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Annunziata G, Caprio M, Verde L, Carella AM, Camajani E, Benvenuto A, Paolini B, De Nicola L, Aucella F, Bellizzi V, Barberi S, Grassi D, Fogacci F, Colao A, Cicero AFG, Prodam F, Aimaretti G, Muscogiuri G, Barrea L. Nutritional assessment and medical dietary therapy for management of obesity in patients with non-dialysis chronic kidney disease: a practical guide for endocrinologist, nutritionists and nephrologists. A consensus statement from the Italian society of endocrinology (SIE), working group of the club nutrition-hormones and metabolism; the Italian society of nutraceuticals (SINut), club ketodiets and nutraceuticals "KetoNut-SINut"; and the Italian society of nephrology (SIN). J Endocrinol Invest 2024:10.1007/s40618-024-02446-8. [PMID: 39292364 DOI: 10.1007/s40618-024-02446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/19/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE Chronic kidney disease (CKD) is a serious health concern with an estimated prevalence of about 13.4% worldwide. It is cause and consequence of various comorbidities, including cardiovascular diseases. In parallel, common pathological conditions closely related to ageing and unhealthy dietary habits increase the risk of CKD development and progression, including type 2 diabetes and obesity. Among these, obesity is either independent risk factor for new onset kidney disease or accelerates the rate of decline of kidney function by multiple mechanisms. Therefore, the role of diets aimed at attaining weight loss in patients with obesity is clearly essential to prevent CKD as to slow disease progression. Various dietary approaches have been licensed for the medical dietary therapy in CKD, including low-protein diet and Mediterranean diet. Interestingly, emerging evidence also support the use of low-carbohydrate/ketogenic diet (LCD/KD) in these patients. More specifically, LCD/KDs may efficiently promote weight loss, improve metabolic parameters, and reduce inflammation and oxidative stress, resulting in a dietary strategy that act globally in managing collateral conditions that are directly and indirectly related to the kidney function. CONCLUSION This consensus statement from the Italian Society of Endocrinology (SIE), working group of the Club Nutrition - Hormones and Metabolism; the Italian Society of Nutraceuticals (SINut), Club Ketodiets and Nutraceuticals "KetoNut-SINut"; and the Italian Society of Nephrology (SIN) is intended to be a guide for Endocrinologist, Nutritionists and Nephrologist who deal with the management of patients with obesity with non-dialysis CKD providing a practical guidance on assessing nutritional status and prescribing the optimal diet in order to best manage obesity to prevent CKD and its progression to dialysis.
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Affiliation(s)
- G Annunziata
- Facoltà di Scienze Umane, della Formazione e dello Sport, Università Telematica Pegaso, Via Porzio, Centro Direzionale, Isola F2, 80143, Naples, Italy
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy
- Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166, Rome, Italy
| | - L Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - A M Carella
- Facoltà di Scienze Umane, della Formazione e dello Sport, Università Telematica Pegaso, Via Porzio, Centro Direzionale, Isola F2, 80143, Naples, Italy
- Internal Medicine Department, "T. Masselli-Mascia" Hospital-San Severo (Foggia), Foggia, Italy
| | - E Camajani
- Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166, Rome, Italy
| | - A Benvenuto
- Internal Medicine Department, "T. Masselli-Mascia" Hospital-San Severo (Foggia), Foggia, Italy
| | - B Paolini
- Department of Innovation, experimentation and clinical research, Unit of dietetics and clinical nutrition, S. Maria Alle Scotte Hospital, University of Siena, Siena, SI, Italy
| | - L De Nicola
- Nephrology and Dialysis Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Aucella
- Nephrology and Dialysis Unit, "Casa Sollievo Della Sofferenza" Foundation, Scientific Institut for Reserch and Health Care, San Giovanni Rotondo, FG, Italy
| | - V Bellizzi
- Nephrology and Dialysis Division, AORN "Sant'Anna E San Sebastiano" Hospital, Caserta, Italy
| | - S Barberi
- Department of Clinical and Molecular Medicine, Renal Unit, Sant'Andrea University Hospital, "Sapienza" University of Rome, Rome, Italy
| | - D Grassi
- Internal Medicine Unit-Val Vibrata Hospital-Sant'Omero (TE)-Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Fogacci
- Hypertension and Cardiovascular Risk Factors Research Centre, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40100, Bologna, Italy
- Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, 40138, Bologna, Italy
| | - A Colao
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute e Allo Sviluppo Sostenibile", University Federico II, 80131, Naples, Italy
| | - A F G Cicero
- Hypertension and Cardiovascular Risk Factors Research Centre, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40100, Bologna, Italy
- Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, 40138, Bologna, Italy
| | - F Prodam
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - G Aimaretti
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - G Muscogiuri
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Cattedra Unesco "Educazione Alla Salute e Allo Sviluppo Sostenibile", University Federico II, 80131, Naples, Italy.
| | - L Barrea
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento di Benessere, Nutrizione e Sport, Università Telematica Pegaso, Centro Direzionale, Via Porzio, Isola F2, 80143, Naples, Italy
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Cheng X, Sun S, Chen M, Zhou X, Rao M, Guo D, Xie J, Huang Q, Su L. Evaluating the efficacy of intermittent fasting and exercise combinations for weight loss: A network meta-analysis. Obes Rev 2024:e13834. [PMID: 39275892 DOI: 10.1111/obr.13834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/11/2024] [Accepted: 08/18/2024] [Indexed: 09/16/2024]
Abstract
OBJECTIVE The purpose of this study is to utilize network meta-analysis (NMA) to synthesize relevant randomized controlled trials (RCTs) and evaluate the most effective intermittent fasting (IF) combined with exercise interventions for weight loss. METHODS This study searched five databases up until April 2024, obtaining RCTs that investigated the effects of intermittent fasting (IF) combined with exercise. The quality of the literature was assessed using the Cochrane tool, followed by a random-effects statistical analysis of each intervention. Eventually, a NMA was conducted to compare the effectiveness of each intervention on weight loss, thereby determining their combined effectiveness on reducing weight. RESULTS A total of nine trials, comparing 12 interventions involving 570 participants, were included. All interventions significantly reduced body weight (BW) and fat mass (FM) compared to the control (CON) group. In terms of BW reduction, the alternate-day fasting + moderate-intensity continuous training (ADF + MICT) intervention had the highest surface under the cumulative ranking curve average (SUCRA) score 88.1(MD: -4.44,95% CI -5.95, -2.92). Furthermore, for improving FM, the ADF + MICT intervention also had the highest SUCRA score 92.7(MD: -3.65,95% CI -5.05, -2.25), making it the optimal intervention for improving FM. CONCLUSION The NMA results indicate that all interventions are effective in reducing weight. Among them, ADF + MICT is the most effective strategy for reducing BW, and it is also the best approach for improving FM.
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Affiliation(s)
- Xiaoyan Cheng
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Shunli Sun
- Jiangxi Province Sports Science and Medical Center, Nanchang, China
| | - Maolin Chen
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Xinyou Zhou
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Mingxin Rao
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Dongjuan Guo
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Jinfeng Xie
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Qiang Huang
- Physical Education of College, Jiangxi Normal University, Nanchang, China
| | - Liqiang Su
- Physical Education of College, Jiangxi Normal University, Nanchang, China
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Rose L, Wood A, Gill T. Gender differences in adherence and retention in Mediterranean diet interventions with a weight-loss outcome: A systematic review and meta-analysis. Obes Rev 2024:e13824. [PMID: 39228092 DOI: 10.1111/obr.13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 08/13/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND The Mediterranean diet has been shown to be effective in improving health outcomes and for weight loss. Adherence and retention in dietary interventions are critical to ensure the benefits of the exposure. No studies to date have assessed the role of gender in understanding participants who remain engaged and adhere to Mediterranean diet interventions. AIMS This study aimed to explore gender differences in recruitment, adherence, and retention for Mediterranean diet interventions and whether these were associated with differences in weight-loss outcomes. METHODS A systematic search was completed in EMBASE, Medline, Cochrane, and clinicaltrials.gov from inception to March 2023. A meta-analysis of studies reporting retention by gender was completed using odds ratios comparing female to male dropout numbers. A second meta-analysis was completed for adherence comparing standardized mean difference of Mediterranean diet scores stratified by gender. Newcastle Ottawa score was used to assess risk of bias. RESULTS A total of 70 articles were included in the systematic review with six articles included in the adherence meta-analysis and nine in the dropout meta-analysis. No statistically significant difference was shown for adherence or retention by gender. Weight-loss outcomes were inconsistent. CONCLUSIONS The results of the study suggest a higher adherence and lower dropout for women although these results were not statistically significant. Future studies of Mediterranean diet interventions should include adherence, retention, and weight-loss data stratified by gender to allow further investigation of this relationship.
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Affiliation(s)
- Laekin Rose
- Nutrition and Dietetics, School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Amelia Wood
- Nutrition and Dietetics, School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Timothy Gill
- Charles Perkins Centre, D17, University of Sydney, Camperdown, Australia
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Rusch C, Beke M, Nieves C, Mai V, Stiep T, Tholanikunnel T, Ramirez-Zamora A, Hess CW, Langkamp-Henken B. Promotion of a Mediterranean Diet Alters Constipation Symptoms and Fecal Calprotectin in People with Parkinson's Disease: A Randomized Controlled Trial. Nutrients 2024; 16:2946. [PMID: 39275262 PMCID: PMC11396875 DOI: 10.3390/nu16172946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/21/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Parkinson's disease is associated with gastrointestinal (GI) dysfunction, including constipation symptoms and abnormal intestinal permeability and inflammation. A Mediterranean diet (MediDiet) may aid in disease management. This parallel, randomized, controlled trial in people with Parkinson's (PwP) and constipation symptoms compared a MediDiet against standard of care on change in constipation symptoms, dietary intake, and fecal zonulin and calprotectin concentrations as markers of intestinal permeability and inflammation, respectively. Participants were randomized to either standard of care for constipation (control; n = 17, 65.1 ± 2.2 years) or a MediDiet plus standard of care (n = 19, 68.8 ± 1.4 years) for 8 weeks. Constipation scores decreased with both interventions (p < 0.01), but changes from baseline were not different between groups (MediDiet, -0.5 [-1.0, 0]; control, -0.8 [-1.0, 0.2]; median [25th, 75th]; p = 0.60). The MediDiet group had a higher intake of dietary fiber at week 4 than the control group (13.1 ± 0.7 g/1000 kcal vs. 9.8 ± 0.7 g/1000 kcal; p < 0.001). No differences in fecal zonulin were observed between groups (p = 0.33); however, fecal calprotectin tended to be lower in the MediDiet group at week 8 (45.8 ± 15.1 µg/g vs. 93.9 ± 26.8 µg/g; p = 0.05). The MediDiet and standard interventions reduced constipation symptoms; however, the MediDiet provided additional benefit of increased dietary fiber intake and less intestinal inflammation.
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Affiliation(s)
- Carley Rusch
- Food Science and Human Nutrition Department, Center for Nutritional Sciences, University of Florida, Gainesville, FL 32611-0370, USA
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610-0236, USA
| | - Matthew Beke
- Food Science and Human Nutrition Department, Center for Nutritional Sciences, University of Florida, Gainesville, FL 32611-0370, USA
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610-0236, USA
| | - Carmelo Nieves
- Food Science and Human Nutrition Department, Center for Nutritional Sciences, University of Florida, Gainesville, FL 32611-0370, USA
| | - Volker Mai
- Department of Epidemiology, Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610-0009, USA
| | - Tamara Stiep
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610-0236, USA
| | - Tracy Tholanikunnel
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610-0236, USA
| | - Adolfo Ramirez-Zamora
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610-0236, USA
| | - Christopher W Hess
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL 32610-0236, USA
| | - Bobbi Langkamp-Henken
- Food Science and Human Nutrition Department, Center for Nutritional Sciences, University of Florida, Gainesville, FL 32611-0370, USA
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Mehok LE, Walsh KT, Miller MM, Anastas TM, Hirsh AT. Exercise and Dietary Recommendations for Women with Chronic Pain: What's Weight and Race Got To Do with It? THE JOURNAL OF PAIN 2024; 25:104505. [PMID: 38484856 PMCID: PMC11283970 DOI: 10.1016/j.jpain.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/08/2024] [Accepted: 03/03/2024] [Indexed: 05/12/2024]
Abstract
Exercise and diet are beneficial for pain, yet many patients do not receive such recommendations from providers. This may be due to biases related to gender, race, and weight. We recruited medical students (N = 90) to view videos of women with chronic back pain performing a functional task; patients varied by weight (overweight/obese) and race (Black/White). For each woman patient, providers rated their likelihood of recommending exercises or dietary changes. Ratings significantly differed across recommendations (F(2.75, 244.72) = 6.19, P < .01) in that providers were more likely to recommend flexibility exercises than aerobic exercises and dietary changes and were more likely to recommend strength exercises than dietary changes. Results also indicated that women with obesity were more likely to receive aerobic (F(1,89) = 17.20, P < .01), strength (F(1,89) = 6.08, P = .02), and dietary recommendations (F(1,89) = 37.56, P < .01) than were women with overweight. Additionally, White women were more likely to receive a recommendation for flexibility exercises (F(1,89) = 4.92, P = .03) than Black women. Collectively, these findings suggest that providers' exercise and dietary recommendations for women with chronic pain are influenced by the weight status and racial identity of the patient. Future studies are needed to identify the reasons underlying these systematic differences, including the stereotypes and attitudes that may be driving these effects. PERSPECTIVE: This article presents results on how patient weight and race impact providers' exercise and diet recommendations for women with chronic back pain. Provider recommendations for these modalities may be systematically biased in a way that impedes care and impacts patient functioning.
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Affiliation(s)
- Lauren E. Mehok
- Behavioral Health Care Line, New Mexico Veterans Affairs Healthcare System, Albuquerque, NM
| | - Kaitlyn T. Walsh
- Department of Psychology, Indiana University Indianapolis (IUI), Indianapolis, IN
| | - Megan M. Miller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tracy M. Anastas
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Adam T. Hirsh
- Department of Psychology, Indiana University Indianapolis (IUI), Indianapolis, IN
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Gletsu-Miller N, Henschel B, Tekwe CD, Thiagarajah K. A Cross-Sectional Study on the Association of Walnut Consumption with Obesity and Relative Fat Mass among United States Adolescents and Young Adults in NHANES (2003-2020). Curr Dev Nutr 2024; 8:104407. [PMID: 39157012 PMCID: PMC11324821 DOI: 10.1016/j.cdnut.2024.104407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/17/2024] [Accepted: 06/21/2024] [Indexed: 08/20/2024] Open
Abstract
Background Walnuts contain nutrients and phytochemicals that can promote metabolic health. However, the high energy content of walnuts along with other nuts raises the concern that consuming nuts promotes obesity. Objectives We sought to investigate the associations between consumption of walnuts as well as other nuts and measures of obesity in adolescents and young adults. Methods This study included 8874 adolescents (12-19 y) and 10,323 young adults (20-39 y) from 8 waves of National Health and Nutrition Examination Survey data (2003-2020). The associations of consumption of 1) walnuts only (WO); 2) walnuts with other nuts (WON); 3) other nuts (ON); and 4) no nuts (NN) with obesity status and relative fat mass (RFM) were assessed using logistic and linear regressions stratified by age group and sex. Sample weights were used in all statistical analyses. Results The mean daily intake of walnuts was not different between the 2 walnut consumption groups within each age group (adolescents: 2.18 [standard error (SE) 0.14] g; P = 0.917; young adults: 4.23 [0.37] g; P = 0.682). The WON group had the lowest prevalence of obesity (adolescents: 8.3%; young adults: 21.1%) while the NN group had the highest prevalence (adolescents: 24.1%; young adults: 35.4%). The models indicated lower odds of obesity in adolescent girls (odds ratio [OR]: 0.27; P < 0.05) and young adult women (OR: 0.58; P < 0.05) who consumed WON than in those who consumed NN. In both young women and girls, RFM was significantly lower in the WON and ON groups than the NN group (P < 0.001). In young men, WON consumption was also associated with a lower RFM (OR: -1.24; 95% confidence interval: -2.21, -0.28) compared with NN consumption. Conclusions For adolescents girls and young women, dietary intake of walnuts combined with other nuts has the strongest inverse association with measures of obesity.
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Affiliation(s)
- Nana Gletsu-Miller
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Beate Henschel
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Carmen D Tekwe
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Krisha Thiagarajah
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States
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Kim HJ, Kwon O. Nutrition and exercise: Cornerstones of health with emphasis on obesity and type 2 diabetes management-A narrative review. Obes Rev 2024; 25:e13762. [PMID: 38715378 DOI: 10.1111/obr.13762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/22/2024] [Accepted: 04/06/2024] [Indexed: 07/11/2024]
Abstract
While a broad consensus exists that integrated nutrition and regular exercise are foundational for health maintenance and serve as a robust non-pharmacological strategy against cardiometabolic diseases, the nuanced interplay between these elements remains incompletely understood. Through multifaceted interactions, these factors profoundly influence primary metabolic organs, notably the skeletal muscle and adipose tissue. Despite the critical nature of this interactivity, a holistic understanding of the combined effects of physical activity and dietary practices is still emerging. This narrative review aims to elucidate the intertwined roles of nutrition and exercise. It provides a comprehensive overview of their synergistic dynamics and emphasizes the importance of a dual-focus approach in mitigating and managing cardiometabolic disorders, predominantly obesity and type 2 diabetes.
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Affiliation(s)
- Hye Jin Kim
- Laboratory of Developmental Biology and Genomics, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
- Korea Mouse Phenotyping Center (KMPC), Seoul, Republic of Korea
- Logme Inc., Seoul, Republic of Korea
| | - Oran Kwon
- Logme Inc., Seoul, Republic of Korea
- Department of Nutritional Science and Food Management, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
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Brown AGM, Adas S, de Jesus J, Farmer N, Fisher R, Pratt CA. Bridging the Gap: The Need to Implement Dietary Guidance to Address Cardiovascular Health. Nutrients 2024; 16:2125. [PMID: 38999873 PMCID: PMC11243232 DOI: 10.3390/nu16132125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the U.S. and globally. Research demonstrates that diet is a leading contributor to the development of CVD, its prevention and management, and the overall promotion of cardiovascular health. This article describes the current state of the evidence, including research on the DASH and Mediterranean diets to promote cardiovascular health and prevent CVD. The article suggests approaches to implement evidence-based diets and federal dietary guidance to promote the adoption and integration of these interventions in both community and clinical settings. It highlights the current U.S. federal interest in "Food is Medicine" and its importance in addressing diet-related chronic diseases and promoting cardiovascular health.
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Affiliation(s)
- Alison G M Brown
- National Heart Lung and Blood Institute, Division of Cardiovascular Sciences, U.S. Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Samantha Adas
- Office of Nutrition Research, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD 20852, USA
| | - Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health Clinical Center, U.S. Department of Health and Human Services, Bethesda, MD 20892, USA
| | - Rachel Fisher
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD 20852, USA
| | - Charlotte A Pratt
- National Heart Lung and Blood Institute, Division of Cardiovascular Sciences, U.S. Department of Health and Human Services, Bethesda, MD 20892, USA
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Mao D, Li G, Liang M, Wang S, Ren X. Dietary patterns and multiple chronic diseases in older adults. Nutr Metab (Lond) 2024; 21:36. [PMID: 38915027 PMCID: PMC11194917 DOI: 10.1186/s12986-024-00814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The prevalence rate of multiple chronic diseases among the elderly is relatively high, posing a risk to their health and also imposing a financial burden on them. Optimal dietary patterns have positive effects on multiple chronic diseases. This study aimed to identify dietary patterns associated with multiple chronic diseases in older adults. METHODS Dietary intake was assessed through two non-consecutive 24-hour dietary recalls. The presence of multiple chronic diseases was assessed based on the existence of dyslipidemia, hypertension, chronic kidney disease, sleep disorders, diabetes, moderate or severe depressive symptoms, and cognitive impairment, with two or more of these conditions being considered. Latent class analysis was used to identify types of multiple chronic diseases, and two-step cluster analysis was used to determine individual dietary patterns. Logistic regression analysis with robust standard errors was conducted to determine the associations between dietary patterns and types of multiple chronic diseases. RESULTS Three dietary patterns and three types of multiple chronic diseases were identified. Individuals following a diet rich in legumes, meat, vegetables and fruits (HLMVF dietary pattern) were 59% less likely to have the cardiometabolic cognitive impairment comorbidity (CCC) than those following a diet rich in milk and eggs but with low grain intake (HME-LG) (OR = 0.41, 95% CI: 0.27-0.64, P < 0.001) and 66% less likely to have the especially sleep disorders comorbidity (ESC) than those following a diet rich in grains but lacking milk and eggs (HG-LME) (OR = 0.34, 95% CI: 0.14-0.87, P < 0.05). DISCUSSION The HLMVF dietary pattern may serve as a healthy dietary pattern to reduce the incidence of multiple chronic diseases and should be promoted among the older adult population.
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Affiliation(s)
- Danhui Mao
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
- Health Management and Policy Research Center, School of Management, Shanxi Medical University, Taiyuan, China.
| | - Gongkui Li
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Moxuan Liang
- Health Management and Policy Research Center, School of Management, Shanxi Medical University, Taiyuan, China
| | - Shiyun Wang
- Health Management and Policy Research Center, School of Management, Shanxi Medical University, Taiyuan, China
| | - Xiaojun Ren
- Shanxi Bethune Hospital, Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
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Islam MA, Sehar U, Sultana OF, Mukherjee U, Brownell M, Kshirsagar S, Reddy PH. SuperAgers and centenarians, dynamics of healthy ageing with cognitive resilience. Mech Ageing Dev 2024; 219:111936. [PMID: 38657874 DOI: 10.1016/j.mad.2024.111936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
Graceful healthy ageing and extended longevity is the most desired goal for human race. The process of ageing is inevitable and has a profound impact on the gradual deterioration of our physiology and health since it triggers the onset of many chronic conditions like dementia, osteoporosis, diabetes, arthritis, cancer, and cardiovascular disease. However, some people who lived/live more than 100 years called 'Centenarians" and how do they achieve their extended lifespans are not completely understood. Studying these unknown factors of longevity is important not only to establish a longer human lifespan but also to manage and treat people with shortened lifespans suffering from age-related morbidities. Furthermore, older adults who maintain strong cognitive function are referred to as "SuperAgers" and may be resistant to risk factors linked to cognitive decline. Investigating the mechanisms underlying their cognitive resilience may contribute to the development of therapeutic strategies that support the preservation of cognitive function as people age. The key to a long, physically, and cognitively healthy life has been a mystery to scientists for ages. Developments in the medical sciences helps us to a better understanding of human physiological function and greater access to medical care has led us to an increase in life expectancy. Moreover, inheriting favorable genetic traits and adopting a healthy lifestyle play pivotal roles in promoting longer and healthier lives. Engaging in regular physical activity, maintaining a balanced diet, and avoiding harmful habits such as smoking contribute to overall well-being. The synergy between positive lifestyle choices, access to education, socio-economic factors, environmental determinants and genetic supremacy enhances the potential for a longer and healthier life. Our article aims to examine the factors associated with healthy ageing, particularly focusing on cognitive health in centenarians. We will also be discussing different aspects of ageing including genomic instability, metabolic burden, oxidative stress and inflammation, mitochondrial dysfunction, cellular senescence, immunosenescence, and sarcopenia.
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Affiliation(s)
- Md Ariful Islam
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Omme Fatema Sultana
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Upasana Mukherjee
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Malcolm Brownell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Sudhir Kshirsagar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA.
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11
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McHugh A, O'Connell E, Gurd B, Rae P, George ES, Kleckner AS, Baguley BJ. Mediterranean-style dietary interventions in adults with cancer: a systematic review of the methodological approaches, feasibility, and preliminary efficacy. Eur J Clin Nutr 2024; 78:463-476. [PMID: 38459161 PMCID: PMC11182747 DOI: 10.1038/s41430-024-01426-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Cancer and its treatments can lead to excess body fat, decreases in lean mass, cardiotoxicity, and other side effects. The Mediterranean diet (MED-diet) has the potential to improve clinical and supportive care outcomes. The aim of this systematic review was to evaluate the feasibility, safety, and efficacy of the MED-diet on health outcomes in adults with cancer. METHODS Three databases were searched from inception to February 2023. Eligible studies included randomised controlled trials testing a MED-diet intervention among adults with cancer. Within- and between-group differences for adherence, dietary intake and health outcomes were extracted. RESULTS Fifteen studies describing fourteen interventions were included, and there were considerable differences in study design and implementation of the MED-diet. Studies were predominately in women with a history of breast cancer. The MED-diet was safe with no adverse events reported, and feasible with high adherence and/or increases in MED-diet-compliant foods. The MED-diet when applied with an energy restriction below estimated requirements for weight loss demonstrated reductions in body weight (range: -3.9 kg to -0.7 kg). Interventions that showed significant reductions in body weight also improved quality of life. There is limited evidence to evaluating the MED-diet on cardiovascular and inflammatory markers, and heterogenous MED-diet prescriptions impede definitive conclusions on these health outcomes. CONCLUSION The MED-diet was feasible and safe for adults with cancer. There were reported benefits for weight loss following a MED-diet when an energy restriction was applied, however further evaluation to determine the effects on cardiometabolic biomarkers and other outcomes are required.
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Affiliation(s)
- Aoife McHugh
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Ellie O'Connell
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Bridie Gurd
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Paige Rae
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Elena S George
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Amber S Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Brenton J Baguley
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia.
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia.
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12
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Abdel-Aal NM, Kamil RM, Tayel DI, Hamed RH, Ragab MM, Abd El-Azeim AS. Impact of adding Mediterranean diet to aerobic and strengthening exercise program on pain, inflammation, and muscle performance in females with rheumatoid arthritis: a randomized controlled trial. Physiother Theory Pract 2024:1-17. [PMID: 38804549 DOI: 10.1080/09593985.2024.2358122] [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: 01/03/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND People with rheumatoid arthritis (RA) frequently use dietary interventions such as Mediterranean diet (MedDiet) and exercises to complement pharmacotherapy. OBJECTIVE To investigate the effect of adding MedDiet to a designed exercise program on quadriceps and hamstrings muscles performance, pain, C-reactive protein (CRP), handgrip strength, bodyweight, and function in females with RA. METHODS Sixty females were allocated randomly to the MedDiet plus exercise program (n = 30) or exercise program only (n = 30). The interventions continued for 6 months followed by 6 months of follow-up with no intervention. The primary outcome was the quadriceps and hamstrings muscles performance (agonist-antagonist ratio). The secondary outcomes were visual analog scale (VAS) for pain, CRP blood marker for inflammation, handheld dynamometer for handgrip strength, Health AssessmentQuestionnaire disability index (HAQ-DI) for function, and body weight. All outcomes were measured at baseline, 6-month post-intervention, and 12 months from baseline as a follow-up. RESULTS The MedDiet group showed statistically significant improvements in all the measured outcomes than the control group (p < .05) after 6 and 12 months. After 6 months of intervention, the mean±SD for agonist-antagonist ratio, pain, and HAQ-DI were 84.59 ± 5.33 and 69.92 ± 5.56 (p < .001, ƞ2 = 0.65), 42.33 ± 8.98 and 54.33 ± 10.06 (p < .001, ƞ2 = 0.3), 1.13 ± 0.48 and 1.9 ± 0.59 (p < .001, ƞ2 = 0.34) in the MedDiet and control groups, respectively. CONCLUSION Adding MedDiet to aerobic and strengthening exercise program improved quadriceps and hamstrings muscles performance, pain, functional ability, CRP, handgrip strength, and body weight. Consequently, Mediterranean diet should be considered as adjunctive therapy in treating females with RA.
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Affiliation(s)
- Nabil M Abdel-Aal
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ragia M Kamil
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Dalia I Tayel
- Department of Nutrition, High institute of public health Alexander University, Alexandria, Egypt
| | - Rania H Hamed
- Faculty of Physical Therapy, Nahda University, Beni Suef, Egypt
| | - Mohamed M Ragab
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Alshaymaa S Abd El-Azeim
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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13
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Díaz-González BV, Bautista-Castaño I, Hernández García E, Cornejo Torre J, Hernández Hernández JR, Serra-Majem L. Bariatric Surgery: An Opportunity to Improve Quality of Life and Healthy Habits. Nutrients 2024; 16:1466. [PMID: 38794704 PMCID: PMC11123891 DOI: 10.3390/nu16101466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Bariatric surgery therapy (BST) is an effective treatment for obesity; however, little is known about its impacts on health-related quality of life (HRQoL) and related factors. This study aimed to evaluate changes in HRQoL and its relationship with weight loss, depression status, physical activity (PA), and nutritional habits after BST. Data were obtained before and 18 months postprocedure from 56 obese patients who underwent BST. We administered four questionnaires: Short Form-36 health survey for HRQoL, 14-item MedDiet adherence questionnaire, Rapid Assessment of PA (RAPA) questionnaire, and Beck's Depression Inventory-II. Multivariable linear regression analysis was used to identify factors associated with improvement in HRQoL. After the surgery, MedDiet adherence and HRQoL improved significantly, especially in the physical component. No changes in PA were found. Patients without previous depression have better mental quality of life, and patients who lost more than 25% of %TBWL have better results in physical and mental quality of life. In the multivariable analysis, we found that %TBWL and initial PCS (inversely) were related to the improvement in PCS and initial MCS (inversely) with the MCS change. In conclusion, BST is an effective intervention for obesity, resulting in significant weight loss and improvements in HRQoL and nutritional habits.
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Affiliation(s)
- Beatriz Vanessa Díaz-González
- Triana Primary Health Care Center, Canarian Health Service, 35002 Las Palmas de Gran Canaria, Spain;
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (E.H.G.); (J.C.T.); (J.R.H.H.); (L.S.-M.)
| | - Inmaculada Bautista-Castaño
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (E.H.G.); (J.C.T.); (J.R.H.H.); (L.S.-M.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Elisabeth Hernández García
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (E.H.G.); (J.C.T.); (J.R.H.H.); (L.S.-M.)
| | - Judith Cornejo Torre
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (E.H.G.); (J.C.T.); (J.R.H.H.); (L.S.-M.)
| | - Juan Ramón Hernández Hernández
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (E.H.G.); (J.C.T.); (J.R.H.H.); (L.S.-M.)
- Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain
| | - Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain; (E.H.G.); (J.C.T.); (J.R.H.H.); (L.S.-M.)
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas de Gran Canaria, Spain
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14
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Damigou E, Georgoulis M, Chrysohoou C, Barkas F, Vlachopoulou E, Adamidis PS, Kravvariti E, Tsioufis C, Pitsavos C, Liberopoulos E, Sfikakis PP, Panagiotakos D. Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002-2022). Nutrients 2024; 16:1128. [PMID: 38674819 PMCID: PMC11054262 DOI: 10.3390/nu16081128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/28/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Evidence of the association between dietary habits and long-term body weight status is scarce. This study aimed to evaluate changes in Mediterranean-type diet (MTD) adherence in relation to body weight during 20 years of follow-up. Data from n = 1582 participants from the ATTICA cohort study (2002-2022) were used. MTD adherence was assessed via MedDietScore, and body weight status via body mass index (BMI) by 3 different measurements. We found that MTD adherence and changes in this adherence were inversely related to BMI at 20 years and the mean BMI during the 20-year follow-up. In multi-adjusted linear regression models, a 1/55 increase in baseline, 10-year, and 20-year MedDietScore was associated with a decrease of 0.05-0.13 kg/m2 in BMI at 20 years and of 0.08-0.09 kg/m2 in the mean BMI. Being consistently close to the MTD for 20 years was associated with a >90% decreased risk of maintaining overweight/obesity during the 20-year period. Strong, protective, long-lasting effects of the MTD were observed, even in those who deviated from the MTD in the follow-up (41% of the sample). Our results highlight the need to focus on the overall diet quality to minimize the risk of maintaining an excessive body weight during the life-course.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece; (E.D.); (M.G.)
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece; (E.D.); (M.G.)
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Elpiniki Vlachopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece; (E.D.); (M.G.)
| | - Petros S. Adamidis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Petros P. Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece; (E.D.); (M.G.)
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Sochacka K, Kotowska A, Lachowicz-Wiśniewska S. The Role of Gut Microbiota, Nutrition, and Physical Activity in Depression and Obesity-Interdependent Mechanisms/Co-Occurrence. Nutrients 2024; 16:1039. [PMID: 38613071 PMCID: PMC11013804 DOI: 10.3390/nu16071039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/14/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Obesity and depression are interdependent pathological disorders with strong inflammatory effects commonly found worldwide. They determine the health status of the population and cause key problems in terms of morbidity and mortality. The role of gut microbiota and its composition in the treatment of obesity and psychological factors is increasingly emphasized. Published research suggests that prebiotic, probiotic, or symbiotic preparations can effectively intervene in obesity treatment and mood-dysregulation alleviation. Thus, this literature review aims to highlight the role of intestinal microbiota in treating depression and obesity. An additional purpose is to indicate probiotics, including psychobiotics and prebiotics, potentially beneficial in supporting the treatment of these two diseases.
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Affiliation(s)
- Klaudia Sochacka
- Faculty of Medicine and Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Agata Kotowska
- Department of Social Policy, Institute of Sociological Sciences, College of Social Sciences, University of Rzeszow, 35-310 Rzeszow, Poland;
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Ray S, Kapoor N, Deshpande N, Chatterjee S, Kumar J, Tantia O, Goyal G, Mukherjee JJ, Singh AK. An overview of therapeutic options of obesity management in India: the Integrated Diabetes and Endocrinology Academy (IDEA) 2023 Congress update. Expert Rev Clin Pharmacol 2024; 17:349-362. [PMID: 38471973 DOI: 10.1080/17512433.2024.2330468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/11/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION With newer anti-obesity medications (AOMs) being introduced at a rapid pace, it is prudent to make a concise and updated clinical practice document that may help busy clinicians in daily clinical practice. A group of metabolic physicians, diabetologists, endocrinologists, and bariatric surgeons assembled during the Integrated Diabetes and Endocrine Academy 2023 Congress (IDEACON, July 2023, Kolkata, India) to compile an update of pharmacotherapeutic options for managing people with obesity in India. AREAS COVERED After an extensive review of the literature by experts in different domains, this update provides all available information on the management of obesity, with a special emphasis on both currently available and soon-to-be-available AOMs, in people with obesity. EXPERT OPINION Several newer AOMs have been shown to reduce body weight significantly, thus poised to make a paradigm shift in the management of obesity. While the tolerability and key adverse events associated with these AOMs appear to be acceptable in randomized controlled trials, pharmacovigilance is vital in real-world settings, given the absence of sufficiently long-term studies. The easy availability and affordability of these drugs is another area of concern, especially in developing countries like India.
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Affiliation(s)
- Subir Ray
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
- Non-Communicable disease Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Neeta Deshpande
- Belgaum Diabetes Centre and CentraCare Institute of Diabetes, Obesity and Metabolic Health (CIDOM), Belgaum, Karnataka, India
| | - Sanjay Chatterjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Janardanan Kumar
- Department of Medicine, SRM Hospital & Research Centre, SRMIST, Kattankulathur, Tamil Nadu, India
| | - Om Tantia
- Department of Minimal Access and Bariatric Surgery, ILS Hospital, Kolkata, West Bengal, India
| | - Ghanshyam Goyal
- Department of Medicine, ILS Hospital, Salt Lake, Kolkata, West Bengal, India
| | - Jagat Jyoti Mukherjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Awadhesh Kumar Singh
- Department of Diabetes & Endocrinology, G.D Hospital & Diabetes Institute, Kolkata, West Bengal, India
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Tsamos G, Kalopitas G, Evripidou K, Vasdeki D, Koufakis T, Kanavas V, Antza C, Germanidis G, Chourdakis M. The Effects of Olive Oil Consumption on Biochemical Parameters and Body Mass Index of People with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2024; 16:857. [PMID: 38542768 PMCID: PMC10976078 DOI: 10.3390/nu16060857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disorder, is closely associated with insulin resistance, obesity, and metabolic syndromes. A body of research has proposed that olive oil, a basic component of the Mediterranean diet with antioxidant and anti-inflammatory properties, may alleviate metabolic disturbances and retard the progression of NAFLD. We conducted a systematic review and meta-analysis to assess the effectiveness of olive oil intake in people with NAFLD. We systematically searched the major electronic databases (PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials), as well as grey literature sources, to identify randomized controlled trials (RCTs) investigating the effects of olive oil consumption on biochemical and anthropometric parameters of individuals with NAFLD. The quality of the studies was evaluated using the risk-of-bias tool 2.0 (RoB 2). The mean difference (MD) and the 95% confidence interval (CI) were calculated using fixed-effects and random-effects models. Seven RCTs involving 515 subjects were included in the analysis. In the random-effects model, no statistically significant differences were identified with respect to alanine transaminase (MD = -1.83 IU/L, 95% CI: -5.85, 2.19 IU/L, p = 0.37, I2 = 69%) and aspartate transaminase (MD = -1.65 IU/L, 95% CI: -4.48, 1.17 IU/L, p = 0.25, I2 = 72%) levels or waist circumference values (MD = -0.23 cm, 95% CI: -1.23, 0.76 cm, p = 0.65, I2 = 0%). However, a significant effect on body mass index was observed (MD = -0.57 kg/m2, 95% CI: -1.08, -0.06 kg/m2, p = 0.03, I2 = 51%) for subjects who received olive oil compared to those who received an alternative diet or placebo. The findings of the present meta-analysis suggest a modestly positive impact of olive oil intake on body weight in people with NAFLD.
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Affiliation(s)
- Georgios Tsamos
- Department of Gastroenterology, Norfolk and Norwich University Hospital NHS Trust, Norwich NR4 7UY, UK
| | - Georgios Kalopitas
- Division of Gastroenterology and Hepatology, 1st Department of Internal Medicine, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece; (G.K.); (G.G.)
| | - Kleo Evripidou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (K.E.); (M.C.)
| | - Dimitra Vasdeki
- Division of Endocrinology and Metabolism and Diabetes Center, 1st Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 546 36 Thessaloniki, Greece;
| | - Theocharis Koufakis
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 546 42 Thessaloniki, Greece;
| | - Vasileios Kanavas
- Laboratory of Biomathematics, School of Medicine, University of Thessaly, 412 22 Larissa, Greece;
| | - Christina Antza
- 3rd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, 564 03 Thessaloniki, Greece;
| | - Georgios Germanidis
- Division of Gastroenterology and Hepatology, 1st Department of Internal Medicine, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece; (G.K.); (G.G.)
| | - Michail Chourdakis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (K.E.); (M.C.)
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D’Adamo CR, Kaplan MB, Campbell PS, McLaughlin K, Swartz JS, Wattles KR, Lukaczer D, Scheinbaum S. Functional medicine health coaching improved elimination diet compliance and patient-reported health outcomes: Results from a randomized controlled trial. Medicine (Baltimore) 2024; 103:e37148. [PMID: 38394515 PMCID: PMC11309605 DOI: 10.1097/md.0000000000037148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The objective of this study was to determine whether an elimination diet with virtually provided functional medicine health coaching support would be more effective than a typical self-guided elimination diet with respect to dietary compliance and patient-reported health and quality of life. METHODS A parallel arm, randomized controlled trial was conducted among a sample of healthcare professionals. Participants were randomized to either an elimination diet with 5 sessions of functional medicine health coaching support (intervention arm) or a self-guided elimination diet (control arm). Outcomes assessed at baseline and at the conclusion of the 10-week study included PROMIS Global Health (GH) and medical symptoms questionnaire (MSQ). Compliance with the elimination diet was assessed at the conclusion of the study. Baseline and end of study outcomes were compared within study arms via paired t tests and between study arms with unpaired t tests. Subgroup analysis of symptomatology at baseline was performed. RESULTS 125 randomized participants (n = 64 intervention, n = 61 control) provided baseline outcomes data. There were statistically and clinically significant within-group improvements in patient-reported outcomes in both the intervention arm (PROMIS GH-physical = 4.68, PROMIS GH-mental = 3.53, MSQ = 28.9) and control arm (PROMIS GH-physical = 48.4, PROMIS GH-mental = 3.18, MSQ = 24.1). There were no between-group differences in the primary analysis (P > .1). However, participants with more symptoms at baseline had statistically and clinically significant between-group differences in PROMIS GH-mental health (3.90, P = .0038) and MSQ (12.3, P = .047) scores that favored the functional medicine health coaching arm. CONCLUSIONS An elimination diet, whether self-guided or with functional medicine health coaching support, may improve patient-reported health outcomes among relatively healthy healthcare professionals. While studies in more diverse samples are needed, functional medicine health coaching support appears to be superior to a self-guided approach with regard to both dietary compliance and improving health outcomes among those with greater symptomatology.
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Affiliation(s)
- Christopher R. D’Adamo
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD
| | | | | | | | | | | | - Dan Lukaczer
- The Institute for Functional Medicine, Federal Way, WA
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19
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Pant A, Chew DP, Mamas MA, Zaman S. Cardiovascular Disease and the Mediterranean Diet: Insights into Sex-Specific Responses. Nutrients 2024; 16:570. [PMID: 38398894 PMCID: PMC10893368 DOI: 10.3390/nu16040570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of mortality and disease burden in women globally. A healthy diet is important for the prevention of CVD. Research has consistently favoured the Mediterranean diet as a cardio-protective diet. Several studies have evaluated associations between the Mediterranean diet and cardiovascular outcomes, including traditional risk factors like hypertension, type 2 diabetes mellitus, and obesity. In addition, consistent evidence suggests that the components of the Mediterranean diet have a synergistic effect on cardiovascular risk due to its anti-inflammatory profile and microbiome effects. While the benefits of the Mediterranean diet are well-established, health advice and dietary guidelines have been built on largely male-dominant studies. Few studies have investigated the beneficial associations of the Mediterranean diet in sex-specific populations, including those with non-traditional risk factors that are specific to women, for instance polycystic ovarian syndrome and high-risk pregnancies, or more prevalent in women, such as chronic inflammatory diseases. Therefore, this review aims to provide a comprehensive overview of the current evidence regarding the Mediterranean diet in women in relation to cardiovascular health outcomes.
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Affiliation(s)
- Anushriya Pant
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
| | - Derek P. Chew
- Victorian Heart Hospital, Victorian Heart Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Newcastle ST5 5BG, UK
| | - Sarah Zaman
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
- Department of Cardiology, Westmead Hospital, Sydney, NSW 2145, Australia
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20
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Gonçalves C, Moreira H, Santos R. Systematic review of mediterranean diet interventions in menopausal women. AIMS Public Health 2024; 11:110-129. [PMID: 38617417 PMCID: PMC11007410 DOI: 10.3934/publichealth.2024005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 04/16/2024] Open
Abstract
The increasing lifespan of women and their extended time spent in menopause pose significant challenges for health care systems, primarily due to the impacts of postmenopausal estrogen deficiency and aging on health. Menopause's onset is linked to a heightened prevalence of obesity, metabolic syndrome, cardiovascular disease, and osteoporosis. Diet is particularly relevant during menopause given its impact on quality of life and longevity and its modifiability. Because the Mediterranean diet is currently regarded as one of the healthiest dietary models in the world, the aim of this systematic review was to assess current evidence regarding the effectiveness of studies on the Mediterranean diet as an intervention for menopausal women. A systematic review of intervention-based studies involving the Mediterranean diet among menopausal women was performed in Scopus, PubMed, and Web of Science. The results of seven that met the inclusion criteria suggests that adherence to the Mediterranean diet can have beneficial impacts on menopausal women's health, including reductions in weight, blood pressure, blood ω6: ω3 ratio, triglycerides, total cholesterol, and LDL levels. Those results seem to be relevant for public health interventions aimed at improving menopausal women's quality of life.
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Affiliation(s)
- Carla Gonçalves
- CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
- EPIUnit - Instituto de Saúde Pública - Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- CISAS - Center for Research and Development in Agrifood Systems and Sustainability, Instituto Politécnico de Viana do Castelo, 4900-347 Viana do Castelo, Portugal
| | - Helena Moreira
- CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
- CIDESD - Research Center in Sports Sciences, Health Sciences and Human Development, Laboratory of Biomechanics, Body Composition and Health (LaB2Health), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Ricardo Santos
- CIFI2D - Centre of Research, Education, Innovation and Intervention in Sport, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
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Verde L, Camajani E, Annunziata G, Sojat A, Marina LV, Colao A, Caprio M, Muscogiuri G, Barrea L. Ketogenic Diet: A Nutritional Therapeutic Tool for Lipedema? Curr Obes Rep 2023; 12:529-543. [PMID: 37924422 DOI: 10.1007/s13679-023-00536-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE OF REVIEW This review aims to provide an overview of the current evidence on the efficacy, also considering the anti-inflammatory properties and safety of very low-calorie ketogenic diet (VLCKD) as a potential treatment for lipedema, particularly in the context of obesity. RECENT FINDINGS Lipedema is a chronic disease characterized by abnormal and painful fat buildup on the legs and/or arms. It is often misdiagnosed as obesity or lymphedema. However, although lipedema and obesity can coexist, unlike obesity, lipedema usually affects the legs and thighs without affecting the feet or hands, and the abnormal deposition of adipose tissue in lipedema is painful. The current lifestyle interventions are often unsuccessful in the management of lipedema. There is no consensus on the most effective nutritional approach for managing lipedema. Recent studies have suggested that VLCKD may be an effective treatment for lipedema, demonstrating that it is also superior to other nutritional approaches such as Mediterranean diet or intermittent fasting. Lipedema is a chronic and debilitating disease characterized by abnormal and painful accumulation of adipose tissue in the legs. VLCKD has been shown to be an effective treatment for lipedema, especially in the context of obesity, due to its anti-inflammatory properties. However, further research is needed to determine the long-term safety and efficacy of VLCKD as a treatment for lipedema.
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Affiliation(s)
- Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy
| | - Giuseppe Annunziata
- Department of Experimental Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Antoanstefan Sojat
- Department for Obesity, Metabolic and Reproductive Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Ljiljana V Marina
- Department for Obesity, Metabolic and Reproductive Disorders, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Annamaria Colao
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Diabetologia ed Andrologia, Unità di Endocrinologia, Università Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Dipartimento di Medicina Clinica e Chirurgia, Diabetologia ed Andrologia, Unità di Endocrinologia, Università Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy.
| | - Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale, Via Porzio, Isola F2, 80143, Naples, Italy
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22
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de Luis Román D, Primo Martín D, Izaola Jáuregui O. Association of resistin (rs3138167) gene polymorphism with metabolic response after a hypocaloric Mediterranean diet. NUTR HOSP 2023. [PMID: 37929859 DOI: 10.20960/nh.04763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND the single nucleotide polymorphism (SNP) (rs3138167) of resistin (RETN) gene is a polymorphism that has been associated with metabolic disorder in obese subjects and its effect on the metabolic response after a dietary intervention has not been evaluated. OBJECTIVE our aim was to analyze the effects of the rs3138167 RETN gene polymorphism on metabolic changes secondary to weight loss with a hypocaloric diet with a Mediterranean pattern. METHOD one thousand and eight Caucasian obese patients were evaluated. Before and after 12 weeks on a hypocaloric diet with Mediterranean pattern, an anthropometric evaluation and a biochemical analysis were performed. The statistical analysis was performed as a dominant model (CC vs CT + TT). RESULTS the values of insulin, HOMA-IR and resistin were higher in T allele carriers than non-T allele carriers in pre- and post-intervention time. In non-T allele carriers, resistin, insulin, HOMA-IR, triglycerides and C-reactive protein levels decreased. The improvement was statistically superior in non-T allele carriers; resistin (-1.2 ± 0.2 ng/dl; p = 0.02), triglycerides (-18.3 ± 4.3 mg/dl; p = 0.02), C-reactive protein (-2.6 ± 0.3 mg/dl; p = 0.02), insulin -4.4 ± 1.9 mUI/l; p = 0.02) and HOMA-IR (-2.1 ± 0.7; p = 0.03). CONCLUSION we report an association of rs3138167 with a worse metabolic response (insulin, HOMA-IR, triglyceride and C-reactive protein) in T allele carriers after weight loss with a hypocaloric diet with Mediterranean pattern.
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Affiliation(s)
- Daniel de Luis Román
- Centro de Investigación de Endocrinología y Nutrición Clínica de Valladolid (IENVA). Facultad de Medicina. Universidad de Valladolid
| | - David Primo Martín
- Centro de Investigación de Endocrinología y Nutrición Clínica de Valladolid (IENVA). Facultad de Medicina. Universidad de Valladolid
| | - Olatz Izaola Jáuregui
- Centro de Investigación de Endocrinología y Nutrición Clínica de Valladolid (IENVA). Facultad de Medicina. Universidad de Valladolid
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23
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Konieczna J, Ruiz-Canela M, Galmes-Panades AM, Abete I, Babio N, Fiol M, Martín-Sánchez V, Estruch R, Vidal J, Buil-Cosiales P, García-Gavilán JF, Moñino M, Marcos-Delgado A, Casas R, Olbeyra R, Fitó M, Hu FB, Martínez-Gonzalez MÁ, Martínez JA, Romaguera D, Salas-Salvadó J. An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition: An Interim Subgroup Analysis of the PREDIMED-Plus Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2337994. [PMID: 37851444 PMCID: PMC10585413 DOI: 10.1001/jamanetworkopen.2023.37994] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/01/2023] [Indexed: 10/19/2023] Open
Abstract
Importance Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. Objective To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. Design, Setting, and Participants The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. Intervention Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. Main Outcomes and Measures The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imputation was performed to include data of participants lost to follow-up (intention-to-treat analyses). Results A total of 1521 individuals were included (mean [SD] age, 65.3 [5.0] years; 52.1% men). In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, -0.94% [95% CI, -1.19 to -0.69]; 3 years, -0.38% [95% CI, -0.64 to -0.12] and visceral fat storage after 1 year, -126 g [95% CI, -179 to -73.3 g]; 3 years, -70.4 g [95% CI, -126 to -15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95% CI, 0.09%-0.60%]). The intervention group was more likely to show improvements of 5% or more in baseline body components (absolute risk reduction after 1 year, 13% for total fat mass, 11% for total lean mass, and 14% for visceral fat mass; after 3-years: 6% for total fat mass, 6% for total lean mass, and 8% for visceral fat mass). The number of participants needed to treat was between 12 and 17 to attain at least 1 individual with possibly clinically meaningful improvements in body composition. Conclusions and Relevance The findings of this trial suggest a weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity significantly reduced total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome. Continued follow-up is warranted to confirm the long-term consequences of these changes on cardiovascular clinical end points. Trial Registration isrctn.org Identifier: ISRCTN89898870.
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Affiliation(s)
- Jadwiga Konieczna
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands, University Hospital Son Espases, Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IDISNA, University of Navarra, Pamplona, Spain
| | - Aina M. Galmes-Panades
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Global Health Research Group, Health Research Institute of the Balearic Islands, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Itziar Abete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, University of Navarra, Pamplona, Spain
| | - Nancy Babio
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain
- Institut d’Investigació Pere Virgili, Reus, Spain
| | - Miquel Fiol
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands, University Hospital Son Espases, Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
| | - Vicente Martín-Sánchez
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine, University of León, León, Spain
| | - Ramón Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria, University of Barcelona, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology, Institut d’Investigacions Biomédiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Pilar Buil-Cosiales
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IDISNA, University of Navarra, Pamplona, Spain
- Primary Care Services, Navarra Regional Health Service, Pamplona, Spain
| | - Jesús F. García-Gavilán
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain
- Institut d’Investigació Pere Virgili, Reus, Spain
| | - Manuel Moñino
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands, University Hospital Son Espases, Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
| | | | - Rosa Casas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria, University of Barcelona, Barcelona, Spain
| | - Romina Olbeyra
- Department of Endocrinology, Institut d’Investigacions Biomédiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Frank B. Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Miguel Ángel Martínez-Gonzalez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IDISNA, University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - J. Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, University of Navarra, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Dora Romaguera
- Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology, Health Research Institute of the Balearic Islands, University Hospital Son Espases, Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición, Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain
- Institut d’Investigació Pere Virgili, Reus, Spain
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24
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Martínez-González MA, Montero P, Ruiz-Canela M, Toledo E, Estruch R, Gómez-Gracia E, Li J, Ros E, Arós F, Hernáez A, Corella D, Fiol M, Lapetra J, Serra-Majem L, Pintó X, Cofán M, Sorlí JV, Babio N, Márquez-Sandoval YF, Castañer O, Salas-Salvadó J. Yearly attained adherence to Mediterranean diet and incidence of diabetes in a large randomized trial. Cardiovasc Diabetol 2023; 22:262. [PMID: 37775736 PMCID: PMC10542699 DOI: 10.1186/s12933-023-01994-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Several large observational prospective studies have reported a protection by the traditional Mediterranean diet against type 2 diabetes, but none of them used yearly repeated measures of dietary intake. Repeated measurements of dietary intake are able to improve subject classification and to increase the quality of the assessed relationships in nutritional epidemiology. Beyond observational studies, randomized trials provide stronger causal evidence. In the context of a randomized trial of primary cardiovascular prevention, we assessed type 2 diabetes incidence according to yearly repeated measures of compliance with a nutritional intervention based on the traditional Mediterranean diet. METHODS PREDIMED (''PREvención con DIeta MEDiterránea'') was a Spanish trial including 7447 men and women at high cardiovascular risk. We assessed 3541 participants initially free of diabetes and originally randomized to 1 of 3 diets: low-fat diet (n = 1147, control group), Mediterranean diet supplemented with extra virgin olive (n = 1154) or Mediterranean diet supplemented with mixed nuts (n = 1240). As exposure we used actual adherence to Mediterranean diet (cumulative average), yearly assessed with the Mediterranean Diet Adherence Screener (scoring 0 to 14 points), and repeated up to 8 times (baseline and 7 consecutive follow-up years). This score was categorized into four groups: < 8, 8-< 10, 10- < 12, and 12-14 points. The outcome was new-onset type 2 diabetes. RESULTS Multivariable-adjusted hazard ratios from time-varying Cox models were 0.80 (95% confidence interval, 0.70-0.92) per + 2 points in Mediterranean Diet Adherence Screener (linear trend p = .001), and 0.46 (0.25-0.83) for the highest (12-14 points) versus the lowest (< 8) adherence. This inverse association was maintained after additionally adjusting for the randomized arm. Age- and sex-adjusted analysis of a validated plasma metabolomic signature of the Mediterranean Diet Adherence Screener (constituted of 67 metabolites) in a subset of 889 participants also supported these results. CONCLUSIONS Dietary intervention trials should quantify actual dietary adherence throughout the trial period to enhance the benefits and to assist results interpretation. A rapid dietary assessment tool, yearly repeated as a screener, was able to capture a strong inverse linear relationship between Mediterranean diet and type 2 diabetes. Trial registration ISRCTN35739639.
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Affiliation(s)
- Miguel A Martínez-González
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Pedro Montero
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Miguel Ruiz-Canela
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Estefanía Toledo
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Ramón Estruch
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Deparment of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Emilio Ros
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic,, University of Barcelona, Barcelona, Spain
| | - Fernando Arós
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Osakidetza Basque Health Service, Bioaraba Health Research Institute, Araba University Hospital, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Alvaro Hernáez
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Dolores Corella
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Miquel Fiol
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Platform for Clinical Trials, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Lluis Serra-Majem
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Xavier Pintó
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Montse Cofán
- Lipid Clinic, Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic,, University of Barcelona, Barcelona, Spain
| | - José V Sorlí
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Nancy Babio
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana (Grup ANUT-DSM). Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain
| | - Yolanda F Márquez-Sandoval
- Cuerpo Académico UDG-CA-454 Alimentación y Nutrición en el Proceso de Salud-enfermedad, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Olga Castañer
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- Centro de Investigacion Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain
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Saad B. A Review of the Anti-Obesity Effects of Wild Edible Plants in the Mediterranean Diet and Their Active Compounds: From Traditional Uses to Action Mechanisms and Therapeutic Targets. Int J Mol Sci 2023; 24:12641. [PMID: 37628822 PMCID: PMC10454857 DOI: 10.3390/ijms241612641] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Obesity is a long-term condition resulting from a continuous imbalance between the amount of energy consumed and expended. It is associated with premature mortality and contributes to a large portion of the global chronic disease burden, including diabesity, cardiovascular disease, hypertension, and some cancers. While lifestyle changes and dietary adjustments are the primary ways to manage obesity, they may not always be sufficient for long-term weight loss. In these cases, medication may be necessary. However, the options for drugs are limited due to their potential side effects. As a result, there is a need to identify safe and effective alternative treatments. Recently, dietary compounds, plants, and bioactive phytochemicals have been considered as promising sources for discovering new pharmacological agents to treat obesity and its related complications. These natural products can function independently or synergistically with other plants to augment their effects at various levels of the body. They can modulate appetite, lipase activity, thermogenesis and fat synthesis and degradation, satiation, adipogenesis, and adipocyte apoptosis. Additionally, targeting adipocyte growth and differentiation with diverse medicinal plants/diet is a significant strategy for devising new anti-obesity drugs that can intervene in preadipocytes, maturing preadipocytes, and mature adipocytes. Clinical trials have shown that the wild edible plants in the Mediterranean diet can reduce the risk of obesity and its related diseases. This review examines the effectiveness of the common components of the Mediterranean diet in managing obesity and its associated health issues. We conducted a comprehensive literature review using PubMed, Science Direct, Google Scholar, and Medline Plus to gather data on the therapeutic effects of the Mediterranean diet and phytochemicals in treating obesity and its associated diseases.
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Affiliation(s)
- Bashar Saad
- Qasemi Research Center, Al-Qasemi Academic College, P.O. Box 124, Baqa al-Gharbiyye 3010000, Israel;
- Department of Biochemistry, Faculty of Medicine, The Arab American University, Jenin P.O. Box 240, Palestine;
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Bryl A, Mrugacz M, Falkowski M, Zorena K. A Mediterranean Diet May Be Protective in the Development of Diabetic Retinopathy. Int J Mol Sci 2023; 24:11145. [PMID: 37446322 DOI: 10.3390/ijms241311145] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The Mediterranean diet is recognized as one of the healthiest available dietary patterns. This perception results from its beneficial effects on the cardiovascular system and, also, on hypertension, diabetes, and cancer compared with other diets. Its impact on the course of diabetes is assessed in the available scientific literature; however, little information is available about its impact on diabetic retinopathy. The MD is characterized mainly by the consumption of fish, seafood, foods of plant origin, and fresh fruit and vegetables. It is also recommended to consume legumes, which are a source of folic acid, magnesium, iron, and dietary fiber. High consumption of nuts and unrefined grains is also recommended in the MD. Marine fish provide polyunsaturated acids from the omega-3 group. Olive oil plays a very important role, especially olive oil obtained from mechanical pressing. Additionally, olive oil contains vitamins E, K, and polyphenols. Polyphenols, which are present in a diverse range of vegetables, fruits, and seeds, have the ability to decrease oxidative stress, inflammation, and insulin resistance. Resveratrol is naturally found in grape skins and seeds, as well as in peanuts and berries, and is a constituent of red wine. Resveratrol can inhibit increased vascular leakage and loss of pericytes and regulate the level of VEGF protein in the retina, thus inhibiting the development of DR. Consumption of fruits, vegetables, fish, and olive oil may be correlated with a lower risk of diabetic retinopathy. This paper presents the definition of the Mediterranean diet and its influence on the course of diabetes and diabetic retinopathy.
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Affiliation(s)
- Anna Bryl
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Małgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Mariusz Falkowski
- PhD Studies, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environmental Microbiology, Medical University of Gdansk, 80-211 Gdansk, Poland
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Lee V. Introduction to the dietary management of obesity in adults. Clin Med (Lond) 2023; 23:304-310. [PMID: 38614642 PMCID: PMC10541054 DOI: 10.7861/clinmed.2023-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Obesity is a multifaceted and complex condition that requires holistic management. It currently affects nearly one in four adults in the UK, with the UK ranked 10th globally for the highest obesity rates. Obesity is projected to have an economic burden of ∼£2 billion per year by 2030 in the UK.1 Excess weight gain can coincide with myriad health concerns and multiple health conditions, which can be physical, metabolic or psychosocial. This includes type 2 diabetes mellitus (T2DM), hypertension, coronary heart disease, osteoarthritis, obstructive sleep apnoea, reproductive disorders, depression and cancer2; hence, there has been a significant emphasis on obesity prevention. Obesity is often associated with weight stigma, impacting psychological wellbeing and quality of life. This can influence an individual's likelihood of seeking support, delaying appropriate input from healthcare professionals, with a knock-on effect on pre-existing health conditions. This review explores the management of obesity from a nutritional perspective, because modifying dietary intake is essential to reduce the risk of non-communicable diseases, including those associated with obesity.
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Richardson LA, Basu A, Chien LC, Alman AC, Snell-Bergeon JK. Longitudinal Associations of Healthy Dietary Pattern Scores with Coronary Artery Calcification and Pericardial Adiposity in United States Adults with and without Type 1 Diabetes. J Nutr 2023; 153:2085-2093. [PMID: 37187353 PMCID: PMC10375506 DOI: 10.1016/j.tjnut.2023.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Pericardial adipose tissue volume (PAT) and coronary artery calcification (CAC) are prognostic indicators for future cardiovascular events; however, no studies have assessed the long-term associations of adherence to dietary patterns (DPs) with PAT and CAC in adults with and without type 1 diabetes (T1D). OBJECTIVES We investigated the longitudinal associations of the Mediterranean Diet (MedDiet) and Dietary Approaches to Stop Hypertension (DASH) diet with PAT and CAC progression in adults with and without T1D. METHODS The Coronary Artery Calcification in Type 1 Diabetes (CACTI) study is a population-based, prospective study of 652 T1D and 764 nondiabetic mellitus (nonDM) (19-56 y) participants that began in 2000-2002 with follow-up visits in 2003-2004 and 2006-2007. At each visit, food frequency questionnaires were collected and used to develop adherence scores for the MedDiet and DASH diets. PAT and CAC were measured at each visit using electron beam computed tomography. CAC progression was defined as a ≥2.5 mm square root-transformed volume. Mixed effect models were used to conduct statistical analyses. RESULTS Combined models found a significant-0.09 cm3 (95% CI: -0.14, -0.03; P = 0.0027) inverse association in PAT for every 1-point increase in the MedDiet score and a significant-0.26 cm3 (95% CI: -0.38, -0.14; P < 0.0001) inverse association in PAT for every 1-point increase in the DASH score. In combined models, the DPs were not significantly associated with lower odds of CAC progression; however, both DPs had significant interactions by diabetes status for CAC. Only the DASH diet was associated with lower odds of CAC progression in the nonDM group (OR: 0.96; 95% CI: 0.93, 0.99; P = 0.0224). CONCLUSIONS These data suggest that the DPs are associated with lower PAT, which may reduce future cardiovascular events. The DASH diet may be beneficial for lower odds of CAC progression in those without T1D.
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Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, United States.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, Las Vegas, NV, United States
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO, United States
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Del Bo' C, Perna S, Allehdan S, Rafique A, Saad S, AlGhareeb F, Rondanelli M, Tayyem RF, Marino M, Martini D, Riso P. Does the Mediterranean Diet Have Any Effect on Lipid Profile, Central Obesity and Liver Enzymes in Non-Alcoholic Fatty Liver Disease (NAFLD) Subjects? A Systematic Review and Meta-Analysis of Randomized Control Trials. Nutrients 2023; 15:nu15102250. [PMID: 37242133 DOI: 10.3390/nu15102250] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 04/27/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
The effectiveness of the Mediterranean diet (MD) in non-alcoholic fatty liver disease (NAFLD) subjects has been evaluated in several randomized controlled trials (RCTs). This systematic review and meta-analysis aimed to evaluate the overall effects of MD intervention in a cohort of NAFLD patients targeting specific markers such as central obesity, lipid profile, liver enzymes and fibrosis, and intrahepatic fat (IHF). Google Scholar, PubMed, and Scopus were explored to collect relevant studies from the last 10 years. RCTs with NAFLD subjects were included in this systematic review with a mean intervention duration from 6 weeks to 1 year, and different intervention strategies, mainly including energy restriction MD (normal or low glycaemic index), low-fat MD with increased monounsaturated and polyunsaturated fatty acids, and increased exercise expenditure. The outcomes measured in this meta-analysis were gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), total cholesterol (TC), waist circumference (WC), and liver fibrosis. Ten randomized controlled trials, which involved a total of 737 adults with NAFLD, were included. According to the results, the MD seems to decrease the liver stiffness (kPa) by -0.42 (CI95% -0.92, 0.09) (p = 0.10) and significantly reduce the TC by -0.46 mg/dl (CI95% -0.55, -0.38) (p = 0.001), while no significant findings were documented for liver enzymes and WC among patients with NAFLD. In conclusion, the MD might reduce indirect and direct outcomes linked with NAFLD severity, such as TC, liver fibrosis, and WC, although it is important to consider the variations across trials. Further RCTs are necessary to corroborate the findings obtained and provide further evidence on the role of the MD in the modulation of other disorders related to NAFLD.
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Affiliation(s)
- Cristian Del Bo'
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, 20133 Milano, Italy
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, 20133 Milano, Italy
| | - Sabika Allehdan
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Bahrain
| | - Ayesha Rafique
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Bahrain
| | - Sara Saad
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Bahrain
| | - Fahad AlGhareeb
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, Zallaq P.O. Box 32038, Bahrain
| | - Mariangela Rondanelli
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Unit of Human and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Reema F Tayyem
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Mirko Marino
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, 20133 Milano, Italy
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, 20133 Milano, Italy
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, Università degli Studi di Milano, 20133 Milano, Italy
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Samakidou GE, Koliaki CC, Liberopoulos EN, Katsilambros NL. Non-Classical Aspects of Obesity Pathogenesis and Their Relative Clinical Importance for Obesity Treatment. Healthcare (Basel) 2023; 11:1310. [PMID: 37174852 PMCID: PMC10178220 DOI: 10.3390/healthcare11091310] [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: 03/16/2023] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023] Open
Abstract
Obesity is a chronic disease and a major public health problem due to its association with non-communicable diseases and all-cause mortality. An increased energy intake and decreased physical activity have been long recognized as the classical parameters that contribute to the development of obesity. However, several other, non-classical factors have also been associated with obesity through various complex mechanisms. Some of them are diet related, such as diet quality, dietary habits and speed of eating. Other factors are non-dietary, such as endocrine-disrupting chemicals, sleep quality and quantity, psychotropic medications and light at night. The scope of the present narrative review is to address these non-classical factors that are implicated in the pathogenesis of obesity, to clarify their potential role in the management of obesity and, where possible, to provide some practical clinical recommendations.
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Affiliation(s)
- Georgia E. Samakidou
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece; (C.C.K.); (E.N.L.); (N.L.K.)
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Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Effects of the Mediterranean Diet on Health and Gut Microbiota. Nutrients 2023; 15:2150. [PMID: 37432307 DOI: 10.3390/nu15092150] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/25/2023] [Accepted: 04/29/2023] [Indexed: 07/12/2023] Open
Abstract
The Mediterranean Diet (MD) is plant-based and consists of multiple daily portions of vegetables, fruit, cereals, and olive oil. Although there are challenges with isolating the MD from the typical Mediterranean lifestyle and culture (including prolonged 'social' meals and siestas), much evidence supports the health benefits of the MD that include improved longevity, reduced metabolic risk of Diabetes Mellitus, obesity, and Metabolic Syndrome, reduced risk of malignancy and cardiovascular disease, and improved cognitive function. The MD is also associated with characteristic modifications to gut microbiota, mediated through its constituent parts (primarily dietary fibres, extra virgin olive oil, and polyunsaturated fatty acids [including ω-3]). These include enhanced growth of species that produce short-chain fatty acids (butyrate), such as Clostridium leptum and Eubacterium rectale, enhanced growth of Bifidobacteria, Bacteroides, and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes in gut microbiota are known to be associated favourably with inflammatory and oxidative status, propensity for malignancy and overall metabolic health. A key challenge for the future is to explore the extent to which the health benefits of the MD are mediated by such changes to gut microbiota. The MD confers both health and environmental benefits. Adoption of the MD should perhaps be encouraged and facilitated more generally and not just restricted to populations from Mediterranean regions. However, there are key challenges to this approach that include limited perennial availability of the constituent parts of the MD in some non-Mediterranean regions, intolerability of a high-fibre diet for some people, and potential cultural disconnects that juxtapose some traditional (including Western) diets with the MD.
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Affiliation(s)
- Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Stefan Kabisch
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße, 85764 Neuherberg, Germany
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße, 85764 Neuherberg, Germany
| | - Martin O Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV2 2DX, UK
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Khadem A, Shiraseb F, Mirzababaei A, Noori S, Mirzaei K. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolically unhealthy overweight/obesity phenotypes among Iranian women: a cross sectional study. BMC Endocr Disord 2023; 23:84. [PMID: 37076804 PMCID: PMC10114364 DOI: 10.1186/s12902-023-01333-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Paradoxes have been found in obesity, including individuals with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO), and diet may be one of the reasons for the creation of these metabolic phenotypes. Hence, the purpose of the present study was to investigate the association of the Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet with metabolically unhealthy overweight/obesity (MUHOW/O) phenotypes. METHODS In this cross-sectional study, 229 overweight and obese women (body mass index (BMI) ≥ 25 kg/m2) aged 18-48 years were examined. Anthropometric measures and biochemical parameters were collected from all participants. The body composition of each participant was assessed using a bioelectrical impedance analyzer (BIA). The MIND diet score was determined based on 15 components using a valid and reliable food frequency questionnaire (FFQ) containing 147 items. Karelis criteria was used to determine metabolically healthy/unhealthy phenotype (MH/MUH). RESULTS Among the participants, 72.5% of individuals were identified as MUH and 27.5% as MH, with a mean ± standard deviation (SD) age of 36.16 (8.33) years. The results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was no significant association observed between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.01, 95% CI: 0.86-4.17, P-value = 0.10), T3 (OR: 1.89, 95% CI: 0.86-4.17, P-value = 0.11) of MIND score, and only the odds of MUH relative to MH with a marginal significant decreasing trend was observed from the second to the third tertile (1.89 vs. 2.01) (P - trend = 0.06). Also, after additional adjustment for marital status, the nonsignificant association between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.13, 95% CI: 0.89-5.10, P-value = 0.08), T3 (OR: 1.87, 95% CI: 0.83-4.23, P-value = 0.12) of MIND score remained, and the odds of MUH relative to MH with a significant decreasing trend was observed with increasing tertiles (P-trend = 0.04). CONCLUSIONS In conclusion, no significant associations were found between adherence to MIND diet with MUH, and only a significant downward trend in the odds of MUH was observed with increasing tertiles. We suggest further studies in this field.
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Affiliation(s)
- Alireza Khadem
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Dominguez LJ, Veronese N, Di Bella G, Cusumano C, Parisi A, Tagliaferri F, Ciriminna S, Barbagallo M. Mediterranean diet in the management and prevention of obesity. Exp Gerontol 2023; 174:112121. [PMID: 36792040 DOI: 10.1016/j.exger.2023.112121] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023]
Abstract
The current pandemic of obesity represents a major global public health problem, mainly due to its association with chronic non-communicable disabling conditions and with increased mortality. Population aging increases the chances of non-communicable chronic diseases allowing a longer exposure to risk factors for these disabling conditions. Obesity is a major risk factor contributing to pathological aging. Numerous epidemiological studies have shown that the risk of death due to cardiovascular disease and cancer increases progressively as overweight and obesity rise. Nutrition research is now focused on the effects of combinations of foods in dietary patterns instead of those of single nutrients or foods. The dietary model with the largest body of evidence of health benefit is that traditionally followed by inhabitants of some Mediterranean countries. There is evidence confirming the inverse association of adhering to Mediterranean diet with overweight and obesity. Four meta-analyses of randomized controlled trials, including up to 16 trials, have shown a greater reduction of body weight and BMI with MedDiet compared to other diets, while a meta-analysis of 7 prospective cohort studies, found a reduced risk of becoming obese and gaining weight over time associated with a higher adherence to MedDiet. This narrative review examines studies reporting inverse associations of a higher adherence to the MedDiet with overweight/obesity and with age-associated chronic diseases related to obesity.
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Affiliation(s)
- Ligia J Dominguez
- Faculty of Medicine and Surgery, "Kore" University of Enna, Enna, Italy; Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Claudia Cusumano
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
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Garcia-Unciti M, Palacios Samper N, Méndez-Sandoval S, Idoate F, Ibáñez-Santos J. Effect of Combining Impact-Aerobic and Strength Exercise, and Dietary Habits on Body Composition in Breast Cancer Survivors Treated with Aromatase Inhibitors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4872. [PMID: 36981785 PMCID: PMC10049091 DOI: 10.3390/ijerph20064872] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
This study examines both the effect of a twice-weekly combined exercise-1 h session of strength and 1 h session of impact-aerobic-on body composition and dietary habits after one year of treatment with aromatase inhibitors (AI) in breast cancer survivors. Overall, forty-three postmenopausal women with a BMI ≤ 35 kg/m2, breast cancer survivors treated with AI, were randomized into two groups: a control group (CG) (n = 22) and a training group (IG) (n = 21). Body composition, i.e., abdominal, visceral, and subcutaneous adipose tissue) was measured by magnetic resonance. In addition, some questionnaires were used to gather dietary data and to measure adherence to the Mediterranean diet. After one year, women in the IG showed a significant improvement in body composition, indicated by decreases in subcutaneous and visceral adipose tissue, and total fat tissue. Furthermore, the dietary habits were compatible with moderate adherence to the Mediterranean diet pattern and a low dietary intake of Ca, Zn, Folic Ac, and vitamins D, A, and E. A twice-weekly training program combining impact aerobic exercise and resistance exercise may be effective in improving the body composition for postmenopausal women who have breast cancer treated with AI, and the results suggest the need for nutritional counselling for this population.
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Affiliation(s)
- Marisol Garcia-Unciti
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, c/Irunlarrea 1, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Natalia Palacios Samper
- Centro de Estudios, Investigación y Medicina del Deporte (CEIMD), Gobierno de Navarra, 31005 Pamplona, Spain
- Department of Gerontology and Public Health, Faculty of Health Science, University of Jyväskylä, Seminaarinkatu 15, Jyväskylän Yliopisto, 40014 Jyväskylä, Finland
- Department of Physiology, Faculty of Health Science, Public University of Navarre, Av. Cataluña, s/n, 31006 Pamplona, Spain
| | - Sofía Méndez-Sandoval
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
| | - Fernando Idoate
- Servicio de Radiología de la Mutua Navarra, 31012 Pamplona, Spain;
| | - Javier Ibáñez-Santos
- Centro de Estudios, Investigación y Medicina del Deporte (CEIMD), Gobierno de Navarra, 31005 Pamplona, Spain
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de Luis DA, Primo D, Izaola O, Aller R. Role of resistin (rs7139228) gene polymorphism with metabolic response after a hypocaloric mediterranean diet. ENDOCRINOL DIAB NUTR 2023; 70:88-97. [PMID: 36841628 DOI: 10.1016/j.endien.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/16/2022] [Indexed: 02/25/2023]
Abstract
BACKGROUND The SNP (rs7139228) of the RETN gene is a polymorphism that has been associated with metabolic disorder in subjects with obesity, and its effect on metabolic response after dietary intervention has not been evaluated. OBJECTIVE Our objective was to analyse the effects of the polymorphism of the RETN gene rs7139228 on metabolic changes secondary to weight loss with a hypocaloric Mediterranean diet. DESIGN 1000 obese Caucasian patients were evaluated. An anthropometric evaluation and a biochemical analysis were performed before and after 12 weeks of a hypocaloric Mediterranean diet. The statistical analysis was performed as a dominant model (GG vs GA+AA). RESULTS Improvements in anthropometric parameters, leptin levels and systolic blood pressure were similar in both genotype groups. In non- A allele carriers, levels of resistin, insulin, HOMA-IR, triglycerides and C-reactive protein decreased. The improvements were statistically significant in this group; resistin (-1.3+0.1ng/dL: p=0.02), triglycerides (-22.9+4.9mg/dl: p=0.02), CRP (-2.7+0 0.4mg/dl: p=0.02), insulin -6.5+1.8 mIU/L: p=0.02) and HOMA-IR (-2.2+0.8: p=0, 03). In addition, insulin, HOMA-IR and resistin levels were higher in A allele carriers than in non-carriers. Finally, the prevalence of metabolic syndrome and hyperglycaemia were higher in A allele carriers, and these percentages only decreased after intervention in non-A allele carriers. CONCLUSION The A rs7139228 allele is associated with a worse metabolic response (insulin, HOMA-IR, triglycerides and CRP) after weight loss with a hypocaloric Mediterranean diet. A non-significant decrease in the prevalence of metabolic syndrome and hyperglycaemia were detected in A allele carriers.
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Affiliation(s)
- Daniel Antonio de Luis
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina y Svo Endocrinología y Nutrición Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain.
| | - David Primo
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina y Svo Endocrinología y Nutrición Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain
| | - Olatz Izaola
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina y Svo Endocrinología y Nutrición Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain
| | - Rocío Aller
- Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina y Svo Endocrinología y Nutrición Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain
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Turner-McGrievy GM, Wilson MJ, Carswell J, Okpara N, Aydin H, Bailey S, Davey M, Hutto B, Wilcox S, Friedman DB, Sarzynski MA, Liese AD. A 12-Week Randomized Intervention Comparing the Healthy US, Mediterranean, and Vegetarian Dietary Patterns of the US Dietary Guidelines for Changes in Body Weight, Hemoglobin A1c, Blood Pressure, and Dietary Quality among African American Adults. J Nutr 2023; 153:579-587. [PMID: 36894249 PMCID: PMC10196600 DOI: 10.1016/j.tjnut.2022.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The US Dietary Guidelines (USDG) form the basis of nutrition guidelines, but the research informing the 3 USDG dietary patterns (Healthy US-Style [H-US], Mediterranean [Med], and vegetarian [Veg]) has been drawn largely from observational studies among White populations. OBJECTIVES The Dietary Guidelines 3 Diets study was a 3-arm, 12-wk randomly assigned intervention among African American (AA) adults at risk of type 2 diabetes mellitus that tested the 3 USDG dietary patterns. METHODS The AAs (ages 18-65 y, BMI 25-49.9 kg/m2, and BMI was measured in kg/m2) with ≥3 type 2 diabetes mellitus risk factors were recruited. Weight, HbA1c, blood pressure, and dietary quality (healthy eating index [HEI]) were collected at baseline and 12 wk. In addition, participants attended weekly online classes that were designed using material from the USDG/MyPlate. Repeated measures, mixed models with maximum likelihood estimation, and robust computation of standard errors were tested. RESULTS Of the 227 participants screened, 63 were eligible (83% female; age 48.0 ± 10.6 y, BMI 35.9 ± 0.8 kg/m2) and randomly assigned to the Healthy US-Style Eating Pattern (H-US) (n = 21, 81% completion), healthy Mediterranean-style eating pattern (Med) (n = 22, 86% completion), or healthy vegetarian eating pattern (Veg) (n = 20, 70% completion) groups. Within-group, but not between groups, weight loss was significant (-2.4 ± 0.7 kg H-US, -2.6 ± 0.7 kg Med, -2.4 ± 0.8 kg Veg; P = 0.97 between group). There was also no significant difference between groups for changes in HbA1c (0.03 ± 0.05% H-US, -0.10 ± 0.05% Med, 0.07 ± 0.06% Veg; P = 0.10), systolic BP (-5.5 ± 2.7 mmHg H-US, -3.2 ± 2.5 mmHg Med, -2.4 ± 2.9 mmHg Veg; P = 0.70), diastolic blood pressure (-5.2 ± 1.8 mmHg H-US, -2.0 ± 1.7 mmHg Med, -3.4 ± 1.9 mmHg Veg; P = 0.41), or HEI (7.1 ± 3.2 H-US, 15.2 ± 3.1 Med, 4.6 ± 3.4 Veg; P = 0.06). Post hoc analyses showed that the Med group had significantly greater improvements in HEI compared to the Veg group (difference = -10.6 ± 4.6; 95% CI: -19.7, -1.4; P = 0.02). CONCLUSIONS The present study demonstrates that all 3 USDG dietary patterns lead to significant weight loss among AA adults. However, none of the outcomes were significantly different between groups. This trial was registered at clinicaltrials.gov as NCT04981847.
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Affiliation(s)
- Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Mary J Wilson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jessica Carswell
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nkechi Okpara
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Halide Aydin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shiba Bailey
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Marty Davey
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Mark A Sarzynski
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Siener R, Metzner C. Dietary weight loss strategies for kidney stone patients. World J Urol 2023; 41:1221-1228. [PMID: 36593299 DOI: 10.1007/s00345-022-04268-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/19/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Overweight has been associated with an increased risk of incident and recurrent kidney stone disease. Weight reduction is the therapeutic consequence to decrease the risk of stone formation. This review examines the effectiveness of different weight loss strategies on weight reduction and cardiometabolic risk profile, with a particular focus on risk factors for urolithiasis. METHODS A selective literature search was performed using PubMed and Cochrane library. RESULTS Clinical evidence for the potential benefits of dietary weight loss strategies for kidney stone disease is limited. A conventional, energy-restricted diet may significantly induce weight loss and reduce urinary supersaturation of calcium oxalate in overweight individuals with or without a history of stone formation. The current data indicate that an energy-restricted diet with partial meal replacement may additionally decrease the relative supersaturation of uric acid and further improve the cardiometabolic risk profile, and, thus, may be a favourable option for overweight kidney stone patients. Studies on the Mediterranean and DASH diets on the association between weight loss and the risk of urinary stone formation are lacking. CONCLUSION An energy-restricted diet with or without meal replacement could be a promising weight loss strategy for overweight kidney stone patients. Further studies are needed to evaluate the impact of different weight loss strategies on urinary risk factors and cardiometabolic risk profile in urolithiasis.
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Affiliation(s)
- Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Christine Metzner
- Bonn Education Association for Dietetics r. A., Cologne, Germany.,Clinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), RWTH, Aachen, Germany
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Fateh HL, Muhammad SS, Kamari N. Associations between adherence to MIND diet and general obesity and lipid profile: A cross-sectional study. Front Nutr 2023; 10:1078961. [PMID: 37113290 PMCID: PMC10126273 DOI: 10.3389/fnut.2023.1078961] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Background The term "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has recently been coined to describe a new eating pattern. Recent research is looking at how this food pattern affects chronic illnesses. Thus, this study aimed to investigate the association between the use and adherence to the MIND diet with general obesity and blood lipid profile. Methods In this cross-sectional study, 1,328 Kurdish adults between the ages of 39 and 53 had their dietary intake evaluated using a valid and reliable 168-item Food Frequency Questionnaire (FFQ). Adherence to the MIND diet was examined based on the components advised in this eating pattern. Each subject's lipid profiles and anthropometric measurements were documented. Results The mean age and BMI in the study population were 46.16 ± 7.87 year and 27.19 ± 4.60 kg/m2, respectively. The chances of having increased serum triglycerides (TG) were 42% lower in those in the third tertile of the MIND diet score compared to those in the first tertile (ORs: 0.58; 95% CI 0.38-0.95; P = 0.001). In the crude model and after adjusting for confounders, lowering high-density lipoprotein cholesterol (HDL-C) (ORs: 0.72; 95% CI 0.55-1.15; P = 0.001). Conclusion We found that greater adherence to the MIND diet was associated with the decrease odds of general obesity and lipid profile. Further study is essential owing to the relevance of chronic diseases like MetS and obesity in health status.
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Affiliation(s)
- Hawal Lateef Fateh
- Nursing Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Sarmad S. Muhammad
- Medical Laboratory Technology Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Negin Kamari
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
- *Correspondence: Negin Kamari,
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Mediterranean Diet and Chronic Kidney Disease (CKD): A Practical Approach. Nutrients 2022; 15:nu15010097. [PMID: 36615755 PMCID: PMC9824533 DOI: 10.3390/nu15010097] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Chronic kidney disease has become a serious public health issue, as well as others health problems such as hypertension, DM, and obesity. Mediterranean diet (MD) can reduce the risk of cardiovascular disease and cancer and can lead to weight loss in obesity. There are studies that suggest that MD could be the diet of choice for patients with CKD for its influence on endothelial function, inflammation, lipid profile and blood pressure. There are few studies that tell us how to adapt MD to this group of patients. This review aims to offer a practical approach to Mediterranean diet adaptation as nutritional treatment in CKD patients.
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Anti-Inflammatory Mechanisms of Dietary Flavones: Tapping into Nature to Control Chronic Inflammation in Obesity and Cancer. Int J Mol Sci 2022; 23:ijms232415753. [PMID: 36555392 PMCID: PMC9779861 DOI: 10.3390/ijms232415753] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Flavones are natural phytochemicals broadly distributed in our diet. Their anti-inflammatory properties provide unique opportunities to control the innate immune system and inflammation. Here, we review the role of flavones in chronic inflammation with an emphasis on their impact on the molecular mechanisms underlying inflammatory diseases including obesity and cancer. Flavones can influence the innate immune cell repertoire restoring the immune landscape. Flavones impinge on NF-κB, STAT, COX-2, or NLRP3 inflammasome pathways reestablishing immune homeostasis. Devoid of adverse side effects, flavones could present alternative opportunities for the treatment and prevention of chronic inflammation that contributes to obesity and cancer.
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Papel del polimorfismo del gen de la resistina (rs7139228) en la respuesta metabólica tras una dieta mediterránea hipocalórica. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Muscogiuri G, Verde L, Sulu C, Katsiki N, Hassapidou M, Frias-Toral E, Cucalón G, Pazderska A, Yumuk VD, Colao A, Barrea L. Mediterranean Diet and Obesity-related Disorders: What is the Evidence? Curr Obes Rep 2022; 11:287-304. [PMID: 36178601 PMCID: PMC9729142 DOI: 10.1007/s13679-022-00481-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Obesity is a chronic disease, a major public health problem due to its association with non-communicable diseases and all-cause mortality. Indeed, people with obesity are at increased risk for a variety of obesity-related disorders including hypertension, dyslipidemia, type 2 diabetes mellitus, cardiovascular disease, and several cancers. Many popular diets with very different macronutrient composition, including the Mediterranean diet (MD), have been used, proposed, and studied for prevention and management of obesity. In particular, MD has been the subject of countless studies over the years and now boasts a large body of scientific literature. In this review, we aimed to update current knowledge by summarizing the most recent evidence on the effect of MD on obesity and obesity-related disorders. RECENT FINDINGS The negative effects of obesity are partly reversed by substantial weight loss that can be achieved with MD, especially when low-calorie and in combination with adequate physical activity. In addition, the composition of MD has been correlated with an excellent effect on reducing dyslipidemia. It also positively modulates the gut microbiota and immune system, significantly decreasing inflammatory mediators, a common ground for many obesity-related disorders. People with obesity are at increased risk for a variety of medical disorders including hypertension, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. Therefore, there is an inevitable need for measures to manage obesity and its related disorders. At this point, MD has been proposed as a valuable nutritional intervention. It is characterized by a high consumption of vegetables, fruit, nuts, cereals, whole grains, and extra virgin olive oil, as well as a moderate consumption of fish and poultry, and a limited intake of sweets, red meat, and dairy products. MD proves to be the healthiest dietary pattern available to tackle obesity and prevent several non-communicable diseases, including cardiovascular disease and type 2 diabetes.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Naples, Italy.
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy.
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy.
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Cem Sulu
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Niki Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Evelyn Frias-Toral
- School of Medicine, Universidad Católica Santiago de Guayaquil, Av. Pdte. Carlos Julio Arosemena Tola, Guayaquil, 090615, Ecuador
| | - Gabriela Cucalón
- Escuela Superior Politécnica del Litoral, ESPOL, Lifescience Faculty, ESPOL Polytechnic University, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Agnieszka Pazderska
- Division of Endocrinology, Metabolism, and Diabetes-Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Volkan Demirhan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy.
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Naples, 80143, Italy.
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Moore E, Fadel A, Lane KE. The effects of consuming a Mediterranean style diet on associated COVID-19 severity biomarkers in obese/overweight adults: A systematic review. Nutr Health 2022; 28:647-667. [PMID: 36131504 PMCID: PMC9494166 DOI: 10.1177/02601060221127853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: COVID-19 severity is strongly associated with high Body Mass Index (BMI) (≥25kg/m2) amongst adults and elevated inflammatory markers have enabled prediction of disease progression. The composition of a Mediterranean diet provides favourable outcomes on weight reduction and inflammatory markers. Aim: This systematic review aimed to investigate the effects of consuming a Mediterranean diet on BMI and inflammatory markers of obese/overweight adults (≥18 years) at risk of developing severe COVID-19 outcomes. Methods: PubMed Central, Cochrane Library and MEDLINE databases were searched to identify randomised controlled trials published between January 2010 to August 2021 evaluating the impact of Mediterranean diet on BMI and inflammatory markers in overweight/obese adults. The review followed the PRISMA checklist, used Cochrane Collaboration search strategies, and is PROSPERO registered (CRD42021277070). Two authors independently screened and evaluated studies for methodological quality. Papers were extracted and included based eligibility, despite risk of bias scores. Results: Of 65 extracted records, six studies met the eligibility criteria and were included. Reductions in BMI, TNF-α, IL-6 and hs-CRP were reported amongst most findings, the majority of which were significant. Conclusion: The main findings indicate a hypocaloric, fibre dense Mediterranean diet is a short-term (<4 months) mitigation strategy to significantly reduce BMI and inflammatory markers amongst overweight/obese adults at risk of developing severe COVID-19 outcomes. Further research is now needed to examine the role of Mediterranean diet in COVID-19 prevalence, severity, morbidity and mortality.
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Affiliation(s)
- Ella Moore
- Research Institute for Sport and Exercise Science,
School of Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK
| | - Abdulmannan Fadel
- Research Institute for Sport and Exercise Science,
School of Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK
| | - Katie E. Lane
- Research Institute for Sport and Exercise Science,
School of Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK
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Gioxari A, Grammatikopoulou MG, Katsarou C, Panagiotakos DB, Toutouza M, Kavouras SA, Sidossis LS, Maraki MI. A Modified Mediterranean Diet Improves Fasting and Postprandial Glucoregulation in Adults with Overweight and Obesity: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15347. [PMID: 36430066 PMCID: PMC9692994 DOI: 10.3390/ijerph192215347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
The ideal lifestyle intervention to battle both obesity and diabetes is currently unknown. The aim of this pilot uncontrolled intervention trial was to assess the effect of a modified Mediterranean diet (MedDiet) on weight loss and glucoregulation among overweight/obese adults. Eleven men and women with overweight/obesity, aged 37 ± 12 years, participated in a free-living intervention until 10% weight loss was achieved. Participants followed an individualized MedDiet high in monounsaturated fat and protein with decreased carbohydrate and saturated fat contents. Physical activity and dietary intake were monitored with pedometers and food records, respectively. Upon weight loss achievement, anthropometric measurements, blood metabolic profiles and individual responses to oral glucose and mixed-meal tests were evaluated pre- and post-intervention. The results showed significant ameliorations in body fat, waist circumference and leptin levels (p < 0.01), with concomitant increases in adiponectin-leptin ratios (p < 0.001). Glucoregulation was significantly improved according to glucose and insulin responses, homeostatic model assessment of insulin resistance indices and postprandial insulin sensitivity indices (p < 0.05). In conclusion, the modified Mediterranean diet may induce significant improvements in body composition, adipocytokine profile and glucose metabolism in overweight/obese individuals. Notably, ameliorated glycemia and increased insulin sensitivity may be retained even at postprandial level, irrespective of the meal consumed.
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Affiliation(s)
- Aristea Gioxari
- Department of Nutritional Science and Dietetics, School of Health Science, University of the Peloponnese, Antikalamos, GR24100 Kalamata, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR41110 Larissa, Greece
| | - Christina Katsarou
- Laboratory of Nutrition & Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, 70th Eleftheriou Venizelou Str., GR17676 Athens, Greece
| | - Demosthenes B. Panagiotakos
- Laboratory of Nutrition & Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, 70th Eleftheriou Venizelou Str., GR17676 Athens, Greece
| | - Marina Toutouza
- Department of Microbiology and Immunology, Hippokration General Hospital, 2–4 Mesogeion Avenue, GR11527 Athens, Greece
| | - Stavros A. Kavouras
- Hydration Science Lab, College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Labros S. Sidossis
- Laboratory of Nutrition & Clinical Dietetics, Department of Nutrition and Dietetics, Harokopio University, 70th Eleftheriou Venizelou Str., GR17676 Athens, Greece
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08854, USA
| | - Maria I. Maraki
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, GR72300 Sitia, Greece
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistaseos Str., GR17237 Athens, Greece
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45
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Gonzalez-Nahm S, Marchesoni J, Maity A, Maguire RL, House JS, Tucker R, Atkinson T, Murphy SK, Hoyo C. Maternal Mediterranean Diet Adherence and Its Associations with Maternal Prenatal Stressors and Child Growth. Curr Dev Nutr 2022; 6:nzac146. [PMID: 36406812 PMCID: PMC9665863 DOI: 10.1093/cdn/nzac146] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/19/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background Psychosocial and physiologic stressors, such as depression and obesity, during pregnancy can have negative consequences, such as increased systemic inflammation, contributing to chronic disease for both mothers and their unborn children. These conditions disproportionately affect racial/ethnic minorities. The effects of recommended dietary patterns in mitigating the effects of these stressors remain understudied. Objectives We aimed to evaluate the relations between maternal Mediterranean diet adherence (MDA) and maternal and offspring outcomes during the first decade of life in African Americans, Hispanics, and Whites. Methods This study included 929 mother-child dyads from the NEST (Newborn Epigenetics STudy), a prospective cohort study. FFQs were used to estimate MDA in pregnant women. Weight and height were measured in children between birth and age 8 y. Multivariable linear regression models were used to examine associations between maternal MDA, inflammatory cytokines, and pregnancy and postnatal outcomes. Results More than 55% of White women reported high MDA during the periconceptional period compared with 22% of Hispanic and 18% of African American women (P < 0.05). Higher MDA was associated with lower likelihood of depressive mood (β = -0.45; 95% CI: -0.90, -0.18; P = 0.02) and prepregnancy obesity (β = -0.29; 95% CI: -0.57, -0.0002; P = 0.05). Higher MDA was also associated with lower body size at birth, which was maintained to ages 3-5 and 6-8 y-this association was most apparent in White children (3-5 y: β = -2.9, P = 0.02; 6-8 y: β = -3.99, P = 0.01). Conclusions If replicated in larger studies, our data suggest that MDA provides a potent avenue by which effects of prenatal stressors on maternal and fetal outcomes can be mitigated to reduce ethnic disparities in childhood obesity.
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Affiliation(s)
- Sarah Gonzalez-Nahm
- Department of Nutrition, University of Massachusetts Amherst, Amherst, MA, USA
| | - Joddy Marchesoni
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Arnab Maity
- Department of Statistics, North Carolina State University, Raleigh, NC, USA
| | - Rachel L Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - John S House
- National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Rachel Tucker
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Tamara Atkinson
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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46
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D’Adamo CR, Workman K, Barnabic C, Retener N, Siaton B, Piedrahita G, Bowden B, Norman N, Berman BM. Culinary Medicine Training in Core Medical School Curriculum Improved Medical Student Nutrition Knowledge and Confidence in Providing Nutrition Counseling. Am J Lifestyle Med 2022; 16:740-752. [PMID: 36389046 PMCID: PMC9644147 DOI: 10.1177/15598276211021749] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2023] Open
Abstract
Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved (P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.
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Affiliation(s)
- Christopher R. D’Adamo
- Department of Family & Community Medicine,
University of Maryland School of Medicine, Baltimore, Maryland
- Department of Epidemiology & Public Health,
University of Maryland School of Medicine, Baltimore, Maryland
| | - Kayli Workman
- Department of Family & Community Medicine,
University of Maryland School of Medicine, Baltimore, Maryland
| | - Christine Barnabic
- Department of Family & Community Medicine,
University of Maryland School of Medicine, Baltimore, Maryland
| | - Norman Retener
- Department of Medicine, University of Maryland
School of Medicine, Baltimore, Maryland
| | - Bernadette Siaton
- Department of Medicine, University of Maryland
School of Medicine, Baltimore, Maryland
| | | | - Brandin Bowden
- The Institute for Integrative Health,
Baltimore, Maryland
| | - Nicola Norman
- Department of Medicine, University of Maryland
School of Medicine, Baltimore, Maryland
- The Institute for Integrative Health,
Baltimore, Maryland
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47
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Di Rosa C, Lattanzi G, Spiezia C, Imperia E, Piccirilli S, Beato I, Gaspa G, Micheli V, De Joannon F, Vallecorsa N, Ciccozzi M, Defeudis G, Manfrini S, Khazrai YM. Mediterranean Diet versus Very Low-Calorie Ketogenic Diet: Effects of Reaching 5% Body Weight Loss on Body Composition in Subjects with Overweight and with Obesity-A Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13040. [PMID: 36293616 PMCID: PMC9603454 DOI: 10.3390/ijerph192013040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
The best nutritional strategy to fight the rise in obesity remains a debated issue. The Mediterranean diet (MD) and the Very Low-Calorie Ketogenic diet (VLCKD) are effective at helping people lose body weight (BW) and fat mass (FM) while preserving fat-free mass (FFM). This study aimed to evaluate the time these two diets took to reach a loss of 5% of the initial BW and how body composition was affected. We randomized 268 subjects with obesity or overweight in two arms, MD and VLCKD, for a maximum of 3 months or until they reached 5% BW loss. This result was achieved after one month of VLCKD and 3 months of MD. Both diets were effective in terms of BW (p < 0.0001) and FM loss (p < 0.0001), but the MD reached a higher reduction in both waist circumference (p = 0.0010) and FM (p = 0.0006) and a greater increase in total body water (p = 0.0017) and FFM (p = 0.0373) than VLCKD. The population was also stratified according to gender, age, and BMI. These two nutritional protocols are both effective in improving anthropometrical parameters and body composition, but they take different time spans to reach the goal. Therefore, professionals should evaluate which is the most suitable according to each patient's health status.
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Affiliation(s)
- Claudia Di Rosa
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Greta Lattanzi
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Chiara Spiezia
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Elena Imperia
- Unit of Gastroenterology, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Sara Piccirilli
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Ivan Beato
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Gianluigi Gaspa
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Vanessa Micheli
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Federica De Joannon
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Noemi Vallecorsa
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistic and Molecular Epidemiology, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Giuseppe Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Yeganeh Manon Khazrai
- Unit of Food Science and Human Nutrition, Campus Bio-Medico University of Rome, 00128 Rome, Italy
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48
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Hynicka LM, Piedrahita G, Barnabic C, Rambob I, Berman BM, D'Adamo CR. Interprofessional Culinary Medicine Training Enhanced Nutrition Knowledge, Nutrition Counseling Confidence, and Interprofessional Experience. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:811-820. [PMID: 35834608 DOI: 10.1089/jicm.2022.0573] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Culinary medicine training combining evidence-based nutrition instruction with experiential cooking application has improved nutrition knowledge, skills, and attitudes in the professional and personal lives of medical students. However, interprofessional culinary training remains largely unstudied among professional students who will be involved in collaborative patient care. The goal of this study was to evaluate the feasibility and effectiveness of an elective interprofessional culinary medicine course for students in the medical, pharmacy, social work, nursing, law, and dentistry schools at the University of Maryland, Baltimore. Methods: The interprofessional culinary medicine course was offered in-person at the teaching kitchen of the Nova Institute for Health in 2020 and virtually in 2021 during the COVID pandemic. The training featured five workshops combining instruction in a variety of popular diets, cooking a meal inspired by the diet in focus, and group discussion. Paired t tests were utilized to evaluate changes in pre-/post-training nutrition and interprofessional experience outcomes. Linear regression models were constructed to compare outcomes between in-person and virtual delivery. Results: A total of 62 students participated in the culinary medicine training. Confidence in all nutrition knowledge, skills, and attitudes, as well as interprofessional experience outcomes, improved after the training (p < 0.05). Similar improvements were noted in most outcomes with in-person and virtual delivery in linear regression modeling. Discussion: Interprofessional culinary medicine training is feasible, and virtual delivery may help enhance replicability in other settings.
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Affiliation(s)
- Lauren M Hynicka
- Pharmacy Practice and Science Department, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | | | - Christine Barnabic
- Department of Family & Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Isabel Rambob
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Brian M Berman
- Nova Institute for Health, Baltimore, MD, USA
- Department of Family & Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christopher R D'Adamo
- Nova Institute for Health, Baltimore, MD, USA
- Department of Family & Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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49
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Overcash F, Crusan AC. Substitution Modeling Shows Simple Dietary Changes Increase Mediterranean-Style Diet Pattern Scores for US Adults. Curr Dev Nutr 2022; 6:nzac125. [PMID: 36204328 PMCID: PMC9529220 DOI: 10.1093/cdn/nzac125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 11/14/2022] Open
Abstract
Background A Mediterranean-style diet pattern (MSDP) is a recommended diet pattern in the 2020-2025 Dietary Guidelines for Americans. Few studies report widespread adherence to the diet, which suggests Americans may benefit from strategies to help them improve alignment to an MSDP. Objectives The purpose of this study was to assess the impact of isocaloric food substitutions on adherence to an MSDP in US adults. Methods Using data from NHANES (2007-2018), alignment to an MSDP was determined by calculation of a Mediterranean diet scoring index appropriate for non-Mediterranean populations (0-100 points for the total score, with higher scores indicating greater adherence). The sample was divided into 2 groups, a high-adherence group (HA) and a non-high-adherence group (nHA), to differentiate food groups to be used for isocaloric food substitution modeling. Substitution modeling via multiple regression analyses determined food selections that have the greatest impact on MSDP scores. Honey was added to the substitutions in recipe form and evaluated for its impact on MSDP scores. Results The study consisted of 19,978 adults, ages 25-65, with complete dietary data. The nHA had a lower mean total MSDP score (7.07 ± 0.04 points) compared to the HA (16.45 ± 0.09 points). Increasing olive oil from nonuse to partial use had the greatest impact (>+2 points) for both groups. Other isocaloric substitutions also improved adherence, albeit to a lesser degree, including substituting 1 oz of whole grains for 1 oz of refined grains, 4 oz of fish for 4 oz of red meat, and 4.9 cups of kale for 0.7 cups of starchy or root vegetables. Improved MSDP scores were sustained when honey was added to the substitutions. Conclusions Simple dietary substitutions can help a diet more closely align with an MSDP. Adding honey to the simple substitutions may increase palatability without sacrificing nutritional benefits.
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Affiliation(s)
- Francine Overcash
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Ambria C Crusan
- Department of Nutrition and Dietetics, St. Catherine University, St. Paul, MN, USA
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50
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Pelczyńska M, Burak W, Królak S, Geppert A, Lipczyński M, Grzybołowska J, Kociubiński P. The role of the dietary patterns in the cardiovascular disease risk prevention. JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Cardiovascular diseases (CVD) are a part of a wide group of diseases, which became main threat to the life and health of the population in highly developed countries. To prevent and treat CVD, in addition to implementation of pharmacological methods, there are a number of lifestyle components, including eating habits, that significantly influence the development of these diseases. The dietary patterns strongly correlate with the risk of cardiovascular disease. Modifications of the dietary habits allow to control many parameters such as: body weight, cholesterol/triglyceride levels or blood pressure. Alternative diets are frequently used to reduce the risk of developing a CVD. The main recommended dietary patterns includes Mediterranean diet (MD), the DASH diet (Dietary Approach to Stop Hypertension) and mild variants of vegetarianism. The more controversial nutritional styles includes the ketogenic or vegan diets. Due to various assumptions as well as the mechanisms of action of each diets, an attempt of its evaluation have been made. The aim of our study is to review and analyze the available data on the impact of various nutrition models regarding to cardiovascular diseases risk prevention.
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