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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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Poklar Vatovec T, Jenko Pražnikar Z, Petelin A. Adherence and Sociodemographic Determinants of Adherence to the Mediterranean Diet among Slovenian Adults and the Elderly. Nutrients 2023; 15:3219. [PMID: 37513637 PMCID: PMC10384731 DOI: 10.3390/nu15143219] [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: 06/14/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The Mediterranean diet (MD) is considered a model for good health, and is promoted worldwide as one of the healthiest dietary patterns. Despite the MD's health benefits, the literature suggests that adherence to the MD tends to be in decline in most populations worldwide, including those in the Mediterranean region. The aim of this study was to investigate adherence to the MD, and its main sociodemographic and lifestyle factors, in the Slovenian population. Using a nationwide cross-sectional food consumption survey (SI.Menu), data were collected from a general questionnaire, from the 14-item MD adherence screener (14-MEDAS score), and from a questionnaire on the dietary habits of 850 adults and elderly people. The mean MEDAS score for the total study sample was 5.6 (SD 2.1), indicating a low adherence to the MD among the Slovenian population. The adherence to the MD was higher among women (OR = 1.534; 95% Cl 1.156-2.034), those with a university degree (OR = 1.527; 1.098-2.125; compared to those with no university degree), those who lived in a suburb or city (OR = 1.511; 1.016-2.249; OR = 1.568; 1.122-2.191; compared with those who lived in a village), non-smokers (OR = 1.561; 1.380-1.830; compared with smokers), and those who lived in the western part of Slovenia (OR = 1.558; 1.170-2.074; compared with those who lived in eastern Slovenia). Adherence to the MD in the Slovenian population is low, and is strongly related to educational level, gender, geographic region, place of residence, and smoking status. The frequency of the consumption of different food groups is also closely related.
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Affiliation(s)
- Tamara Poklar Vatovec
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Zala Jenko Pražnikar
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Ana Petelin
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
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Dogan BG, Tengilimoglu-Metin MM. Does mindful eating affect the diet quality of adults? Nutrition 2023; 110:112010. [PMID: 37001225 DOI: 10.1016/j.nut.2023.112010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/13/2023] [Accepted: 02/17/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES This study aimed to examine the relationship between mindful eating and diet quality among adults in Turkey. METHODS A total of 207 adults, 138 women (66.7% of 207) and 69 men (33.3%), participated. This cross-sectional survey was carried out among adults aged 20-50 y. The following data were collected from face-to-face interviews: sociodemographic variables, health information, nutritional habits, anthropometric measurements, 24-h dietary records, and scores from the Mindful Eating Questionnaire (MEQ), Mediterranean Diet Adherence Screener (MEDAS), and Healthy Eating Index-2015 (HEI-2015). RESULTS The mean MEDAS scores of females were higher than those of males (P = 0.012). The mean HEI-2015 scores did not significantly differ between females and males (P > 0.05). The mean scores of the MEQ (P = 0.024) and its disinhibition (P = 0.005) and emotional eating (P = 0.000) subfactors were higher in males than in females. The MEQ mean score was negatively associated with daily energy (P = 0.038), carbohydrate (P = 0.046), and fat intake (P = 0.036). As the MEQ mean score increased, the greens and beans score (P = 0.009) and dairy intake score (P = 0.031) increased. A positive correlation was present between the eating discipline subfactor of the MEQ score and both the HEI-2015 (P = 0.002) and MEDAS mean scores (P = 0.001). However, no significant correlation was found between the mean MEQ and HEI-2015 scores and the MEDAS mean scores (P > 0.05). CONCLUSIONS Developing mindful eating might be helpful for individual health promotion and quality of life by providing improvements in diet quality of adults.
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Affiliation(s)
- Buse Gorgulu Dogan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - M Merve Tengilimoglu-Metin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
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Béjar LM, Mesa-Rodríguez P, Quintero-Flórez A, Ramírez-Alvarado MDM, García-Perea MD. Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial. Nutrients 2023; 15:nu15071688. [PMID: 37049528 PMCID: PMC10096856 DOI: 10.3390/nu15071688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/17/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).
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Best N, Flannery O. Association between adherence to the Mediterranean Diet and the Eatwell Guide and changes in weight and waist circumference in post-menopausal women in the UK Women's Cohort Study. Post Reprod Health 2023; 29:25-32. [PMID: 36738286 PMCID: PMC10009324 DOI: 10.1177/20533691231156643] [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] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study investigated the associations between adherence to the Mediterranean Diet and the Eatwell Guide (EWG) and changes in weight and waist circumference in post-menopausal women. STUDY DESIGN Post-hoc analysis of post-menopausal women from the UK Women's Cohort Study. MAIN OUTCOME MEASURES Changes in weight, waist circumference and the risk of abdominal and general obesity. RESULTS 4162 post-menopausal women were selected. Higher adherence to both the EWG and the Mediterranean Diet was associated with smaller increases in waist circumference over 4 years (EWG: β -0.47, CI -0.75, -0.20 per 1 tertile increase in score), (Mediterranean Diet: β -0.29, CI -0.58, -0.01 per 1 tertile increase in score); and lower risk of abdominal obesity (EWG: OR 0.55, CI 0.43, 0.70 third versus the first tertile), (Mediterranean Diet: OR 0.60, CI 0.46, 0.76 third versus the first tertile), but was not associated with weight changes (EWG: β 0.14, CI -0.07, 0.36 per 1 tertile increase in score), (Mediterranean Diet: β 0.03, CI -0.19, 0.25 per 1 tertile increase in score) or risk of becoming overweight or obese (EWG: OR 1.09, CI 0.77, 1.52 third versus the first tertile), (Mediterranean Diet: OR 0.91, CI 0.65, 1.27 third versus the first tertile). CONCLUSIONS The results suggest that adherence to either the Mediterranean Diet or the EWG can help to prevent abdominal obesity in post-menopausal women.
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Affiliation(s)
- Nicola Best
- Faculty of Health and Education, 5289Manchester Metropolitan University, Manchester, UK
| | - Orla Flannery
- Faculty of Health and Education, 5289Manchester Metropolitan University, Manchester, UK
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Angulo E, Stern D, Castellanos-Gutiérrez A, Monge A, Lajous M, Bromage S, Fung TT, Li Y, Bhupathiraju SN, Deitchler M, Willett WC, Batis C. Changes in the Global Diet Quality Score, Weight, and Waist Circumference in Mexican Women. J Nutr 2021; 151:152S-161S. [PMID: 34689194 PMCID: PMC8542099 DOI: 10.1093/jn/nxab171] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Evidence on concurrent changes in overall diet quality and weight and waist circumference in women of reproductive age from low- and middle-income countries is limited. OBJECTIVES We examined the associations of changes in the Global Diet Quality Score (GDQS) and each GDQS food group with concurrent weight and waist circumference change in Mexican women. METHODS We followed prospectively 8967 nonpregnant nonlactating women aged 25-49 y in the Mexican Teachers' Cohort between 2006 and 2008. We assessed diet using an FFQ of the previous year and anthropometric measures were self-reported. Regression models were used to examine 2-y changes in the GDQS and each food group (servings/d) with weight and waist circumference changes within the same period, adjusting for demographic and lifestyle factors. RESULTS Compared with those with little change in the GDQS (-2 to 2 points), women with the largest increase in the GDQS (>5 points) had less weight (β: -0.81 kg/2 y; 95% CI: -1.11, -0.51 kg/2 y) and waist circumference gain (β: -1.05 cm/2 y; 95% CI: -1.62, -0.48 cm/2 y); likewise, women with the largest decrease in the GDQS (<-5 points) had more weight (β: 0.36 kg/2 y; 95% CI: 0.06, 0.66 kg/2 y) and waist circumference gain (β: 0.71 cm/2 y; 95% CI: 0.09, 1.32 cm/2 y). Increased intake of dark green leafy vegetables, cruciferous vegetables, deep orange vegetables, citrus fruits, and fish and shellfish was associated with less weight gain. In addition, deep orange vegetables, low fat and high fat dairy, whole grains, and fish were associated with less waist circumference gain within the 2-y period. CONCLUSIONS Improvements in diet quality over a 2-y period reflected by an increase in the GDQS and changes in consumption of specific components of the GDQS were associated with less weight and waist circumference gain in Mexican women.
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Affiliation(s)
- Erick Angulo
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Dalia Stern
- CONACYT-Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Martín Lajous
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sabri Bromage
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Teresa T Fung
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yanping Li
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | | | - Megan Deitchler
- Intake-Center for Dietary Assessment, FHI Solutions, Washington, DC, USA
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Carolina Batis
- CONACYT-Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
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López-Moreno M, Garcés-Rimón M, Miguel M, Iglesias López MT. Adherence to Mediterranean Diet, Alcohol Consumption and Emotional Eating in Spanish University Students. Nutrients 2021; 13:3174. [PMID: 34579051 PMCID: PMC8466414 DOI: 10.3390/nu13093174] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 01/02/2023] Open
Abstract
(1) Introduction: The university period may increase the risk of different unhealthy habits, such as low adherence to the Mediterranean diet, high alcohol consumption and eating in response to specific emotions. The aim of this study was to detect early-risk alcohol consumption and alcohol dependence (ADS), the degree of adherence to the Mediterranean diet and emotional eating in university students of the Madrid community. (2) Methods: For each individual, anthropometric parameters, the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption (AUDIT-C), the Mediterranean Diet Adherence Screener (MEDAS) and the Emotional Eater Questionnaire (EEQ) were assessed. (3) Results: A total of 584 university students aged 20.5 (sex ratio = 0.39) were enrolled in a cross-sectional study. In total, 63.6% of students showed low adherence to the Mediterranean diet, with no differences by sex (64.3% female versus 61.5% male, p = 0.19). According to the AUDIT questionnaire, 26.2% of participants were categorized as high-risk drinkers and 7.7% as ADS. About 38.6% of the students were categorized as eating very emotionally or eating emotionally, and 37.2% were categorized as low emotional eaters. A weak positive correlation was observed between the EEQ and BMI in female students (rho= 0.15, p = 0.03). (4) Conclusions: University students in our sample showed a low adherence to the Mediterranean diet, an important high-risk alcohol consumption and low emotional eating.
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Affiliation(s)
- Miguel López-Moreno
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.)
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Marta Garcés-Rimón
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.)
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Marta Miguel
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.)
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Lotfi K, Saneei P, Hajhashemy Z, Esmaillzadeh A. Adherence to the Mediterranean Diet, Five-Year Weight Change, and Risk of Overweight and Obesity: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2021; 13:152-166. [PMID: 34352891 PMCID: PMC8803490 DOI: 10.1093/advances/nmab092] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/07/2021] [Accepted: 07/06/2021] [Indexed: 12/31/2022] Open
Abstract
Findings from earlier studies on the association between adherence to a Mediterranean diet and risk of overweight/obesity were inconsistent. We summarized cohort studies investigating the association between the Mediterranean diet and risk of overweight and/or obesity and weight change in adults. A systematic search of PubMed, Scopus, ISI Web of Science, and Google Scholar was conducted up to May 2021. Prospective cohorts that examined the Mediterranean diet adherence in adults as the exposure, and overweight and/or obesity or weight change as the outcomes, and reported RRs or β coefficients and 95% CIs as the effect sizes were included. Seven prospective cohort studies were included of which 6 studies (with 244,678 adult participants) reported the risk of overweight and/or obesity, and 4 cohorts (with 436,617 participants) reported the weight change (3 cohorts reported both overweight and/or obesity risk and weight change). Combining 15 effect sizes from 6 cohorts revealed that greater adherence to the Mediterranean diet was significantly associated with a 9% decreased risk of overweight and/or obesity (RR: 0.91; 95% CI: 0.88, 0.94; I2 = 44.7%; PQ-test = 0.031). This association was significant in the case of studies investigating combined overweight and obesity (RR: 0.92; 95% CI: 0.88, 0.96; I2 = 29.4%; PQ-test = 0.166), but not for studies that reported on obesity (RR: 0.68; 95% CI: 0.43, 1.10, I2 = 50.6%, PQ-test = 0.132). Linear dose-response analysis of 6 studies showed a 2% decreased risk of overweight and/or obesity for 1 additional Mediterranean diet score (RR: 0.98; 95% CI: 0.96, 0.99). Each unit increase in the Mediterranean diet score was associated with 0.04 kg less weight gain over 5 y (-0.04 kg; 95% CI: -0.07, -0.02 kg; 13 effect sizes from 4 cohorts). In conclusion, Mediterranean diet adherence is inversely associated with risk of overweight and/or obesity as well as 5-y weight gain and thus has practical importance for public health.
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Affiliation(s)
- Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Hajhashemy
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Shatwan IM, Alhinai EA, Alawadhi B, Surendran S, Aljefree NM, Almoraie NM. High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries. Nutrients 2021; 13:nu13030995. [PMID: 33808684 PMCID: PMC8003341 DOI: 10.3390/nu13030995] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023] Open
Abstract
The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20–55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.
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Affiliation(s)
- Israa M. Shatwan
- Food and Nutrition Department, Human Sciences and Design Faculty, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (N.M.A.); (N.M.A.)
- Correspondence:
| | - Eiman A. Alhinai
- Dietetics Department, Al Nahdha Hospital, Ministry of Health, Ruwi 937, Muscat PC 112, Oman;
| | - Balqees Alawadhi
- The Public Authority of Applied Education and Training (PAAET), Department of Food and Nutritional Sciences, College of Health Sciences, Shuwaikh, Kuwait;
| | - Shelini Surendran
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK;
| | - Najlaa M. Aljefree
- Food and Nutrition Department, Human Sciences and Design Faculty, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (N.M.A.); (N.M.A.)
| | - Noha M. Almoraie
- Food and Nutrition Department, Human Sciences and Design Faculty, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (N.M.A.); (N.M.A.)
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Jalilpiran Y, Jayedi A, Djafarian K, Shab-Bidar S. The Nordic diet and the risk of non-communicable chronic disease and mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2020; 62:3124-3136. [PMID: 33354987 DOI: 10.1080/10408398.2020.1863906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We aimed to investigate the association between adherence to the Nordic diet (ND) and the risk of chronic disease. PubMed, Scopus, and ISI Web of Science were searched to February 2020 to find prospective cohort studies. The relative risks (RRs) were calculated using a fixed-effects/random-effects model. The certainty of evidence was rated using the GRADE approach. Thirteen prospective cohort studies with 930,153 participants were included. The RRs for the highest compared to the lowest category of adherence to the ND were 0.78 (95%CI: 0.69, 0.87; I2 = 51%, n = 6) for all-cause mortality, 0.78 (95%CI: 0.74, 0.83; I2 = 70%, n = 4) for cardiovascular mortality, 0.86 (95%CI: 0.80, 0.93; I2 = 83%, n = 4) for cancer mortality, 0.88 (95%CI: 0.79, 0.98; I2 = 3%, n = 3) for stroke, 0.80 (95%CI: 0.68, 0.95; I2 = 47%, n = 3) for myocardial infarction, and 0.90 (95%CI: 0.82, 0.99; I2 = 33%, n = 4) for type 2 diabetes. There was an inverse linear association between the ND score and the risk of mortality, and an inverse monotonic association for type 2 diabetes. The certainty in the estimates ranged from very low to low.
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Affiliation(s)
- Yahya Jalilpiran
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Ramezani-Jolfaie N, Mohammadi M, Salehi-Abargouei A. Effects of a healthy Nordic diet on weight loss in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Eat Weight Disord 2020; 25:1141-1150. [PMID: 31522379 DOI: 10.1007/s40519-019-00773-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/31/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Studies on the effect of the Nordic diet (ND) on body weight and adiposity indices were conflicting. This study targeted to perform a systematic review and meta-analysis of randomized controlled clinical trials (RCTs) examined the effect of the ND on body weight and composition. METHODS PubMed, Scopus, ISI web of Science, ProQuest and Google Scholar were searched for the eligible studies up to August 2019. The weighted mean difference (WMD) in body weight and composition indices between the ND and control groups/periods was derived using random-effects model. RESULTS In total, seven studies (n = 774 participants) were included in the present study. Five studies had illustrated the effect of the ND on weight, three on waist circumference (WC), two on body fat, and two on body mass index (BMI). The pooled analysis of eligible trials showed that those adhered to the ND lost 1.83 kg [95% confidence interval (CI) - 2.94, - 0.73, P = 0.001] more weight compared to controls. Qualitative assessment of other anthropometric indices also showed a beneficial effect of this dietary pattern in improving body fat and BMI values; however, these findings are not conclusive because of limited number of studies. CONCLUSION Adherence to the ND significantly improves body weight; however, there is also no certainty that this diet is effective for improving other anthropometric indices. Future studies regarding the effect of the ND on weight and body composition in populations other than Nordic populations are highly recommended. Level of evidence Level I, systematic reviews and meta-analyses.
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Affiliation(s)
- Nahid Ramezani-Jolfaie
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Mohammadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. .,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Bérard S, Morel S, Teasdale E, Shivappa N, Hebert JR, Laverdière C, Sinnett D, Levy E, Marcil V. Diet Quality Is Associated with Cardiometabolic Outcomes in Survivors of Childhood Leukemia. Nutrients 2020; 12:nu12072137. [PMID: 32708379 PMCID: PMC7400871 DOI: 10.3390/nu12072137] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
There is little information about how diet influences the health of childhood acute lymphoblastic leukemia (cALL) survivors. This study explores the associations between diet quality indices, cardiometabolic health indicators and inflammatory biomarkers among cALL survivors. Participants were part of the PETALE study (n = 241, median age: 21.7 years). Adherence to 6 dietary scores and caloric intake from ultra-processed foods were calculated. Multivariate logistirac regressions, Student t-tests and Mann-Whitney tests were performed. We found that 88% of adults and 46% of children adhered poorly to the Mediterranean diet, 36.9% had poor adherence to the World Health Organisation (WHO) recommendations and 76.3% had a diet to be improved according to the HEI-2015 score. On average, ultra-processed foods accounted for 51% of total energy intake. Low HDL-C was associated with a more inflammatory diet (E-DIITM score) and higher intake of ultra-processed foods. A greater E-DII score was associated with elevated insulin resistance (HOMA-IR), and consumption of ultra-processed foods was correlated with high triglycerides. Circulating levels of TNF-α, adiponectin and IL-6 were influenced by diet quality indices, while CRP and leptin were not. In conclusion, survivors of cALL have poor adherence to dietary recommendations, adversely affecting their cardiometabolic health.
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Affiliation(s)
- Sophie Bérard
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5, Canada; (S.B.); (S.M.); (E.T.); (E.L.)
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Sophia Morel
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5, Canada; (S.B.); (S.M.); (E.T.); (E.L.)
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Emma Teasdale
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5, Canada; (S.B.); (S.M.); (E.T.); (E.L.)
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R. Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Caroline Laverdière
- Research Centre, Sainte-Justine University Health Center, Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada; (C.L.); (D.S.)
| | - Daniel Sinnett
- Research Centre, Sainte-Justine University Health Center, Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada; (C.L.); (D.S.)
| | - Emile Levy
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5, Canada; (S.B.); (S.M.); (E.T.); (E.L.)
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Valérie Marcil
- Research Centre, Sainte-Justine University Health Center, Department of Nutrition, Université de Montréal, Montreal, QC H3T 1C5, Canada; (S.B.); (S.M.); (E.T.); (E.L.)
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-514-345-4931 (ext. 3272)
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13
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Cobo-Cuenca AI, Garrido-Miguel M, Soriano-Cano A, Ferri-Morales A, Martínez-Vizcaíno V, Martín-Espinosa NM. Adherence to the Mediterranean Diet and Its Association with Body Composition and Physical Fitness in Spanish University Students. Nutrients 2019; 11:E2830. [PMID: 31752296 PMCID: PMC6893793 DOI: 10.3390/nu11112830] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/12/2022] Open
Abstract
The aims of this study were to assess the association of adherence to the Mediterranean diet (MD) with physical fitness and body composition in Spanish university students and to determine the ability to predict the MD adherence of each Mediterranean Diet Adherence Screener (MEDAS) item. A cross-sectional study was performed involving 310 first-year university students. Adherence to the MD was evaluated with MEDAS-14 items. Anthropometric variables, body composition, and physical fitness were assessed. Muscle strength was determined based on handgrip strength and the standing long jump test. Cardiorespiratory fitness (CRF) was measured using the Course-Navette test. Only 24% of the university students had good adherence to the MD. The ANCOVA models showed a significant difference between participants with high adherence to the MD and those with medium and low adherence in CRF (p = 0.017) and dynamometry (p = 0.005). Logistic binary regression showed that consuming >2 vegetables/day (OR = 20.1; CI: 10.1-30.1; p < 0.001), using olive oil (OR = 10.6; CI: 1.4-19.8; p = 0.021), consuming <3 commercial sweets/week (OR = 10.1; IC: 5.1-19.7; p < 0.001), and consuming ≥3 fruits/day (OR = 8.8; CI: 4.9-15.7; p < 0.001) were the items most associated with high adherence to the MD. In conclusion, a high level of adherence to the MD is associated with high-level muscular fitness and CRF in Spanish university students.
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Affiliation(s)
- Ana Isabel Cobo-Cuenca
- Grupo Interdisciplinar en Cuidados IMCU, Universidad de Castilla la Mancha, 45071 Toledo, Spain;
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (A.S.-C.); (A.F.-M.); (V.M.-V.)
| | - Alba Soriano-Cano
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (A.S.-C.); (A.F.-M.); (V.M.-V.)
| | - Asunción Ferri-Morales
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (A.S.-C.); (A.F.-M.); (V.M.-V.)
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (A.S.-C.); (A.F.-M.); (V.M.-V.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 1101 Talca, Chile
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14
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Adherence to the healthy Nordic diet is associated with weight change during 7 years of follow-up. Br J Nutr 2019; 120:101-110. [PMID: 29936927 DOI: 10.1017/s0007114518001344] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Studies indicate that the healthy Nordic diet may improve heart health, but its relation to weight change is less clear. We studied the association between the adherence to the healthy Nordic diet and long-term changes in weight, BMI and waist circumference. Furthermore, the agreement between self-reported and measured body anthropometrics was examined. The population-based DIetary, Lifestyle and Genetic Determinants of Obesity and Metabolic syndrome Study in 2007 included 5024 Finns aged 25-75 years. The follow-up was conducted in 2014 (n 3735). One-third of the participants were invited to a health examination. The rest were sent measuring tape and written instructions along with questionnaires. The Baltic Sea Diet Score (BSDS) was used to measure adherence to the healthy Nordic diet. Association of the baseline BSDS and changes in BSDS during the follow-up with changes in body anthropometrics were examined using linear regression analysis. The agreement between self-reported and nurse-measured anthropometrics was determined with Bland-Altman analysis. Intra-class correlation coefficients between self-reported and nurse-measured anthropometrics exceeded 0·95. The baseline BSDS associated with lower weight (β=-0·056, P=0·043) and BMI (β=-0·021, P=0·031) over the follow-up. This association was especially evident among those who had increased their BSDS. In conclusion, both high initial and improved adherence to the healthy Nordic diet may promote long-term weight maintenance. The self-reported/measured anthropometrics were shown to have high agreement with nurse-measured values which adds the credibility of our results.
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15
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Agnoli C, Sieri S, Ricceri F, Giraudo MT, Masala G, Assedi M, Panico S, Mattiello A, Tumino R, Giurdanella MC, Krogh V. Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutr Diabetes 2018; 8:22. [PMID: 29695712 PMCID: PMC5916888 DOI: 10.1038/s41387-018-0023-3] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/14/2017] [Accepted: 01/06/2018] [Indexed: 12/20/2022] Open
Abstract
Excessive calorie intake and physical inactivity are considered key determinants of the rapid worldwide increase in obesity prevalence, however the relationship between diet and weight gain is complex. We investigated associations between adherence to a Mediterranean diet and long-term changes in weight and waist circumference in volunteers recruited to the Italian section of the prospective European Prospective Investigation into Cancer and Nutrition (EPIC). We investigated 32,119 cohort members who provided anthropometric measures at recruitment and updated information on recall a mean of 12 years later. Adherence to a Mediterranean diet was assessed using the Italian Mediterranean Index (score range 0-11). Associations between index score and weight and waist changes were assessed by multivariate linear regression models. Risks of developing overweight/obesity and abdominal obesity were investigated by multivariate logistic models. Increasing Italian Mediterranean Index score (indicating better adherence) was associated with lower 5-year weight change in volunteers of normal weight at baseline (β -0.12, 95% CI -0.16 to -0.08 for 1 tertile increase in score), but not in those overweight/obese at baseline (P interaction between Index score and BMI 0.0001). High adherence was also associated with reduced risk of becoming overweight/obese (OR 0.91, 95% CI 0.84-0.99 third vs. first tertile); smaller 5-year change in waist circumference (β -0.09, 95% CI -0.14 to -0.03 for 1 tertile increase in score); and lower risk of abdominal obesity (OR 0.91, 95% CI 0.84-0.99 third vs. first tertile). Adherence to a traditional Italian Mediterranean diet may help prevent weight gain and abdominal obesity.
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Affiliation(s)
- Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service, Grugliasco, Turin, Italy
| | | | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Melania Assedi
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - Salvatore Panico
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy
| | - Amalia Mattiello
- Department of Clinical and Experimental Medicine, Federico II University of Naples, Naples, Italy
| | - Rosario Tumino
- Cancer Registry, Provincial Health Unit (ASP) Ragusa, Ragusa, Italy
| | | | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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16
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Bendall CL, Mayr HL, Opie RS, Bes-Rastrollo M, Itsiopoulos C, Thomas CJ. Central obesity and the Mediterranean diet: A systematic review of intervention trials. Crit Rev Food Sci Nutr 2017; 58:3070-3084. [PMID: 29039967 DOI: 10.1080/10408398.2017.1351917] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Central obesity is associated with chronic low-grade inflammation, and is a risk factor for cardiometabolic syndrome. The Mediterranean diet pattern has a convincing evidence-base for improving cardiometabolic health. This review investigated the impact of Mediterranean diet interventions on central obesity, specifically. A systematic literature search was conducted in the MEDLINE, CINAHL, EMBASE and Cochrane library databases. Search terms included: 'Mediterranean Diet', 'Mediterranean dietary pattern', 'central obesity' and 'visceral fat'. The search was limited to English language and humans ≥18 years. Eighteen articles met the eligibility criteria and reported at least one outcome measure of central obesity with Mediterranean diet intervention. Central obesity measures included waist circumference (16 studies), waist-hip ratio (5 studies) and visceral fat (2 studies). Thirteen (72%) of the studies, totaling 7186 subjects (5168 subjects assigned to a Mediterranean Diet), reported a significant reduction in central obesity with a Mediterranean-type diet. However, seven out of these 13 interventions employed energy restriction, and only three showed a statistically significant favorable effect of the Mediterranean diet relative to a control group. This systematic review highlights the potential for a Mediterranean diet intervention to reduce central obesity and in turn reduce obesity-related chronic disease risk and associated public health burden.
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Affiliation(s)
- C L Bendall
- a Department of Rehabilitation, Nutrition and Sport , School of Allied Health, La Trobe University , Victoria , Australia
| | - H L Mayr
- a Department of Rehabilitation, Nutrition and Sport , School of Allied Health, La Trobe University , Victoria , Australia
| | - R S Opie
- a Department of Rehabilitation, Nutrition and Sport , School of Allied Health, La Trobe University , Victoria , Australia
| | - M Bes-Rastrollo
- b Department of Preventive Medicine and Public Health , University of Navarra , Spain.,c CIBERobn, Instituto de Salud Carlos III , Spain.,d IDISNA Navarra's Health Research Institute
| | - C Itsiopoulos
- a Department of Rehabilitation, Nutrition and Sport , School of Allied Health, La Trobe University , Victoria , Australia
| | - C J Thomas
- e Department of Physiology, Anatomy and Microbiology, School of Life Sciences , La Trobe University , Victoria , Australia
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17
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Ratjen I, Schafmayer C, di Giuseppe R, Waniek S, Plachta-Danielzik S, Koch M, Nöthlings U, Hampe J, Schlesinger S, Lieb W. Postdiagnostic Mediterranean and Healthy Nordic Dietary Patterns Are Inversely Associated with All-Cause Mortality in Long-Term Colorectal Cancer Survivors. J Nutr 2017; 147:636-644. [PMID: 28228505 DOI: 10.3945/jn.116.244129] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/14/2016] [Accepted: 01/25/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Dietary factors are known to affect the risk of new-onset colorectal cancer (CRC), but information on the extent to which postdiagnostic diet affects mortality in long-term CRC survivors is scarce.Objective: We investigated the association of 2 a priori-defined postdiagnostic dietary patterns [Modified Mediterranean Diet Score (MMDS) and healthy Nordic Food Index (HNFI)] with all-cause mortality in long-term CRC survivors.Methods: Diet was assessed at a median time of 6 y after cancer diagnosis in 1404 CRC survivors (median age: 69 y; 56% men) in a prospective cohort study in Northern Germany by using a semiquantitative food-frequency questionnaire. Cox proportional hazard models, adjusting for clinical and sociodemographic characteristics, were used to assess associations of the MMDS and the HNFI with all-cause mortality.Results: A total of 204 patients died during a median follow-up time of 7 y after diet assessment. In multivariable-adjusted models, higher adherence to the modified Mediterranean diet was significantly associated with lower all-cause mortality (HR: 0.48; 95% CI: 0.32, 0.74 for highest compared with lowest score quartile and HR: 0.88; 95% CI: 0.81, 0.96 per 1-point increment in pattern score). Similarly, the HNFI was inversely associated with all-cause mortality when the highest was compared with the lowest index quartile (HR: 0.63; 95% CI: 0.39, 1.04) and when modeled as a continuous trait (HR: 0.90; 95% CI: 0.82, 0.99 per 1-point increment in the score).Conclusions: Our results suggest that higher adherences to the Mediterranean diet and to the healthy Nordic diet after CRC diagnosis are associated with better overall survival in long-term CRC survivors.
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Affiliation(s)
- Ilka Ratjen
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Clemens Schafmayer
- Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Romina di Giuseppe
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sabina Waniek
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Manja Koch
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ute Nöthlings
- Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - Jochen Hampe
- Medical Department 1, University Hospital Dresden, Technical University Dresden, Dresden, Germany; and
| | - Sabrina Schlesinger
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany;
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18
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Brinks J, Fowler A, Franklin BA, Dulai J. Lifestyle Modification in Secondary Prevention: Beyond Pharmacotherapy. Am J Lifestyle Med 2017; 11:137-152. [PMID: 30202327 PMCID: PMC6125029 DOI: 10.1177/1559827616651402] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/19/2016] [Accepted: 05/04/2016] [Indexed: 12/17/2022] Open
Abstract
Despite significant advances in medical technology and pharmacology, cardiovascular disease (CVD) remains a major contributor to health care expenses and the leading cause of death in the United States. Patients with established CVD and their health care providers are challenged with achieving cardiovascular risk reduction to decrease the likelihood of recurrent cardiovascular events. This "secondary prevention" can be achieved, in part, through adherence to prescribed pharmacotherapies that favorably modify major coronary risk factors (ie, hypertension, hypercholesterolemia, diabetes, and obesity). However, lifestyle modification can also be helpful in this regard, providing independent and additive benefits to the associated reductions in cardiovascular morbidity and mortality. Accordingly, physicians and other health care providers should routinely counsel their coronary patients to engage in structured exercise and increased lifestyle physical activity, consume a heart-healthy diet, quit smoking and avoid secondhand smoke, and purposefully address psychosocial stressors that may elevate cardiovascular risk. These lifestyle interventions, either as an adjunct to medication therapy or independently in those patients where medications may be poorly tolerated, cost prohibitive, or ineffective, can significantly decrease cardiovascular mortality and the risk of recurrent cardiac events.
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Affiliation(s)
- Jenna Brinks
- Jenna Brinks, MS, Manager, Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Beaumont Health Center, Cardiac Rehabilitation, 4949 Coolidge Highway, Royal Oak, MI 48073, USA; e-mail:
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