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Franchini C, Biasini B, Sogari G, Wongprawmas R, Andreani G, Dolgopolova I, Gómez MI, Roosen J, Menozzi D, Mora C, Scazzina F, Rosi A. Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students. Nutr J 2024; 23:56. [PMID: 38797846 PMCID: PMC11129378 DOI: 10.1186/s12937-024-00962-0] [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: 01/19/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors. METHODS MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed. RESULTS A sample of 1485 participants (median (IQR) age 21.0 (19.0-22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen. CONCLUSIONS Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.
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Affiliation(s)
- Cinzia Franchini
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
| | - Beatrice Biasini
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
| | - Giovanni Sogari
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
| | | | - Giulia Andreani
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
| | - Irina Dolgopolova
- Department of Marketing and Supply Chain Management, School of Business and Economics, Maastricht University, LM Maastricht, 6211, The Netherlands
| | - Miguel I Gómez
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, NY, 14853, USA
| | - Jutta Roosen
- Marketing and Consumer Research, School of Management, Technical University of Munich, 85354, Freising, Weihenstephan, Germany
| | - Davide Menozzi
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
| | - Cristina Mora
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
| | - Francesca Scazzina
- Department of Food and Drug, University of Parma, Parma, 43124, Italy.
- Medical School, Building A, Via Volturno 39, Parma, 43125, Italy.
| | - Alice Rosi
- Department of Food and Drug, University of Parma, Parma, 43124, Italy
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Mohammadifard N, Alavi Tabatabaei G, Haghighatdoost F, Zarepur E, Nouri F, Javanbakht S, Nouhi F, Alikhasi H, Kazemi T, Azdaki N, Salehi N, Solati K, Lotfizadeh M, Ghaffari S, Javanmardi E, Salari A, Dehghani M, Cheraghi M, Assareh A, Haybar H, Namayandeh SM, Madadi R, Sarrafzadegan N. The relationship between nut consumption and premature coronary artery disease in a representative sample of Iranians: Iran-premature coronary artery disease (IPAD) study. Public Health Nutr 2023; 26:2771-2779. [PMID: 37927082 PMCID: PMC10755431 DOI: 10.1017/s1368980023002392] [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: 01/05/2023] [Revised: 07/22/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE The cardioprotective effects of nuts are well established. However, the positive impacts of nuts in preventing CVD at a younger age, a condition known as premature coronary artery disease (PCAD), is still debated. Therefore, we aim to determine the association between nuts and PCAD occurrence and its severity in different Iranian ethnicities. DESIGN This case-control study was conducted within the framework of the Iran-premature coronary artery disease (I-PAD) study, an ongoing multi-centric study on Iranian patients of different ethnicities. SETTING This multi-centric case-control study was conducted in among 3253 persons under the age of 70 years in women and 60 years in men from different ethnicities in Iran. PARTICIPANTS Information on nut consumption was collected using a validated FFQ. Subjects were selected from among the candidates for angiography. Cases were those whose coronary angiography showed stenosis of more than 75 % in at least one vessel or more than 50 % of the left main artery, while the control group participants had normal angiography results. RESULTS In the crude model, compared to the first quartile, the highest quartile of nut consumption was significantly associated with a lower risk of PCAD (OR = 0·26, 95 % CI (0·21, 0·32); Pfor trend = 0·001). In the top quartile of nut intake, a substantial decrease in PCAD was observed after controlling for putative confounders (OR = 0·32; 95 % CI (0·24, 0·43); Pfor trend = 0·001). Additionally, a 75 % decrease in the risk of severe PCAD was observed in the participants in the highest quartile of nut intake. CONCLUSION A significant inverse association was observed between nut intake and the risk and severity of PCAD in the Iranian population. Large-scale clinical trials are required to confirm these findings.
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Affiliation(s)
- Noushin Mohammadifard
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghazaal Alavi Tabatabaei
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Zarepur
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Cardiology, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahel Javanbakht
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereidoon Nouhi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran & President of Iranian Network of Cardiovascular Research (INCVR)
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Iranian Network of Cardiovascular Research
| | - Hassan Alikhasi
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Clinical Research Development Unit, Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Nahid Azdaki
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Clinical Research Development Unit, Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Nahid Salehi
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kamal Solati
- Department of Psychiatry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran & Member of the INCVR
| | - Elmira Javanmardi
- Department of Cardiovascular Medicine, Heart Center, Maragheh University of Medical Sciences, Amiralmomenin Hospital, Iran
| | - Arsalan Salari
- Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mostafa Dehghani
- Department of Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Science, Khorramabad, Iran
| | - Mostafa Cheraghi
- Department of Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Science, Khorramabad, Iran
| | - Ahmadreza Assareh
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran & Member of the INCVR
| | - Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran & Member of the INCVR
| | | | - Reza Madadi
- Department of Cardiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Baer DJ, Dalton M, Blundell J, Finlayson G, Hu FB. Nuts, Energy Balance and Body Weight. Nutrients 2023; 15:nu15051162. [PMID: 36904160 PMCID: PMC10004756 DOI: 10.3390/nu15051162] [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: 01/27/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
Over several decades, the health benefits of consuming nuts have been investigated, resulting in a large body of evidence that nuts can reduce the risk of chronic diseases. The consumption of nuts, being a higher-fat plant food, is restricted by some in order to minimize weight gain. In this review, we discuss several factors related to energy intake from nuts, including food matrix and its impact on digestibility, and the role of nuts in regulating appetite. We review the data from randomized controlled trials and observational studies conducted to examine the relationship between nut intake and body weight or body mass index. Consistently, the evidence from RCTs and observational cohorts indicates that higher nut consumption does not cause greater weight gain; rather, nuts may be beneficial for weight control and prevention of long-term weight gain. Multiple mechanisms likely contribute to these findings, including aspects of nut composition which affect nutrient and energy availability as well as satiety signaling.
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Affiliation(s)
- David J. Baer
- US Department of Agriculture, Agricultural Research Service, Beltsville, MD 20705, USA
- Correspondence: ; Tel.: +1-(301)-504-8719
| | - Michelle Dalton
- School of Psychology, Leeds Trinity University, Leeds LS18 5HD, UK
| | - John Blundell
- School of Psychology, Appetite Control and Energy Balance Research Group, University of Leeds, Leeds LS2 9JT, UK
| | - Graham Finlayson
- School of Psychology, Appetite Control and Energy Balance Research Group, University of Leeds, Leeds LS2 9JT, UK
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health; Boston, MA 02115, USA
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Effects of Nut Consumption on Blood Lipids and Lipoproteins: A Comprehensive Literature Update. Nutrients 2023; 15:nu15030596. [PMID: 36771303 PMCID: PMC9920334 DOI: 10.3390/nu15030596] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/25/2023] Open
Abstract
In the present review, we provide a comprehensive narrative overview of the current knowledge on the effects of total and specific types of nut consumption (excluding nut oil) on blood lipids and lipoproteins. We identified a total of 19 systematic reviews and meta-analyses of randomized controlled trials (RCTs) that were available in PubMed from the inception date to November 2022. A consistent beneficial effect of most nuts, namely total nuts and tree nuts, including walnuts, almonds, cashews, peanuts, and pistachios, has been reported across meta-analyses in decreasing total cholesterol (mean difference, MD, -0.09 to -0.28 mmol/L), LDL-cholesterol (MD, -0.09 to -0.26 mmol/L), and triglycerides (MD, -0.05 to -0.17 mmol/L). However, no effects on HDL-cholesterol have been uncovered. Preliminary evidence indicates that adding nuts into the regular diet reduces blood levels of apolipoprotein B and improves HDL function. There is also evidence that nuts dose-dependently improve lipids and lipoproteins. Sex, age, or nut processing are not effect modifiers, while a lower BMI and higher baseline lipid concentrations enhance blood lipid/lipoprotein responses. While research is still emerging, the evidence thus far indicates that nut-enriched diets are associated with a reduced number of total LDL particles and small, dense LDL particles. In conclusion, evidence from clinical trials has shown that the consumption of total and specific nuts improves blood lipid profiles by multiple mechanisms. Future directions in this field should include more lipoprotein particle, apolipoprotein B, and HDL function studies.
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Takase T, Nagao M, Kanai R, Nishida T, Arima T, Iwai F, Yamada S, Nakamoto M, Hirayama M, Fujisawa T. Intake of allergenic foods at 1.5 years and 3 years of age in a general child population in Japan: a cross-sectional study. Environ Health Prev Med 2023; 28:6. [PMID: 36682814 PMCID: PMC9884563 DOI: 10.1265/ehpm.22-00213] [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] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Recent studies indicate that the timing of introduction of potentially allergenic food is crucial for the development of food allergy in children. This cross-sectional study aimed to clarify the reality of allergen food intake in a general population of young children in Japan. METHODS A questionnaire survey of caregivers was conducted at health checkups for 1.5-year (18-month)-old and 3-year-old children in the fall of 2020. The caregivers were asked about (1) the presence/absence of allergic disease symptoms based on the ISAAC questionnaire, and (2) foods that caregivers avoided giving their children. Ordinal logistic regression analyses were periformed to determine factors associated with food avoidance. RESULTS Questionnaires were distributed to 1720 caregivers, and 1603 (93%) responded. The responders consisted of 771 and 832 caregivers who participated in 1.5-year-old and 3-year-old checkups, respectively. The prevalence of allergic diseases was comparable to recent epidemiological studies in Japan, indicating that the population may be representative. At 1.5 years old, more than 50% of the children were not exposed to peanuts, tree nuts, fish eggs, shellfish, and buckwheat. At 3 years old, the avoidance rates of the foods had decreased but were still between 18.8% and 32.0%. On the other hand, the avoidance rates of chicken egg and cow's milk, the top 2 common allergenic foods in Japan, were much lower at 2.8% and 1.5% at 1.5 years, and they decreased to 1.4% and 0.7% at 3 years old, respectively. Ordinal logistic analysis showed that avoidance of chicken egg, cow's milk, and wheat was associated with food allergy diagnosis and chicken egg avoidance with eczema, but avoidance of other foods showed no associations with any risk factors for food allergy. CONCLUSION Caregivers avoided giving various foods, independent of allergy risk factors, to their young children. Since delayed introduction of an allergenic food has been reported to increase the risk of developing an allergy to the food, the results warrant future investigation of the development of food allergies in relation to current eating habits and recommendations.
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Affiliation(s)
- Takafumi Takase
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Mizuho Nagao
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Rei Kanai
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Takahiro Nishida
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Tomoyuki Arima
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Fumiko Iwai
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Shingo Yamada
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Makiko Nakamoto
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine
| | - Takao Fujisawa
- Allergy Center and Department of Clinical Research, National Hospital Organization Mie National Hospital
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