHCCs using a validated self-administered questionnaire which assessed adherence levels to 14 dietary aspects related to the Mediterranean diet. The questionnaire enabled calculation of an adherence score (0–14), where inadequate adherence was assumed for scores ≤7. Factors of adherence included general socio-demographic characteristics, medical history, lifestyle, and cardiovascular risk factors such as body mass index, waist-to-hip ratio, blood pressure, and fasting and 1-h postprandial blood glucose levels. Results Of the 265 participants (50.6% males), inadequate adherence was reported in 74.3%. Adherence scores were higher in married participants than in unmarried ones (6.68 ± 1.74 vs. 6.24 ± 1.79, p = 0.04), as well as in those who engaged in regular physical activity vs. those who did not (6.79 ± 1.90 vs. 6.30 ± 1.63, p = 0.02). Furthermore, Mediterranean diet adherence increased with age (B = 0.02, r = 0.133; p < 0.001). Interestingly, adherence scores were not associated with major cardiovascular risk factors except for a significantly higher diastolic blood pressure in participants with adequate as opposed to low adherence (77.96 ± 12.20 vs. 74.01 ± 12.24, respectively, p = 0.022). Conclusion One out of 4 non-diabetic patients attending PHCCs exhibited good adherence to a Mediterranean diet without considerable association with cardiovascular risk factors. Further studies are recommended to investigate awareness and knowledge regarding the Mediterranean diet among Saudi populations. Subsequently, awareness programs could be tailored accordingly.
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Affiliation(s)
- Mydaa K Aljabri
- Joint Program of Family Medicine, King Abdulaziz University, Jeddah, KSA
| | - Rajaa Al-Raddadi
- Department of Community Medicine, King Abdulaziz University, Jeddah, KSA
| | - Suhad M Bahijri
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Jawaher Al Ahmadi
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Ghada Ajabnoor
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Hanan A Jambi
- Department of Food and Nutrition- Home Economics, King Abdulaziz University, Jeddah, KSA
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69
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Sotos-Prieto M, Jin Q, Rainey D, Coyle M, Kales SN. Barriers and solutions to improving nutrition among fire academy recruits: a qualitative assessment. Int J Food Sci Nutr 2019; 70:771-779. [PMID: 30764673 DOI: 10.1080/09637486.2019.1570087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The primary health concerns among US firefighters are cardiovascular disease, cancer, and depression and occur in an occupational setting where dietary habits are suboptimal. To understand if a diet or lifestyle modification works in a fire academy training setting, it is important to evaluate the cultural barriers and challenges that might be faced. A semi-structured telephone interview method followed by a focus group was used to gather common themes among fire service leaders. Twelve leaders participated in the telephonic interviews and a subset of five in the subsequent group session. Five main themes were identified. The study identified a need for staff and recruits to develop a cohesive culture that facilitates long-term change. Participants reported that incentives for good choices and the elimination of certain poor choices from the food environment would promote healthier choices. The study supports an intervention using education of fire recruits and modifications of the fire academy food environment.
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Affiliation(s)
- Mercedes Sotos-Prieto
- a Division of Food and Nutrition Sciences, School of Applied Health Sciences and Wellness , Ohio University , Athens , OH , USA.,b The Diabetes Institute, Ohio University , Athens , OH , USA.,c Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Qi Jin
- a Division of Food and Nutrition Sciences, School of Applied Health Sciences and Wellness , Ohio University , Athens , OH , USA
| | - David Rainey
- c Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Maria Coyle
- a Division of Food and Nutrition Sciences, School of Applied Health Sciences and Wellness , Ohio University , Athens , OH , USA
| | - Stefanos N Kales
- c Department of Environmental Health , Harvard T.H. Chan School of Public Health , Boston , MA , USA
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Dominguez LJ, Barbagallo M. Mediterranean Diet and Longevity. REFERENCE MODULE IN BIOMEDICAL SCIENCES 2019. [DOI: 10.1016/b978-0-12-801238-3.62178-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Khalili-Moghadam S, Mirmiran P, Bahadoran Z, Azizi F. The Mediterranean diet and risk of type 2 diabetes in Iranian population. Eur J Clin Nutr 2018; 73:72-78. [DOI: 10.1038/s41430-018-0336-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 07/19/2018] [Accepted: 09/18/2018] [Indexed: 02/07/2023]
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Abenavoli L, Di Renzo L, Boccuto L, Alwardat N, Gratteri S, De Lorenzo A. Health benefits of Mediterranean diet in nonalcoholic fatty liver disease. Expert Rev Gastroenterol Hepatol 2018; 12:873-881. [PMID: 30033779 DOI: 10.1080/17474124.2018.1503947] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Insulin resistance and obesity-related inflammatory status, associated with genetic, dietary, and lifestyle factors, are involved in its pathogenesis. There is no consensus concerning the pharmacological treatment of NAFLD. However, the international guidelines agree to define a dietetic nutritional management to achieve weight loss, as an essential component of any therapeutic strategy. Areas covered: An overview on the beneficial effects of the Mediterranean diet in the prevention and treatment of NAFLD. Expert commentary: On the basis of its components, the literature reports the beneficial effects of the Mediterranean diet in preventing major chronic diseases, including obesity, diabetes, cardiovascular diseases, and some forms of cancers. In recent years, a growing body of evidence has supported the idea that the Mediterranean diet, associated with physical activity and cognitive behavior therapy, may be the reference nutritional profile for the prevention and the treatment of NAFLD patients.
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Affiliation(s)
- Ludovico Abenavoli
- a Department of Health Sciences , University Magna Graecia , Catanzaro , Italy
| | - Laura Di Renzo
- b Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
| | - Luigi Boccuto
- c Greenwood Genetic Center, Greenwood , Clemson University School of Health Research , Clemson , SC , USA
| | - Nuha Alwardat
- b Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
| | - Santo Gratteri
- d Department of Surgery and Medical Science , University Magna Graecia , Catanzaro , Italy
| | - Antonino De Lorenzo
- b Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention , University of Rome Tor Vergata , Rome , Italy
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Altieri B, Barrea L, Modica R, Muscogiuri G, Savastano S, Colao A, Faggiano A. Nutrition and neuroendocrine tumors: An update of the literature. Rev Endocr Metab Disord 2018; 19:159-167. [PMID: 30267297 DOI: 10.1007/s11154-018-9466-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms with worldwide increasing incidence, high prevalence and survival. Both the tumor itself and the systemic therapy may have an impact on patients' nutrition. Malnutrition negatively impacts on outcome in NETs patients. Moreover, it has been demonstrated that body mass index was a risk factor for NET development and that metabolic syndrome was associated with worse prognosis in these patients. Of note, food could also interact with the metabolism of oral target therapy and antineoplastic agents used for the treatment of progressive NETs. Therefore, the nutritional assessment, based on body composition, and lifestyle modifications should be an integral component of management of the NET patients. The nutrition care plans are an integral part of the multidisciplinary management team for patients with NETs. Nutritionists with expertise in NETs can provide dietary approaches to improve the quality of life and nutritional status during various therapeutic modalities used in patients with NETs. The aim of this review is to critically discuss the importance of nutrition and body composition in patients with NETs.
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Affiliation(s)
- Barbara Altieri
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Luigi Barrea
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy
| | - Roberta Modica
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy
| | - Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy
| | - Antongiulio Faggiano
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 82121, Naples, Italy.
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