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Papadima EI, Vassilakou T, Grigoriadis T, Boutsiadis A, Ivanidou S, Kalampalikis A, Michala L. Nutrition knowledge, attitudes, and perceptions of Greek menopausal women. Menopause 2024; 31:415-429. [PMID: 38564702 DOI: 10.1097/gme.0000000000002342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Nutritional guidelines for postmenopausal women differ. This study aimed to assess postmenopausal women's knowledge, beliefs, and practices regarding nutrition during menopause and their dietary habits. METHODS This cross-sectional study was conducted in a menopause clinic, and data from 105 women were analyzed. A nutrition knowledge, attitudes, and perceptions (KAP) questionnaire was designed, structured, and piloted before implementation, based on the Hellenic dietary guidelines. International Physical Activity Questionnaire-Greek version, MedDietScore, and Menopause-specific Quality of Life questionnaires were administered. RESULTS The mean ± SD age of the women was 56.9 ± 4.6 years. The mean ± SD KAP score was 12.2 ± 3.5. Those who lived in rural areas had lower KAP scores than those who lived in urban areas ( P = 0.004). Of all the women, 74.5% knew the Mediterranean diet pyramid, whereas 9.8% knew the Hellenic dietary guidelines. Women who had read the guidelines showed better knowledge of Mediterranean diet food groups (Pearson, 0.309; P = 0.039). Knowledge of dairy services was correlated with consumption of dairy products ( P = 0.002). Furthermore, 76.4% were willing to participate in nutrition education programs. The International Physical Activity Questionnaire score was positively correlated with years of smoking ( P = 0.002). Physical activity correlated with adherence to the Mediterranean diet ( P = 0.044). CONCLUSIONS The majority of postmenopausal Greek women in this study were unaware of the Hellenic dietary guidelines. In general, women's knowledge of nutrition during menopause was moderate. Greek postmenopausal women are willing to participate in nutrition education programs, which should raise awareness of healthy lifestyles through nutrition, exercise, and smoking cessation.
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Affiliation(s)
- Evgenia-Ioanna Papadima
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Themos Grigoriadis
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Sofia Ivanidou
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Kalampalikis
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lina Michala
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Waist-to-height ratio cut-off points to predict obesity in adolescents and associa-tion with inflammatory markers. NUTR HOSP 2022; 39:1272-1279. [PMID: 36250764 DOI: 10.20960/nh.03962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction Introduction: obesity increases inflammatory molecules and cardiovascular risk even in young populations. New indicators are being investigated, including the waist-to-height ratio (WHtR) to predict obesity and the relationship with inflammatory markers in childhood and adolescence. Objective: to identify the cut-off points of the WHtR to determine obesity and its association with inflammatory markers in adolescents in São Luís, state of Maranhão, Brazil. Methods: this is a cross-sectional study, with 2,209 adolescents aged 18 and 19, belonging to the third phase of the birth cohort entitled "RPS", carried out in 2016. The total area under the ROC curve (AUC) was identified to assess the predictive capacity of WHtR in relation to body fat percentage (%BF), obtained by air displacement plethysmography (ADP). The association of WHtR with inflammatory markers interleukin-6 (IL-6), tumor necrosis factor (TNF-α) and c-reactive protein (CRP) was evaluated. Results: prevalence of obesity by the %BF was 10.3 % in males and 40.4 % in females. The cut-off points for the WHtR were 0.50 for females and 0.51 for males, with an AUC of 0.90 (95 % CI: 0.88-0.92) and 0.93 (95 % CI: 0.90-0.97). There was an association of elevated WHtR with higher levels of IL-6 and CRP (p < 0.05). Conclusion: the predictive capacity of WHtR for obesity was excellent. Elevated values of the WHtR were associated with early inflammatory markers. This study contributed to the identification of cut-off points for simple and low-cost anthropometric indicators.
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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 2022; 13:152-166. [PMID: 34352891 PMCID: PMC8803490 DOI: 10.1093/advances/nmab092] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Jalilpiran Y, Darooghegi Mofrad M, Mozaffari H, Bellissimo N, Azadbakht L. Adherence to dietary approaches to stop hypertension (DASH) and Mediterranean dietary patterns in relation to cardiovascular risk factors in older adults. Clin Nutr ESPEN 2020; 39:87-95. [DOI: 10.1016/j.clnesp.2020.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 01/28/2023]
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Hasegawa M, Akter S, Hu H, Kashino I, Kuwahara K, Okazaki H, Sasaki N, Ogasawara T, Eguchi M, Kochi T, Miyamoto T, Nakagawa T, Honda T, Yamamoto S, Murakami T, Shimizu M, Uehara A, Yamamoto M, Imai T, Nishihara A, Tomita K, Nagahama S, Hori A, Konishi M, Kabe I, Mizoue T, Kunugita N, Dohi S. Five-year cumulative incidence of overweight and obesity, and longitudinal change in body mass index in Japanese workers: The Japan Epidemiology Collaboration on Occupational Health Study. J Occup Health 2020; 62:e12095. [PMID: 31677232 PMCID: PMC6970396 DOI: 10.1002/1348-9585.12095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/30/2019] [Accepted: 10/03/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The present study aimed to estimate cumulative incidence of overweight and obesity and describe 5-year longitudinal changes in body mass index (BMI) in a large occupational cohort in Japan. METHODS Participants were 55 229 Japanese employees, who were aged 20-59 years and attended at all subsequent annual health check-ups between 2009 and 2014. Mixed model analysis was performed to examine the effects of age and cohort by gender on BMI change, with age as a random variable. Cumulative incidence of overweight (23.0≤ BMI <27.5 kg/m2 ) and obesity (BMI ≥27.5 kg/m2 ) was calculated. Logistic regression analysis was used to estimate odds ratios for the incidence of overweight and obesity according to age group. RESULTS The incidence of overweight and obesity was approximately double in men (28.3% and 6.7%, respectively) compared to women (14.3% and 3.9%, respectively).The incidence of obesity decreased with age in men, but did not differ according to age in women (P for trend: .02 and .89, respectively). Among overweight participants, the incidence of obesity was higher in women (18.9%) than men (14.5%) and decreased with advancing age (P for trend: <.001 in men and .003 in women). Mean BMI was higher in men than women in all age groups throughout the period. Younger cohorts tended to have a higher BMI change compared with older cohorts. CONCLUSIONS In this Japanese occupational cohort, transition from overweight to obesity is higher in women than men, and the more recent cohorts had a higher change in mean BMI than the older cohorts.
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Affiliation(s)
- Miyuki Hasegawa
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Shamima Akter
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Huanhuan Hu
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Ikuko Kashino
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Keisuke Kuwahara
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
- Teikyo University Graduate School of Public HealthTokyoJapan
| | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus CorporationKanagawaJapan
| | | | | | | | | | | | | | | | - Taizo Murakami
- Mizue Medical ClinicKeihin Occupational Health CenterKanagawaJapan
| | - Makiko Shimizu
- Mizue Medical ClinicKeihin Occupational Health CenterKanagawaJapan
| | | | | | | | | | | | | | - Ai Hori
- Department of Global Public HealthUniversity of TsukubaIbarakiJapan
| | - Maki Konishi
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
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Serra-Majem L, Román-Viñas B, Sanchez-Villegas A, Guasch-Ferré M, Corella D, La Vecchia C. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Mol Aspects Med 2019; 67:1-55. [PMID: 31254553 DOI: 10.1016/j.mam.2019.06.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 01/16/2023]
Abstract
More than 50 years after the Seven Countries Study, a large number of epidemiological studies have explored the relationship between the Mediterranean diet (MD) and health, through observational, case-control, some longitudinal and a few experimental studies. The overall results show strong evidence suggesting a protective effect of the MD mainly on the risk of cardiovascular disease (CVD) and certain types of cancer. The beneficial effects have been attributed to the types of food consumed, total dietary pattern, components in the food, cooking techniques, eating behaviors and lifestyle behaviors, among others. The aim of this article is to review and summarize the knowledge derived from the literature focusing on the benefits of the MD on health, including those that have been extensively investigated (CVD, cancer) along with more recent issues such as mental health, immunity, quality of life, etc. The review begins with a brief description of the MD and its components. Then we present a review of studies evaluating metabolic biomarkers and genotypes in relation to the MD. Other sections are dedicated to observation and intervention studies for various pathologies. Finally, some insights into the relationship between the MD and sustainability are explored. In conclusion, the research undertaken on metabolomics approaches has identified potential markers for certain MD components and patterns, but more investigation is needed to obtain valid measures. Further evaluation of gene-MD interactions are also required to better understand the mechanisms by which the MD diet exerts its beneficial effects on health. Observation and intervention studies, particularly PREDIMED, have provided invaluable data on the benefits of the MD for a wide range of chronic diseases. However further research is needed to explore the effects of other lifestyle components associated with Mediterranean populations, its environmental impact, as well as the MD extrapolation to non-Mediterranean contexts.
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Affiliation(s)
- Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain.
| | - Blanca Román-Viñas
- Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain; School of Health and Sport Sciences (EUSES), Universitat de Girona, Salt, Spain; Department of Physical Activity and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Almudena Sanchez-Villegas
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H.Chan School of Public Health, Boston, MA, USA; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dolores Corella
- Genetic and Molecular Epidemiology Unit. Department of Preventive Medicine. University of Valencia, Valencia, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
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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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Papavagelis C, Avgeraki E, Augoulea A, Stamatelopoulos K, Lambrinoudaki I, Yannakoulia M. Dietary patterns, Mediterranean diet and obesity in postmenopausal women. Maturitas 2018; 110:79-85. [DOI: 10.1016/j.maturitas.2018.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
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Filippatos TD, Kyrou I, Georgousopoulou EN, Chrysohoou C, Kouli GM, Tsigos C, Tousoulis D, Stefanadis C, Pitsavos C, Panagiotakos DB. Modeling anthropometric indices in relation to 10-year (2002-2012) incidence of cardiovascular disease, among apparently healthy individuals: The ATTICA study. Diabetes Metab Syndr 2017; 11 Suppl 2:S789-S795. [PMID: 28606442 DOI: 10.1016/j.dsx.2017.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 05/31/2017] [Indexed: 12/29/2022]
Abstract
AIMS Body fat accumulation is implicated in the development of cardiovascular disease (CVD). Our objective was to explore potential associations between anthropometric indices and the 10-year CVD incidence in Greek adults without previous CVD. METHODS During 2001-2, we enrolled 3042 adults without CVD from the general population of Attica, Greece. In 2011-2, the 10-year study follow-up was performed, recording the CVD incidence in 1958 participants with baseline body mass index (BMI) ≥18.5kg/m2. RESULTS The study 10-year CVD incidence was 15.8%, exhibiting a gradual increase according to the baseline body mass index (BMI) category. Baseline BMI ≥30kg/m2 was related with significantly higher 10-year CVD risk compared to BMI <25kg/m2, even after adjustment for age and other known CVD risk factors. Baseline BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio and waist-to-hip-to-height ratio were independently associated with the 10-year CVD risk in multi-adjusted models. Gender-specific analyses showed that these associations were more evident in men compared to women, with baseline BMI exhibiting an independent association with the 10-year CVD incidence in men. CONCLUSIONS Our results indicate that even simple anthropometric indices exhibit independent associations with CVD risk in a representative sample of the Greek general population without previous CVD.
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Affiliation(s)
- Theodosios D Filippatos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ioannis Kyrou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Aston Medical Research Institute, Aston Medical School, Aston University, B4 7ET, Birmingham, UK; Translational & Experimental Medicine, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, CV4 7AL, Coventry, UK; WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, CV2 2DX, Coventry, UK
| | - Ekavi N Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Georgia-Maria Kouli
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Constantine Tsigos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
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Effects of increased body weight and short-term weight loss on serum PCSK9 levels - a prospective pilot study. ACTA ACUST UNITED AC 2017; 2:e46-e51. [PMID: 29242844 PMCID: PMC5728080 DOI: 10.5114/amsad.2017.70502] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 07/31/2017] [Indexed: 12/13/2022]
Abstract
Introduction Proprotein convertase subtilisin/kexin type 9 (PCSK9) is associated with low-density lipoprotein (LDL) catabolism, but its serum concentration is not uniformly associated with cardiovascular disease in clinical studies. Obesity is linked with increased cardiovascular risk, but the effect of increased body weight and short-term weight loss on serum PCSK9 levels is not well studied. Material and methods The aim of this prospective pilot study was to assess differences in serum PCSK9 levels (determined with a quantitative sandwich enzyme immunoassay) between otherwise healthy drug-naïve obese subjects and healthy individuals with normal body weight. Additionally, PCSK9 levels were determined at baseline and after a 3-month weight-loss program with a low-fat diet in a randomly assigned subgroup of the obese subjects (n = 15). Results Obese subjects (n = 35) were older (age: 43 ±11 years) and had significantly higher body mass index, total cholesterol, triglycerides, LDL cholesterol (LDL-C), apolipoprotein B and homeostasis model assessment of insulin resistance (HOMA) index levels, as well as significantly lower high-density lipoprotein cholesterol (HDL-C) concentration, compared with normal-weight subjects (n = 20, age: 35 ±6 years). Serum PCSK9 levels were significantly higher in obese subjects compared with normal-weight individuals, even after adjustment for age, LDL-C, triglycerides, HDL-C, apolipoprotein A1, apolipoprotein B, apolipoprotein E, glucose, insulin and HOMA index levels (p = 0.018). Obese subjects experienced significant weight loss (from 109 ±22 to 104 ±23 kg, p < 0.01), but serum PCSK9 levels did not significantly change after the 3-month weight-loss program. Conclusions Serum PCSK9 levels are higher in obese subjects than in normal-weight individuals. Short-term weight loss with a low-fat diet does not significantly affect PCSK9 levels.
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Laville M, Segrestin B, Alligier M, Ruano-Rodríguez C, Serra-Majem L, Hiesmayr M, Schols A, La Vecchia C, Boirie Y, Rath A, Neugebauer EAM, Garattini S, Bertele V, Kubiak C, Demotes-Mainard J, Jakobsen JC, Djurisic S, Gluud C. Evidence-based practice within nutrition: what are the barriers for improving the evidence and how can they be dealt with? Trials 2017; 18:425. [PMID: 28893297 PMCID: PMC5594518 DOI: 10.1186/s13063-017-2160-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/24/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Evidence-based clinical research poses special barriers in the field of nutrition. The present review summarises the main barriers to research in the field of nutrition that are not common to all randomised clinical trials or trials on rare diseases and highlights opportunities for improvements. METHODS Systematic academic literature searches and internal European Clinical Research Infrastructure Network (ECRIN) communications during face-to-face meetings and telephone conferences from 2013 to 2017 within the context of the ECRIN Integrating Activity (ECRIN-IA) project. RESULTS Many nutrients occur in multiple forms that differ in biological activity, and several factors can alter their bioavailability which raises barriers to their assessment. These include specific difficulties with blinding procedures, with assessments of dietary intake, and with selecting appropriate outcomes as patient-centred outcomes may occur decennia into the future. The methodologies and regulations for drug trials are, however, applicable to nutrition trials. CONCLUSIONS Research on clinical nutrition should start by collecting clinical data systematically in databases and registries. Measurable patient-centred outcomes and appropriate study designs are needed. International cooperation and multistakeholder engagement are key for success.
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Affiliation(s)
- Martine Laville
- Centre de Recherche en Nutrition Humaine Rhone-Alpes, French Obesity Centre of Excellence (FCRIN-FORCE), Lyon 1 University, Hospices Civils de Lyon, Lyon, France
| | - Berenice Segrestin
- Centre de Recherche en Nutrition Humaine Rhone-Alpes, French Obesity Centre of Excellence (FCRIN-FORCE), Lyon 1 University, Hospices Civils de Lyon, Lyon, France
| | - Maud Alligier
- Centre de Recherche en Nutrition Humaine Rhone-Alpes, French Obesity Centre of Excellence (FCRIN-FORCE), Lyon 1 University, Hospices Civils de Lyon, Lyon, France
| | - Cristina Ruano-Rodríguez
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCII), Spanish Goverment, Madrid, Spain
| | - Lluis Serra-Majem
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN, CB06/03), Instituto de Salud Carlos III (ISCII), Spanish Goverment, Madrid, Spain
| | - Michael Hiesmayr
- Division of Cardiac, Thoracic, Vascular Anaesthesia and Intensive Care, Vienna General Hospital, Währinger Gürtel, Vienna, Austria
| | - Annemie Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano Via Vanzetti, Milan, Italy
| | - Yves Boirie
- Service de Nutrition Clinique, CHU de Clermont-Ferrand, Unité de Nutrition Humaine, Clermont-Ferrand, France
| | - Ana Rath
- Orphanet, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | - Edmund A M Neugebauer
- Brandenburg Medical School, Neuruppin, and Witten/Herdecke University, Witten, Germany
| | - Silvio Garattini
- IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Vittorio Bertele
- IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Christine Kubiak
- European Clinical Research Infrastructure Network (ECRIN), Paris, France
| | | | - Janus C Jakobsen
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK 2100, Copenhagen, Denmark.,Department of Cardiology, Holbæk Hospital, Holbaek, Denmark
| | - Snezana Djurisic
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK 2100, Copenhagen, Denmark.
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK 2100, Copenhagen, Denmark.
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Karfopoulou E, Brikou D, Mamalaki E, Bersimis F, Anastasiou CA, Hill JO, Yannakoulia M. Dietary patterns in weight loss maintenance: results from the MedWeight study. Eur J Nutr 2016; 56:991-1002. [PMID: 26744302 DOI: 10.1007/s00394-015-1147-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 12/22/2015] [Indexed: 01/15/2023]
Abstract
PURPOSE The dietary habits contributing to weight loss maintenance are not sufficiently understood. We studied weight loss maintainers in comparison with regainers, to identify the differentiating behaviors. METHODS The MedWeight study is a Greek registry of weight loss maintainers and regainers. Participants had intentionally lost ≥10 % of their weight and either had maintained this loss for over a year, or had regained weight. Questionnaires on demographics and lifestyle habits were completed online. Dietary assessment was carried out by two telephone 24-h recalls. RESULTS Present analysis focused on 361 participants (32 years old, 39 % men): 264 maintainers and 97 regainers. Energy and macronutrient intake did not differ by maintenance status (1770 ± 651 kcal in maintainers vs. 1845 ± 678 kcal in regainers, p = 0.338), although protein intake per kg of body weight was higher in maintainers (1.02 ± 0.39 vs. 0.83 ± 0.28 g/kg in regainers, p < 0.001). Physical activity energy expenditure was greater for maintainers in men (by 1380 kcal per week, p = 0.016), but not women. Salty snacks, alcohol and regular soda were more frequently consumed by men regainers. Principal component analysis identified a healthy dietary pattern featuring mainly unprocessed cereal, fruit, vegetables, olive oil and low-fat dairy. Male maintainers were 4.6 times more likely to follow this healthy pattern compared to regainers (OR 4.6, 95 % CI 2.0-11.0). No similar finding was revealed in women. Other characteristics of maintainers but not of regainers were: involvement in meal preparation and eating at home for men, and a higher eating frequency and slower eating rate for women. CONCLUSIONS Men maintaining weight loss were much more likely to adhere to a healthy eating pattern. Eating at home, involvement in meal preparation, higher eating frequency and slower eating rate were also associated with maintenance. These lifestyle habits of successful maintainers provide target behaviors to improve obesity treatment.
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Affiliation(s)
- Eleni Karfopoulou
- Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 17671, Athens, Greece
| | - Dora Brikou
- Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 17671, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 17671, Athens, Greece
| | - Fragiskos Bersimis
- Department of Informatics and Telematics, Harokopio University, El. Venizelou 70, 17671, Athens, Greece
| | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 17671, Athens, Greece
| | - James O Hill
- Anschutz Health and Wellness Center, University of Colorado, 12348 E Montview Blvd, Aurora, CO, 80045, USA
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 17671, Athens, Greece.
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Sayer RD, Amankwaah AF, Tamer GG, Chen N, Wright AJ, Tregellas JR, Cornier MA, Kareken DA, Talavage TM, McCrory MA, Campbell WW. Effects of Dietary Protein and Fiber at Breakfast on Appetite, ad Libitum Energy Intake at Lunch, and Neural Responses to Visual Food Stimuli in Overweight Adults. Nutrients 2016; 8:nu8010021. [PMID: 26742068 PMCID: PMC4728635 DOI: 10.3390/nu8010021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/14/2015] [Accepted: 12/17/2015] [Indexed: 01/09/2023] Open
Abstract
Increasing either protein or fiber at mealtimes has relatively modest effects on ingestive behavior. Whether protein and fiber have additive or interactive effects on ingestive behavior is not known. Fifteen overweight adults (5 female, 10 male; BMI: 27.1 ± 0.2 kg/m2; aged 26 ± 1 year) consumed four breakfast meals in a randomized crossover manner (normal protein (12 g) + normal fiber (2 g), normal protein (12 g) + high fiber (8 g), high protein (25 g) + normal fiber (2 g), high protein (25 g) + high fiber (8 g)). The amount of protein and fiber consumed at breakfast did not influence postprandial appetite or ad libitum energy intake at lunch. In the fasting-state, visual food stimuli elicited significant responses in the bilateral insula and amygdala and left orbitofrontal cortex. Contrary to our hypotheses, postprandial right insula responses were lower after consuming normal protein vs. high protein breakfasts. Postprandial responses in other a priori brain regions were not significantly influenced by protein or fiber intake at breakfast. In conclusion, these data do not support increasing dietary protein and fiber at breakfast as effective strategies for modulating neural reward processing and acute ingestive behavior in overweight adults.
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Affiliation(s)
- R Drew Sayer
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Akua F Amankwaah
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Gregory G Tamer
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Ningning Chen
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA.
| | - Amy J Wright
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Jason R Tregellas
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Marc-Andre Cornier
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - David A Kareken
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Thomas M Talavage
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Megan A McCrory
- Department of Nutrition, Georgia State University, Atlanta, GA 30303, USA.
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
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Bertoli S, Leone A, Vignati L, Bedogni G, Martínez-González MÁ, Bes-Rastrollo M, Spadafranca A, Vanzulli A, Battezzati A. Adherence to the Mediterranean diet is inversely associated with visceral abdominal tissue in Caucasian subjects. Clin Nutr 2015; 34:1266-72. [PMID: 26499033 DOI: 10.1016/j.clnu.2015.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 09/12/2015] [Accepted: 10/05/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND & aim: Adherence to the Mediterranean dietary pattern (MDP) is inversely related with abdominal adiposity as detected by waist circumference but the specific association to subcutaneous and visceral abdominal tissue has not been investigated. To this purpose we evaluated the association between MDP, visceral (VAT) and subcutaneous (SAT) abdominal tissue in a large sample of Italian adults. METHODS A cross-sectional study was carried out on 4388 consecutive adults (73.2% women) followed as outpatients at Nutritional Research Centre in Milan, ICANS. VAT and SAT were measured by ultrasonography. MDP was evaluated using a Mediterranean dietary score (MEDscore) obtained from a validated 14-item questionnaire. RESULTS At multiple linear regression adjusted for sex, age, smoking and physical activity, a 1-unit increase in MEDscore was associated with a -0.118 kg/m(2) decrease in BMI (p < 0.01), a -0.292 cm decrease in waist circumference (p < 0.01), a -0.002 cm:cm decrease in waist to height ratio (p < 0.001), a -1.125 mm decrease in the sum of 4 skinfolds (p < 0.001), and with a -0.045 cm decrease in VAT (p < 0.05). MEDscore was, however, not associated with SAT. Finally, the adherence to the MDP was a protective factor for obesity (OR = 0.717, 95%CI: 0.555-0.922) and VAT excess (OR = 0.717, 95%CI: 0.530-0.971). CONCLUSION Our study confirms the inverse association between MDP, BMI and waist circumference and adds that the association with abdominal obesity as detected by waist circumference is due to an association with VAT and not with SAT.
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Affiliation(s)
- Simona Bertoli
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy.
| | - Alessandro Leone
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy
| | - Laila Vignati
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy
| | - Giorgio Bedogni
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Spain; CIBERobn, Instituto de Salud Carlos III, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Spain; CIBERobn, Instituto de Salud Carlos III, Spain
| | - Angela Spadafranca
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy
| | - Angelo Vanzulli
- Division of Radiology, Ospedale Niguarda Cà Granda, Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Italy
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Santiago JCDS, Moreira TMM, Florêncio RS. Association between overweight and characteristics of young adult students: support for nursing care. Rev Lat Am Enfermagem 2015; 23:250-8. [PMID: 26039295 PMCID: PMC4458998 DOI: 10.1590/0104-1169.0174.2549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/25/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to verify associations between overweight and the characteristics of young adult students to support nursing care. METHOD case-control study conducted with young adults from public schools. The sample was composed of 441 participants (147 cases and 294 controls, with and without excess weight, respectively). Sociodemographic and clinical characteristics were collected together with exposure factors and anthropometrics. Multiple logistic regression was used. The study received Institutional Review Board approval. RESULTS statistically significant association with overweight: non-Caucasian, having a partner; weight gain during adolescence, mother's excess weight, the use of obesogenic medication, augmented diastolic blood pressure, of abdominal circumference and waist/hip ratio. In addition to these, schooling and weight gain during childhood were also included in the multivariate analysis. After adjustment, the final model included: having a partner, weight gain during adolescence, augmented diastolic blood pressure and abdominal circumference. CONCLUSION the analysis of predictor variables for excess weight among young adult students supports nurses in planning and developing educational practices aimed to prevent this clinical condition, which is a risk factor for other chronic comorbidities, such as cardiovascular diseases.
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Affiliation(s)
- Jênifa Cavalcante dos Santos Santiago
- Doctoral student, Universidade Estadual do Ceará, Fortaleza, CE, Brazil.
Professor, Universidade Estadual do Ceará, Fortaleza, CE, Brazil. Scholarship holder
from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES),
Brazil
| | - Thereza Maria Magalhães Moreira
- Post-doctoral fellow, Faculdade de Saúde Pública, Universidade de São
Paulo, São Paulo, SP, Brazil. Professor, Universidade Estadual do Ceará, Fortaleza, CE,
Brazil
| | - Raquel Sampaio Florêncio
- Master's student, Universidade Estadual do Ceará, Fortaleza, CE, Brazil.
Scholarship holder from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
(CAPES), Brazil
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Aljadani H, Patterson A, Sibbritt D, Collins CE. Diet Quality and Weight Change in Adults Over Time: A Systematic Review of Cohort Studies. Curr Nutr Rep 2015. [DOI: 10.1007/s13668-014-0115-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Sadeghi M, Talaei M, Oveisgharan S, Rabiei K, Dianatkhah M, Bahonar A, Sarrafzadegan N. The cumulative incidence of conventional risk factors of cardiovascular disease and their population attributable risk in an Iranian population: The Isfahan Cohort Study. Adv Biomed Res 2014; 3:242. [PMID: 25538928 PMCID: PMC4260292 DOI: 10.4103/2277-9175.145749] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 03/13/2013] [Indexed: 01/11/2023] Open
Abstract
Background: Cardiovascular diseases (CVDs) are the leading cause of death in Iran. The present study evaluated the 7-year incidence of CVD risk factors among the participants of Isfahan cohort study (ICS). Materials and Methods: ICS was a longitudinal study on adults over 35 years of age from the urban and rural areas in three counties in central Iran. Data on clinical examination and blood measurements were collected in 2001. Subjects were followed and similar data were collected in 2007. Cumulative incidence was calculated through dividing new cases of each risk factor by the population free of that risk factor at baseline. Incidence proportion was determined for major CVD risk factors including hypertension (HTN), hypercholesterolemia (HC), hypertriglyceridemia (HTg), obesity, diabetes mellitus (DM), metabolic syndrome (MetS), and smoking. Results: A total number of 6323 adults free of CVDs were recruited. After 7 years of follow-up, 3283 individuals were re-evaluated in 2007. The participants’ age was 49.2 ± 10.3 years in 2001 (mean ± SD). The 7-year cumulative incidence of HTN, HC, HTg, overweight, obesity, DM, MetS, and smoking was 22.8%, 37.4%, 28.0%, 26.3%, 7.4%, 9.5%, 23.9%, and 5.9% in men and 22.2%, 55.4%, 33.5%, 35.0%, 18.8%, 11.3%, 36.1%, and 0.7% in women, respectively. Among those with overweight or obesity, 14.7% of men and 7.9% of women decreased their weight up to the normal level. Conclusions: The present study revealed a high incidence of CVD risk factors especially dyslipidemia, obesity, MetS and HTN. Therefore, the application of life-style modification interventions seems necessary.
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Affiliation(s)
- Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Talaei
- Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Oveisgharan
- Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
| | - Katayoun Rabiei
- Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Minoo Dianatkhah
- Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Bahonar
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Yannakoulia M, Aggelopoulou D, Skenderi K, Koinaki S, Yiannakouris N. A Mediterranean-like breakfast affects energy intake and appetite-related feelings. Int J Food Sci Nutr 2014; 65:899-902. [PMID: 25010358 DOI: 10.3109/09637486.2014.931359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Energy intake and appetite feelings after the consumption of two different types of breakfast, a high-fiber, traditional, Mediterranean-type breakfast and a low-fiber, Western-type breakfast were compared. Sixteen non-obese young men received the two treatments on separate days: the Mediterranean- and the Western-type breakfasts were isocaloric, similar in volume and macronutrient content, but different in fiber content. Following a 4-hour fast, subjects offered an ad libitum lunch. Food consumed and subjective feelings of hunger, fullness, and desire to eat were evaluated. Energy intake in the ad libitum lunch was significantly lower after the Mediterranean-type, compared to the Western-type breakfast, adjusting for previous day's energy intake (1488 ± 468 versus 1674 ± 416 kcal, respectively), whereas no energy compensation was made throughout the day. Furthermore, those who had the Mediterranean-type breakfast reported lower values in the desire to eat during study's course. These findings propose a fulfilling effect of a traditional, Mediterranean, high in fiber breakfast.
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Affiliation(s)
- Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University , Athens , Greece
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Mediterranean diet impact on changes in abdominal fat and 10-year incidence of abdominal obesity in a Spanish population. Br J Nutr 2014; 111:1481-7. [PMID: 24382017 DOI: 10.1017/s0007114513003966] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abdominal obesity is a strong predictor of metabolic disorders. Prospective data on the association between the Mediterranean diet and surrogate markers of abdominal adiposity are scarce. The present study evaluated the relationship between adherence to the Mediterranean diet and (1) changes in waist circumference (WC) and (2) 10-year incidence of abdominal obesity. We conducted a prospective, population-based study in 3058 male and female Spaniards aged 25-74 years, followed from 2000 to 2009. Dietary intake and leisure-time physical activity levels were recorded using validated questionnaires. Weight, height and WC were measured. Adherence to the Mediterranean diet, determined using the previously validated REGICOR-Mediterranean diet score (R-MDS), based on the distribution of population food intake and on the dietary recommendations (MDS-rec), was negatively associated with WC gain (P = 0.007 and 0.024, respectively) in fully adjusted models. In the multivariate logistic analysis, the odds of abdominal obesity incidence decreased across the tertiles of the R-MDS, but the association was not significant. In conclusion, adherence to the Mediterranean diet was associated with lower abdominal fat gain, but not with 10-year incidence of abdominal obesity.
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Grosso G, Mistretta A, Frigiola A, Gruttadauria S, Biondi A, Basile F, Vitaglione P, D’Orazio N, Galvano F. Mediterranean Diet and Cardiovascular Risk Factors: A Systematic Review. Crit Rev Food Sci Nutr 2013; 54:593-610. [DOI: 10.1080/10408398.2011.596955] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Aljadani H, Patterson A, Sibbritt D, Collins C. The association between dietary patterns and weight change in adults over time: a systematic review of studies with follow up. ACTA ACUST UNITED AC 2013. [DOI: 10.11124/jbisrir-2013-714] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Comparison and evaluation of the reliability of indexes of adherence to the Mediterranean diet. Public Health Nutr 2012; 14:2338-45. [PMID: 22166193 DOI: 10.1017/s1368980011002606] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To compare and evaluate the reliability of several indexes of adherence to the Mediterranean diet. DESIGN The ten indexes included in the analysis were: Mediterranean Diet Score (MDS), Mediterranean Score (MS), Dietary Score (DS), Mediterranean-Dietary Quality Index (Med-DQI), Mediterranean Dietary Pattern adherence index (MDP), Mediterranean Adequacy Index (MAI), Mediterranean Style Dietary Pattern Score (MSDPS), Mediterranean food pattern PREDIMED Study (MeDiet-PREDIMED), relative Mediterranean diet (rMED) and Cardioprotective Mediterranean diet index. Factor analysis using the correlations between indexes was applied. The correlation with factors and the reliability coefficient were calculated. SETTING A total of 324 healthy undergraduates at the University of Barcelona, Spain, were surveyed. RESULTS The highest correlations were observed between MDP adherence index and MAI (0·82); MAI and MSDPS (0·80); and MDS and rMED (0·77). Factor analysis showed a hidden common factor that explained over 70 % of the variability (71·03 %). This factor is understood as 'adherence to the Mediterranean diet'. The indexes that showed the highest correlation with this factor were Med-DQI (0·85), MDS (0·84), rMED (0·80) and MAI (0·80). These indexes showed acceptable performance in measuring the adherence to the Mediterranean diet. The components that correlated strongly with this factor were monounsaturated-to-saturated fatty acid ratio (MS ratio), fruit and vegetables. Furthermore, a second common factor was found explaining 18 % of the variability. This second factor is highly positive related to dairy products and lean meat, and negative related to MS ratio. CONCLUSIONS The indexes showed satisfactory performance in assessing adherence to the Mediterranean diet. However, in order to improve the reliability and concordance between the indexes, further studies are required to select the components, the number of components, and the scoring criteria of the indexes to improve their internal consistency.
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Conde WL, Borges C. O risco de incidência e persistência da obesidade entre adultos Brasileiros segundo seu estado nutricional ao final da adolescência. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2011; 14 Suppl 1:71-9. [DOI: 10.1590/s1415-790x2011000500008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 06/10/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: A prevalência da obesidade vem aumentando entre adultos nos países desenvolvidos e em desenvolvimento. No Brasil, a obesidade entre adultos atingiu entre 2008 a 2009 pelo menos 10% da população. OBJETIVOS: Com base nos dados do VIGITEL, neste trabalho, serão estimadas a incidência e a persistência da obesidade entre brasileiros adultos no período de 2006 a 2009. MÉTODOS: Nas amostras de 2006 a 2009, foram utilizados casos com registros demográficos, socioeconômicos e antropométricos completos. As estimativas foram expandidas para a população brasileira em 2007. A estimativa do risco relativo (RR) para incidência e persistência da obesidade ou excesso de peso entre homens e mulheres foi feita com regressão múltipla de Poisson, e ajustada para hábito de fumar, idade e atividade física. RESULTADOS: A incidência do excesso de peso entre indivíduos com peso baixo ou normal, aos 20 anos, é estimada em 40%, no sexo masculino, e em 30%, no feminino. A persistência da obesidade, por sua vez, é estimada em 65%, no sexo masculino, e em 47%, no feminino. O gradiente da obesidade como função da escolarização é virtualmente nulo no sexo masculino. Entre mulheres, o gradiente é negativo, com associações lineares e estatisticamente significantes. CONCLUSÃO: Essas características, associadas à forte expansão da obesidade entre adultos jovens detectada em outros estudos, apontam a urgência da utilização de políticas públicas mais incisivas e efetivas, que reduzam a exposição da população à alimentação com má qualidade nutricional e desenvolvam ações voltadas à promoção da atividade física.
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Mutoh E, Senba K, Akieda-Asai S, Miyashita A, Poleni P, Date Y. Sex differences in energy metabolism in pre-pubescent, early pubescent and adult rats. Obes Res Clin Pract 2011; 5:e79-e156. [DOI: 10.1016/j.orcp.2010.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 12/14/2010] [Accepted: 12/21/2010] [Indexed: 01/25/2023]
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Esposito K, Kastorini CM, Panagiotakos DB, Giugliano D. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord 2010; 9:1-12. [PMID: 20973675 DOI: 10.1089/met.2010.0031] [Citation(s) in RCA: 223] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The epidemiological evidence supporting a causal link between Mediterranean diets and body weight is contrasting. We evaluated the effect of Mediterranean diets on body weight in randomized controlled trials (RCTs) using a meta-analysis. METHODS We searched English and non-English publications in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from inception to January, 2010. Two evaluators independently selected and reviewed eligible studies. Sixteen randomized controlled trials, with 19 arms and 3,436 participants (1,848 assigned to a Mediterranean diet and 1,588 assigned to a control diet) were included. RESULTS In a random-effects meta-analysis of all 19 arms, the Mediterranean diet group had a significant effect on weight [mean difference between Mediterranean diet and control diet, -1.75 kg; 95% confidence interval (CI), -2.86 to -0.64 kg] and body mass index (mean difference, -0.57 kg/m², -0.93 to -0.21 kg/m²). The effect of Mediterranean diet on body weight was greater in association with energy restriction (mean difference, -3.88 kg, -6.54 to -1.21 kg), increased physical activity (-4.01 kg, -5.79 to -2.23 kg), and follow up longer than 6 months (-2.69 kg, -3.99 to -1.38 kg). No study reported significant weight gain with a Mediterranean diet. CONCLUSIONS Mediterranean diet may be a useful tool to reduce body weight, especially when the Mediterranean diet is energy-restricted, associated with physical activity, and more than 6 months in length. Mediterranean diet does not cause weight gain, which removes the objection to its relatively high fat content. These results may be useful for helping people to lose weight.
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Affiliation(s)
- Katherine Esposito
- Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.
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Romaguera D, Norat T, Vergnaud AC, Mouw T, May AM, Agudo A, Buckland G, Slimani N, Rinaldi S, Couto E, Clavel-Chapelon F, Boutron-Ruault MC, Cottet V, Rohrmann S, Teucher B, Bergmann M, Boeing H, Tjønneland A, Halkjaer J, Jakobsen MU, Dahm CC, Travier N, Rodriguez L, Sanchez MJ, Amiano P, Barricarte A, Huerta JM, Luan J, Wareham N, Key TJ, Spencer EA, Orfanos P, Naska A, Trichopoulou A, Palli D, Agnoli C, Mattiello A, Tumino R, Vineis P, Bueno-de-Mesquita HB, Büchner FL, Manjer J, Wirfält E, Johansson I, Hellstrom V, Lund E, Braaten T, Engeset D, Odysseos A, Riboli E, Peeters PH. Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr 2010; 92:912-21. [PMID: 20810975 DOI: 10.3945/ajcn.2010.29482] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is an association between a greater adherence to a Mediterranean diet and a reduced risk of developing chronic diseases. However, it is not clear whether this dietary pattern may be protective also against the development of obesity. OBJECTIVE We assessed the association between the adherence to the Mediterranean dietary pattern (MDP), prospective weight change, and the incidence of overweight or obesity. DESIGN We conducted a prospective cohort study [the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol Consumption, Cessation of Smoking, Eating Out of Home, and Obesity (EPIC-PANACEA) project] in 373,803 individuals (103,455 men and 270,348 women; age range: 25-70 y) from 10 European countries. Anthropometric measurements were obtained at recruitment and after a median follow-up time of 5 y. The relative Mediterranean Diet Score (rMED; score range: 0-18) was used to assess adherence to the MDP according to the consumption of 9 dietary components that are characteristic of the Mediterranean diet. The association between the rMED and 5-y weight change was modeled through multiadjusted mixed-effects linear regression. RESULTS Individuals with a high adherence to the MDP according to the rMED (11-18 points) showed a 5-y weight change of -0.16 kg (95% CI: -0.24, -0.07 kg) and were 10% (95% CI: 4%, 18%) less likely to develop overweight or obesity than were individuals with a low adherence to the MDP (0-6 points). The low meat content of the Mediterranean diet seemed to account for most of its positive effect against weight gain. CONCLUSION This study shows that promoting the MDP as a model of healthy eating may help to prevent weight gain and the development of obesity.
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Affiliation(s)
- Dora Romaguera
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
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Kimokoti RW, Newby PK, Gona P, Zhu L, Jasuja GK, Pencina MJ, McKeon-O'Malley C, Fox CS, D'Agostino RB, Millen BE. Diet quality, physical activity, smoking status, and weight fluctuation are associated with weight change in women and men. J Nutr 2010; 140:1287-93. [PMID: 20484553 PMCID: PMC2884329 DOI: 10.3945/jn.109.120808] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 01/28/2010] [Accepted: 05/01/2010] [Indexed: 12/20/2022] Open
Abstract
The effect of diet quality on weight change, relative to other body weight determinants, is insufficiently understood. Furthermore, research on long-term weight change in U.S. adults is limited. We evaluated prospectively patterns and predictors of weight change in Framingham Offspring/Spouse (FOS) women and men (n = 1515) aged > or =30 y with BMI > or = 18.5 kg/m2 and without cardiovascular disease, diabetes, and cancer at baseline over a 16-y period. Diet quality was assessed using the validated Framingham Nutritional Risk Score. In women, older age (P < 0.0001) and physical activity (P < 0.05) were associated with lower weight gain. Diet quality interacted with former smoking status (P-interaction = 0.02); former smokers with lower diet quality gained an additional 5.2 kg compared with those with higher diet quality (multivariable-adjusted P-trend = 0.06). Among men, older age (P < 0.0001) and current smoking (P < 0.01) were associated with lower weight gain, and weight fluctuation (P < 0.01) and former smoking status (P < 0.0001) were associated with greater weight gain. Age was the strongest predictor of weight change in both women (partial R(2) = 11%) and men (partial R(2) = 8.6%). Normal- and overweight women gained more than obese women (P < 0.05) and younger adults gained more weight than older adults (P < 0.0001). Patterns and predictors of weight change differ by sex. Age in both sexes and physical activity among women as well as weight fluctuation and smoking status in men were stronger predictors of weight change than diet quality among FOS adults. Women who stopped smoking over follow-up and had poor diet quality gained the most weight. Preventive interventions need to be sex-specific and consider lifestyle factors.
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Affiliation(s)
- Ruth W Kimokoti
- Department of Family Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
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Kontogianni MD, Farmaki AE, Vidra N, Sofrona S, Magkanari F, Yannakoulia M. Associations between Lifestyle Patterns and Body Mass Index in a Sample of Greek Children and Adolescents. ACTA ACUST UNITED AC 2010; 110:215-21. [DOI: 10.1016/j.jada.2009.10.035] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 09/05/2009] [Indexed: 10/19/2022]
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Tyrovolas S, Bountziouka V, Papairakleous N, Zeimbekis A, Anastassiou F, Gotsis E, Metallinos G, Polychronopoulos E, Lionis C, Panagiotakos D. Adherence to the Mediterranean diet is associated with lower prevalence of obesity among elderly people living in Mediterranean islands: the MEDIS study. Int J Food Sci Nutr 2009; 60 Suppl 6:137-50. [DOI: 10.1080/09637480903130546] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kesse-Guyot E, Castetbon K, Estaquio C, Czernichow S, Galan P, Hercberg S. Association between the French nutritional guideline-based score and 6-year anthropometric changes in a French middle-aged adult cohort. Am J Epidemiol 2009; 170:757-65. [PMID: 19656810 DOI: 10.1093/aje/kwp174] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In light of increasing obesity among the elderly, understanding the role of nutritional guidelines in preventing weight gain is of major importance. The authors evaluated the impact of the French Programme National Nutrition Santé (PNNS)-Guideline Score (GS) (maximum score, 15 points) on anthropometric changes in a large population-based study. Subjects in the present analysis (n = 3,531) were participants in the SUplémentation en VItamines et Minéraux AntioXydants (SU.VI.MAX) study (1994-2002) and had available data for estimating the PNNS-GS and anthropometric data at baseline and 6 years later. Data were analyzed by using multivariate linear regression models for the association with anthropometric changes and multiple logistic regression to estimate odds ratios of becoming overweight or obese. The authors found a significant negative association between PNNS-GS and changes in markers of anthropometry. In addition, better adherence to the PNNS-GS was associated with a lower incidence of overweight (odds ratio = 0.93, 95% confidence interval: 0.88, 0.99) and obesity (odds ratio = 0.89, 95% confidence interval: 0.80, 0.99) after a 6-year follow-up period. These observations support the role of nutritional guidelines in prevention of age-related weight increase and development of obesity.
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- INSERMU557, INRAU1125, CNAM, Paris 13 University, Human Nutrition Research Center, Bobigny, France.
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