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Foster C, Gagnon CA, Ashraf AP. Altered lipid metabolism and the development of metabolic-associated fatty liver disease. Curr Opin Lipidol 2024; 35:200-207. [PMID: 38484227 DOI: 10.1097/mol.0000000000000933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW An increasing amount of research has underscored the significant role of lipoproteins in the pathogenesis of metabolic-associated fatty liver disease (MAFLD). This comprehensive review examines the intricate relationship between lipoprotein abnormalities and the development of MAFLD. RECENT FINDINGS Atherogenic dyslipidemia seen in insulin resistance states play a significant role in initiating and exacerbating hepatic lipid accumulation. There are also specific genetic factors ( PNPLA3 , TM6SF2 , MBOAT7 , HSD17B13 , GCKR- P446L) and transcription factors (SREBP-2, FXR, and LXR9) that increase susceptibility to both lipoprotein disorders and MAFLD. Most monogenic primary lipid disorders do not cause hepatic steatosis unless accompanied by metabolic stress. Hepatic steatosis occurs in the presence of secondary systemic metabolic stress in conjunction with predisposing environmental factors that lead to insulin resistance. Identifying specific aberrant lipoprotein metabolic factors promoting hepatic fat accumulation and subsequently exacerbating steatohepatitis will shed light on potential targets for therapeutic interventions. SUMMARY The clinical implications of interconnection between genetic factors and an insulin resistant environment that predisposes MAFLD is many fold. Potential therapeutic strategies in preventing or mitigating MAFLD progression include lifestyle modifications, pharmacological interventions, and emerging therapies targeting aberrant lipoprotein metabolism.
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Affiliation(s)
- Christy Foster
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Alabama at Birmingham
| | - Charles A Gagnon
- University of Alabama at Birmingham Marnix E. Heersink School of Medicine, Birmingham, Alabama, USA
| | - Ambika P Ashraf
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Alabama at Birmingham
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Pérez-Vega KA, Sanllorente A, Zomeño MD, Quindós A, Muñoz-Martínez J, Malcampo M, Aldea-Perona A, Hernáez Á, Lluansí A, Llirós M, Elias I, Elias-Masiques N, Aldeguer X, Muñoz D, Gaixas S, Blanchart G, Schröder H, Hernando-Redondo J, Carrón N, González-Torres P, Konstantinidou V, Fitó M, Castañer O. Sourdough Bread with Different Fermentation Times: A Randomized Clinical Trial in Subjects with Metabolic Syndrome. Nutrients 2024; 16:2380. [PMID: 39125261 PMCID: PMC11314010 DOI: 10.3390/nu16152380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/12/2024] Open
Abstract
The Mediterranean diet, featuring sourdough bread, shows promise in managing metabolic syndrome. This study explored the effects of two sourdough breads, with differing fermentation times but similar nutritional profiles, on inflammation, satiety, and gut microbiota composition in adults with metabolic syndrome. In a double-blind clinical trial, participants were randomized to consume either Elias Boulanger® long-fermentation (48 h) sourdough bread (EBLong) or Elias Boulanger® short-fermentation (2 h) sourdough bread (EBShort) over a two-month period. We assessed clinical parameters, inflammatory biomarkers, satiety-related hormones, and the richness and abundance of gut microbiota at baseline and follow-up. The participants included 31 individuals (mean age, 67, 51.6% female). EBShort was associated with reduced levels of soluble intercellular adhesion molecule (sICAM), and all participants, regardless of the intervention, exhibited a decrease in sICAM and diastolic pressure from baseline (p < 0.017). At follow-up, plasminogen activator inhibitor-1 (PAI-1) levels were lower in EBShort (-744 pg/mL; 95%CI: -282 to -1210 pg/mL) compared to EBLong. No differences in microbiota richness or abundance were observed. EBShort bread was effective in reducing some inflammation markers. The consumption of sourdough bread may offer potential benefits in reducing inflammation markers in individuals with metabolic syndrome; however, longer fermentation times did not show additional benefits.
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Affiliation(s)
- Karla Alejandra Pérez-Vega
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- PhD Program in Food Science and Nutrition, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Albert Sanllorente
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unitat de Suport a la Recerca Metropolitana Sud, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08907 Hospitalet de Llobregat, Spain
- Direcció d’Atenció Primària Metropolitana Sud, Institut Català de la Salut, 08907 Hospitalet de Llobregat, Spain
| | - María-Dolores Zomeño
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
| | - Ana Quindós
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
| | - Júlia Muñoz-Martínez
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Global Research on Wellbeing Research Group (GRoW), Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, 08025 Barcelona, Spain
- Research Group on Pedagogy, Society and Innovation with ICT Support (PSITIC), Facultat de Psicologia, Ciències de l’Educació i l’Esport Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain
| | - Mireia Malcampo
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
| | - Ana Aldea-Perona
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
| | - Álvaro Hernáez
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
| | - Aleix Lluansí
- Digestive Diseases and Microbiota Group, Institut d’Investigació Biomèdica de Girona, 17190 Salt, Spain; (A.L.); (M.L.); (X.A.)
- Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, 08950 Barcelona, Spain
| | - Marc Llirós
- Digestive Diseases and Microbiota Group, Institut d’Investigació Biomèdica de Girona, 17190 Salt, Spain; (A.L.); (M.L.); (X.A.)
- Bioinformatics and Bioimaging (BI-SQUARED) Research Group, Biosciences Department, Faculty of Sciences, Technology and Engineerings Universitat de Vic—Universitat Central de Catalunya, 08500 Vic, Spain
| | - Isidre Elias
- Elias–Boulanger S.L., 08340 Vilassar de Mar, Spain; (I.E.)
| | | | - Xavier Aldeguer
- Digestive Diseases and Microbiota Group, Institut d’Investigació Biomèdica de Girona, 17190 Salt, Spain; (A.L.); (M.L.); (X.A.)
- GoodGut S.L., 17003 Girona, Spain
- Digestive Service, Hospital Universitari de Girona Dr. Josep Trueta, 17007 Girona, Spain
| | - Daniel Muñoz
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sònia Gaixas
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
| | - Gemma Blanchart
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
| | - Helmut Schröder
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Javier Hernando-Redondo
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Nerea Carrón
- Microomics Systems S.L., 08041 Barcelona, Spain; (N.C.); (P.G.-T.)
| | | | - Valentini Konstantinidou
- Medoliali S.L. (DNANUTRICOACH®), 08006 Barcelona, Spain;
- Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), 08018 Barcelona, Spain
| | - Montserrat Fitó
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Olga Castañer
- Hospital del Mar Research Institute, 08003 Barcelona, Spain; (K.A.P.-V.); (A.S.); (M.-D.Z.); (A.Q.); (J.M.-M.); (M.M.); (A.A.-P.); (Á.H.); (D.M.); (S.G.); (G.B.); (H.S.); (J.H.-R.); (O.C.)
- Consorcio Centro de Investigación Biomédica En Red (CIBER), M.P. Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Lyons OC, Kerr MA, Flynn MAT, Hoey L, Hughes CF, Caffrey A, Laird E, Moore K, Porter KM, Cunningham C, McCarroll K, Molloy AM, Tracey F, O'Kane M, Strain JJ, Ward M, McNulty H. Identification of nutrition factors in the metabolic syndrome and its progression over time in older adults: analysis of the TUDA cohort. Diabetol Metab Syndr 2024; 16:125. [PMID: 38849940 PMCID: PMC11162058 DOI: 10.1186/s13098-024-01367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Nutrition is recognized as playing an important role in the metabolic syndrome (MetS), but the dietary components involved are unclear. We aimed to investigate nutrition factors in relation to MetS and its progression in older adults over a follow-up period of 5.4 years. METHODS Community-dwelling adults (≥ 60y) from the Trinity-Ulster-Department-of-Agriculture study, sampled at baseline (2008-12) and follow-up (2014-18; n 953), were classified as 'with MetS' by having three or more of: waist circumference (≥ 102 cm, males; ≥ 88 cm, females); HDL-cholesterol (< 1.0 mmol/L, males; < 1.3 mmol/L, females); triglycerides (≥ 1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and hemoglobin A1c (≥ 39 mmol/mol). RESULTS MetS was identified in 67% of participants, increasing to 74% at follow-up. Predictors at baseline for the development of metabolic syndrome (MetS) at follow-up were higher waist circumference (odds ratio [95%CI]; 1.06 [1.01-1.11]), but not BMI, and increased triglyceride concentrations (2.01 [1.29-3.16]). In dietary analysis (at follow-up), higher protein (g/kg bodyweight/day) and monounsaturated fatty acid (g/day) intakes were each associated with lower risk of MetS (0.06 [0.02-0.20] and 0.88 [0.78-1.00], respectively), whilst higher protein was also associated with lower abdominal obesity (0.10 [0.02-0.51]) and hypertension (0.22 [0.00-0.80]). Furthermore, participants with, compared to without, MetS consumed less high-quality protein foods (P = 0.006) and more low-quality protein foods (P < 0.001), as defined by the protein digestibility-corrected amino acid score. CONCLUSIONS Dietary interventions targeting protein quantity and quality may have specific benefits in preventing or delaying the progression of MetS in at-risk older people, but this requires investigation in the form of randomized trials.
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Affiliation(s)
- Oonagh C Lyons
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK.
| | - Mary A T Flynn
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Aoife Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Katie Moore
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Kirsty M Porter
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Conal Cunningham
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Fergal Tracey
- Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, UK
| | - Maurice O'Kane
- Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland, UK
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Filippou CD, Thomopoulos CG, Konstantinidis DG, Dimitriadis KS, Chrysochoou CA, Tatakis FA, Siafi EP, Tousoulis DM, Nihoyannopoulos PI, Panagiotakos DB, Tsioufis KP. Effect of DASH vs. mediterranean diet accompanied by a salt restriction on metabolic syndrome and cardiometabolic risk factors in adults with high normal blood pressure or grade 1 hypertension: secondary analyses of a randomized controlled trial. Hellenic J Cardiol 2024:S1109-9666(24)00110-6. [PMID: 38777087 DOI: 10.1016/j.hjc.2024.05.006] [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: 02/02/2024] [Revised: 03/29/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE Lifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic risk factors. However, studies directly comparing the cardiometabolic effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) accompanied by salt restriction are currently lacking. Thus, with the present secondary analyses of a randomized trial, we aimed to assess the cardiometabolic effects of a 3-month intensive dietary intervention implementing salt restriction alone or on top of the DASH and MedDiet compared to no/minimal intervention in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension. METHODS We randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60). RESULTS According to the intention-to-treat analysis, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of metabolic syndrome compared to the SRG and lower odds of elevated BP levels than the DDG and the SRG. Moreover, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/diastolic BP were reduced in all three intervention groups compared to the CG. CONCLUSION On a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.
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Affiliation(s)
- Christina D Filippou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Dimitrios G Konstantinidis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos S Dimitriadis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christina A Chrysochoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Fotis A Tatakis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Eirini P Siafi
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios M Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Petros I Nihoyannopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Konstantinos P Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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Duarte A, Martins J, Silva MJ, Augusto C, Martins SP, Rosário R. The Role of Parental Adherence to the Mediterranean Diet and Family Time Together in Children's Weight Status: The BeE-School Project. Nutrients 2024; 16:916. [PMID: 38612950 PMCID: PMC11013135 DOI: 10.3390/nu16070916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
The family context has been associated with children's weight status. This study aims to investigate the association of parents' adherence to the Mediterranean diet and family time with the weight status of children. The research is part of BeE-school, a cluster-randomized trial implemented in primary schools located in socially vulnerable contexts. A total of 735 children (380 boys and 355 girls) aged 6 to 10 participated in the study. Anthropometrics were assessed during school time, and weight status was categorized, while parents self-reported sociodemographic variables, adherence to the Mediterranean diet (MEDAS questionnaire), and family time. Children from families with higher education levels whose parents have a high adherence to the Mediterranean diet have lower odds of overweight/obesity (odds ratio (OR) 0.301, 95% CI 0.143-0.634, p = 0.002). Also, children from families with lower education levels who have more time together with their family have lower odds of overweight/obesity (OR 0.731, 95% CI 0.573-0.934, p = 0.012). The family environment, mainly family time together and adherence to the Mediterranean diet, exerts a significant influence on children's weight status. Professionals working in children's health should consider the family when fostering health-promoting behaviors.
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Affiliation(s)
- Ana Duarte
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Child Studies (CIEC-UM), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Juliana Martins
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Maria José Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Cláudia Augusto
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Silvana Peixoto Martins
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- ProChild CoLAB Against Poverty and Social Exclusion Association, Campus de Couros, Rua Vila Flor, 166, 4810-225 Guimarães, Portugal
| | - Rafaela Rosário
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Child Studies (CIEC-UM), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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Liu J, Xu J, Guan S, Wang W. Effects of different treatments on metabolic syndrome in patients with obstructive sleep apnea: a meta-analysis. Front Med (Lausanne) 2024; 11:1354489. [PMID: 38515989 PMCID: PMC10955063 DOI: 10.3389/fmed.2024.1354489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Background Obstructive sleep apnea (OSA) and metabolic syndrome (MetS) often coexist, and the causal relationship between them is not yet clear; treatments for OSA include continuous positive airway pressure (CPAP), mandibular advancement device (MAD), surgery, and lifestyle intervention and so on. However, the effects of different treatments on metabolic syndrome in OSA patients are still under debate. Objectives Review the effects of different treatments on metabolic syndrome in OSA patients by meta-analysis. Methods we searched articles in PubMed, Embase, Cochrane Library, CNKI, CBM, and Wanfang data from database construction to Feb. 2024.RevMan5.4 and Stata software were used to conduct a meta-analysis of 22 articles. Results A total of 22 articles were finally included. The results showed that CPAP treatment could reduce the prevalence of metabolic syndrome in OSA patients in randomized controlled trials (RCTs) (RR = 0.82 [95% CI, 0.75 to 0.90]; p < 0.01) and single-arm studies (RR = 0.73 [95% CI, 0.63 to 0.84]; p < 0.01). As for metabolic syndrome components, CPAP treatment reduces blood pressure, fasting glucose (FG), triglycerides (TG), and waist circumference (WC) but can't affect high-density lipoprotein cholesterol (HDL-C) levels. Lifestyle intervention could significantly reduce the prevalence of metabolic syndrome in OSA patients (RR = 0.60 [95% CI, 0.48 to 0.74]; p < 0.01) and can lower blood pressure, fasting glucose, and waist circumference but can't affect the lipid metabolism of OSA patients. Upper airway surgery can only reduce TG levels in OSA patients (MD = -0.74 [95% CI, -1.35 to -0.13]; p = 0.02) and does not affect other components of metabolic syndrome. There is currently no report on the impact of upper airway surgery on the prevalence of metabolic syndrome. No study has reported the effect of MAD on metabolic syndrome in OSA patients. Conclusion We confirmed that both CPAP and lifestyle intervention can reduce the prevalence of MetS in OSA patients. CPAP treatment can lower blood pressure, fasting glucose, waist circumference, and triglyceride levels in OSA patients. Lifestyle intervention can lower blood pressure, fasting glucose, and waist circumference in OSA patients. Upper airway surgery can only reduce TG levels in OSA patients. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022326857.
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Affiliation(s)
| | | | | | - Wei Wang
- Institute of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, Liaoning, China
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7
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Berrino F, Villarini A, Gargano G, Krogh V, Grioni S, Bellegotti M, Venturelli E, Raimondi M, Traina A, Zarcone M, Amodio R, Mano MP, Johansson H, Panico S, Santucci de Magistris M, Barbero M, Gavazza C, Mercandino A, Consolaro E, Galasso R, Del Riccio L, Bassi MC, Simeoni M, Premoli P, Pasanisi P, Bonanni B, Bruno E. The Effect of Diet on Breast Cancer Recurrence: The DIANA-5 Randomized Trial. Clin Cancer Res 2024; 30:965-974. [PMID: 37847493 PMCID: PMC10905522 DOI: 10.1158/1078-0432.ccr-23-1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/02/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE The DIANA-5 randomized controlled trial assessed the effectiveness of a diet based on Mediterranean and macrobiotic traditions (macro-Mediterranean diet) in reducing breast cancer recurrence. PATIENTS AND METHODS The DIANA-5 study involved 1,542 patients with breast cancer at high risk of recurrence because of estrogen receptor-negative cancer, or metabolic syndrome, or high plasma levels of insulin or testosterone. Women were randomly assigned to an active dietary intervention (IG) or a control group (CG). Both groups received the 2007 American Institute for Cancer Research/World Cancer Research Fund recommendations for cancer prevention. The intervention consisted of meetings with kitchen classes, community meals, and dietary recommendations. Recommended foods included whole grain cereals, legumes, soy products, vegetables, fruit, nuts, olive oil, and fish. Foods to be avoided were refined products, potatoes, sugar and desserts, red and processed meat, dairy products, and alcoholic drinks. A compliance Dietary Index was defined by the difference between recommended and discouraged foods. RESULTS Over the 5 years of follow-up, 95 patients of the IG and 98 of the CG developed breast cancer recurrence [HR = 0.99; 95% confidence interval (CI): 0.69-1.40]. The analysis by compliance to the dietary recommendations (IG and CG together) showed that the women in the upper tertile of Dietary Index change had an HR of recurrence of 0.59 (95% CI: 0.36-0.92) compared with women in the lower tertile. CONCLUSIONS The DIANA-5 dietary intervention trial failed to show a reduction in breast cancer recurrence, although self-reported diet at year 1 in IG and CG combined showed a protective association with the higher Dietary Index change. See related commentary by McTiernan, p. 931.
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Affiliation(s)
- Franco Berrino
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
- La Grande Via Foundation, Milan, Italy
| | - Anna Villarini
- Department of Medicine and Surgery, Section of Hygiene and Public Health, University of Perugia, Perugia, Italy
| | - Giuliana Gargano
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Vittorio Krogh
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Sara Grioni
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Manuela Bellegotti
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Elisabetta Venturelli
- Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Milena Raimondi
- Department of Epidemiology and Data Science, S.C. Epidemiology and Prevention, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Adele Traina
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, University of Palermo, Palermo, Italy
| | - Maurizio Zarcone
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, University of Palermo, Palermo, Italy
| | - Rosalba Amodio
- Palermo and Province Cancer Registry, Clinical Epidemiology Unit with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”, University of Palermo, Palermo, Italy
| | - Maria Piera Mano
- Dipartimento Scienze Chirurgiche, Study University, Turin, Italy
- S.C. Epidemiologia dei Tumori, AOU Città della Salute e della Scienza, CPO Piemonte, Turin, Italy
| | - Harriet Johansson
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | | | | | | | | | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Rionero in Vulture, Italy
| | - Luciana Del Riccio
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Rionero in Vulture, Italy
| | | | | | | | - Patrizia Pasanisi
- Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Eleonora Bruno
- Department of Experimental Oncology, S.S.D. Nutrition Research and Metabolomics, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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8
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Zayed S, Goldfarb DS, Joshi S. Popular Diets and Kidney Stones. ADVANCES IN KIDNEY DISEASE AND HEALTH 2023; 30:529-536. [PMID: 38453270 DOI: 10.1053/j.akdh.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 03/09/2024]
Abstract
Popular diets often influence dietary patterns, which have different implications for kidney stone risk. Despite the wide variety of popular diets, some general principles can be gleaned from investigating their potential impact on nephrolithiasis. Plant-based diets, including Dietary Approaches to Stop Hypertension, Mediterranean, flexitarian, and vegetarian diets, may protect against nephrolithiasis when they consist largely of unprocessed plant foods, while carbohydrate-restricted diets (including high-protein diets and the ketogenic diet) may raise kidney stone risk. Patients should be advised to consume a diet rich in whole plants, particularly fruits and vegetables, and minimize their consumption of animal proteins. Accompanying fruits and vegetables that are higher in oxalate content with more water and some dairy intake may also be useful. (We address the oxalate content of fruits and vegetables further below). Calcium consumption is an important component of decreasing the risk of kidney stones, as higher dietary calcium from dairy or nondairy sources is independently associated with lower kidney stone risk. Patients should also be advised to be conscious of fat intake, as fat in the intestinal lumen may complex with calcium and therefore increase urinary oxalate excretion. Finally, patients should avoid consumption of processed foods, which often contain added fructose and high sodium content, two factors that increase kidney stone risk.
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Affiliation(s)
- Sara Zayed
- New York University Grossman School of Medicine, New York, NY; Department of Medicine, New York University Grossman School of Medicine, New York, NY.
| | - David S Goldfarb
- New York University Grossman School of Medicine, New York, NY; Department of Medicine, New York University Grossman School of Medicine, New York, NY; Nephrology Section, New York Harbor VA Healthcare System, New York, NY
| | - Shivam Joshi
- Department of Medicine, New York University Grossman School of Medicine, New York, NY; Department of Veterans Affairs, Orlando VAMC, Orlando, FL.
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9
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De Amicis R, Menichetti F, Leone A. The Effect of the Mediterranean Diet on Metabolic Health. Nutrients 2023; 15:3397. [PMID: 37571334 PMCID: PMC10421236 DOI: 10.3390/nu15153397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 06/29/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The Mediterranean Diet (MedDiet) is one of the healthiest and most balanced dietary patterns worldwide [...].
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Affiliation(s)
- Ramona De Amicis
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (R.D.A.); (F.M.)
- IRCCS Istituto Auxologico Italiano, Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, 20145 Milan, Italy
| | - Francesca Menichetti
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (R.D.A.); (F.M.)
| | - Alessandro Leone
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (R.D.A.); (F.M.)
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10
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Varesi A, Campagnoli LIM, Chirumbolo S, Candiano B, Carrara A, Ricevuti G, Esposito C, Pascale A. The Brain-Gut-Microbiota Interplay in Depression: a key to design innovative therapeutic approaches. Pharmacol Res 2023; 192:106799. [PMID: 37211239 DOI: 10.1016/j.phrs.2023.106799] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Depression is the most prevalent mental disorder in the world associated with huge socio-economic consequences. While depressive-related symptoms are well known, the molecular mechanisms underlying disease pathophysiology and progression remain largely unknown. The gut microbiota (GM) is emerging as a key regulator of the central nervous system homeostasis by exerting fundamental immune and metabolic functions. In turn, the brain influences the intestinal microbial composition through neuroendocrine signals, within the so-called gut microbiota-brain axis. The balance of this bidirectional crosstalk is important to ensure neurogenesis, preserve the integrity of the blood-brain barrier and avoid neuroinflammation. Conversely, dysbiosis and gut permeability negatively affect brain development, behavior, and cognition. Furthermore, although not fully defined yet, changes in the GM composition in depressed patients are reported to influence the pharmacokinetics of common antidepressants by affecting their absorption, metabolism, and activity. Similarly, neuropsychiatric drugs may shape in turn the GM with an impact on the efficacy and toxicity of the pharmacological intervention itself. Consequently, strategies aimed at re-establishing the correct homeostatic gut balance (i.e., prebiotics, probiotics, fecal microbiota transplantation, and dietary interventions) represent an innovative approach to improve the pharmacotherapy of depression. Among these, probiotics and the Mediterranean diet, alone or in combination with the standard of care, hold promise for clinical application. Therefore, the disclosure of the intricate network between GM and depression will give precious insights for innovative diagnostic and therapeutic approaches towards depression, with profound implications for drug development and clinical practice.
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Affiliation(s)
- Angelica Varesi
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy.
| | | | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37121 Verona, Italy
| | - Beatrice Candiano
- Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy
| | - Adelaide Carrara
- Child Neurology and Psychiatric Unit, IRCCS Mondino, Pavia, Italy
| | | | - Ciro Esposito
- Department of Internal Medicine and Therapeutics, University of Pavia, Italy; Nephrology and dialysis unit, ICS S. Maugeri SPA SB Hospital, Pavia, Italy; High School in Geriatrics, University of Pavia, Italy
| | - Alessia Pascale
- Department of Drug Sciences, Section of Pharmacology, University of Pavia, Pavia, Italy.
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11
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Soleimani M, Barone S, Luo H, Zahedi K. Pathogenesis of Hypertension in Metabolic Syndrome: The Role of Fructose and Salt. Int J Mol Sci 2023; 24:4294. [PMID: 36901725 PMCID: PMC10002086 DOI: 10.3390/ijms24054294] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Metabolic syndrome is manifested by visceral obesity, hypertension, glucose intolerance, hyperinsulinism, and dyslipidemia. According to the CDC, metabolic syndrome in the US has increased drastically since the 1960s leading to chronic diseases and rising healthcare costs. Hypertension is a key component of metabolic syndrome and is associated with an increase in morbidity and mortality due to stroke, cardiovascular ailments, and kidney disease. The pathogenesis of hypertension in metabolic syndrome, however, remains poorly understood. Metabolic syndrome results primarily from increased caloric intake and decreased physical activity. Epidemiologic studies show that an enhanced consumption of sugars, in the form of fructose and sucrose, correlates with the amplified prevalence of metabolic syndrome. Diets with a high fat content, in conjunction with elevated fructose and salt intake, accelerate the development of metabolic syndrome. This review article discusses the latest literature in the pathogenesis of hypertension in metabolic syndrome, with a specific emphasis on the role of fructose and its stimulatory effect on salt absorption in the small intestine and kidney tubules.
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Affiliation(s)
- Manoocher Soleimani
- Research Services, New Mexico Veterans Health Care Medical Center, Albuquerque, NM 87108, USA
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Sharon Barone
- Research Services, New Mexico Veterans Health Care Medical Center, Albuquerque, NM 87108, USA
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Henry Luo
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Kamyar Zahedi
- Research Services, New Mexico Veterans Health Care Medical Center, Albuquerque, NM 87108, USA
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
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12
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Comparison of a pre-bariatric surgery very low-calorie ketogenic diet and the Mediterranean diet effects on weight loss, metabolic parameters, and liver size reduction. Sci Rep 2022; 12:20686. [PMID: 36450844 PMCID: PMC9712493 DOI: 10.1038/s41598-022-24959-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022] Open
Abstract
This study compared the effects on weight as well as on metabolic parameters and liver size of a very low-calorie ketogenic diet versus a Mediterranean diet in patients with morbid obesity preparing to undergo bariatric surgery. This prospective comparison study evaluated patients 18-65 years of age who enrolled for bariatric surgery. Study duration was limited to an immediate preoperative period of 15 days. The very low-calorie ketogenic diet incorporated 10-12 kcal/kg/day of energy and 1-1.2 g/kg of protein using Kalibra (Societa Dietetica Medica) (VLCKD-SDM). The Mediterranean diet (MD) included 15-20% protein, 45-50% carbohydrate, and 25-35% fat. Changes in body mass index (BMI), liver size, and anthropometric and metabolic measurements were assessed. Between January 2016 and March 2017, of 45 patients enrolled, 30 completed the study (VLCKD-SDM, n = 15; MD, n = 15). Respective median BMI loss after VLCKD-SDM was 2.7 kg/m2 versus MD 1.4 kg/m2 (p < 0.05); median fat percentage reduction was 3.2 units versus 1.7 units (p < 0.05). Median liver size decreased 5.5% in the VLCKD-SDM group versus 1.7% in the MD group (p < 0.05). Median total cholesterol, and LDL levels decreased in both groups (p < 0.05), with greater relative decreases in the VLCKD-SDM group. Short-term preoperative diet-based weight loss in patients with morbid obesity preparing for bariatric surgery was significantly greater following a very low-calorie ketogenic diet versus a Mediterranean diet. The very low-calorie diet also significantly improved anthropometric and metabolic parameters and reduced preoperative liver size above that of the MD.
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13
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Akhavanfar R, Hojati A, Kahrizi MS, Farhangi MA, Ardekani AM. Adherence to lifelines diet score and risk factors of metabolic syndrome among overweight and obese adults: A cross-sectional study. Front Nutr 2022; 9:961468. [PMID: 36466413 PMCID: PMC9713010 DOI: 10.3389/fnut.2022.961468] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/02/2022] [Indexed: 09/28/2023] Open
Abstract
Background Metabolic syndrome (MetS) is one of the most significant public health issues worldwide, and diet quality is an important controllable environmental factor influencing the incidence of MetS. Numerous dietary scores have been established to assess compliance with dietary recommendations or eating patterns, many of which are not entirely food-based. Hence, Lifelines Diet Score (LLDS) was developed in response to the shortcomings of existing tools. This study aimed to assess any possible links between total food quality and cardiometabolic risk factors among overweight and obese adults. Methods This cross-sectional study included 338 overweight and obese individuals [body mass index (BMI) > 25 kg/m2] aged 20-50 years in Tabriz, Iran. To collect dietary data, we used a validated semi-quantitative Food Frequency Questionnaire (FFQ) for Iranian population. Enzymatic-colorimetric methods were used to assess serum glucose and lipids, and enzyme-linked immunosorbent assay (ELISA) kits were used to measure insulin levels. In addition, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. Results BMI and hip circumference (HC) were significantly different (P < 0.05) amongst LLDS tertiles. Adherence to the highest tertile of LLDS was associated with lower SBP, and the subjects in higher LLDS tertiles significantly had lower systolic blood pressure (SBP) (P = 0.04). Triglyceride (TG) levels were also lower in the third tertile of LLDS with a near-significant P-value (P = 0.05). Conclusion According to our results, a higher diet quality score, determined by LLDS, can be associated with a lower risk of MetS. Further experimental and longitudinal studies are needed to better understand this relationship.
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Affiliation(s)
- Roozbeh Akhavanfar
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Hojati
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Abnoos Mokhtari Ardekani
- Endocrinoligy and Metabolism Research Center, Institute of Basic and Clinical Physiology Science and Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
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14
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Kinshella MLW, Omar S, Scherbinsky K, Vidler M, Magee LA, von Dadelszen P, Moore SE, Elango R. Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review. Reprod Health 2022; 19:188. [PMID: 36064716 PMCID: PMC9442926 DOI: 10.1186/s12978-022-01485-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia. METHODS A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility. RESULTS The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence. CONCLUSION A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Shazmeen Omar
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Kerri Scherbinsky
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Laura A Magee
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Peter von Dadelszen
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, UK
- MRC Unit The Gambia at the London, School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rajavel Elango
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada.
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
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15
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Obesity and Lifestyle Habits among Kidney Transplant Recipients. Nutrients 2022; 14:nu14142892. [PMID: 35889847 PMCID: PMC9319556 DOI: 10.3390/nu14142892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Obesity may negatively impact clinical outcomes in kidney transplant (KT) recipients. Limited information is available on the prevalence of obesity in this population, and on the lifestyle habits associated with obesity. Methods: we conducted an online, anonymous survey to assess of the proportion of KT recipients with obesity, adherence to the Mediterranean diet (i.e., a dietary regimen with proven renal and cardiovascular outcomes) using the MEDI-Lite questionnaire, and level of physical activity using the International Physical Activity Questionnaire (IPAQ) short form among KT recipients. Results: 255 KT recipients participated. Median (25th−75th quartile) age was 56.0 (48.0; 62.0) years, 43.9% female, median BMI 23.9 (21.6; 26.5) kg/m2. The proportion of KT recipients with obesity was 9.8% (95% confidence interval, 6.4 to 14.1%). Adequate adherence to the Mediterranean diet (Medi-Lite score >9) was overall low (44.7%; 40.0 vs. 45.2% in those with or without obesity, respectively; p = 0.618). In participants with obesity the Medi-Lite score inversely correlated with BMI (R = −0.45; p < 0.025). Overall, 30.6% of participants had a low level of physical activity (44.0 vs. 29.1% of those with or without obesity, respectively; p = 0.125). The amount of energy expended walking was significantly lower among participants with obesity (462 (0.0; 1436) vs. 1056 (433; 2005) METs/week, p = 0.017). Conclusions: the burden of obesity among KT recipients is similar to that of the general population. Adherence to the Mediterranean diet was generally low, and nearly one-third of participants had a low level of physical activity. Building specialized multidisciplinary teams to manage obesity in KT recipients is urgently needed.
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Leone A, De Amicis R, Battezzati A, Bertoli S. Adherence to the Mediterranean Diet and Risk of Metabolically Unhealthy Obesity in Women: A Cross-Sectional Study. Front Nutr 2022; 9:858206. [PMID: 35548567 PMCID: PMC9084308 DOI: 10.3389/fnut.2022.858206] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/09/2022] [Indexed: 01/13/2023] Open
Abstract
Some obese individuals do not present any metabolic alteration and are considered metabolically healthy (MHO). Adherence to high-quality dietary pattern may favor this phenotype. We aimed to evaluate the association between the adherence to the Mediterranean diet and risk of metabolically unhealthy obesity (MUO) in women. We conducted a cross-sectional study on 2,115 obese women. All patients underwent a medical examination, anthropometric evaluation, bioelectrical impedance, ultrasound measurements of abdominal visceral (VAT) and subcutaneous (SAT) fat, blood sampling and evaluation of adherence to the Mediterranean diet through MEDAS questionnaire. The diagnosis of MHO and MUO was made using the harmonized criteria. A multivariable logistic regression adjusted for age, BMI, fat free mass, ultrasound-estimated VAT:SAT ratio, marital status, education, past diet, antidepressant use, family history of diabetes and cardiovascular disease, menopausal status, smoking, and physical activity was used to assess the association between Mediterranean diet and MUO risk. The prevalence of MHO was 21.2% (N = 449). Compared to MUO women, MHO women were younger, had lower BMI and VAT, and had higher fat free mass and SAT. In the multivariable model, the adherence to the Mediterranean diet was not associated with the risk of MUO (OR = 0.91, 95%CI: 0.62; 1.34, P = 0.624). Given the impact of menopause on metabolic health we also carried out the analysis in pre- and post-menopausal women separately. Higher adherence to the Mediterranean diet was associated with a lower risk of MUO in postmenopausal women (OR = 0.55, 95%CI: 0.31; 0.96, P = 0.034). No association was found in premenopausal women (OR = 1.18, 95%CI: 0.70; 1.99, P = 0.532). In conclusion, adherence to the Mediterranean diet was associated with a better metabolic health in postmenopausal women. Further studies are needed to confirm the ability of the Mediterranean diet in promoting maintenance of the healthy phenotype and reversion from MUO.
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Affiliation(s)
- Alessandro Leone
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Ramona De Amicis
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy.,Lab of Nutrition and Obesity Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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Peiris C, Harding K, Porter J, Shields N, Gilfillan C, Taylor N. Understanding the hidden epidemic of metabolic syndrome in people accessing community rehabilitation: a cross-sectional study of physical activity, dietary intake, and health literacy. Disabil Rehabil 2022; 45:1471-1479. [PMID: 35476590 DOI: 10.1080/09638288.2022.2065540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the prevalence of metabolic syndrome in patients attending outpatient community rehabilitation in Melbourne, Australia and to compare health literacy, physical activity, and dietary intake of people with and without metabolic syndrome. MATERIALS AND METHODS A cross-sectional, multi-centre, observational study of adults (n = 193) presenting to rehabilitation with various health complaints. Metabolic syndrome was determined according to the International Diabetes Federation joint consensus worldwide definition. Health literacy was assessed using the Rapid Estimate of Adult literacy in Medicine (REALM) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Physical activity was assessed using accelerometers and dietary intake was assessed using a food frequency questionnaire. RESULTS One hundred and twenty three participants (64%) had metabolic syndrome. Of these, only three (2%) knew they had it. People with metabolic syndrome scored lower on health literacy (S-TOFHLA MD -2.10, 95% confidence interval (CI) -3.98 to -0.22) and took 1311 (95%CI 375 to 2246) fewer daily steps than those without metabolic syndrome. There were no differences in dietary intake. CONCLUSIONS Metabolic syndrome is a prevalent and under-recognised condition in community rehabilitation. Community healthcare professionals and health services may need to consider a broader approach to management including lifestyle assessment and intervention of patients with various conditions. Implications for rehabilitationAlmost two-thirds of adults in community rehabilitation had underlying, undetected metabolic syndrome.Adults with metabolic syndrome completed less objectively measured physical activity and had lower health literacy levels than those without metabolic syndrome.A broader approach to management may need to be considered in community rehabilitation where patients presenting for rehabilitation of various conditions would likely benefit from lifestyle assessment and intervention.
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Affiliation(s)
- Casey Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Katherine Harding
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Eastern Health, Allied Health Clinical Research Office, Box Hill, Australia
| | - Judi Porter
- School of Exercise and Nutrition Science, Deakin University, Burwood, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Chris Gilfillan
- Eastern Clinical Research Unit, Eastern Health, Box Hill, Australia
| | - Nicholas Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Eastern Health, Allied Health Clinical Research Office, Box Hill, Australia
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18
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Mendonça N, Gregório MJ, Salvador C, Henriques AR, Canhão H, Rodrigues AM. Low Adherence to the Mediterranean Diet Is Associated with Poor Socioeconomic Status and Younger Age: A Cross-Sectional Analysis of the EpiDoC Cohort. Nutrients 2022; 14:nu14061239. [PMID: 35334895 PMCID: PMC8954252 DOI: 10.3390/nu14061239] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 01/10/2023] Open
Abstract
The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns as it has been consistently associated with several beneficial health outcomes. Adherence to the MD pattern has been decreasing in southern European countries for the last decades, especially among low socioeconomic groups. The aim of this study was to assess the adherence to the MD in Portugal, to evaluate regional differences, and explore associated factors (sociodemographic, economic, and lifestyles behaviors). This study used the third data collection wave of the Epidemiology of Chronic Diseases Cohort Study (EpiDoC 3). MD adherence was assessed using the Portuguese-validated MD adherence score (MEDAS) questionnaire. Non-adjusted and adjusted logistic regression models were used to assess the risk factors for low MD adherence and individual MEDAS items. In this cross-sectional evaluation of the EpiDoC 3 cohort study (n = 5647), 28.8% of the Portuguese population had low adherence to a MD. Azores and Madeira had lower adherence to the MD than the rest of the country. Younger individuals in lower income categories (e.g., ORfinding it very difficult = 1.48; 95% CI 1.16-1.91) and with a lower educational level (e.g., OR0-4 years = 2.63; 95% CI 2.09-3.32) had higher odds of having a lower adherence to the MD. Portuguese adults have a high prevalence of low adherence to the MD, especially among those who are younger and have lower socioeconomic status. Public health policies to promote adherence to the MD should pay special attention to these groups.
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Affiliation(s)
- Nuno Mendonça
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1099-085 Lisboa, Portugal; (N.M.); (M.J.G.); (C.S.); (A.R.H.); (H.C.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1150-082 Lisboa, Portugal
| | - Maria João Gregório
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1099-085 Lisboa, Portugal; (N.M.); (M.J.G.); (C.S.); (A.R.H.); (H.C.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1150-082 Lisboa, Portugal
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4200-465 Porto, Portugal
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
| | - Clara Salvador
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1099-085 Lisboa, Portugal; (N.M.); (M.J.G.); (C.S.); (A.R.H.); (H.C.)
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
| | - Ana Rita Henriques
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1099-085 Lisboa, Portugal; (N.M.); (M.J.G.); (C.S.); (A.R.H.); (H.C.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1150-082 Lisboa, Portugal
| | - Helena Canhão
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1099-085 Lisboa, Portugal; (N.M.); (M.J.G.); (C.S.); (A.R.H.); (H.C.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1150-082 Lisboa, Portugal
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
| | - Ana M. Rodrigues
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1099-085 Lisboa, Portugal; (N.M.); (M.J.G.); (C.S.); (A.R.H.); (H.C.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), 1150-082 Lisboa, Portugal
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Rheumatology Unit, Hospital dos Lusíadas, 1500-458 Lisboa, Portugal
- Correspondence: ; Tel.: +351-218803000
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Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. Int J Mol Sci 2022; 23:ijms23020786. [PMID: 35054972 PMCID: PMC8775991 DOI: 10.3390/ijms23020786] [Citation(s) in RCA: 400] [Impact Index Per Article: 200.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/18/2022] Open
Abstract
Metabolic syndrome (MetS) forms a cluster of metabolic dysregulations including insulin resistance, atherogenic dyslipidemia, central obesity, and hypertension. The pathogenesis of MetS encompasses multiple genetic and acquired entities that fall under the umbrella of insulin resistance and chronic low-grade inflammation. If left untreated, MetS is significantly associated with an increased risk of developing diabetes and cardiovascular diseases (CVDs). Given that CVDs constitute by far the leading cause of morbidity and mortality worldwide, it has become essential to investigate the role played by MetS in this context to reduce the heavy burden of the disease. As such, and while MetS relatively constitutes a novel clinical entity, the extent of research about the disease has been exponentially growing in the past few decades. However, many aspects of this clinical entity are still not completely understood, and many questions remain unanswered to date. In this review, we provide a historical background and highlight the epidemiology of MetS. We also discuss the current and latest knowledge about the histopathology and pathophysiology of the disease. Finally, we summarize the most recent updates about the management and the prevention of this clinical syndrome.
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20
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Mirmiran P, Farhadnejad H, Teymoori F, Parastouei K, Azizi F. The higher adherence to healthy lifestyle factors is associated with a decreased risk of metabolic syndrome in Iranian adults. NUTR BULL 2022; 47:57-67. [DOI: 10.1111/nbu.12537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Clinical Nutrition and Dietetics Faculty of Nutrition Sciences and Food Technology National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Karim Parastouei
- Department of Cellular and Molecular Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran
| | - Fereidoun Azizi
- Endocrine Research Center Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
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21
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Rong L, Zou J, Ran W, Qi X, Chen Y, Cui H, Guo J. Advancements in the treatment of non-alcoholic fatty liver disease (NAFLD). Front Endocrinol (Lausanne) 2022; 13:1087260. [PMID: 36726464 PMCID: PMC9884828 DOI: 10.3389/fendo.2022.1087260] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a series of diseases, involving excessive lipid deposition in the liver and is often accompanied by obesity, diabetes, dyslipidemia, abnormal blood pressure, and other metabolic disorders. In order to more accurately reflect its pathogenesis, an international consensus renamed NAFLD in 2020 as metabolic (dysfunction) associated with fatty liver disease (MAFLD). The changes in diet and lifestyle are recognized the non-drug treatment strategies; however, due to the complex pathogenesis of NAFLD, the current drug therapies are mainly focused on its pathogenic factors, key links of pathogenesis, and related metabolic disorders as targets. There is still a lack of specific drugs. In clinical studies, the common NAFLD treatments include the regulation of glucose and lipid metabolism to protect the liver and anti-inflammation. The NAFLD treatments based on the enterohepatic axis, targeting gut microbiota, are gradually emerging, and various new metabolism-regulating drugs are also under clinical development. Therefore, this review article has comprehensively discussed the research advancements in NAFLD treatment in recent years.
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Affiliation(s)
- Li Rong
- Department of Gastroenterology, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, China
| | - Junyan Zou
- Medical Research Institute, Southwest University, Chongqing, China
- Medical Research Institute, Southwest University, Public Health Hospital Affiliated to Southwest University, Chongqing, China
| | - Wei Ran
- Medical Research Institute, Southwest University, Public Health Hospital Affiliated to Southwest University, Chongqing, China
| | - Xiaohong Qi
- Department of General surgery, Baoshan People’s Hospital of Yunnan Province, Baoshan, Yunnan, China
| | - Yaokai Chen
- Medical Research Institute, Southwest University, Public Health Hospital Affiliated to Southwest University, Chongqing, China
| | - Hongjuan Cui
- Medical Research Institute, Southwest University, Chongqing, China
| | - Jinjun Guo
- Department of Gastroenterology, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, China
- *Correspondence: Jinjun Guo,
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22
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Sangsefidi ZS, Lorzadeh E, Nadjarzadeh A, Mirzaei M, Hosseinzadeh M. The association between low-carbohydrate diet score and metabolic syndrome among Iranian adults. Public Health Nutr 2021; 24:6299-6308. [PMID: 34294177 PMCID: PMC11148582 DOI: 10.1017/s1368980021003074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Assessing the relationship between low-carbohydrate diet (LCD) score and metabolic syndrome (Mets) in Iranian adults. DESIGN Cross-sectional study. SETTING Yazd Health Study and Taghzieh Mardom-e-Yazd study. PARTICIPANTS Data of 2074 participants were used. Dietary intakes were assessed by a validated semi-quantitative FFQ. LCD score was calculated for each person by summing up the assigned scores to deciles of energy percentages from macronutrients. Mets was evaluated using National Cholesterol Education Program Adult Treatment Panel III. Eventually, association between LCD score and Mets was examined using logistic regression. RESULTS Total Mets prevalence was approximately 40·5 %. After adjustment for confounders, subjects in the higher quartile of LCD score had a significant lower chance of Mets than lower quartile among all participants (Q4 v. Q1: OR: 0·68, 95 % CI (0·50, 0·92)) and separately in men (Q4 v. Q1: OR: 0·54, 95 % CI (0·34, 0·86)) and women (Q2 v. Q1: OR: 0·53, 95 % CI (0·34, 0·82)). Furthermore, more LCD adherence in men reduced abdominal obesity by 47 % (Q3 v. Q1: OR: 0·53, 95 % CI (0·28, 0·99)). A significant inverse relation was also observed between low HDL cholesterol and LCD score in all participants (Q4 versus Q1 OR: 0·74, 95% CI: 0·56-0·99) and separately in men (Q4 versus Q1 OR: 0·63, 95% CI: 0·40-0·98). CONCLUSIONS More adherence to LCD might be related to lower chance of Mets and some of its components such as low HDL-cholesterol and abdominal obesity specially in men. Further studies are required to confirm the findings.
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Affiliation(s)
- Zohreh Sadat Sangsefidi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition and Public Health, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Elnaz Lorzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Hosseinzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Abstract
Scientific evidence has been reporting the health and environmental benefits of the Mediterranean diet. However, countries of the Mediterranean region, Portugal included, are gradually abandoning this traditional food pattern. The aim of the present work was to develop the Portuguese Mediterranean diet wheel. Three main steps were followed: (1) establishment of the most relevant Mediterranean diet and lifestyle principles to improve this pattern among the Portuguese population; (2) converting those principles into a captivating and easy to understand tool and (3) obtaining experts' opinion. By a matter of consistency, the preservation and transmission of the Mediterranean heritage was represented through an upgrade of the current Portuguese food wheel guide. This complementary tool highlights the Mediterranean diet enlarged character that encompasses a healthy lifestyle and reinforces sociocultural and environmental features. It was launched at the end of 2016 and was nationally disseminated with the support of the Portuguese Health Directorate. Initially it was presented in a poster format image that was subsequently spread in different communication formats. This newly developed Mediterranean food guide is a complementary educational tool that will support health and education professionals in the never ending mission of promoting healthy food choices.
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Bôto JM, Marreiros A, Diogo P, Pinto E, Mateus MP. Health behaviours as predictors of the Mediterranean diet adherence: a decision tree approach. Public Health Nutr 2021; 25:1-13. [PMID: 34369348 PMCID: PMC9991829 DOI: 10.1017/s1368980021003293] [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: 10/13/2020] [Revised: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to identify health behaviours that determine adolescent's adherence to the Mediterranean diet (MD) through a decision tree statistical approach. DESIGN Cross-sectional study, with data collected through a self-fulfilment questionnaire with five sections: (1) eating habits; (2) adherence to the MD (KIDMED index); (3) physical activity; (4) health habits and (5) socio-demographic characteristics. Anthropometric and blood pressure data were collected by a trained research team. The Automatic Chi-square Interaction Detection (CHAID) method was used to identify health behaviours that contribute to a better adherence to the MD. SETTING Eight public secondary schools, in Algarve, Portugal. PARTICIPANTS Adolescents with ages between 15 and 19 years (n 325). RESULTS According to the KIDMED index, we found a low adherence to MD in 9·0 % of the participants, an intermediate adherence in 45·5 % and a high adherence in 45·5 %. Participants that regularly have breakfast, eat vegetable soup, have a second piece of fruit/d, eat fresh or cooked vegetables 1 or more times a day, eat oleaginous fruits at least 2 to 3 times a week, and practice sports and leisure physical activities outside school show higher adherence to the MD (P < 0·001). CONCLUSIONS The daily intake of two pieces of fruit and vegetables proved to be a determinant health behaviour for high adherence to MD. Strategies to promote the intake of these foods among adolescents must be developed and implemented.
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Affiliation(s)
- Joana Margarida Bôto
- University of Algarve – School of Health, Department of Dietetics and Nutrition, Gambelas Campus, 8005-139Faro, Portugal
| | - Ana Marreiros
- University of Algarve – School of Health, Department of Dietetics and Nutrition, Gambelas Campus, 8005-139Faro, Portugal
- Department of Biomedical Sciences and Medicine, Faro, Portugal
| | - Patrícia Diogo
- University of Algarve – School of Health, Department of Dietetics and Nutrition, Gambelas Campus, 8005-139Faro, Portugal
- Necton SA, Olhão, Algarve, Portugal
| | - Ezequiel Pinto
- University of Algarve – School of Health, Department of Dietetics and Nutrition, Gambelas Campus, 8005-139Faro, Portugal
- School of Health, Department of Dietetics and Nutrition, Faro, Portugal
- Centre for Health Studies and Development, Faro, Portugal
| | - Maria Palma Mateus
- University of Algarve – School of Health, Department of Dietetics and Nutrition, Gambelas Campus, 8005-139Faro, Portugal
- School of Health, Department of Dietetics and Nutrition, Faro, Portugal
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25
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Boqué N, Tarro L, Rosi A, Torrell H, Saldaña G, Luengo E, Rachman Z, Pires A, Tavares NT, Pires AS, Botelho MF, Mena P, Scazzina F, Del Rio D, Caimari A. Study Protocol of a Multicenter Randomized Controlled Trial to Tackle Obesity through a Mediterranean Diet vs. a Traditional Low-Fat Diet in Adolescents: The MED4Youth Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4841. [PMID: 34062731 PMCID: PMC8125034 DOI: 10.3390/ijerph18094841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 12/26/2022]
Abstract
Youth obesity is a strong predictor of adult obesity, which has well-known negative health consequences. Thus, addressing adult obesity requires tackling youth obesity. MED4Youth's main objective is to strengthen the link between the Mediterranean Diet (MD) and the health benefits against youth obesity and associated cardiovascular disease (CVD) risk factors, identifying positive effects exerted by an MD including sourdough bread and healthy products from the Mediterranean basis (chickpeas/hummus, nuts, and pomegranate juice). For this purpose, a multicenter randomized controlled trial in which an MD-based intervention will be compared to a traditional low-fat diet intervention will be carried out with 240 overweight and obese adolescents (13-17 years) from Spain, Portugal, and Italy. Both interventions will be combined with an educational web-application addressed to engage the adolescents through a learning-through-playing approach, using both educational materials and games. To assess the interventions, adherence to the MD, dietary records, physical activity, food frequency, sociodemographic, and quality of life questionnaires as well as classical anthropometric and biochemical parameters will be evaluated. Furthermore, an omics approach will be performed to elucidate whether the interventions can shape the gut microbiota and gut-derived metabolites to gain knowledge on the mechanisms through which the MD can exert its beneficial effects.
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Affiliation(s)
- Noemi Boqué
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, 43204 Reus, Spain; (N.B.); (L.T.)
| | - Lucía Tarro
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, 43204 Reus, Spain; (N.B.); (L.T.)
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43125 Parma, Italy; (A.R.); (P.M.); (F.S.); (D.D.R.)
| | - Helena Torrell
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (Joint Unit Eurecat-Universitat Rovira i Virgili), Unique Scientific and Technical Infrastructures (ICTS), 43204 Reus, Spain;
| | - Guillermo Saldaña
- NOVAPAN S.L, Research & Development Department, 50014 Zaragoza, Spain; (G.S.); (E.L.)
| | - Elisa Luengo
- NOVAPAN S.L, Research & Development Department, 50014 Zaragoza, Spain; (G.S.); (E.L.)
| | - Zeev Rachman
- SHIKMA Field Crops, 8531500 Kibbutz Mishmar HaNegev, Israel;
| | - António Pires
- Pediatric Cardiology Department, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-075 Coimbra, Portugal;
| | - Nuno Tiago Tavares
- Institute of Biophysics, Faculty of Medicine, Institute for Clinical and Biomedical Research (iCBR) Area of CIMAGO, University of Coimbra, 3000-548 Coimbra, Portugal; (N.T.T.); (A.S.P.); (M.F.B.)
- Centre for Inovative Biomedicine and Biotechnology, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-548 Coimbra, Portugal
| | - Ana Salomé Pires
- Institute of Biophysics, Faculty of Medicine, Institute for Clinical and Biomedical Research (iCBR) Area of CIMAGO, University of Coimbra, 3000-548 Coimbra, Portugal; (N.T.T.); (A.S.P.); (M.F.B.)
- Centre for Inovative Biomedicine and Biotechnology, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-548 Coimbra, Portugal
| | - Maria Filomena Botelho
- Institute of Biophysics, Faculty of Medicine, Institute for Clinical and Biomedical Research (iCBR) Area of CIMAGO, University of Coimbra, 3000-548 Coimbra, Portugal; (N.T.T.); (A.S.P.); (M.F.B.)
- Centre for Inovative Biomedicine and Biotechnology, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3000-548 Coimbra, Portugal
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43125 Parma, Italy; (A.R.); (P.M.); (F.S.); (D.D.R.)
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43125 Parma, Italy; (A.R.); (P.M.); (F.S.); (D.D.R.)
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Food and Drug, University of Parma, 43125 Parma, Italy; (A.R.); (P.M.); (F.S.); (D.D.R.)
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Avinguda Universitat, 1, 43204 Reus, Spain
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Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain. Cardiovasc Diabetol 2021; 20:5. [PMID: 33402187 PMCID: PMC7786987 DOI: 10.1186/s12933-020-01195-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence). Results Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions The Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.
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Khalatbari-Soltani S, Marques-Vidal P, Imamura F, Forouhi NG. Prospective association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus cohort study. BMJ Open 2020; 10:e040959. [PMID: 33371031 PMCID: PMC7757450 DOI: 10.1136/bmjopen-2020-040959] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The Mediterranean diet has been promoted as a healthy dietary pattern, but whether the Mediterranean diet may help to prevent hepatic steatosis is not clear. This study aimed to evaluate the prospective association between adherence to the Mediterranean diet and risk of hepatic steatosis. DESIGN Population-based prospective cohort study. SETTING The Swiss CoLaus Study. PARTICIPANTS We evaluated 2288 adults (65.4% women, aged 55.8±10.0 years) without hepatic steatosis at first follow-up in 2009-2012. Adherence to the Mediterranean diet was scaled as the Mediterranean diet score (MDS) based on the Mediterranean diet pyramid ascertained with responses to Food Frequency Questionnaires. OUTCOME MEASURES New onset of hepatic steatosis was ascertained by two indices separately: the Fatty Liver Index (FLI, ≥60 points) and the non-alcoholic fatty liver disease (NAFLD) score (≥-0.640 points). Prospective associations between adherence to the Mediterranean diet and risk of hepatic steatosis were quantified using Poisson regression. RESULTS During a mean 5.3 years of follow-up, hepatic steatosis was ascertained in 153 (6.7%) participants by FLI criteria and in 208 (9.1%) by NAFLD score. After multivariable adjustment, higher adherence to MDS was associated with lower risk of hepatic steatosis based on FLI: risk ratio 0.84 (95% CI 0.73 to 0.96) per 1 SD of MDS; 0.85 (0.73 to 0.99) adjusted for BMI; and 0.85 (0.71 to 1.02) adjusted for both BMI and waist circumference. When using NAFLD score, no significant association was found between MDS and risk of hepatic steatosis (0.95 (0.83 to 1.09)). CONCLUSION A potential role of the Mediterranean diet in the prevention of hepatic steatosis is suggested by the inverse association observed between adherence to the Mediterranean diet and incidence of hepatic steatosis based on the FLI. The inconsistency of this association when hepatic steatosis was assessed by NAFLD score points to the need for accurate population-level assessment of fatty liver and its physiological markers.
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Affiliation(s)
- Saman Khalatbari-Soltani
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, New South Wales, Australia
- ARC Centre for Excellence in Population Ageing Research (CEPAR), University of Sydney, Sydney, New South Wales, Australia
- Department of Internal Medicine, Internal Medicine, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Internal Medicine, Internal Medicine, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
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Mohammadpour S, Ghorbaninejad P, Janbozorgi N, Shab-Bidar S. Associations between adherence to MIND diet and metabolic syndrome and general and abdominal obesity: a cross-sectional study. Diabetol Metab Syndr 2020; 12:101. [PMID: 33292507 PMCID: PMC7673080 DOI: 10.1186/s13098-020-00611-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is a lack of studies examining the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and metabolic syndrome (MetS) and obesity. Thus, this study aimed to investigate the association of adherence to the MIND diet with MetS and general and abdominal obesity. METHODS This cross-sectional study was performed on 836 Iranian adults, 18-75 years old. A 167-item food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. Anthropometric measurements, blood pressure, fasting blood glucose and lipid profile of each participant were recorded. The guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III) was used to define MetS. RESULTS Mean age of study participants was 47.7 ± 10.7 years. The prevalence of MetS was 36.1% and mean body mass index (BMI) and waist circumference (WC) was 27.7 ± 4.69 kg/m2 and 92.0 ± 12.4 cm respectively. Those who were in the third tertile of the MIND diet score compared to the first tertile had 12% lower odds of having the MetS (ORs: 0.88; 95% CI 0.62-1.24) but the association was not significant (P = 0.77). There was a significant inverse association between the MIND diet score and odds of reduced high-density lipoprotein cholesterol (HDL-C) (ORs: 0.59; 95% CI 0.41-0.85; P = 0.008) and general obesity (ORs: 1.190.80-1.78; 95% CI 0.80-1.78; P = 0.02) in crude model and after controlling for confounders. CONCLUSIONS We found that the MIND diet score is inversely associated with odds of reduced HDL and general obesity in Iranian adults.
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Affiliation(s)
- Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Nasim Janbozorgi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran.
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Nuts and Non-Alcoholic Fatty Liver Disease: Are Nuts Safe for Patients with Fatty Liver Disease? Nutrients 2020; 12:nu12113363. [PMID: 33139607 PMCID: PMC7693493 DOI: 10.3390/nu12113363] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 12/16/2022] Open
Abstract
Diet and lifestyle interventions are the recommended treatment for patients with non-alcoholic fatty liver disease (NAFLD), with the aim of achieving a 7-10% weight loss. Several dietary patterns have been suggested for this purpose, however, to date, the best one is represented by the Mediterranean diet (MD) as it is rich in macro- and micro- nutrients known for their effectiveness in health-promotion and cardio-vascular disease prevention. Moreover, MD is characterized by the inclusion of nuts. These foods have shown potential benefits in health-promotion as they are rich in fibers, which have lipid-lowering effects, rich in mono- and poly-unsaturated fatty acids, which help reduce insulin-resistance and serum cholesterol, and contain anti-oxidants which reduce oxidative stress and inflammation. Additionally, nuts are associated with a better control, or reduction, of Body Mass Index (BMI). All these effects are useful targets to achieve in NAFLD, so that nuts have been proposed as a suitable dietary treatment supplement for weight and metabolic control in these patients. In recent years, health authorities raised an alert on nuts consumption as these may be at high risk of aflatoxin (AF) contamination, for which controls and legislations are different among countries. AF is a well-known cancerogenic agent and a recognized risk factor for hepatocellular carcinoma. Patients with NAFLD have an overall, inherent sevenfold increased risk of developing hepatocellular carcinoma as compared with the general population. In this context, one could argue that recommending the inclusion of nuts in the diet of NAFLD patients has to be balanced with the risk of potential chronic exposure to AF, and every effort should be pursued to assure the safety of these nutrients. In this review, we aim to summarize the benefits of nuts consumption, the evidence for AF contamination of nuts and the consequent potential risks in patients with NAFLD.
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Chen D, Ye Z, Shao J, Tang L, Zhang H, Wang X, Qiu R, Zhang Q. Effect of electronic health interventions on metabolic syndrome: a systematic review and meta-analysis. BMJ Open 2020; 10:e036927. [PMID: 33033085 PMCID: PMC7545661 DOI: 10.1136/bmjopen-2020-036927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE We aimed to examine whether eHealth interventions can effectively improve anthropometric and biochemical indicators of patients with metabolic syndrome (MetS). DESIGN Systematic review and meta-analysis. METHODS PubMed, the Web of Science, Embase, Medline, CINAHL, PsycINFO, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Wanfang and Weipu databases were comprehensively searched for papers that were published from database inception to May 2019. Articles were included if the participants were metabolic syndrome (MetS) patients, the participants received eHealth interventions, the participants in the control group received usual care or were wait listed, the outcomes included anthropometric and biochemical indicators of MetS, and the study was a randomised controlled trial (RCT) or a controlled clinical trial (CCT). The Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality of the included articles. The meta-analysis was conducted using Review Manager V.5.3 software. RESULTS In our review, seven RCTs and two CCTs comprising 935 MetS participants met the inclusion criteria. The results of the meta-analysis revealed that eHealth interventions resulted in significant improvements in body mass index (standardised mean difference (SMD)=-0.36, 95% CI (-0.61 to -0.10), p<0.01), waist circumference (SMD=-0.47, 95% CI (-0.84 to -0.09), p=0.01) and systolic blood pressure(SMD=-0.35, 95% CI (-0.66 to -0.04), p=0.03) compared with the respective outcomes associated with the usual care or wait-listed groups. Based on the included studies, we found significant effects of the eHealth interventions on body weight. However, we did not find significant positive effects of the eHealth interventions on other metabolic parameters. CONCLUSIONS The results indicated that eHealth interventions were beneficial for improving specific anthropometric outcomes, but did not affect biochemical indicators of MetS. Therefore, whether researchers adopt eHealth interventions should be based on the purpose of the study. More rigorous studies are needed to confirm these findings.
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Affiliation(s)
- Dandan Chen
- Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhihong Ye
- Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Shao
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Leiwen Tang
- Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Zhang
- Guizhou Provincial People's Hospital, Guiyang, China
| | - Xiyi Wang
- Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ruolin Qiu
- Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Zhang
- Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Cardiometabolic Benefits of a Weight-Loss Mediterranean Diet/Lifestyle Intervention in Patients with Obstructive Sleep Apnea: The "MIMOSA" Randomized Clinical Trial. Nutrients 2020; 12:nu12061570. [PMID: 32481487 PMCID: PMC7352432 DOI: 10.3390/nu12061570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022] Open
Abstract
Although continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA), its cardiometabolic benefits are questionable. Our aim was to explore whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care leads to greater cardiometabolic improvements compared with standard care alone. We randomly assigned 187 adult, overweight, polysomnography-diagnosed moderate-to-severe OSA patients to a standard care group (SCG, n = 65), a Mediterranean diet group (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All three groups were prescribed with CPAP. Additionally, the SCG only received brief written healthy lifestyle advice, while intervention arms were subjected to a six-month weight-loss behavioral intervention based on the Mediterranean diet. The MLG also received guidance for improving physical activity and sleep habits. Glucose metabolism indices, blood lipids, liver enzymes and blood pressure improved only in intervention arms, and were significantly lower compared to the SCG post-intervention (all p < 0.05). The age-, sex-, baseline- and CPAP use-adjusted relative risk (95% confidence interval) of metabolic syndrome was 0.58 (0.34–0.99) for the MDG and 0.30 (0.17–0.52) for the MLG compared to the SCG. The MLG additionally presented a lower relative risk of metabolic syndrome compared to the MDG (0.52 (0.30–0.89)). After further adjustment for body-weight change, a lower relative risk of metabolic syndrome was still evident for the MLG compared to the SCG. In conclusion, although standard care alone does not improve OSA patients’ cardiometabolic profile, its combination with a weight-loss Mediterranean diet/lifestyle intervention leads to significant cardiometabolic benefits.
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Gregório MJ, Rodrigues AM, Salvador C, Dias SS, de Sousa RD, Mendes JM, Coelho PS, Branco JC, Lopes C, Martínez-González MA, Graça P, Canhão H. Validation of the Telephone-Administered Version of the Mediterranean Diet Adherence Screener (MEDAS) Questionnaire. Nutrients 2020; 12:E1511. [PMID: 32455971 PMCID: PMC7284796 DOI: 10.3390/nu12051511] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 01/10/2023] Open
Abstract
A 14-Item Mediterranean Diet Adherence Screener (MEDAS) questionnaire was developed and validated in face-to-face interviews, but not via telephone. The aims of this study were to evaluate the validity and reliability of a telephone-administered version of the MEDAS as well as to validate the Portuguese version of the MEDAS questionnaire. A convenience community-based sample of adults (n = 224) participated in a three-stage survey. First, trained researchers administered MEDAS via a telephone. Second, the Portuguese version of Food Frequency Questionnaire (FFQ), and MEDAS were administered in a semi-structured face-to-face interview. Finally, MEDAS was again administered via telephone. The telephone-administered MEDAS questionnaire was compared with the face-to-face-version using several metrics. The telephone-administered MEDAS was significantly correlated with the face-to-face-administered MEDAS [r = 0.805, p < 0.001; interclass correlation coefficient (ICC) = 0.803, p < 0.001] and showed strong agreement (k = 0.60). The MEDAS scores that were obtained in the first and second telephone interviews were significantly correlated (r = 0.661, p < 0.001; ICC = 0.639, p < 0.001). The overall agreement between the Portuguese version of MEDAS and the FFQ-derived Mediterranean diet adherence score had a Cohen's k = 0.39. The telephone-administered version of MEDAS is a valid tool for assessing the adherence to the Mediterranean diet and acquiring data for large population-based studies.
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Affiliation(s)
- Maria João Gregório
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal;
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
| | - Ana M. Rodrigues
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
| | - Clara Salvador
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
| | - Sara S. Dias
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Escola Superior de Saúde do Instituto Politécnico de Leiria, Unidade de Investigação em Saúde (UI), 2411-901 Leiria, Portugal
| | - Rute D. de Sousa
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
| | - Jorge M. Mendes
- NOVA Information Management School, Universidade Nova de Lisboa, 1070-312 Lisboa, Portugal; (J.M.M.); (P.S.C.)
| | - Pedro S. Coelho
- NOVA Information Management School, Universidade Nova de Lisboa, 1070-312 Lisboa, Portugal; (J.M.M.); (P.S.C.)
| | - Jaime C. Branco
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Serviço de Reumatologia do Hospital Egas Moniz—Centro Hospitalar Lisboa Ocidental (CHLO-E.P.E.), 1349-019 Lisboa, Portugal
| | - Carla Lopes
- Instituto de Saúde Pública da Universidade do Porto, 4050-091 Porto, Portugal;
| | | | - Pedro Graça
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal;
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
| | - Helena Canhão
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, 1600-560 Lisboa, Portugal
- Unidade de Reumatologia—Centro Hospitalar Universitário Lisboa Central (CHULC-Hospital Curry Cabral), 1169-050 Lisboa, Portugal
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López-Jaramillo P, Barbosa E, Molina DI, Sanchez R, Diaz M, Camacho PA, Lanas F, Pasquel M, Accini JL, Ponte-Negretti CI, Alcocer L, Cobos L, Wyss F, Sebba-Barroso W, Coca A, Zanchetti A. Latin American Consensus on the management of hypertension in the patient with diabetes and the metabolic syndrome. J Hypertens 2020; 37:1126-1147. [PMID: 30882601 DOI: 10.1097/hjh.0000000000002072] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
: The prevalence of hypertension, type 2 diabetes mellitus (DM2) and the metabolic syndrome continues to increase in Latin America, while the rates of diagnosis, treatment and control of these disorders remain low. The frequency of the risk factors that constitute the metabolic syndrome and are associated with an increased risk of cardiovascular disease has not diminished since the publication of the previous consensus. This document discusses the socioeconomic, demographic, environmental and cultural characteristics of most associated Latin American countries and partially explains the lack of better results in improving clinical and public health actions that allow high morbidity and mortality rates caused by cardiovascular diseases and DM2 to be reduced through programs aligned with the so-called precision medicine, which should be predictive, preventive, personalized and participatory. The Consensus ratifies the diagnostic criteria expressed in the previous consensus to define hypertension and DM2 but, for the metabolic syndrome, and in the absence of evidence, the recommendation is to implement a cohort study that determines the abdominal perimeter value associated with hard outcomes, such as DM2 and CVD. Meanwhile, we recommend modifying the criterion to more than 94 cm in men and more than 84 cm in women according to WHO recommendations. We also recommend the carrying out of a study that identifies the situation of hypertension and DM2 in people of African ancestry who, in Latin America, exceed 75 million and whose epidemiology does not include solid studies. With respect to the proposed therapeutic targets, we recommended maintaining those defined in the previous consensus, but insisting that early pharmacological management of prediabetes with metformin should be introduced, as should the treatment of diabetic hypertensive patients with a combination therapy of two fixed-dose antihypertensive drugs and management with statins. To increase adherence, the use of different drugs combined in a single pill (polypill) is recommended. The simplification of the therapeutic regimen is accompanied by greater control of cardiovascular risk factors, both in primary and secondary prevention, and has been shown to be cost-effective. The consensus recommends the use of the currently available polypill combining an angiotensin-converting enzyme inhibitor, a statin and aspirin for secondary cardiovascular prevention and in patients with a high cardiovascular risk, such as hypertension patients with DM2.
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Affiliation(s)
- Patricio López-Jaramillo
- Clinica de Síndrome Metabolico, Prediabetes y Diabetes, Direccion de Investigaciones FOSCAL y Facultad de Salud, Universidad de Santander (UDES), Bucaramanga, Colombia
| | | | - Dora I Molina
- Universidad de Caldas e IPS Médicos Internistas de Caldas, Manizales, Colombia
| | - Ramiro Sanchez
- Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina
| | | | - Paul A Camacho
- Direccion de Investigaciones FOSCAL y Facultad de Salud, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| | | | | | - José L Accini
- Fundacion Hospital Universidad del Norte y Universidad Libre, Barranquilla, Colombia
| | | | - Luis Alcocer
- Instituto Mexicano de Salud Cardiovascular, Ciudad de Mexico, Mexico
| | - Leonardo Cobos
- Unidad de Cardiologia, Hospital El Pino, Santiago, Chile
| | - Fernando Wyss
- Servicios y Tecnologica Cardiovascular de Gautemala, S.A., Guatemala
| | | | - Antonio Coca
- Hospital Clínico, Universidad de Barcelona, Spain
| | - Alberto Zanchetti
- Istituto Auxologico Italiano, IRCCS, and Università degli Studi of Milan, Italy
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Dietary Glycemic Index and Glycemic Load Are Not Associated with the Metabolic Syndrome in Lebanese Healthy Adults: A Cross-Sectional Study. Nutrients 2020; 12:nu12051394. [PMID: 32414004 PMCID: PMC7284586 DOI: 10.3390/nu12051394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 11/26/2022] Open
Abstract
High dietary glycemic index (GI) and glycemic load (GL) were suggested to increase the risk of metabolic syndrome (MetS). This study aims to estimate dietary GI and GL in a sample of healthy Lebanese adults and examine their association with MetS and its individual abnormalities. The study uses data from a community-based survey of 501 Lebanese urban adults. Dietary intake was assessed using a food frequency questionnaire. Biochemical, anthropometric, and blood pressure measurements were obtained. Subjects with previous diagnosis of chronic disease, metabolic abnormalities, or with incomplete data or implausible energy intakes were excluded, yielding a sample of 283. Participants were grouped into quartiles of GI and GL. Multivariate logistic regression analyses were performed. Average dietary GI and GL were estimated at 59.9 ± 8 and 209.7 ± 100.3. Participants belonging to the highest GI quartile were at increased risk of having MetS (odds ratio (OR) = 2.251, 95% CI:1.120–4.525) but this association lost significance with further adjustments. Those belonging to the second quartile of GI had significantly lower odds of having hyperglycemia (OR: 0.380, 95% CI:0.174–0.833). No associations were detected between GL and MetS. The study contributes to the body of evidence discussing the relationship between GI, GL, and MetS, in a nutrition transition context.
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Katsagoni CN, Psarra G, Georgoulis M, Tambalis K, Panagiotakos DB, Sidossis LS. High and moderate adherence to Mediterranean lifestyle is inversely associated with overweight, general and abdominal obesity in children and adolescents: The MediLIFE-index. Nutr Res 2020; 73:38-47. [DOI: 10.1016/j.nutres.2019.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/24/2022]
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Mediterranean Diet and NAFLD: What We Know and Questions That Still Need to Be Answered. Nutrients 2019; 11:nu11122971. [PMID: 31817398 PMCID: PMC6949938 DOI: 10.3390/nu11122971] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/28/2019] [Accepted: 11/30/2019] [Indexed: 12/16/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is expected to become the leading cause of end-stage liver disease worldwide over the next few decades. In fact, NAFLD encompasses different clinical scenarios, from the simple accumulation of fat (steatosis) to steatohepatitis (NASH), NASH-cirrhosis, and cirrhosis complications. In this context, it is fundamental to pursue strategies aimed at both preventing the disease and reducing the progression of liver fibrosis once liver damage is already initiated. As of today, no pharmacological treatment has been approved for NAFLD/NASH, and the only recommended treatment of proven efficacy are life-style modifications, including diet and physical exercise pointing at weight loss of 5%–7%. Different dietetic approaches have been proposed in this setting, and in this review, we will discuss the evidence regarding the efficacy of the Mediterranean Diet as a treatment for NAFLD. In particular, we will report the effects on liver-related outcomes.
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Martín Mateos R, Allen AM. Characterizing specific subgroups in patients with NAFLD: overweight vs obese phenotype. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2019; 111:253-255. [PMID: 30917662 DOI: 10.17235/reed.2019.6269/2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as the most common cause of chronic liver disease worldwide, with a global prevalence of 25.2%. The high burden of NAFLD extends beyond liver diseases, as patients are at risk of developing not only liver related conditions, including cirrhosis and hepatocellular carcinoma, but also cardiovascular complications associated to metabolic syndrome. The present special issue of The Spanish Journal of Gastroenterology (Revista Española de Enfermedades Digestivas) focusses on diverse key aspects of NAFLD, including characterization of fecal microbiota profiles, the role of bariatric endoscopy, evaluation of suitable pre-clinical models for NAFLD or differential epidemiological risk factors associated to NASH and fibrosis.
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Affiliation(s)
| | - Alina M Allen
- Gastroenterology and Hepatology, Mayo Clinic, Estados Unidos
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Panagiotakos DB, Kouvari M. Behavioral healthy nutrition and physical activity counseling in cardiovascular disease prevention: where we are now? Hepatobiliary Surg Nutr 2019; 8:534-536. [PMID: 31673549 DOI: 10.21037/hbsn.2018.11.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Department of Kinesiology and Health, School of Arts and Sciences, Rutgers University, New Brunswick, NJ, USA.,Faculty of Health, University of Canberra, Canberra, Australia.,School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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Pavić E, Hadžiabdić MO, Mucalo I, Martinis I, Romić Ž, Božikov V, Rahelić D. Effect of the Mediterranean diet in combination with exercise on metabolic syndrome parameters: 1-year randomized controlled trial. INT J VITAM NUTR RES 2019; 89:132-143. [DOI: 10.1024/0300-9831/a000462] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract. This work aimed to evaluate and compare the benefits of the energy restricted Mediterranean diet (MD) and Standard hypolipemic diet (SHD) accompanied by exercise on metabolic syndrome parameters. A 12-month, randomized, single-blinded, diet-controlled study was conducted on 124 obese participants in the University Hospital Dubrava. Participants were assigned to the MD (n = 63) or the SHD (n = 61) and received the same amount of nutritional education and guidance on physical activity. The completion rate was 67.7 %. Both diets produced significant beneficial changes in body weight and waist circumference (P < 0.001 for MD and SHD). Compared with the SHD, HDL cholesterol increased (P = 0.031) and systolic blood pressure (SBP) decreased (P = 0.020) in the MD group. Fasting plasma glucose decreased significantly in both diet groups (P < 0.001 for MD; P = 0.026 for SHD). Although both diets accompanied by physical activity yielded similar weight reduction results, adherence to the MD was associated with more prominent reduction of the MetS components, namely HDL level elevation and SBP reduction.
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Affiliation(s)
- Eva Pavić
- Department of Nutrition and Dietetics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Maja Ortner Hadžiabdić
- Centre for Applied Pharmacy, University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Iva Mucalo
- Centre for Applied Pharmacy, University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Irena Martinis
- Department of Nutrition, University Hospital Dubrava, Zagreb, Croatia
| | - Željko Romić
- Clinical Department of Laboratory Diagnostics, Dubrava University Hospital, Zagreb, Croatia
| | - Velimir Božikov
- Department of Endocrinology, Diabetes and Metabolism Disorders, Dubrava University Hospital, Zagreb, Croatia
| | - Dario Rahelić
- Department of Endocrinology, Diabetes and Metabolism Disorders, Dubrava University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Aoun C, Papazian T, Helou K, El Osta N, Khabbaz LR. Comparison of five international indices of adherence to the Mediterranean diet among healthy adults: similarities and differences. Nutr Res Pract 2019; 13:333-343. [PMID: 31388410 PMCID: PMC6669066 DOI: 10.4162/nrp.2019.13.4.333] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/13/2019] [Accepted: 07/03/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES To compare five indices of adherence to the Mediterranean Diet (MD) among adults living in the Mediterranean region. SUBJECTS/METHODS A total of 100 healthy Lebanese adults aged between 18 and 65 years. Face-to-face interviews to collect sociodemographic and medical information, to take anthropometric measurements, and to fill a validated, culturally adapted, food frequency questionnaire (FFQ). The score for each item was calculated following the recommendations for each corresponding index. The five MD indices were Mediterranean Diet Scale (MDScale), Mediterranean Food Pattern (MFP), MD Score (MDS), Short Mediterranean Diet Questionnaire (SMDQ), and the MedDiet score. RESULTS Significant correlations were detected between items with P-values < 0.001. Minimal agreement was seen between MDScale and MedDiet score and maximal agreement between MDS and MedDiet score. Univariate and multivariate analyses showed that MDS and MedDiet scores had significant correlations with fiber and olive oil intake, main components of the MD. MDScale showed a significant correlation with waist-to-hip ratio and with total energy intake but none of the five indices was correlated to body mass index (BMI). CONCLUSIONS The indices that showed the highest correlation with variables related to the MD are the MDScale and the MedDiet score; therefore, they can be used to assess our future study populations. Based on the current results, more than half of the study population was non-adherent to the MD and adherence to this diet did not appear to protect against being overweight (BMI ≥ 30).
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Affiliation(s)
- Carla Aoun
- Laboratoire de pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon.,Department of nutrition, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon
| | - Tatiana Papazian
- Laboratoire de pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon.,Department of nutrition, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon
| | - Khalil Helou
- Department of nutrition, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon
| | - Nada El Osta
- Department of Public Health, Faculty of Medicine, Saint-Joseph University, Beirut, 1107 2180, Lebanon.,Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University, 1107 2180, Beirut, Lebanon.,Centre de Recherche en Odontologie Clinique, EA 4847, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Lydia Rabbaa Khabbaz
- Laboratoire de pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, 1107 2180, Lebanon
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Samji NS, Verma R, Satapathy SK. Magnitude of Nonalcoholic Fatty Liver Disease: Western Perspective. J Clin Exp Hepatol 2019; 9:497-505. [PMID: 31516266 PMCID: PMC6728535 DOI: 10.1016/j.jceh.2019.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 05/07/2019] [Indexed: 12/12/2022] Open
Abstract
The incidence of nonalcoholic fatty liver disease (NAFLD) is continuing to rise worldwide, and it is estimated that this disquieting trend will continue for another 10-15 years before prevalence begins to decrease. NAFLD is the hepatic manifestation of metabolic syndrome. As obesity, diabetes, and other lifestyle-related diseases continue to rise, the spectrum of NAFLD, e.g., nonalcoholic steatohepatitis, liver fibrosis, liver cirrhosis, liver-related morbidity, and mortality, will increase in parallel. Its widespread prevalence and associated economic burden have drawn significant attention, and a multitude of pharmaceutical companies are participating in active research trying to find a "cure". Unfortunately, as of now, no targeted treatment exists to treat this condition, and therefore, emphasis has been on its prevention. The current review focuses on the epidemiology, clinical characteristics, risk factors, and clinical outcomes of NAFLD in Western countries. It is important to understand the magnitude of NAFLD and its risk factors in Western countries where the prevalence of NAFLD has now reached epidemic proportions to identify the best strategy to prevent and possibly control this epidemic.
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Affiliation(s)
- Naga S. Samji
- Tenova Cleveland Hospital, 2305 Chambliss Ave NW, Cleveland, TN, 37311, USA
| | - Rajanshu Verma
- Tenova Cleveland Hospital, 2305 Chambliss Ave NW, Cleveland, TN, 37311, USA
- Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN, 38139, USA
| | - Sanjaya K. Satapathy
- Division of Hepatology and Sandra Atlas Bass Center for Liver Diseases, Northwell Health, Manhasset, NY, 11030, USA
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Howatt BC, Muñoz Torrecillas MJ, Cruz Rambaud S, Takahashi T. A New Analysis on Self-Control in Intertemporal Choice and Mediterranean Dietary Pattern. Front Public Health 2019; 7:165. [PMID: 31316959 PMCID: PMC6611428 DOI: 10.3389/fpubh.2019.00165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/04/2019] [Indexed: 11/22/2022] Open
Abstract
This paper completes Muñoz Torrecillas et al. (1) results and conclusions investigating the relationship between adherence to healthy dietary habits, specifically the Mediterranean Diet (hereinafter, MD), and impulsivity in intertemporal choices. Impulsivity can be defined as the strong preference for small immediate payoffs over larger delayed payoffs, and in the original study this behavior was captured by the parameter k (discount rate of the hyperbolic discount function), calculated using an automated scoring mechanism. Adherence to MD was measured by the KIDMED index and then grouped into three levels: high, medium, and low. While the authors observed that individuals in the high adherence group had the shallowest discounting and individuals in the low adherence group had the steepest discounting, the data were not statistically analyzed in depth. Therefore, the purpose of the present paper is to propose a preliminary quantitative model for this relationship and evaluate its significance. Tests revealed a significant interaction between adherence to MD and magnitude of delayed rewards when predicting discount rates. Specifically, the degree to which impulsivity decreases as adherence to MD increases is strongly influenced by delayed rewards of smaller magnitude. These findings are consistent with the authors' claims that healthy dietary habits may be closely linked with greater self-control when payoffs are small, and thus warrant further examination. The results do not indicate causality though, so future studies could also investigate the directions of this relationship as a means of developing behavioral interventions.
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Affiliation(s)
- Brian C. Howatt
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, United States
| | | | | | - Taiki Takahashi
- Department of Behavioral Science, Center for Experimental Research in Social Sciences, Hokkaido University, Hokkaido, Japan
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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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Bridgman AC, Qureshi AA, Li T, Tabung FK, Cho E, Drucker AM. Inflammatory dietary pattern and incident psoriasis, psoriatic arthritis, and atopic dermatitis in women: A cohort study. J Am Acad Dermatol 2019; 80:1682-1690. [PMID: 30797850 DOI: 10.1016/j.jaad.2019.02.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/04/2019] [Accepted: 02/14/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Diet is a modulator of inflammation that might impact inflammatory skin diseases. OBJECTIVE To assess the relationship between pro-inflammatory dietary patterns and incident psoriasis, psoriatic arthritis (PsA), and atopic dermatitis (AD). METHODS We conducted cohort studies among women in the Nurses' Health Study II. The Empirical Dietary Inflammatory Pattern (EDIP) score was calculated at baseline and every 4 years. Incident psoriasis, PsA, and AD were assessed by validated self-report. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDIP quintiles and risk for psoriasis, PsA, and AD. RESULTS We had 85,185 participants in the psoriasis analysis and 63,443 in the AD analysis. There were 1432 cases of psoriasis, 262 cases of PsA, and 403 cases of AD. Pro-inflammatory dietary patterns were not associated with the risk for outcomes in multivariable models (all P values for trend >.05). HRs comparing the highest to the lowest EDIP quintile were 0.99 (95% CI 0.83-1.18) for psoriasis, 1.22 (95% CI 0.81-1.83) for PsA, and 0.96 (95% CI 0.69-1.34) for AD. LIMITATIONS Recall and self-report. CONCLUSION Our findings do not support dietary inflammatory potential as a risk factor for psoriasis, PsA, or AD.
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Affiliation(s)
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tricia Li
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fred K Tabung
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Aaron M Drucker
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada; Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada.
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Healthy Lifestyle and Incidence of Metabolic Syndrome in the SUN Cohort. Nutrients 2018; 11:nu11010065. [PMID: 30598006 PMCID: PMC6357191 DOI: 10.3390/nu11010065] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 01/22/2023] Open
Abstract
We assessed the relationship between a healthy lifestyle and the subsequent risk of developing metabolic syndrome. The “Seguimiento Universidad de Navarra” (SUN) Project is a prospective cohort study, focused on nutrition, lifestyle, and chronic diseases. Participants (n = 10,807, mean age 37 years, 67% women) initially free of metabolic syndrome were followed prospectively for a minimum of 6 years. To evaluate healthy lifestyle, nine habits were used to derive a Healthy Lifestyle Score (HLS): Never smoking, moderate to high physical activity (>20 MET-h/week), Mediterranean diet (≥4/8 adherence points), moderate alcohol consumption (women, 0.1–5.0 g/day; men, 0.1–10.0 g/day), low television exposure (<2 h/day), no binge drinking (≤5 alcoholic drinks at any time), taking a short afternoon nap (<30 min/day), meeting up with friends >1 h/day, and working at least 40 h/week. Metabolic syndrome was defined according to the harmonizing definition. The association between the baseline HLS and metabolic syndrome at follow-up was assessed with multivariable-adjusted logistic regressions. During follow-up, we observed 458 (4.24%) new cases of metabolic syndrome. Participants in the highest category of HLS adherence (7–9 points) enjoyed a significantly reduced risk of developing metabolic syndrome compared to those in the lowest category (0–3 points) (adjusted odds ratio (OR) = 0.66, 95% confidence interval (CI) = 0.47–0.93). Higher adherence to the Healthy Lifestyle Score was associated with a lower risk of developing metabolic syndrome. The HLS may be a simple metabolic health promotion tool.
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Morales-Ivorra I, Romera-Baures M, Roman-Viñas B, Serra-Majem L. Osteoarthritis and the Mediterranean Diet: A Systematic Review. Nutrients 2018; 10:E1030. [PMID: 30087302 PMCID: PMC6115848 DOI: 10.3390/nu10081030] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis (OA) affects 240 million people globally. Few studies have examined the links between osteoarthritis and the Mediterranean diet (MD). The aim of this paper was to systematically review and analyze the epidemiological evidence in humans on the MD and its association with OA. A systematic search of EMBASE identified three studies that explored the association between MD and OA. Two of them were cross-sectional and the third one was a 16-week randomized clinical trial. Prisma declaration was followed to carry out this review. These studies described a positive association between a higher adherence to a MD and the quality of life of participants suffering OA. The prevalence of OA was lower in participants with a higher adherence to a Mediterranean diet. Biomarkers of inflammation and cartilage degradation related to OA were also analyzed and significant differences were detected only for IL1-α, which decreased in the MD group. Exploring the relationship between MD and OA is complex, moreover, the limited evidence and methodological differences in such studies makes it difficult to compare results. In conclusion, the three studies included in this systematic review demonstrated some relation between osteoarthritis and a Mediterranean diet. However, prospective and longer interventions are required to evaluate the long-term efficacy of the Mediterranean diet to improve symptomatology and preventing osteoarthritis.
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Affiliation(s)
- Isabel Morales-Ivorra
- Department of Rheumatology, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Montserrat Romera-Baures
- Department of Rheumatology, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Blanca Roman-Viñas
- School of Health and Sport Sciences (EUSES), University of Girona, 17190 Salt, Spain.
- Blanquerna Faculty of Psychology, Education Sciences and Sport (FPCEE), Universitat Ramon Llull, 08022 Barcelona, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
- Research Institute of Biomedical and Health Sciences IUIBS, University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain.
- Nutrition Research Foundation, University of Barcelona Science Park, 08028 Barcelona, Spain.
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A randomized controlled trial of Mediterranean diet and metformin to prevent age-related diseases in people with metabolic syndrome. TUMORI JOURNAL 2018; 104:137-142. [PMID: 28106245 DOI: 10.5301/tj.5000599] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Age-related non-communicable chronic diseases (ArCDs) are the leading cause of mortality. The major metabolic risk factor for their development is the metabolic syndrome (MetS), defined as a clustering of risk factors of metabolic origin such as abdominal obesity, high blood pressure, dyslipidemia and high fasting glycemia. There is increasing observational and experimental evidence that improving diet and the use of metformin (a calorie-restriction mimetic drug) may modify the risk of developing MetS and ArCD. We designed a phase III randomized controlled trial (the Me.Me.Me trial) to evaluate the effect of a comprehensive lifestyle intervention (including moderate physical activity and a Mediterranean-macrobiotic diet) and the effect of treatment with metformin in the prevention of ArCDs in healthy people with MetS. This report describes the scientific protocol of this trial. METHODS The design of the study is 2 × 2 factorial with 2,000 volunteers to be randomized into 4 equal groups of 500 each, which are allocated to the following treatments: metformin (1,700 mg/day) + active lifestyle intervention, placebo + active lifestyle intervention, metformin (1,700 mg/day) alone, and placebo alone. The metformin/placebo component of the study is double blind. The study is planned for a term of 5 years. RESULTS The Me.Me.Me. trial is ongoing and recruitment of participants is underway. No patient has completed the 5 years of follow-up. CONCLUSIONS We believe that the results of the trial will clarify the importance of lifestyle for primary prevention and the role of metformin as a potential chemopreventive agent. The trial is registred on ClinicalTrials.gov with the identification NCT02960711.
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Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective. Nutr Res Rev 2018; 29:152-162. [PMID: 27955720 DOI: 10.1017/s095442241600007x] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The metabolic syndrome (MetS) is a key indicator of two main causes of death worldwide: CVD and diabetes. The present paper aimed to perform a review of the population-based research on the association of dietary patterns and the MetS in terms of methodology and findings. For the purpose of the present study, a scoping literature review was conducted using MEDLINE and EMBASE databases and hand searching in Google Scholar. Thirty-nine population-based studies were selected. Most of these studies used the factor analysis method and the a priori dietary approach, which had been initially extracted via a posteriori methods such as using the Mediterranean dietary pattern. The main finding was that following the Mediterranean or similar 'healthy' pattern reduced risk of the MetS, while following a 'Western' pattern increased risk of the MetS. The methodological approach in determining the dietary pattern of a population, whether a priori or a posteriori, should be chosen based on the purpose of the research. Overall, evidence suggests a diet based on the components of the Mediterranean diet and the avoidance of the 'Western' diet can aid in preventing the MetS.
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Sureda A, Bibiloni MDM, Julibert A, Bouzas C, Argelich E, Llompart I, Pons A, Tur JA. Adherence to the Mediterranean Diet and Inflammatory Markers. Nutrients 2018; 10:E62. [PMID: 29320413 PMCID: PMC5793290 DOI: 10.3390/nu10010062] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 12/22/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023] Open
Abstract
The aim was to assess inflammatory markers among adults and adolescents in relation to the adherence to the Mediterranean diet. A random sample (219 males and 379 females) of the Balearic Islands population (12-65 years) was anthropometrically measured and provided a blood sample to determine biomarkers of inflammation. Dietary habits were assessed and the adherence to the Mediterranean dietary pattern calculated. The prevalence of metabolic syndrome increased with age in both sexes. The adherence to the Mediterranean diet in adolescent males was 51.3% and 45.7% in adults, whereas in females 53.1% and 44.3%, respectively. In males, higher adherence to the Mediterranean diet was associated with higher levels of adiponectin and lower levels of leptin, tumor necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1 (PAI-1) and high-sensitivity C-reactive protein (hs-CRP) in adults, but not in young subjects. In females, higher adherence was associated with lower levels of leptin in the young group, PAI-1 in adults and hs-CRP in both groups. With increasing age in both sexes, metabolic syndrome increases, but the adherence to the Mediterranean diet decreases. Low adherence to the Mediterranean dietary pattern (MDP) is directly associated with a worse profile of plasmatic inflammation markers.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Maria del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Alicia Julibert
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
| | - Emma Argelich
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
| | - Isabel Llompart
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
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Platania A, Zappala G, Mirabella MU, Gullo C, Mellini G, Beneventano G, Maugeri G, Marranzano M. Association between Mediterranean diet adherence and dyslipidaemia in a cohort of adults living in the Mediterranean area. Int J Food Sci Nutr 2017; 69:608-618. [PMID: 29063802 DOI: 10.1080/09637486.2017.1389860] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of the present study was to determine the association between Mediterranean diet adherence and dyslipidaemia in a cohort of adults living in the Mediterranean area. The cross-sectional study comprised a total sample of 2044 men and women, aged >18 years old from southern Italy. The Mediterranean diet adherence was assessed using a validated score (MEDI-LITE score). Clinical data were investigated and anthropometric examinations were collected using standardised methods. Among included individuals, 18.4% had dyslipidaemia. The percentage of females with dyslipidaemia was higher than males (21.2% vs. 14.6%). Higher adherence to Mediterranean diet was inversely associated with dyslipidaemia (OR: 0.56, 95% Cl: 0.36, 0.86). Similar association was observed in men, but not in women. On the contrary, a positive association was found between dyslipidaemia and current smoking and higher occupational status. Our results support the potential effectiveness of this diet in the prevention of dyslipidaemia and justify future intervention studies.
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Affiliation(s)
- Armando Platania
- a Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia" , University of Catania , Catania , Italy
| | - Gaetano Zappala
- a Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia" , University of Catania , Catania , Italy
| | | | - Carmelo Gullo
- b Provincial Health Authority of Catania , Catania , Italy
| | - Giulio Mellini
- b Provincial Health Authority of Catania , Catania , Italy
| | | | | | - Marina Marranzano
- a Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia" , University of Catania , Catania , Italy
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