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Menotti A, Puddu PE. Time Changes of Survival and Cardiovascular Determinants in a Cohort of Middle-Aged Men Followed Up for 61 Years until Extinction. J Cardiovasc Dev Dis 2024; 11:221. [PMID: 39057641 PMCID: PMC11277176 DOI: 10.3390/jcdd11070221] [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: 06/17/2024] [Revised: 07/07/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE To study possible determinants of longevity in a cohort of middle-aged men followed for 61 years until extinction using measurements taken at baseline and at years 31 or 61 of follow-up. MATERIAL AND METHODS In 1960, two rural cohorts including a total of 1712 men aged 40-59 years were enrolled within the Italian section of the Seven Countries Study of Cardiovascular Diseases, and measurements related to mainly cardiovascular risk factors, lifestyle behaviors, and chronic diseases were taken at year 0 and year 31 of follow-up (when only 390 could be examined). Multiple linear regression models were computed to relate personal characteristics with the length of survival in both dead men and survivors. RESULTS Baseline cardiovascular risk factors, smoking and dietary habits, and chronic diseases (taken at year 0 with men aged 40-59 years) were significant predictors of the length of survival both from year 0 to year 31 and from year 0 to year 61, but only chronic diseases were independent predictors for the period of 31 to 61 years. Significant predictors of survival using measurements taken at year 31 (age range 71 to 90 years) were only smoking and dietary habits and chronic diseases. CONCLUSIONS During a lifetime of follow-up, the personal characteristics with continuous predictive power of survival were only lifestyle behaviors and major chronic diseases.
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Affiliation(s)
| | - Paolo Emilio Puddu
- Association for Cardiac Research, Via Voghera, 31, 00182 Rome, Italy;
- EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions D’ischémie Reperfusion Myocardique, Université de Normandie, 14000 Caen, France
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2
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Poulsen W, Christensen K, Dalgård C. Dietary patterns and survival to 100 + years: an empty systematic review of cohort and case–control studies. Arch Public Health 2022; 80:161. [PMID: 35768834 PMCID: PMC9241213 DOI: 10.1186/s13690-022-00914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Centenarians are used as a model of healthy ageing and longevity. Diet is a factor known to affect mortality in middle aged adults and elderly. However, it is unknown whether diet has an impact on survival to 100 + years. The aims of this systematic review were to summarize the evidence on (i) the association between dietary patterns in late adult life and survival to 100 + years and (ii) the common characteristics across dietary patterns that are shown to be positively associated with survival to 100 + years.
Methods
We performed a systematic literature search in MEDLINE and EMBASE, and a hand search at four longevity projects homepages up to 4 June 2021. We searched for cohort and case–control studies investigating the association between dietary patterns and all-cause mortality among individuals aged ≥ 65 years at enrolment regardless of their health status and residence. Studies were excluded if follow-up was performed too soon to allow the population or a subgroup of it to have become 100 + years of age.
Results
Of 3,685 identified records 108 reports were retrieved and full text screened. No studies met our inclusion criteria, thus the review process resulted in no eligible studies found. Hence, no risk of bias assessment and no synthesis of data was performed.
Conclusions
No studies have investigated dietary patterns in late adult life in relation to survival to 100 + years of age. We have observed that as of June 2021 published cohort studies exist investigating all-cause mortality risk from different dietary patterns among the oldest old, but follow-up has been performed before the cohort could have reached 100 years of age. However, cohorts do exist where data on dietary habits in adult life has been collected decades ago and where follow-up in 2022 will allow the participants to have become 100 + years old.
Registration
The review protocol is published at University of Southern Denmark’s Research Portal (Poulsen et al. Dietary Patterns and Survival to 100 + Years: Protocol for a Systematic Review of cohort and case–control studies University of Southern Denmark's Research Portal: University of Southern Denmark, 2021) available at https://portal.findresearcher.sdu.dk/en/publications/kostm%C3%B8nstre-og-overlevelse-til-100-%C3%A5r-protokol-for-en-systematisk. We have specified aim (i) of our research question in this report compared to the protocol, by adding “late” to “adult life”.
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3
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Darooghegi Mofrad M, Naghshi S, Lotfi K, Beyene J, Hypponen E, Pirouzi A, Sadeghi O. Egg and Dietary Cholesterol Intake and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Front Nutr 2022; 9:878979. [PMID: 35711545 PMCID: PMC9195585 DOI: 10.3389/fnut.2022.878979] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
Objective This systematic review and meta-analysis of prospective cohort studies examined the associations between egg and dietary cholesterol intake and the risk of mortality from all causes, including cardiovascular disease (CVD) and cancer. Methods We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until April 2021, as well as references to the relevant articles retrieved. Random-effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CIs) for the highest vs. lowest categories of egg and dietary cholesterol intake. Also, linear and non-linear dose–response analyses were conducted to examine the dose-response relationships. Results We included 55 studies, comprising data from 2,772,486 individuals with 228,425, 71,745, and 67,211 cases of all-cause, CVD, and cancer mortality, respectively. Intake of each additional egg per day was associated with a 7% higher risk of all-cause (1.07, 95% CI: 1.02–1.12, I2 = 84.8%) and a 13% higher risk of cancer mortality (1.13, 95% CI: 1.06–1.20, I2 = 54.2%), but was not associated with CVD mortality (1.00, 95% CI: 0.92–1.09, I2 = 81.5%). Non-linear analyses showed increased risks for egg consumption of more than 1.5 and 0.5 eggs/day, respectively. Each 100 mg/day increment in dietary cholesterol intake was associated with a 6% higher risk of all-cause mortality (1.06, 95% CI: 1.03–1.08, I2 = 34.5%) and a 6% higher risk of cancer mortality (1.06, 95% CI: 1.05–1.07, I2 = 0%), but was not associated with CVD mortality (1.04, 95% CI: 0.99–1.10, I2 = 85.9%). Non-linear analyses demonstrated elevated risks of CVD and cancer mortality for intakes more than 450 and 250 mg/day, respectively. Conclusions and Relevance High-dietary intake of eggs and cholesterol was associated with all-cause and cancer mortality. Little evidence for elevated risks was seen for intakes below 0.5 egg/day or 250 mg/day of dietary cholesterol. Our findings should be considered with caution because of small risk estimates and moderate between-study heterogeneity. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564, PROSPERO, identifier: CRD42021252564.
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Affiliation(s)
- Manije Darooghegi Mofrad
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada
| | - Elina Hypponen
- Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Aliyar Pirouzi
- Cellular and Molecular Department, Gerash University of Medical Sciences, Gerash, Iran
| | - Omid Sadeghi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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English LK, Ard JD, Bailey RL, Bates M, Bazzano LA, Boushey CJ, Brown C, Butera G, Callahan EH, de Jesus J, Mattes RD, Mayer-Davis EJ, Novotny R, Obbagy JE, Rahavi EB, Sabate J, Snetselaar LG, Stoody EE, Van Horn LV, Venkatramanan S, Heymsfield SB. Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review. JAMA Netw Open 2021; 4:e2122277. [PMID: 34463743 PMCID: PMC8408672 DOI: 10.1001/jamanetworkopen.2021.22277] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022] Open
Abstract
Importance The 2020 Dietary Guidelines Advisory Committee conducted a systematic review of existing research on diet and health to inform the current Dietary Guidelines for Americans. The committee answered this public health question: what is the association between dietary patterns consumed and all-cause mortality (ACM)? Objective To ascertain the association between dietary patterns consumed and ACM. Evidence Review Guided by an analytical framework and predefined inclusion and exclusion criteria developed by the committee, the US Department of Agriculture's Nutrition Evidence Systematic Review (NESR) team searched PubMed, the Cochrane Central Register of Controlled Trials, and Embase and dual-screened the results to identify articles that were published between January 1, 2000, and October 4, 2019. These studies evaluated dietary patterns and ACM in participants aged 2 years and older. The NESR team extracted data from and assessed risk of bias in included studies. Committee members synthesized the evidence, developed conclusion statements, and graded the strength of the evidence supporting the conclusion statements. Findings A total of 1 randomized clinical trial and 152 observational studies were included in the review. Studies enrolled adults and older adults (aged 17-84 years at baseline) from 28 countries with high or very high Human Development Index; 53 studies originated from the US. Most studies were well designed, used rigorous methods, and had low or moderate risks of bias. Precision, directness, and generalizability were demonstrated across the body of evidence. Results across studies were highly consistent. Evidence suggested that dietary patterns in adults and older adults that involved higher consumption of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish, and lean meat or poultry (when meat was included) were associated with a decreased risk of ACM. These healthy patterns were also relatively low in red and processed meat, high-fat dairy, and refined carbohydrates or sweets. Some of these dietary patterns also included intake of alcoholic beverages in moderation. Results based on additional analyses with confounding factors generally confirmed the robustness of main findings. Conclusions and Relevance In this systematic review, consuming a nutrient-dense dietary pattern was associated with reduced risk of death from all causes.
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Affiliation(s)
- Laural K. English
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Jamy D. Ard
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, North Carolina
| | - Regan L. Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Marlana Bates
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Lydia A. Bazzano
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Carol J. Boushey
- Epidemiology Program, University of Hawai’i Cancer Center, Honolulu
| | | | - Gisela Butera
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Emily H. Callahan
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, US Department of Health and Human Services, Washington, DC
| | - Richard D. Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Elizabeth J. Mayer-Davis
- Departments of Nutrition and Medicine, The University of North Carolina at Chapel Hill, Chapel Hill
| | - Rachel Novotny
- Nutritional Sciences, Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai’i at Mānoa, Honolulu
| | - Julie E. Obbagy
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
| | | | - Joan Sabate
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California
| | | | | | - Linda V. Van Horn
- Nutrition Division, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sudha Venkatramanan
- Nutrition Evidence Systematic Review, Office of Nutrition Guidance and Analysis (ONGA), Center for Nutrition Policy and Promotion (CNPP), US Department of Agriculture (USDA) Food and Nutrition Service (FNS), Alexandria, Virginia
- Panum Group, Bethesda, Maryland
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge
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5
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Lewgood J, Oliveira B, Korzepa M, Forbes SC, Little JP, Breen L, Bailie R, Candow DG. Efficacy of Dietary and Supplementation Interventions for Individuals with Type 2 Diabetes. Nutrients 2021; 13:2378. [PMID: 34371888 PMCID: PMC8308746 DOI: 10.3390/nu13072378] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of Type 2 diabetes (T2D) is increasing, which creates a large economic burden. Diet is a critical factor in the treatment and management of T2D; however, there are a large number of dietary approaches and a general lack of consensus regarding the efficacy of each. Therefore, the purpose of this narrative review is twofold: (1) to critically evaluate the effects of various dietary strategies on diabetes management and treatment, such as Mediterranean diet, plant-based diet, low-calorie and very low-calorie diets, intermittent fasting, low-carbohydrate and very low-carbohydrate diets, and low glycemic diets and (2) to examine several purported supplements, such as protein, branched-chain amino acids, creatine, and vitamin D to improve glucose control and body composition. This review can serve as a resource for those wanting to evaluate the evidence supporting the various dietary strategies and supplements that may help manage T2D.
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Affiliation(s)
- Jessica Lewgood
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada; (J.L.); (R.B.)
| | - Barbara Oliveira
- Okanagan Campus, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC V1V1V7, Canada; (B.O.); (J.P.L.)
| | - Marie Korzepa
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (M.K.); (L.B.)
| | - Scott C. Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB R7A6A9, Canada;
| | - Jonathan P. Little
- Okanagan Campus, School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC V1V1V7, Canada; (B.O.); (J.P.L.)
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (M.K.); (L.B.)
| | - Robert Bailie
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada; (J.L.); (R.B.)
| | - Darren G. Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S0A2, Canada; (J.L.); (R.B.)
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6
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Dominguez LJ, Di Bella G, Veronese N, Barbagallo M. Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity. Nutrients 2021. [PMID: 34204683 DOI: 10.3390/nu130620208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The average life expectancy of the world population has increased remarkably in the past 150 years and it is still increasing. A long life is a dream of humans since the beginning of time but also a dream is to live it in good physical and mental condition. Nutrition research has focused on recent decades more on food combination patterns than on individual foods/nutrients due to the possible synergistic/antagonistic effects of the components in a dietary model. Various dietary patterns have been associated with health benefits, but the largest body of evidence in the literature is attributable to the traditional dietary habits and lifestyle followed by populations from the Mediterranean region. After the Seven Countries Study, many prospective observational studies and trials in diverse populations reinforced the beneficial effects associated with a higher adherence to the Mediterranean diet in reference to the prevention/management of age-associated non-communicable diseases, such as cardiovascular and metabolic diseases, neurodegenerative diseases, cancer, depression, respiratory diseases, and fragility fractures. In addition, the Mediterranean diet is ecologically sustainable. Therefore, this immaterial world heritage constitutes a healthy way of eating and living respecting the environment.
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Affiliation(s)
- Ligia J Dominguez
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy
| | - Giovanna Di Bella
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy
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Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity. Nutrients 2021; 13:nu13062028. [PMID: 34204683 PMCID: PMC8231595 DOI: 10.3390/nu13062028] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/02/2021] [Accepted: 06/10/2021] [Indexed: 02/07/2023] Open
Abstract
The average life expectancy of the world population has increased remarkably in the past 150 years and it is still increasing. A long life is a dream of humans since the beginning of time but also a dream is to live it in good physical and mental condition. Nutrition research has focused on recent decades more on food combination patterns than on individual foods/nutrients due to the possible synergistic/antagonistic effects of the components in a dietary model. Various dietary patterns have been associated with health benefits, but the largest body of evidence in the literature is attributable to the traditional dietary habits and lifestyle followed by populations from the Mediterranean region. After the Seven Countries Study, many prospective observational studies and trials in diverse populations reinforced the beneficial effects associated with a higher adherence to the Mediterranean diet in reference to the prevention/management of age-associated non-communicable diseases, such as cardiovascular and metabolic diseases, neurodegenerative diseases, cancer, depression, respiratory diseases, and fragility fractures. In addition, the Mediterranean diet is ecologically sustainable. Therefore, this immaterial world heritage constitutes a healthy way of eating and living respecting the environment.
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D'Angelo S. Current Evidence on the Effect of Dietary Polyphenols Intake on Brain Health. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401316999200714160126] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
In recent years, the possibility of favorably influencing the cognitive capacity
through the promotion of lifestyle modifications has been increasingly investigated. In particular,
the relationship between nutritional habits and brain health has attracted special attention. Polyphenols
are secondary metabolites of plants. These phytochemicals are present in vegetables, fruits, legumes,
olive oil, nuts. They include several antioxidant compounds and are generally considered to be
involved in defense against chronic human diseases. In recent years, there has been a growing scientific
interest in their potential health benefits to the brain.
Objective:
In this mini-review, we focus on the current evidence defining the position of polyphenols
dietary intake in the prevention/slowdown of human neurodegenerative diseases.
Methods:
A literature research was performed using the keywords “polyphenols”, “brain”, “nutrition”,
individually or all together, focusing on human trials.
Results:
The available clinical studies on the effect of polyphenols on cognitive functions are quite
convincing. Regular dietary intake of polyphenols would seem to reduce the risk of neurodegenerative
diseases. Moreover, beyond their beneficial power on the central nervous system, these phytochemicals
seem also to be able to work on numerous cellular targets. They show different biological
actions, that however, have to be confirmed in long-term randomized clinical trials. Currently, most
data propose that a combination of phytonutrients instead of any single polyphenol is responsible for
health benefits.
Conclusions:
Evolving indications suggest that dietary polyphenols may exercise beneficial actions
on the central nervous system, thus representing a possible tool to preserve cognitive performance.
Key questions to improve the coherence and reproducibility in the development of polyphenols as a
possible future therapeutic drug require a better understanding of the sources of polyphenols, their
treatment and more standardized tests including bioavailability of bioactive metabolites and studies
of permeability of the brain.
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Affiliation(s)
- Stefania D'Angelo
- Department of Motor Sciences and Wellness, University of Naples “Parthenope”, Naples, Italy
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9
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Association of Baltic Sea and Mediterranean diets with frailty phenotype in older women, Kuopio OSTPRE-FPS study. Eur J Nutr 2020; 60:821-831. [PMID: 32462318 PMCID: PMC7900336 DOI: 10.1007/s00394-020-02290-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/18/2020] [Indexed: 02/07/2023]
Abstract
Purpose To evaluate the association between Baltic Sea diet (BSD) and Mediterranean diet (MED) with frailty. Methods This was a secondary analysis on the osteoporosis risk factor and prevention–fracture prevention study on 440 women aged 65–72 years. Frailty was ascertained with the presence of 3–5 and prefrailty 1–2 of the following criteria: weight loss ≥ 5%, low life satisfaction score, walking speed ≤ 0.51 m/s, handgrip strength divided by body mass index ≤ 0.67 kg/m2 and physical activity ≤ 2 h/week. Women answered to questionnaires on lifestyle factors and 3-day food record. BSD score was ascertained using intake of nine and MED score of eight foods or nutrients components from food record. Multinomial logistic regression models adjusted for age, energy intake, smoking, living status, marital status and intervention group evaluated associations between MED and BSD with frailty phenotype status. Results At 3-year follow-up, 206 women (46.8%) were prefrail and 36 (8.2%) were frail. After adjusting for confounders, a tendency was found between BSD per standard deviation (SD)-unit increase and lower likelihood of frailty (β = 0.62, 95% CI = 0.38–1.01, P = 0.057). Further, MED per SD-unit increase was associated with lower likelihood of prefrailty (β = 0.74, 95% CI = 0.6–0.9, P = 0.009). Consumption of vegetables was lower in frail (31.5 ± 36.0 g/day) and prefrail women (37.1 ± 42.0 g/day) than in non-frail women (48.6 ± 40.7 g/day) (P for trend = 0.041). Conclusions Positive behavioral characteristics such as following MED and BSD may be associated with lower likelihood of prefrailty and frailty in older women. However, further longitudinal analyses are warranted. Electronic supplementary material The online version of this article (10.1007/s00394-020-02290-5) contains supplementary material, which is available to authorized users.
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10
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Soltani S, Jayedi A, Shab-Bidar S, Becerra-Tomás N, Salas-Salvadó J. Adherence to the Mediterranean Diet in Relation to All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2019; 10:1029-1039. [PMID: 31111871 PMCID: PMC6855973 DOI: 10.1093/advances/nmz041] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/11/2018] [Accepted: 03/25/2019] [Indexed: 02/07/2023] Open
Abstract
A previous meta-analysis provided convincing evidence for an inverse association between adherence to a Mediterranean diet (MedDiet) and the risk of all-cause mortality. Since then, 19 prospective studies have been published. We updated the evidence from these prospective studies and conducted a dose-response meta-analysis to test the linear and potential nonlinear dose-response associations between adherence to a MedDiet and the risk of all-cause mortality. The PubMed, Scopus, ISI Web of Knowledge, and Embase bibliographic databases were systematically searched up to August 24, 2018. Summary HRs were estimated with the use of a random-effects meta-analysis to assess the association between a 2-point increment in MedDiet adherence and the risk of all-cause mortality. Sensitivity and subgroup analyses were performed and potential publication bias was tested. Twenty-nine prospective studies with 1,676,901 participants and 221,603 cases of all-cause mortality were included in the final analysis. The pooled HR of all-cause mortality was 0.90 (95% CI: 0.89, 0.91; I2 = 81.1%) for a 2-point increment in adherence to a MedDiet. Subgroup analyses showed that a significant inverse association was stronger in participants who lived in the Mediterranean region compared with non-Mediterranean areas (HRs: 0.82 compared with 0.92, respectively), and in studies that used the Panagiotakos MedDiet score. A nonlinear dose-response meta-analysis indicated that the risk of all-cause mortality linearly decreased with the increase in adherence to a MedDiet. The robustness of findings was confirmed in the sensitivity analyses. In conclusion, low-quality evidence from prospective cohort studies suggests an inverse association between adherence to a MedDiet and the risk of all-cause mortality, especially in Mediterranean regions. An inverse linear dose-response relation was also observed between adherence to a MedDiet and the risk of all-cause mortality.
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Affiliation(s)
- Sepideh Soltani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Food (Salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Address correspondence to SS-B (e-mail: )
| | - Nerea Becerra-Tomás
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
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Abstract
The beneficial association of the Mediterranean diet (MedDiet) with longevity has been consistently demonstrated, but the associations of MedDiet components have not been accordingly evaluated. We performed an updated meta-analysis of prospective cohort studies published up to 31 December 2017, to quantify the association of adherence to MedDiet, expressed as an index/score (MDS) and of its components with all-cause mortality. We estimated summary relative risks (SRR) and 95 % CI using random effects models. On the basis of thirty studies (225 600 deaths), SRR for the study-specific highest/lowest and per 1sd MDS increment were 0·79 (95 % CI 0·77, 0·81, Ι 2=42 %, P-heterogeneity 0·02) and 0·92 (95 % CI 0·90, 0·94, Ι 2 56 %, P-heterogeneity <0·01), respectively. Inversely, statistically significant associations were evident in stratified analyses by country, MDS range and publication year, with some evidence for heterogeneity across countries overall (P-heterogeneity 0·011), as well as across European countries (P=0·018). Regarding MDS components, relatively stronger and statistically significant inverse associations were highlighted for moderate/none-excessive alcohol consumption (0·86, 95 % CI 0·77, 0·97) and for above/below-the-median consumptions of fruit (0·88, 95 % CI 0·83, 0·94) and vegetables (0·94, 95 % CI 0·89, 0·98), whereas a positive association was apparent for above/below-the-median intake of meat (1·07, 95 % CI 1·01, 1·13). Our meta-analyses confirm the inverse association of MedDiet with mortality and highlight the dietary components that influence mostly this association. Our results are important for better understanding the role of MedDiet in health and proposing dietary changes to effectively increase adherence to this healthy dietary pattern.
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Serra-Majem L, Román-Viñas B, Sanchez-Villegas A, Guasch-Ferré M, Corella D, La Vecchia C. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Mol Aspects Med 2019; 67:1-55. [PMID: 31254553 DOI: 10.1016/j.mam.2019.06.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 01/16/2023]
Abstract
More than 50 years after the Seven Countries Study, a large number of epidemiological studies have explored the relationship between the Mediterranean diet (MD) and health, through observational, case-control, some longitudinal and a few experimental studies. The overall results show strong evidence suggesting a protective effect of the MD mainly on the risk of cardiovascular disease (CVD) and certain types of cancer. The beneficial effects have been attributed to the types of food consumed, total dietary pattern, components in the food, cooking techniques, eating behaviors and lifestyle behaviors, among others. The aim of this article is to review and summarize the knowledge derived from the literature focusing on the benefits of the MD on health, including those that have been extensively investigated (CVD, cancer) along with more recent issues such as mental health, immunity, quality of life, etc. The review begins with a brief description of the MD and its components. Then we present a review of studies evaluating metabolic biomarkers and genotypes in relation to the MD. Other sections are dedicated to observation and intervention studies for various pathologies. Finally, some insights into the relationship between the MD and sustainability are explored. In conclusion, the research undertaken on metabolomics approaches has identified potential markers for certain MD components and patterns, but more investigation is needed to obtain valid measures. Further evaluation of gene-MD interactions are also required to better understand the mechanisms by which the MD diet exerts its beneficial effects on health. Observation and intervention studies, particularly PREDIMED, have provided invaluable data on the benefits of the MD for a wide range of chronic diseases. However further research is needed to explore the effects of other lifestyle components associated with Mediterranean populations, its environmental impact, as well as the MD extrapolation to non-Mediterranean contexts.
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Affiliation(s)
- Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain.
| | - Blanca Román-Viñas
- Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain; School of Health and Sport Sciences (EUSES), Universitat de Girona, Salt, Spain; Department of Physical Activity and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Almudena Sanchez-Villegas
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H.Chan School of Public Health, Boston, MA, USA; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dolores Corella
- Genetic and Molecular Epidemiology Unit. Department of Preventive Medicine. University of Valencia, Valencia, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
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Caprara G. Diet and longevity: The effects of traditional eating habits on human lifespan extension. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2018. [DOI: 10.3233/mnm-180225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since the dawn of time human beings have been trying to improve the quality of the existence and extend their lifespan. Genetic, environmental, behavioral and dietary factors influence the pathways that regulate aging and life expectancy, thus rendering longevity a very complex phenomenon. Although a long-lived elixir has not yet been found, physicians and scientists agree that nutrition has a major impact on the overall mortality and morbidity, hence becoming the subject of a widespread scientific research. This review describes, analyzes and compares the effects of different types of diets in reducing the onset of typical Western countries non-communicable diseases (NCDs) (cardiovascular diseases, tumors, chronic respiratory diseases, diabetes, etc.), thus increasing the average lifespan. It will first depict the most relevant characteristics, nutraceutical properties and effects on the populations of the Mediterranean, Japanese, Vegetarian and New Nordic Diet. Finally, it will describe the impact of different dietary restrictions in modulating the genetic pathways that regulate metabolism and aging. Overall, this work reinforces the evidence that specific eating habits, in addition to healthy and active lifestyles, are crucial to increase people’s health span and to achieve an optimal longevity.
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Affiliation(s)
- Greta Caprara
- Department of Experimental Oncology, European Institute of Oncology (IEO), Via Adamello 16, 20139 Milan, Italy
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Mediterranean diet and mortality in the elderly: a prospective cohort study and a meta-analysis. Br J Nutr 2018; 120:841-854. [DOI: 10.1017/s0007114518002179] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe Mediterranean diet (MD) has been associated with prolonged survival in the general population, but no meta-analysis has apparently investigated the potential health benefits in relation to mortality in the elderly. We performed a longitudinal analysis on 5200 individuals aged ≥65 years identified within the general population recruited in the Moli-sani study cohort (2005–2010). Adherence to the MD was appraised by the a priori Mediterranean diet score (MDS; range 0–9). Survival estimates were derived using Cox regression and competing risk models. For the meta-analysis, PubMed and Scopus databases were searched from inception until April 2018 to identify prospective studies on the MD and death risk in the elderly. Over a median follow-up of 8·1 years, a total of 900 deaths were ascertained in the elderly sub-sample of the Moli-sani cohort. A one-point increase in the MDS was associated with lower risk of all-cause, coronary artery disease/cerebrovascular and non-cardiovascular/non-cancer mortality (multi-variable hazard ratio (HR)=0·94; 95 % CI 0·90, 0·98; HR=0·91; 95 % CI 0·83, 0·99 and HR=0·89; 95 % CI 0·81, 0·96, respectively). In a meta-analysis of seven prospective studies, including our results, for a total of 11 738 participants and 3874 deaths, one-point increment in MDS was associated with 5 % (4–7 %) lower risk of all-cause death. An inverse linear dose–response relationship was found from a meta-analysis including three studies. In conclusion, a prospective cohort study and a meta-analysis showed that closer adherence to the MD was associated with prolonged survival in elderly individuals, suggesting the appropriateness for older persons to adopt/preserve the MD to maximise their prospects for survival.
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Tognon G, Rothenberg E, Petrolo M, Sundh V, Lissner L. Dairy product intake and mortality in a cohort of 70-year-old Swedes: a contribution to the Nordic diet discussion. Eur J Nutr 2017; 57:2869-2876. [PMID: 29080977 PMCID: PMC6267406 DOI: 10.1007/s00394-017-1556-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 10/03/2017] [Indexed: 01/01/2023]
Abstract
Introduction Conflicting results in the literature exist on the role of dairy products in the context of a Nordic Healthy Diet (NHD). Two recent Swedish studies indicate both negative and positive associations with total mortality when comparing key dairy products. There is no consensus about how to include these foods into the NHD. Purpose To study consumption of cheese and milk products (milk, sour milk and unsweetened yoghurt) by 70-year-old Swedes in relation to all-cause mortality. Methods Cox proportional hazard models, adjusted for potential confounders and stratified by follow-up duration, were used to assess the prediction of all-cause mortality by the above foods. The associations of fat from cheese and milk products with mortality were tested in separate models. Results Cheese intake inversely predicted total mortality, particularly at high protein intakes, and this association decreased in strength with increasing follow-up time. Milk products predicted increased mortality with stable HRs over follow-up. The association between milk products and mortality was strongly influenced by the group with the highest consumption. Fat from cheese mirrored the protective association of cheese intake with mortality, whereas fat from milk products predicted excess mortality, but only in an energy-adjusted model. Conclusion Based on our results, it may be argued that the role of dairy products in the context of a Nordic healthy diet should be more clearly defined by disaggregating cheese and milk products and not necessarily focusing on dairy fat content. Future epidemiological research should consider dairy products as disaggregated food items due to their great diversity in health properties. Electronic supplementary material The online version of this article (doi:10.1007/s00394-017-1556-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gianluca Tognon
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden.
| | | | - Martina Petrolo
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden
| | - Valter Sundh
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 453, SE 405 30, Gothenburg, Sweden
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Associations of Baltic Sea and Mediterranean dietary patterns with bone mineral density in elderly women. Public Health Nutr 2017; 20:2735-2743. [PMID: 28803596 DOI: 10.1017/s1368980017001793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Dietary quality in relation to bone health has been analysed in relatively few studies. The current study aimed to assess the association of the Baltic Sea diet (BSD) and the Mediterranean diet (MD) with bone mineral density (BMD) among elderly women. DESIGN Lumbar, femoral and total body BMD were measured by dual-energy X-ray absorptiometry at baseline and year 3. Dietary intake was measured by 3 d food record at baseline. BSD and MD scores were calculated from food and alcohol consumption and nutrient intake. Information on lifestyle, diseases and medications was collected by questionnaires. Longitudinal associations of BSD and MD scores with BMD were analysed using linear mixed models. SETTING Interventional prospective Kuopio Osteoporosis Risk Factor and Fracture Prevention study including women aged 65-71 years and residing in Kuopio province, Finland. SUBJECTS Women (n 554) with mean age of 67·9 (sd 1·9) years and mean BMI of 28·8 (sd 4·7) kg/m2. RESULTS Higher BSD scores were associated with higher intakes of fruit and berries, vegetables, fish and low-fat dairy products, and lower intake of sausage. Higher MD scores were associated with higher consumption of fruit and berries and vegetables. BSD and MD scores were associated with higher PUFA:SFA and higher fibre intake. Femoral, lumbar or total body BMD was not significantly different among the quartiles of BSD or MD score. CONCLUSION The lack of associations suggest that Baltic Sea and Mediterranean dietary patterns may not adequately reflect dietary factors relevant to bone health.
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Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, Greenwood DC, Riboli E, Vatten LJ, Tonstad S. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol 2017; 46:1029-1056. [PMID: 28338764 PMCID: PMC5837313 DOI: 10.1093/ije/dyw319] [Citation(s) in RCA: 1157] [Impact Index Per Article: 165.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 12/23/2022] Open
Abstract
Background Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. Methods PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. Results For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I 2 = 0%, n = 15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I 2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90-0.95, I 2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I 2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87-0.93, I 2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Bjørknes University College, Oslo, Norway
| | - Edward Giovannucci
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology
- Department of Nutrition, Harvard T. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care & Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - NaNa Keum
- Department of Epidemiology
- Department of Nutrition, Harvard T. Chan School of Public Health, Boston, MA, USA
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | | | - Elio Riboli
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Lars J Vatten
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Serena Tonstad
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
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Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr 2017; 105:1462-1473. [PMID: 28446499 DOI: 10.3945/ajcn.117.153148] [Citation(s) in RCA: 253] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/28/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Suboptimal diet is one of the most important factors in preventing early death and disability worldwide.Objective: The aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality.Design: We conducted a systematic search in PubMed, Embase, and Google Scholar for prospective studies investigating the association between these 12 food groups and risk of all-cause mortality. Summary RRs and 95% CIs were estimated with the use of a random effects model for high-intake compared with low-intake categories, as well as for linear and nonlinear relations. Moreover, the risk reduction potential of foods was calculated by multiplying the RR by optimal intake values (serving category with the strongest association) for risk-reducing foods or risk-increasing foods, respectively.Results: With increasing intake (for each daily serving) of whole grains (RR: 0.92; 95% CI: 0.89, 0.95), vegetables (RR: 0.96; 95% CI: 0.95, 0.98), fruits (RR: 0.94; 95% CI: 0.92, 0.97), nuts (RR: 0.76; 95% CI: 0.69, 0.84), and fish (RR: 0.93; 95% CI: 0.88, 0.98), the risk of all-cause mortality decreased; higher intake of red meat (RR: 1.10; 95% CI: 1.04, 1.18) and processed meat (RR: 1.23; 95% CI: 1.12, 1.36) was associated with an increased risk of all-cause mortality in a linear dose-response meta-analysis. A clear indication of nonlinearity was seen for the relations between vegetables, fruits, nuts, and dairy and all-cause mortality. Optimal consumption of risk-decreasing foods results in a 56% reduction of all-cause mortality, whereas consumption of risk-increasing foods is associated with a 2-fold increased risk of all-cause mortality.Conclusion: Selecting specific optimal intakes of the investigated food groups can lead to a considerable change in the risk of premature death.
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Affiliation(s)
- Lukas Schwingshackl
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany;
| | - Carolina Schwedhelm
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Anna-Maria Lampousi
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Sven Knüppel
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Khalid Iqbal
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | | | - Sabrina Schlesinger
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; and.,Institute for Biometry and Epidemiology, Leibniz Institute for Diabetes Research, Heinrich Heine University Düsseldorf, Dusseldorf, Germany
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
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Tognon G, Nilsson LM, Shungin D, Lissner L, Jansson JH, Renström F, Wennberg M, Winkvist A, Johansson I. Nonfermented milk and other dairy products: associations with all-cause mortality. Am J Clin Nutr 2017; 105:1502-1511. [PMID: 28490510 PMCID: PMC6546226 DOI: 10.3945/ajcn.116.140798] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 04/05/2017] [Indexed: 11/14/2022] Open
Abstract
Background: A positive association between nonfermented milk intake and increased all-cause mortality was recently reported, but overall, the association between dairy intake and mortality is inconclusive.Objective: We studied associations between intake of dairy products and all-cause mortality with an emphasis on nonfermented milk and fat content.Design: A total of 103,256 adult participants (women: 51.0%) from Northern Sweden were included (7121 deaths; mean follow-up: 13.7 y). Associations between all-cause mortality and reported intakes of nonfermented milk (total or by fat content), fermented milk, cheese, and butter were tested with the use of Cox proportional hazards models that were adjusted for age, sex, body mass index, smoking status, education, energy intake, examination year, and physical activity. To circumvent confounding, Mendelian randomization was applied in a subsample via the lactase LCT-13910 C/T single nucleotide polymorphism that is associated with lactose tolerance and milk intake.Results: High consumers of nonfermented milk (≥2.5 times/d) had a 32% increased hazard (HR: 1.32; 95% CI: 1.18, 1.48) for all-cause mortality compared with that of subjects who consumed milk ≤1 time/wk. The corresponding value for butter was 11% (HR: 1.11; 95% CI: 1.07, 1.21). All nonfermented milk-fat types were independently associated with increased HRs, but compared with full-fat milk, HRs were lower in consumers of medium- and low-fat milk. Fermented milk intake (HR: 0.90; 95% CI: 0.86, 0.94) and cheese intake (HR: 0.93; 95% CI: 0.91, 0.96) were negatively associated with mortality. Results were slightly attenuated by lifestyle adjustments but were robust in sensitivity analyses. Mortality was not significantly associated with the LCT-13910 C/T genotype in the smaller subsample. The amount and type of milk intake was associated with lifestyle variables.Conclusions: In the present Swedish cohort study, intakes of nonfermented milk and butter are associated with higher all-cause mortality, and fermented milk and cheese intakes are associated with lower all-cause mortality. Residual confounding by lifestyle cannot be excluded, and Mendelian randomization needs to be examined in a larger sample.
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Affiliation(s)
- Gianluca Tognon
- Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, and
| | - Lena M Nilsson
- Arcum, Arctic Research Center at Umeå University, Umeå, Sweden
| | - Dmitry Shungin
- Odontology,Public Health and Clinical Medicine, Nutritional Research, Umeå University,
Umeå, Sweden
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine, Department of Public Health
and Community Medicine
| | | | - Frida Renström
- Departments of Biobank Research,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Maria Wennberg
- Public Health and Clinical Medicine, Nutritional Research, Umeå University,
Umeå, Sweden
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden,Public Health and Clinical Medicine, Nutritional Research, Umeå University,
Umeå, Sweden
| | - Ingegerd Johansson
- Odontology,Public Health and Clinical Medicine, Nutritional Research, Umeå University,
Umeå, Sweden
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20
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Ratjen I, Schafmayer C, di Giuseppe R, Waniek S, Plachta-Danielzik S, Koch M, Nöthlings U, Hampe J, Schlesinger S, Lieb W. Postdiagnostic Mediterranean and Healthy Nordic Dietary Patterns Are Inversely Associated with All-Cause Mortality in Long-Term Colorectal Cancer Survivors. J Nutr 2017; 147:636-644. [PMID: 28228505 DOI: 10.3945/jn.116.244129] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/14/2016] [Accepted: 01/25/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Dietary factors are known to affect the risk of new-onset colorectal cancer (CRC), but information on the extent to which postdiagnostic diet affects mortality in long-term CRC survivors is scarce.Objective: We investigated the association of 2 a priori-defined postdiagnostic dietary patterns [Modified Mediterranean Diet Score (MMDS) and healthy Nordic Food Index (HNFI)] with all-cause mortality in long-term CRC survivors.Methods: Diet was assessed at a median time of 6 y after cancer diagnosis in 1404 CRC survivors (median age: 69 y; 56% men) in a prospective cohort study in Northern Germany by using a semiquantitative food-frequency questionnaire. Cox proportional hazard models, adjusting for clinical and sociodemographic characteristics, were used to assess associations of the MMDS and the HNFI with all-cause mortality.Results: A total of 204 patients died during a median follow-up time of 7 y after diet assessment. In multivariable-adjusted models, higher adherence to the modified Mediterranean diet was significantly associated with lower all-cause mortality (HR: 0.48; 95% CI: 0.32, 0.74 for highest compared with lowest score quartile and HR: 0.88; 95% CI: 0.81, 0.96 per 1-point increment in pattern score). Similarly, the HNFI was inversely associated with all-cause mortality when the highest was compared with the lowest index quartile (HR: 0.63; 95% CI: 0.39, 1.04) and when modeled as a continuous trait (HR: 0.90; 95% CI: 0.82, 0.99 per 1-point increment in the score).Conclusions: Our results suggest that higher adherences to the Mediterranean diet and to the healthy Nordic diet after CRC diagnosis are associated with better overall survival in long-term CRC survivors.
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Affiliation(s)
- Ilka Ratjen
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Clemens Schafmayer
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Romina di Giuseppe
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sabina Waniek
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Manja Koch
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - Jochen Hampe
- Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany; and
| | - Sabrina Schlesinger
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany;
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Association of the Baltic Sea and Mediterranean diets with indices of sarcopenia in elderly women, OSPTRE-FPS study. Eur J Nutr 2017; 57:1435-1448. [DOI: 10.1007/s00394-017-1422-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 02/27/2017] [Indexed: 12/21/2022]
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22
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Zong G, Gao A, Hu FB, Sun Q. Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Meta-Analysis of Prospective Cohort Studies. Circulation 2017; 133:2370-80. [PMID: 27297341 DOI: 10.1161/circulationaha.115.021101] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/03/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Current findings on associations between whole grain (WG) intake and mortality are inconsistent and have not been summarized by meta-analysis. METHODS AND RESULTS We searched for prospective cohort studies reporting associations between WG intake and mortality from all causes, cardiovascular disease (CVD), and cancer through February 2016 in Medline, Embase, and clinicaltrials.gov, and we further included unpublished results from National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999 to 2004. Fourteen studies were eligible for analysis, which included 786 076 participants, 97 867 total deaths, 23 957 CVD deaths, and 37 492 cancer deaths. Pooled relative risks comparing extreme WG categories (high versus low) were 0.84 (95% confidence interval [CI], 0.80-0.88; P<0.001; I(2)=74%; Pheterogeneity<0.001) for total mortality, 0.82 (95% CI, 0.79-0.85; P<0.001; I(2)=0%; Pheterogeneity=0.53) for CVD mortality, and 0.88 (95% CI, 0.83-0.94; P<0.001; I(2)=54%; Pheterogeneity=0.02) for cancer mortality. Intakes of WG ingredients in dry weight were estimated among studies reporting relative risks for ≥3 quantitative WG categories, and they were <50 g/d among most study populations. The 2-stage dose-response random-effects meta-analysis showed monotonic associations between WG intake and mortality (Pnonlinearity>0.05). For each 16-g/d increase in WG (≈1 serving per d), relative risks of total, CVD, and cancer mortality were 0.93 (95% CI, 0.92-0.94; P<0.001), 0.91 (95% CI, 0.90-0.93; P<0.001), and 0.95 (95% CI, 0.94-0.96; P<0.001), respectively. CONCLUSIONS Our meta-analysis demonstrated inverse associations of WG intake with total and cause-specific mortality, and findings were particularly strong and robust for CVD mortality. These findings further support current Dietary Guidelines for Americans, which recommends at least 3 servings per day of WG intake.
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Affiliation(s)
- Geng Zong
- From the Departments of Nutrition (G.Z., A.G., F.B.H., Q.S.) and Epidemiology (F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.B.H., Q.S.)
| | - Alisa Gao
- From the Departments of Nutrition (G.Z., A.G., F.B.H., Q.S.) and Epidemiology (F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.B.H., Q.S.)
| | - Frank B Hu
- From the Departments of Nutrition (G.Z., A.G., F.B.H., Q.S.) and Epidemiology (F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.B.H., Q.S.)
| | - Qi Sun
- From the Departments of Nutrition (G.Z., A.G., F.B.H., Q.S.) and Epidemiology (F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.B.H., Q.S.).
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Benisi-Kohansal S, Saneei P, Salehi-Marzijarani M, Larijani B, Esmaillzadeh A. Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2016; 7:1052-1065. [PMID: 28140323 PMCID: PMC5105035 DOI: 10.3945/an.115.011635] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
No conclusive information is available about the relation between the consumption of whole grains and the risk of mortality. We aimed to conduct a meta-analysis of prospective cohort studies to summarize the relation between whole-grain intake and risk of mortality from all causes, cardiovascular disease, and total and specific cancers. A systematic search of the literature published earlier than March 2015 was conducted in Medline and PubMed, SCOPUS, EMBASE, and Cochrane Library to identify relevant articles. Prospective cohort studies that examined the association of total whole-grain intake or specific whole-grain foods with risk of mortality from all causes, cardiovascular disease, and total and specific cancers were considered. Twenty prospective cohort studies were included in the systematic review: 9 studies reported total whole-grain intake and 11 others reported specific whole-grain food intake. In a follow-up period of 5.5 to 26 y, there were 191,979 deaths (25,595 from cardiovascular disease, 32,746 from total cancers, and 2671 from specific cancers) in 2,282,603 participants. A greater intake of both total whole grains and specific whole-grain foods was significantly associated with a lower risk of all-cause mortality in the meta-analysis. The pooled RR for all-cause mortality for an increase of 3 servings total whole grains/d (90 g/d) was 0.83 (95% CI: 0.79, 0.88). Total whole-grain intake (0.84; 95% CI: 0.76, 0.93) and specific whole-grain foods (0.82; 95% CI: 0.75, 0.90) were also associated with a reduced risk of mortality from cardiovascular disease. Each additional 3 servings total whole grains/d was associated with a 25% lower risk of mortality from cardiovascular disease. An inverse association was observed between whole-grain intake and risk of mortality from total cancers (0.94; 95% CI: 0.91, 0.98). We found an inverse association between whole-grain intake and mortality from all causes, cardiovascular disease, and total cancers.
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Affiliation(s)
- Sanaz Benisi-Kohansal
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, and .,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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24
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Iacob S, Hersant B, Mezi MS, Meningaud JP. Factors That May Enhance Longevity: A Literature Review and a Comprehensive Update for Aesthetic Surgeons. Aesthetic Plast Surg 2016; 40:625-31. [PMID: 27234525 DOI: 10.1007/s00266-016-0648-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/25/2016] [Indexed: 12/19/2022]
Abstract
INTRODUCTION After surgery, the plastic surgeon is very often questioned about how to maintain the result and more frequently how to slow down the aging process. However, this type of knowledge is not commonly delivered during medical education or at least needs an update. This review could be used as a guide to help plastic surgeons to manage these frequent postoperative consultations. The aim of this literature review was to focus discussion on specific positive factors, identified to have a significant impact on human longevity. MATERIALS AND METHODS A literature review was performed using the automated computerized PubMed search, with the keywords "human longevity." Only papers written in the English language were included. References were screened to identify further relevant articles. Experimental studies based on microorganisms and animals, works published in non-indexed journals, case reports, letters, and viewpoints were excluded. RESULTS One hundred and twenty-four articles reporting factors influencing human longevity were analyzed for data extraction. A total of 59 articles reporting only positive factors were included. Fourteen factors seemed to have a positive impact on longevity: caloric restriction, active effort and sports, happiness, vitamins, vegetarian or Mediterranean diet, oriental practices, socioeconomic status, genetics, sexual activity, sleep, moderate wine consumption, religion, and education. CONCLUSION While some factors with a positive impact on longevity are clearly identified and should be integrated in the postoperative process, further studies are still needed to be able to slow down the aging process. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- S Iacob
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - B Hersant
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
| | - M SidAhmed Mezi
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - J P Meningaud
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillofacial Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
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25
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Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ 2016; 353:i2716. [PMID: 27301975 PMCID: PMC4908315 DOI: 10.1136/bmj.i2716] [Citation(s) in RCA: 542] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To quantify the dose-response relation between consumption of whole grain and specific types of grains and the risk of cardiovascular disease, total cancer, and all cause and cause specific mortality. DATA SOURCES PubMed and Embase searched up to 3 April 2016. STUDY SELECTION Prospective studies reporting adjusted relative risk estimates for the association between intake of whole grains or specific types of grains and cardiovascular disease, total cancer, all cause or cause specific mortality. DATA SYNTHESIS Summary relative risks and 95% confidence intervals calculated with a random effects model. RESULTS 45 studies (64 publications) were included. The summary relative risks per 90 g/day increase in whole grain intake (90 g is equivalent to three servings-for example, two slices of bread and one bowl of cereal or one and a half pieces of pita bread made from whole grains) was 0.81 (95% confidence interval 0.75 to 0.87; I(2)=9%, n=7 studies) for coronary heart disease, 0.88 (0.75 to 1.03; I(2)=56%, n=6) for stroke, and 0.78 (0.73 to 0.85; I(2)=40%, n=10) for cardiovascular disease, with similar results when studies were stratified by whether the outcome was incidence or mortality. The relative risks for morality were 0.85 (0.80 to 0.91; I(2)=37%, n=6) for total cancer, 0.83 (0.77 to 0.90; I(2)=83%, n=11) for all causes, 0.78 (0.70 to 0.87; I(2)=0%, n=4) for respiratory disease, 0.49 (0.23 to 1.05; I(2)=85%, n=4) for diabetes, 0.74 (0.56 to 0.96; I(2)=0%, n=3) for infectious diseases, 1.15 (0.66 to 2.02; I(2)=79%, n=2) for diseases of the nervous system disease, and 0.78 (0.75 to 0.82; I(2)=0%, n=5) for all non-cardiovascular, non-cancer causes. Reductions in risk were observed up to an intake of 210-225 g/day (seven to seven and a half servings per day) for most of the outcomes. Intakes of specific types of whole grains including whole grain bread, whole grain breakfast cereals, and added bran, as well as total bread and total breakfast cereals were also associated with reduced risks of cardiovascular disease and/or all cause mortality, but there was little evidence of an association with refined grains, white rice, total rice, or total grains. CONCLUSIONS This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - NaNa Keum
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lars T Fadnes
- Centre for International Health, Department of Global Public Health and Primary Care and Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Darren C Greenwood
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - Serena Tonstad
- Section of Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| | - Lars J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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26
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Dugué PA, Hodge AM, Brinkman MT, Bassett JK, Shivappa N, Hebert JR, Hopper JL, English DR, Milne RL, Giles GG. Association between selected dietary scores and the risk of urothelial cell carcinoma: A prospective cohort study. Int J Cancer 2016; 139:1251-60. [PMID: 27149545 DOI: 10.1002/ijc.30175] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 04/02/2016] [Accepted: 04/25/2016] [Indexed: 01/28/2023]
Abstract
Studies investigating the association of food and nutrient consumption with the risk of urothelial cell carcinoma (UCC) have produced mixed results. We used three common dietary scores, the Mediterranean Diet Score (MDS), the Alternate Healthy Eating Index 2010 (AHEI-2010) and the Dietary Inflammatory Index (DII) to assess the evidence of an association between diet and the risk of UCC. Over a median follow-up time of 21.3 years, 379 incident UCC cases were diagnosed. Dietary scores were calculated using data from a 121-item food frequency questionnaire administered at baseline. We used Cox models to compute hazard ratios (HR) for the association between dietary scores (per one standard deviation) and UCC risk. In order to reflect overall adherence to a healthy diet, a metascore was constructed by summing the quintiles of each of the three scores. None of the dietary scores was associated with the risk of UCC overall. A healthier diet was found to be inversely associated with the risk of invasive (MDS: HR = 0.86, 95% CI: 0.74-1.00, metascore: HR = 0.84, 95% CI: 0.71-0.98), but not superficial disease (heterogeneity between subtypes p = 0.04 and p = 0.03, respectively). Results were consistent but weaker for the DII and the AHEI-2010. We found some evidence of effect modification by smoking, in particular for the metascore (Current: HR = 0.77, 95% CI: 0.58-1.01, Former: HR = 0.77, 95% CI: 0.64-0.92, Never: HR = 1.01, 95% CI: 0.81-1.26, p for heterogeneity = 0.05). A healthy diet may be protective against the risk of invasive, but not superficial, UCC. Promoting healthy dietary habits may help lower the risk of invasive UCC, especially for current and former smokers.
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Affiliation(s)
- Pierre-Antoine Dugué
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Allison M Hodge
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia
| | - Maree T Brinkman
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia
| | - Julie K Bassett
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Connecting Health Innovations LLC, Columbia, SC
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Connecting Health Innovations LLC, Columbia, SC
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Dallas R English
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Roger L Milne
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
| | - Graham G Giles
- Cancer Council Victoria, Cancer Epidemiology Centre, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia
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27
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Aune D, Sen A, Prasad M, Norat T, Janszky I, Tonstad S, Romundstad P, Vatten LJ. BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. BMJ 2016; 353:i2156. [PMID: 27146380 PMCID: PMC4856854 DOI: 10.1136/bmj.i2156] [Citation(s) in RCA: 499] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of cohort studies of body mass index (BMI) and the risk of all cause mortality, and to clarify the shape and the nadir of the dose-response curve, and the influence on the results of confounding from smoking, weight loss associated with disease, and preclinical disease. DATA SOURCES PubMed and Embase databases searched up to 23 September 2015. STUDY SELECTION Cohort studies that reported adjusted risk estimates for at least three categories of BMI in relation to all cause mortality. DATA SYNTHESIS Summary relative risks were calculated with random effects models. Non-linear associations were explored with fractional polynomial models. RESULTS 230 cohort studies (207 publications) were included. The analysis of never smokers included 53 cohort studies (44 risk estimates) with >738 144 deaths and >9 976 077 participants. The analysis of all participants included 228 cohort studies (198 risk estimates) with >3 744 722 deaths among 30 233 329 participants. The summary relative risk for a 5 unit increment in BMI was 1.18 (95% confidence interval 1.15 to 1.21; I(2)=95%, n=44) among never smokers, 1.21 (1.18 to 1.25; I(2)=93%, n=25) among healthy never smokers, 1.27 (1.21 to 1.33; I(2)=89%, n=11) among healthy never smokers with exclusion of early follow-up, and 1.05 (1.04 to 1.07; I(2)=97%, n=198) among all participants. There was a J shaped dose-response relation in never smokers (Pnon-linearity <0.001), and the lowest risk was observed at BMI 23-24 in never smokers, 22-23 in healthy never smokers, and 20-22 in studies of never smokers with ≥20 years' follow-up. In contrast there was a U shaped association between BMI and mortality in analyses with a greater potential for bias including all participants, current, former, or ever smokers, and in studies with a short duration of follow-up (<5 years or <10 years), or with moderate study quality scores. CONCLUSION Overweight and obesity is associated with increased risk of all cause mortality and the nadir of the curve was observed at BMI 23-24 among never smokers, 22-23 among healthy never smokers, and 20-22 with longer durations of follow-up. The increased risk of mortality observed in underweight people could at least partly be caused by residual confounding from prediagnostic disease. Lack of exclusion of ever smokers, people with prevalent and preclinical disease, and early follow-up could bias the results towards a more U shaped association.
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Affiliation(s)
- Dagfinn Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Epidemiology and Biostatistics, Imperial College, London, UK
| | - Abhijit Sen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Manya Prasad
- Department of Community Medicine, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, Imperial College, London, UK
| | - Imre Janszky
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Serena Tonstad
- Department of Community Medicine, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Pål Romundstad
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Jankovic N, Geelen A, Streppel MT, de Groot LC, Kiefte-de Jong JC, Orfanos P, Bamia C, Trichopoulou A, Boffetta P, Bobak M, Pikhart H, Kee F, O'Doherty MG, Buckland G, Woodside J, Franco OH, Ikram MA, Struijk EA, Pajak A, Malyutina S, Kubinova R, Wennberg M, Park Y, Bueno-de-Mesquita HB, Kampman E, Feskens EJ. WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project. Am J Clin Nutr 2015; 102:745-56. [PMID: 26354545 PMCID: PMC4588736 DOI: 10.3945/ajcn.114.095117] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/23/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly. OBJECTIVE The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y. DESIGN We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model. RESULTS During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable). CONCLUSION Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.
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Affiliation(s)
- Nicole Jankovic
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands; Centre of Clinical Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | | | | | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands; Global Public Health, Leiden University College, the Hague, Netherlands
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Christina Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Antonia Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Paolo Boffetta
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Mark G O'Doherty
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Genevieve Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | - Jayne Woodside
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Ellen A Struijk
- Department of Epidemiology, Julius Centre, Utrecht, Netherlands
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University, Krakow, Poland
| | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
| | | | - Maria Wennberg
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Yikyung Park
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - H Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; and Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Edith J Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands;
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29
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Tognon G, Moreno LA, Mouratidou T, Veidebaum T, Molnár D, Russo P, Siani A, Akhandaf Y, Krogh V, Tornaritis M, Börnhorst C, Hebestreit A, Pigeot I, Lissner L. Adherence to a Mediterranean-like dietary pattern in children from eight European countries. The IDEFICS study. Int J Obes (Lond) 2015; 38 Suppl 2:S108-14. [PMID: 25219407 DOI: 10.1038/ijo.2014.141] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Despite documented benefits of a Mediterranean-like dietary pattern, there is a lack of knowledge about how children from different European countries compare with each other in relation to the adherence to this pattern. In response to this need, we calculated the Mediterranean diet score (MDS) in 2-9-year-old children from the Identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) eight-country study. SUBJECTS AND METHODS Using 24 h dietary recall data obtained during the IDEFICS study (n=7940), an MDS score was calculated based on the age- and sex-specific population median intakes of six food groups (vegetables and legumes, fruit and nuts, cereal grains and potatoes, meat products and dairy products) and the ratio of unsaturated to saturated fats. For fish and seafood, which was consumed by 10% of the population, one point was given to consumers. The percentages of children with high MDS levels (>3) were calculated and stratified by sex, age and by having at least one migrant parent or both native parents. Demographic (sex and age) and socioeconomic characteristics (parental education and income) of children showing high (>3) vs low (⩽3) MDS levels were examined. RESULTS The highest prevalence of children with MDS>3 was found among the Italian pre-school boys (55.9%) and the lowest among the Spanish school-aged girls (26.0%). Higher adherence to a Mediterranean-like dietary pattern was not associated with living in a Mediterranean country or in a highly educated or high-income family, although with some exceptions. Differences in adherence between boys and girls or age groups varied between countries without any general pattern. CONCLUSIONS With the exception of Italian pre-schoolers, similar adherence levels to a Mediterranean-like dietary pattern have been observed among European children.
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Affiliation(s)
- G Tognon
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) research group, University of Zaragoza, Zaragoza, Spain
| | - T Mouratidou
- GENUD (Growth, Exercise, Nutrition and Development) research group, University of Zaragoza, Zaragoza, Spain
| | - T Veidebaum
- Department of Chronic Disease, National Institute for Health Development, Tallinn, Estonia
| | - D Molnár
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - P Russo
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - A Siani
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Y Akhandaf
- Department of Public Health/Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - V Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - C Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - I Pigeot
- 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - L Lissner
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 2014; 17:2769-82. [PMID: 24476641 PMCID: PMC10282340 DOI: 10.1017/s1368980013003169] [Citation(s) in RCA: 664] [Impact Index Per Article: 66.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/05/2013] [Accepted: 10/15/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To update previous meta-analyses of cohort studies that investigated the association between the Mediterranean diet and health status and to utilize data coming from all of the cohort studies for proposing a literature-based adherence score to the Mediterranean diet. DESIGN We conducted a comprehensive literature search through all electronic databases up to June 2013. SETTING Cohort prospective studies investigating adherence to the Mediterranean diet and health outcomes. Cut-off values of food groups used to compute the adherence score were obtained. SUBJECTS The updated search was performed in an overall population of 4 172 412 subjects, with eighteen recent studies that were not present in the previous meta-analyses. RESULTS A 2-point increase in adherence score to the Mediterranean diet was reported to determine an 8 % reduction of overall mortality (relative risk = 0·92; 95 % CI 0·91, 0·93), a 10 % reduced risk of CVD (relative risk = 0·90; 95 % CI 0·87, 0·92) and a 4 % reduction of neoplastic disease (relative risk = 0·96; 95 % CI 0·95, 0·97). We utilized data coming from all cohort studies available in the literature for proposing a literature-based adherence score. Such a score ranges from 0 (minimal adherence) to 18 (maximal adherence) points and includes three different categories of consumption for each food group composing the Mediterranean diet. CONCLUSIONS The Mediterranean diet was found to be a healthy dietary pattern in terms of morbidity and mortality. By using data from the cohort studies we proposed a literature-based adherence score that can represent an easy tool for the estimation of adherence to the Mediterranean diet also at the individual level.
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Affiliation(s)
- Francesco Sofi
- Department of Clinical and Experimental Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Agency of Nutrition, University Hospital of Careggi, Florence, Italy
- Don Carlo Gnocchi Foundation Italy, IRCCS, Florence, Italy
| | - Claudio Macchi
- Don Carlo Gnocchi Foundation Italy, IRCCS, Florence, Italy
| | - Rosanna Abbate
- Department of Clinical and Experimental Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Gian Franco Gensini
- Department of Clinical and Experimental Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Don Carlo Gnocchi Foundation Italy, IRCCS, Florence, Italy
| | - Alessandro Casini
- Department of Clinical and Experimental Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
- Agency of Nutrition, University Hospital of Careggi, Florence, Italy
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Moreira PL, Corrente JE, Villas Boas PJF, Ferreira ALA. Dietary patterns are associated with general and central obesity in elderly living in a Brazilian city. Rev Assoc Med Bras (1992) 2014. [DOI: 10.1590/1806-9282.60.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: dietary pattern evaluation is often used in order to determine wheter a diet is healthy, as well as to predict the onset of diseases. This study aimed to identify dietary patterns, and to examine their associations with general (body mass index) and central (waist circumference and waist-to-hip ratio) obesity in community-living elderly in a Brazilian city. Methods: this cross-sectional study included 126 elderly subjects aged 60 or older (57.1% females and mean age 74.2 ± 6.46 years). Anthropometric variables, weight, height, waist (WC) and hip (HC) circumferences, were measured. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Answers to a Food Frequency Questionnaire were interpreted by Principal Component Analysis in order to identify dietary patterns. Results: five dietary patterns were identified and named as prudent (fruit, vegetables and meat), sweets and fats (pastries, sugary foods, fatty foods, whole milk), typical Brazilian (fried eggs, cooked beans, beef, candy, string beans, fried cassava), Mediterranean (fruit, vegetables, olive oil and nuts) and traditional meal (rice and beans). Moderate and high adherences to the Mediterranean pattern were protective factors to general and central obesity (WHR). High adherence to prudent was also protective to central obesity (WC). Conclusion: adherences to the dietary patterns prudent and Mediterranean were protective factors to general and central obesity in elderly.
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Schwingshackl L, Hoffmann G. Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies. Lipids Health Dis 2014; 13:154. [PMID: 25274026 PMCID: PMC4198773 DOI: 10.1186/1476-511x-13-154] [Citation(s) in RCA: 264] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/26/2014] [Indexed: 12/12/2022] Open
Abstract
Background The aim of the present meta-analysis of cohort studies was to focus on monounsaturated fat (MUFA) and cardiovascular disease, cardiovascular mortality as well as all-cause mortality, and to distinguish between the different dietary sources of MUFA. Methods Literature search was performed using the electronic databases PUBMED, and EMBASE until June 2nd, 2014. Study specific risk ratios and hazard ratios were pooled using a inverse variance random effect model. Results Thirty-two cohort studies (42 reports) including 841,211 subjects met the objectives and were included. The comparison of the top versus bottom third of the distribution of a combination of MUFA (of both plant and animal origin), olive oil, oleic acid, and MUFA:SFA ratio in each study resulted in a significant risk reduction for: all-cause mortality (RR: 0.89, 95% CI 0.83, 0.96, p = 0.001; I2 = 64%), cardiovascular mortality (RR: 0.88, 95% CI 0.80, 0.96, p = 0.004; I2 = 50%), cardiovascular events (RR: 0.91, 95% CI 0.86, 0.96, p = 0.001; I2 = 58%), and stroke (RR: 0.83, 95% CI 0.71, 0.97, p = 0.02; I2 = 70%). Following subgroup analyses, significant associations could only be found between higher intakes of olive oil and reduced risk of all-cause mortality, cardiovascular events, and stroke, respectively. The MUFA subgroup analyses did not reveal any significant risk reduction. Conclusion The results indicate an overall risk reduction of all-cause mortality (11%), cardiovascular mortality (12%), cardiovascular events (9%), and stroke (17%) when comparing the top versus bottom third of MUFA, olive oil, oleic acid, and MUFA:SFA ratio. MUFA of mixed animal and vegetable sources per se did not yield any significant effects on these outcome parameters. However, only olive oil seems to be associated with reduced risk. Further research is necessary to evaluate specific sources of MUFA (i.e. plant vs. animal) and cardiovascular risk. Electronic supplementary material The online version of this article (doi:10.1186/1476-511X-13-154) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lukas Schwingshackl
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Althanstraße 14 (UZAII), A-1090 Vienna, Austria.
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Martínez-González MA, Zazpe I, Razquin C, Sánchez-Tainta A, Corella D, Salas-Salvadó J, Toledo E, Ros E, Muñoz MÁ, Recondo J, Gómez-Gracia E, Fiol M, Lapetra J, Buil-Cosiales P, Serra-Majem L, Pinto X, Schröder H, Tur JA, Sorli JV, Lamuela-Raventós RM, Estruch R. Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Clin Nutr 2014; 34:859-67. [PMID: 25304294 DOI: 10.1016/j.clnu.2014.09.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/29/2014] [Accepted: 09/03/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS There is little evidence on post hoc-derived dietary patterns (DP) and all-cause mortality in Southern-European populations. Furthermore, the potential effect modification of a DP by a nutritional intervention has not been sufficiently assessed. We assessed the association between a posteriori defined baseline major DP and total mortality or cardiovascular events within each of the three arms of a large primary prevention trial (PREDIMED) where participants were randomized to two active interventions with Mediterranean-type diets or to a control group (allocated to a low-fat diet). DESIGN We followed-up 7216 participants for a median of 4.3 years. A validated 137-item food-frequency questionnaire was administered. Baseline DP were ascertained through factor analysis based on 34 predefined groups. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) for cardiovascular disease (CVD) or mortality across quartiles of DP within each of the three arms of the trial. RESULTS We identified two major baseline DP: the first DP was rich in red and processed meats, alcohol, refined grains and whole dairy products and was labeled Western dietary pattern (WDP). The second DP corresponded to a "Mediterranean-type" dietary pattern (MDP). During follow-up, 328 participants died. After controlling for potential confounders, higher baseline adherence to the MDP was associated with lower risk of CVD (adjusted HR for fourth vs. first quartile: 0.52; 95% CI (Confidence Interval): 0.36, 0.74; p-trend <0.001) and all-cause mortality (adjusted HR: 0.53; 95% CI: 0.38, 0.75; p-trend <0.001), regardless of the allocated arm of the trial. An increasing mortality rate was found across increasing quartiles of the WDP in the control group (allocated to a low-fat diet), though the linear trend was not statistically significant (p = 0.098). CONCLUSIONS Higher adherence to an empirically-derived MDP at baseline was associated with a reduced risk of CVD and mortality in the PREDIMED trial regardless of the allocated arm. The WDP was not associated with higher risk of mortality or cardiovascular events.
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Affiliation(s)
- Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain.
| | - Itziar Zazpe
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Nutrition and Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Ana Sánchez-Tainta
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain
| | - Dolores Corella
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain
| | - Emilio Ros
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miguel Ángel Muñoz
- Unitat de Suport a la Recerca, División de Atención Primaria de Salud, Institut Català de la Salut e IDIAP-Jordi Gol, Barcelona, Spain; Departamento de Pediatría, Obstetricia, Ginecología y Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier Recondo
- Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Enrique Gómez-Gracia
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Preventive Medicine, University of Malaga, Malaga, Spain
| | - Miquel Fiol
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Pilar Buil-Cosiales
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Xavier Pinto
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Helmut Schröder
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar-IMIM, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Spain
| | - Josep A Tur
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Fundamental Biology & Health Sciences, University of Balearic Islands, Spain
| | - José V Sorli
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Rosa M Lamuela-Raventós
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Nutrition and Food Science, School of Pharmacy, XaRTA, INSA, University of Barcelona, Barcelona, Spain
| | - Ramón Estruch
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
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Vormund K, Braun J, Rohrmann S, Bopp M, Ballmer P, Faeh D. Mediterranean diet and mortality in Switzerland: an alpine paradox? Eur J Nutr 2014; 54:139-48. [PMID: 24710740 DOI: 10.1007/s00394-014-0695-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 03/27/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE Reports on the protective effect of a Mediterranean diet on mortality usually refer to populations from Mediterranean countries, leaving uncertain whether really diet is the fundamental cause. Our aim was to examine the effect of a Mediterranean diet on mortality in Switzerland, a country combining cultural influences from Mediterranean and Central European countries within a common national health and statistical registry. METHODS In this prospective investigation, we included 17,861 men and women aged ≥16 years who participated 1977-1993 in health studies and were followed up for survival until 2008 by anonymous record linkage with the Swiss National Cohort. A 9-point score Mediterranean Diet Score (MDS) was used to assess adherence to a Mediterranean diet. Mortality hazard ratios (HR) and 95% confidence intervals (CIs) were calculated by using Cox regression models adjusted for age, sex, survey wave, marital status, smoking, body mass index, language region and nationality. RESULTS In all language regions, MDS was inversely associated with mortality. Consumption of dairy products was also consistently associated with lower mortality. When categorizing dairy food consumption as beneficial instead of harmful, this association between MDS and mortality increased in strength and was partly statistically significant. For all causes of death combined (HR for a one-point increase in MDS 0.96, 95% CI 0.94-0.98), in men (0.94, 0.92-0.97), in women (0.98, 0.95-1.02) for cardiovascular diseases (CVD, 0.96, 0.92-0.99; 0.95, 0.90-1.00; 0.98, 0.92-1.04) and for cancer (0.95, 0.92-0.99; 0.92, 0.88-0.97; 0.98, 0.93-1.04). CONCLUSIONS Stronger adherence to a Mediterranean diet was associated with lower all-cause, CVD and cancer mortality, largely independently of cultural background. These associations were primary due to the effect in men. Our finding of a beneficial rather than a deleterious impact of dairy products consumption prompts at considering culturally adapted Mediterranean diet recommendations. However, results should be interpreted with caution since only a crude 1-day dietary estimate was available to assess individuals' habitual dietary intake.
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Tognon G, Hebestreit A, Lanfer A, Moreno LA, Pala V, Siani A, Tornaritis M, De Henauw S, Veidebaum T, Molnár D, Ahrens W, Lissner L. Mediterranean diet, overweight and body composition in children from eight European countries: cross-sectional and prospective results from the IDEFICS study. Nutr Metab Cardiovasc Dis 2014; 24:205-213. [PMID: 23870847 DOI: 10.1016/j.numecd.2013.04.013] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 04/17/2013] [Accepted: 04/27/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND & AIMS A Mediterranean-like dietary pattern has been shown to be inversely associated with many diseases, but its role in early obesity prevention is not clear. We aimed to determine if this pattern is common among European children and whether it is associated with overweight and obesity. METHODS AND RESULTS The IDEFICS study recruited 16,220 children aged 2-9 years from study centers in eight European countries. Weight, height, waist circumference, and skinfolds were measured at baseline and in 9114 children of the original cohort after two years. Diet was evaluated by a parental questionnaire reporting children's usual consumption of 43 food items. Adherence to a Mediterranean-like diet was calculated by a food frequency-based Mediterranean Diet Score (fMDS). The highest fMDS levels were observed in Sweden, the lowest in Cyprus. High scores were inversely associated with overweight including obesity (OR = 0.85, 95% CI: 0.77; 0.94) and percent fat mass (β = -0.22, 95% CI: -0.43; -0.01) independently of age, sex, socioeconomic status, study center and physical activity. High fMDS at baseline protected against increases in BMI (OR = 0.87, 95% CI: 0.78; 0.98), waist circumference (OR = 0.87, 95% CI: 0.77; 0.98) and waist-to-height ratio (OR = 0.88, 95% CI: 0.78; 0.99) with a similar trend observed for percent fat mass (p = 0.06). CONCLUSIONS Although a Mediterranean dietary pattern is inversely associated with childhood obesity, it is not common in children living in the Mediterranean region and should therefore be advocated as part of EU obesity prevention strategies.
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Affiliation(s)
- G Tognon
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - A Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - A Lanfer
- Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - V Pala
- Nutritional Epidemiology Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Siani
- Institute of Food Sciences, Unit of Epidemiology and Population Genetics, National Research Council, Avellino, Italy
| | - M Tornaritis
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - S De Henauw
- Department of Public Health, Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - T Veidebaum
- National Institute for Health Development, Tallin, Estonia
| | - D Molnár
- Department of Pediatrics, Medical Faculty, University of Pécs, Hungary
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, Bremen, Germany; University of Bremen, Bremen, Germany
| | - L Lissner
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Zazpe I, Sánchez-Tainta A, Toledo E, Sánchez-Villegas A, Martínez-González MÁ. Dietary Patterns and Total Mortality in a Mediterranean Cohort: The SUN Project. J Acad Nutr Diet 2014; 114:37-47. [DOI: 10.1016/j.jand.2013.07.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
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Abstract
The aim of the present study was to determine whether the Mediterranean Diet Score (MDS) is associated with reduced total mortality, cardiovascular incidence and mortality in a Danish population. Analyses were performed on 1849 men and women sampled during the 1982-83 Danish MONICA (MONItoring trends and determinants of Cardiovascular disease) population study, whose diet was assessed by means of a validated 7 d food record. The adherence to a Mediterranean dietary pattern was calculated by three different scores: one based on a classification excluding ingredients from mixed dishes and recipes (score 1); another based on a classification including ingredients (score 2); the last one based on a variant of the latter including wine instead of alcohol intake (score 3). The association between these scores and, respectively, total mortality, cardiovascular incidence and mortality was tested by a Cox proportional hazards model adjusted for several potential confounders of the association. Generally, all three scores were inversely associated with the endpoints, although associations with score 1 did not reach statistical significance. Score 2 was inversely associated with total mortality (hazard ratio 0·94; 95 % CI 0·88, 0·99). This association was confirmed for total cardiovascular as well as myocardial infarction (MI) incidence and mortality, but not for stroke. Score 3 was slightly more associated with the same outcomes. All associations were also resistant to adjustment for covariates related to potential CVD pathways, such as blood lipids, blood pressure and weight change after 11 years of follow-up. In a Danish cohort, the MDS was inversely associated with total mortality and with cardiovascular and MI incidence and mortality, but not with stroke incidence or mortality.
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LaRocca TJ, Gioscia-Ryan RA, Hearon CM, Seals DR. The autophagy enhancer spermidine reverses arterial aging. Mech Ageing Dev 2013; 134:314-20. [PMID: 23612189 DOI: 10.1016/j.mad.2013.04.004] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 02/26/2013] [Accepted: 04/13/2013] [Indexed: 01/14/2023]
Abstract
Arterial aging, characterized by stiffening of large elastic arteries and the development of arterial endothelial dysfunction, increases cardiovascular disease (CVD) risk. We tested the hypothesis that spermidine, a nutrient associated with the anti-aging process autophagy, would improve arterial aging. Aortic pulse wave velocity (aPWV), a measure of arterial stiffness, was ~20% greater in old (O, 28 months) compared with young C57BL6 mice (Y, 4 months, P<0.05). Arterial endothelium-dependent dilation (EDD), a measure of endothelial function, was ~25% lower in O (P<0.05 vs. Y) due to reduced nitric oxide (NO) bioavailability. These impairments were associated with greater arterial oxidative stress (nitrotyrosine), superoxide production, and protein cross-linking (advanced glycation end-products, AGEs) in O (all P<0.05). Spermidine supplementation normalized aPWV, restored NO-mediated EDD and reduced nitrotyrosine, superoxide, AGEs and collagen in O. These effects of spermidine were associated with enhanced arterial expression of autophagy markers, and in vitro experiments demonstrated that vascular protection by spermidine was autophagy-dependent. Our results indicate that spermidine exerts a potent anti-aging influence on arteries by increasing NO bioavailability, reducing oxidative stress, modifying structural factors and enhancing autophagy. Spermidine may be a promising nutraceutical treatment for arterial aging and prevention of age-associated CVD.
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Affiliation(s)
- Thomas J LaRocca
- Department of Integrative Physiology, University of Colorado, Boulder, CO 80309, USA
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Poole S, Blades M. The Mediterranean diet – a review of evidence relevant to the food and drink industry. ACTA ACUST UNITED AC 2013. [DOI: 10.1108/00346651311295851] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The mouse as a model organism in aging research: usefulness, pitfalls and possibilities. Ageing Res Rev 2013; 12:8-21. [PMID: 22543101 DOI: 10.1016/j.arr.2012.03.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 03/20/2012] [Accepted: 03/30/2012] [Indexed: 12/29/2022]
Abstract
The mouse has become the favorite mammalian model. Among the many reasons for this privileged position of mice is their genetic proximity to humans, the possibilities of genetically manipulating their genomes and the availability of many tools, mutants and inbred strains. Also in the field of aging, mice have become very robust and reliable research tools. Since laboratory mice have a life expectancy of only a few years, genetic approaches and other strategies for intervening in aging can be tested by examining their effects on life span and aging parameters during the relatively short period of, for example, a PhD project. Moreover, experiments on mice with an extended life span as well as on mice demonstrating signs of (segmental) premature aging, together with genetic mapping strategies, have provided novel insights into the fundamental processes that drive aging. Finally, the results of studies on caloric restriction and pharmacological anti-aging treatments in mice have a high degree of relevance to humans. In this paper, we review a number of recent genetic mapping studies that have yielded novel insights into the aging process. We discuss the value of the mouse as a model for testing interventions in aging, such as caloric restriction, and we critically discuss mouse strains with an extended or a shortened life span as models of aging.
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Campa D, De Rango F, Carrai M, Crocco P, Montesanto A, Canzian F, Rose G, Rizzato C, Passarino G, Barale R. Bitter taste receptor polymorphisms and human aging. PLoS One 2012; 7:e45232. [PMID: 23133589 PMCID: PMC3487725 DOI: 10.1371/journal.pone.0045232] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 08/17/2012] [Indexed: 01/10/2023] Open
Abstract
Several studies have shown that genetic factors account for 25% of the variation in human life span. On the basis of published molecular, genetic and epidemiological data, we hypothesized that genetic polymorphisms of taste receptors, which modulate food preferences but are also expressed in a number of organs and regulate food absorption processing and metabolism, could modulate the aging process. Using a tagging approach, we investigated the possible associations between longevity and the common genetic variation at the three bitter taste receptor gene clusters on chromosomes 5, 7 and 12 in a population of 941 individuals ranging in age from 20 to 106 years from the South of Italy. We found that one polymorphism, rs978739, situated 212 bp upstream of the TAS2R16 gene, shows a statistically significant association (p = 0.001) with longevity. In particular, the frequency of A/A homozygotes increases gradually from 35% in subjects aged 20 to 70 up to 55% in centenarians. These data provide suggestive evidence on the possible correlation between human longevity and taste genetics.
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Affiliation(s)
- Daniele Campa
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Tognon G, Nilsson LM, Lissner L, Johansson I, Hallmans G, Lindahl B, Winkvist A. The Mediterranean diet score and mortality are inversely associated in adults living in the subarctic region. J Nutr 2012; 142:1547-53. [PMID: 22739377 DOI: 10.3945/jn.112.160499] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The Mediterranean diet has been widely promoted and may be associated with chronic disease prevention and a better overall health status. The aim of this study was to evaluate whether the Mediterranean diet score inversely predicted total or cause-specific mortality in a prospective population study in Northern Sweden (Västerbotten Intervention Program). The analyses were performed in 77,151 participants (whose diet was measured by means of a validated FFQ) by Cox proportional hazard models adjusted for several potential confounders. The Mediterranean diet score was inversely associated with all-cause mortality in men [HR = 0.96 (95% CI = 0.93, 0.99)] and women [HR = 0.95 (95% CI = 0.91, 0.99)], although not in obese men. In men, but not in women, the score was inversely associated with total cancer mortality [HR = 0.92 (95% CI = 0.87, 0.98)], particularly for pancreas cancer [HR = 0.82 (95% CI = 0.68, 0.99)]. Cardiovascular mortality was inversely associated with diet only in women [HR = 0.90 (95% CI = 0.82, 0.99)]. Except for alcohol [HR = 0.83 (95% CI = 0.76, 0.90)] and fruit intake [HR = 0.90 (95% CI = 0.83, 0.98)], no food item of the Mediterranean diet score independently predicted mortality. Higher scores were associated with increasing age, education, and physical activity. Moreover, healthful dietary and lifestyle-related factors additively decreased the mortality likelihood. Even in a subarctic region, increasing Mediterranean diet scores were associated with a longer life, although the protective effect of diet was of small magnitude compared with other healthful dietary and lifestyle-related factors examined.
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Affiliation(s)
- Gianluca Tognon
- Public Health Epidemiology Unit, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
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