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Sam-Yellowe TY. Nutritional Barriers to the Adherence to the Mediterranean Diet in Non-Mediterranean Populations. Foods 2024; 13:1750. [PMID: 38890978 PMCID: PMC11171913 DOI: 10.3390/foods13111750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/16/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
Adherence to the Mediterranean diet has been shown to lower the risk of developing chronic non-communicable diseases like cardiovascular and neurodegenerative diseases and cancer. Improvements in depression, participation in daily activities in older individuals, weight loss and a reduction in adverse pregnancy outcomes are associated with adherence to the Mediterranean diet. The number of studies that have evaluated barriers to adherence to the Mediterranean diet in the US and, in particular, in racial and ethnic minority populations within the US are few. Among Native American and Alaskan Native populations, studies evaluating traditional or alternative Mediterranean diet adherence for chronic non-infectious diseases is unavailable. Mediterranean diet scoring instruments used in studies in European and Mediterranean countries and among white participants in the US fail to capture the dietary patterns of racial and ethnic minority populations. In this narrative review, the food components of the traditional Mediterranean diet are discussed, adherence to the Mediterranean diet is examined in Mediterranean and non-Mediterranean countries and barriers preventing adherence to the Mediterranean diet in the US and among racial and ethnic minority populations is reviewed. Recommendations for improving nutrition education and intervention and for increasing adherence and cultural adaptions to the Mediterranean diet are provided.
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Affiliation(s)
- Tobili Y. Sam-Yellowe
- Graduate College, Canisius University, 2001 Main Street, Buffalo, NY 14208-1098, USA;
- Department of Biological, Geological and Environmental Sciences, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH 44115, USA
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Lapidot Y, Maya M, Reshef L, Cohen D, Ornoy A, Gophna U, Muhsen K. Relationships of the gut microbiome with cognitive development among healthy school-age children. Front Pediatr 2023; 11:1198792. [PMID: 37274812 PMCID: PMC10235814 DOI: 10.3389/fped.2023.1198792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 05/05/2023] [Indexed: 06/07/2023] Open
Abstract
Background The gut microbiome might play a role in neurodevelopment, however, evidence remains elusive. We aimed to examine the relationship between the intestinal microbiome and cognitive development of school-age children. Methods This cross-sectional study included healthy Israeli Arab children from different socioeconomic status (SES). The microbiome was characterized in fecal samples by implementing 16S rRNA gene sequencing. Cognitive function was measured using Stanford-Binet test, yielding full-scale Intelligence Quotient (FSIQ) score. Sociodemographics and anthropometric and hemoglobin measurements were obtained. Multivariate models were implemented to assess adjusted associations between the gut microbiome and FSIQ score, while controlling for age, sex, SES, physical growth, and hemoglobin levels. Results Overall, 165 children (41.2% females) aged 6-9 years were enrolled. SES score was strongly related to both FSIQ score and the gut microbiome. Measures of α-diversity were significantly associated with FSIQ score, demonstrating a more diverse, even, and rich microbiome with increased FSIQ score. Significant differences in fecal bacterial composition were found; FSIQ score explained the highest variance in bacterial β-diversity, followed by SES score. Several taxonomic differences were significantly associated with FSIQ score, including Prevotella, Dialister, Sutterella, Ruminococcus callidus, and Bacteroides uniformis. Conclusions We demonstrated significant independent associations between the gut microbiome and cognitive development in school-age children.
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Affiliation(s)
- Yelena Lapidot
- Department of Epidemiology and Preventive Medicine, School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maayan Maya
- Department of Epidemiology and Preventive Medicine, School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leah Reshef
- The Shmunis School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asher Ornoy
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Department of Medical Neurobiology, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Uri Gophna
- The Shmunis School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Lifestyle Risk Factors for Overweight/Obesity in Spanish Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121947. [PMID: 36553390 PMCID: PMC9777298 DOI: 10.3390/children9121947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
Childhood obesity is one of the main public health concerns in Europe. The aim was to identify possible risk factors associated with overweight/obesity in Spanish preschool and school-age children. The sample (1075 (50.7% girls) children aged 3 to 12) is part of the project 'Alimentando el Cambio' whose objective is to promote healthy lifestyles in schools. Child height and weight were measured, and parents filled out questionnaires related to the children's lifestyle. There was a positive and significant association between sweetened beverage consumption and body mass index (BMI) z-score in both sexes and age groups. There was a negative and significant association between BMI z-score and dairy products in girls of both age groups. There was also a protective effect of regular nut consumption on overweight/obesity in girls 6-12 y. Night-time sleep during weekdays showed a negative association with BMI z-score for older boys and girls. A positive and significant association was found between total screen time and BMI z-score during weekdays. Regarding emotional well-being and self-esteem, having girls 6-12 y laughing and feeling happy and good about themselves in the last week was a protective factor against overweight/obesity. Childhood obesity prevention efforts may benefit from targeting these key risk factors.
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Farella I, Miselli F, Campanozzi A, Grosso FM, Laforgia N, Baldassarre ME. Mediterranean Diet in Developmental Age: A Narrative Review of Current Evidences and Research Gaps. CHILDREN 2022; 9:children9060906. [PMID: 35740843 PMCID: PMC9221965 DOI: 10.3390/children9060906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
Numerous studies in recent decades have shown that Mediterranean diet (MD) can reduce the risk of developing obesity in pediatric patients. The current narrative review summarizes recent evidence regarding the impact of MD across the different stages of child development, starting from fetal development, analyzing breastfeeding and weaning, through childhood up to adolescence, highlighting the gaps in knowledge for each age group. A literature search covering evidence published between 1 January 2000 and 1 March 2022 and concerning children only was conducted using multiple keywords and standardized terminology in PubMed database. A lack of scientific evidence about MD adherence concerns the age group undergoing weaning, thus between 6 months and one year of life. In the other age groups, adherence to MD and its beneficial effects in terms of obesity prevention has been extensively investigated, however, there are still few studies that correlate this dietary style with the incidence of non-communicable diseases. Furthermore, research on multi-intervention strategy should be implemented, especially regarding the role of education of children and families in taking up this healthy dietary style.
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Affiliation(s)
- Ilaria Farella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: (I.F.); (M.E.B.)
| | - Francesca Miselli
- Neonatal Intensive Care Unit, University Hospital of Modena, 41125 Modena, Italy;
| | - Angelo Campanozzi
- Department of Pediatrics, University of Foggia, 71122 Foggia, Italy;
| | | | - Nicola Laforgia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Maria Elisabetta Baldassarre
- Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence: (I.F.); (M.E.B.)
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Tepper S, Kissinger M, Avital K, Shahar DR. The Environmental Footprint Associated With the Mediterranean Diet, EAT-Lancet Diet, and the Sustainable Healthy Diet Index: A Population-Based Study. Front Nutr 2022; 9:870883. [PMID: 35662947 PMCID: PMC9161357 DOI: 10.3389/fnut.2022.870883] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/14/2022] [Indexed: 12/20/2022] Open
Abstract
Providing a growing global population with healthy and sustainable diets is an immediate challenge. In the current study, estimates were obtained for the environmental footprints (land, water, and greenhouse gas (GHG) emissions) in association with the Mediterranean diet (MED) and the EAT-Lancet reference diet, which represents a healthy diet derived from sustainable food systems. We used a newly developed Sustainable Healthy Diet (SHED) index that was validated for the Israeli population by Tepper et al. in 2020.
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Affiliation(s)
- Sigal Tepper
- Department of Nutritional Sciences, Tel-Hai College, Tel Hai, Israel
- *Correspondence: Sigal Tepper
| | - Meidad Kissinger
- Department of Geography and Environmental Development, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Kerem Avital
- The International Center of Health Innovation and Nutrition, Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Danit Rivkah Shahar
- The International Center of Health Innovation and Nutrition, Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Socioeconomic disparities and household crowding in association with the fecal microbiome of school-age children. NPJ Biofilms Microbiomes 2022; 8:10. [PMID: 35241676 PMCID: PMC8894399 DOI: 10.1038/s41522-022-00271-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 01/28/2022] [Indexed: 11/08/2022] Open
Abstract
The development of the gut microbiome occurs mainly during the first years of life; however, little is known on the role of environmental and socioeconomic exposures, particularly within the household, in shaping the microbial ecology through childhood. We characterized differences in the gut microbiome of school-age healthy children, in association with socioeconomic disparities and household crowding. Stool samples were analyzed from 176 Israeli Arab children aged six to nine years from three villages of different socioeconomic status (SES). Sociodemographic data were collected through interviews with the mothers. We used 16 S rRNA gene sequencing to characterize the gut microbiome, including an inferred analysis of metabolic pathways. Differential analysis was performed using the analysis of the composition of microbiomes (ANCOM), with adjustment for covariates. An analysis of inferred metagenome functions was performed implementing PICRUSt2. Gut microbiome composition differed across the villages, with the largest difference attributed to socioeconomic disparities, with household crowding index being a significant explanatory variable. Living in a low SES village and high household crowding were associated with increased bacterial richness and compositional differences, including an over-representation of Prevotella copri and depleted Bifidobacterium. Secondary bile acid synthesis, d-glutamine and d-glutamate metabolism and Biotin metabolism were decreased in the lower SES village. In summary, residential SES is a strong determinant of the gut microbiome in healthy school-age children, mediated by household crowding and characterized by increased bacterial richness and substantial taxonomic and metabolic differences. Further research is necessary to explore possible implications of SES-related microbiome differences on children's health and development.
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Lassale C, Fitó M, Morales-Suárez-Varela M, Moya A, Gómez SF, Schröder H. Mediterranean diet and adiposity in children and adolescents: A systematic review. Obes Rev 2022; 23 Suppl 1:e13381. [PMID: 34816577 DOI: 10.1111/obr.13381] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 01/05/2023]
Abstract
Our aim was to summarize, through a systematic review, the current evidence from dietary intervention and observational studies on the impact of adherence to the Mediterranean diet on adiposity markers and obesity in children and adolescents. We searched Medline up to June 1, 2021 for the identification of intervention and observational studies meeting the inclusion criteria, following the PRISMA statement. We included 55 articles: 8 intervention studies and 47 observational studies. Three trials report a beneficial effect of the dietary intervention, whereas two did not, and three did not compare with a control. All observational studies were cross-sectional, and only five studies also included a longitudinal analysis. More than half of the cross-sectional studies found no significant association between adherence to Mediterranean diet and adiposity. Three out of the five longitudinal studies found a negative association. The majority of both observational and intervention studies was of low quality. Despite a large number of published studies, overall, there is only limited evidence of a beneficial effect of following a traditional Mediterranean diet to maintain a healthy body weight in childhood. More high-quality intervention and longitudinal data are needed to form the base of large-scale health programs to prevent childhood obesity.
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Affiliation(s)
- Camille Lassale
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Montserrat Fitó
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
| | - María Morales-Suárez-Varela
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Andrés Moya
- CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,Institute of Integrative Systems Biology, Universitat de València and Spanish Research Council (CSIC), Valencia, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Santiago F Gómez
- Gasol Foundation, Sant Boi de Llobregat, Spain.,GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain
| | - Helmut Schröder
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
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Sinai T, Axelrod R, Shimony T, Boaz M, Kaufman-Shriqui V. Dietary Patterns among Adolescents Are Associated with Growth, Socioeconomic Features, and Health-Related Behaviors. Foods 2021; 10:3054. [PMID: 34945606 PMCID: PMC8700870 DOI: 10.3390/foods10123054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022] Open
Abstract
Dietary patterns (DPs), usually established in adolescents, are important modifiable risk factors in the etiology of malnutrition and chronic diseases. This study aimed to identify DPs of adolescents and examine their associations with growth, sociodemographic, and lifestyle characteristics. A nationally representative, school-based, cross-sectional study was conducted in Israeli adolescents aged 11-18 years during 2015-2016. A self-administered survey queried sociodemographics, health behaviors, and diet. Weight and height were measured, and WHO height z-scores and BMI cutoffs were calculated. Food frequency questionnaire data were analyzed using principal components analysis (PCA) to identify DPs. Associations between growth, lifestyle, and sociodemographic characteristics and DPs were modeled using multivariable logistic regressions. A total of 3902 adolescents (46% males, mean age 15.2 ± 1.6 years) completed the survey. PCA identified five DPs, accounting for 38.3% of the total variance. The first two prominent DPs were the 'plant-based food' DP, which was associated with the female sex, higher socioeconomic status, overweight/obesity, and healthy lifestyle and the 'junk food' DP, which was associated with lower SES, unhealthy lifestyle, and lower height z-scores. Our results elucidate major DPs that strongly correlate with lifestyle risk behaviors and suboptimal growth among adolescents. Implementing screening for DPs should be further examined to identify higher risk health factors among youth.
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Affiliation(s)
- Tali Sinai
- Israel Center for Disease Control, State of Israel Ministry of Health, Ramat-Gan 5265601, Israel; (T.S.); (R.A.); (T.S.)
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
| | - Rachel Axelrod
- Israel Center for Disease Control, State of Israel Ministry of Health, Ramat-Gan 5265601, Israel; (T.S.); (R.A.); (T.S.)
| | - Tal Shimony
- Israel Center for Disease Control, State of Israel Ministry of Health, Ramat-Gan 5265601, Israel; (T.S.); (R.A.); (T.S.)
| | - Mona Boaz
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat Hamada 3, Ariel 40700, Israel;
| | - Vered Kaufman-Shriqui
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat Hamada 3, Ariel 40700, Israel;
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Pribisalić A, Popović R, Salvatore FP, Vatavuk M, Mašanović M, Hayward C, Polašek O, Kolčić I. The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia. Nutrients 2021; 13:nu13113802. [PMID: 34836057 PMCID: PMC8624926 DOI: 10.3390/nu13113802] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18–98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0–24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007–2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (−8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p < 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (−35.1%), fish (−23.4%), white meat (−11.6%), cereals (−10.9%), and dairy products (−9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake.
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Affiliation(s)
- Ajka Pribisalić
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (A.P.); (O.P.)
| | - Romana Popović
- NUTRITIUS—Nutrition Counseling, Primorska 30, 20000 Dubrovnik, Croatia;
| | | | - Maja Vatavuk
- Department of Cardiac Surgery, University Hospital of Split, 21000 Split, Croatia;
| | - Marija Mašanović
- Department for Social Medicine, Division for Health Promotion, Public Health Institute of Dubrovnik Neretva County, Dr. A. Šercera 4a, pp 58, 20001 Dubrovnik, Croatia;
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH8 9YL, UK;
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (A.P.); (O.P.)
- Algebra LAB, Algebra University College, Ilica 242, 10000 Zagreb, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (A.P.); (O.P.)
- Algebra LAB, Algebra University College, Ilica 242, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-91-576-2263
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