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Podadera-Herreros A, Arenas-de Larriva AP, Gutierrez-Mariscal FM, Alcala-Diaz JF, Ojeda-Rodriguez A, Rodriguez-Cantalejo F, Cardelo MP, Rodriguez-Cano D, Torres-Peña JD, Luque RM, Ordovas JM, Perez-Martinez P, Delgado-Lista J, Lopez-Miranda J, Yubero-Serrano EM. Mediterranean diet as a strategy for preserving kidney function in patients with coronary heart disease with type 2 diabetes and obesity: a secondary analysis of CORDIOPREV randomized controlled trial. Nutr Diabetes 2024; 14:27. [PMID: 38755195 PMCID: PMC11099022 DOI: 10.1038/s41387-024-00285-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is recognized an independent risk factor for chronic kidney disease (CKD). The precise contribution and differential response to treatment strategies to reduce kidney dysfunction, depending on whether obesity is present alongside T2DM or not, remain to be fully clarified. Our objective was to improve our understanding of how obesity contributes to kidney function in patients with T2DM and coronary heart disease (CHD), who are highly predisposed to CKD, to assign the most effective dietary approach to preserve kidney function. METHODS 1002 patients with CHD and estimated glomerular filtration rate (eGFR)≥30 ml/min/1.73m2, were randomized to consume a Mediterranean diet (35% fat, 22% MUFA, < 50% carbohydrates) or a low-fat diet (28% fat, 12% MUFA, > 55% carbohydrates). Patients were classified into four groups according to the presence of T2DM and/or obesity at baseline: Non-Obesity/Non-T2DM, Obesity/Non-T2DM, Non-Obesity/T2DM and Obesity/T2DM. We evaluated kidney function using serum creatinine-based estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) before and after 5-years of dietary intervention. RESULTS Patients with Obesity/T2DM had the lowest baseline eGFR and the highest baseline uACR compared to non-diabetics (p < 0.05). After dietary intervention, the Mediterranean diet induced a lower eGFR decline in patients with Obesity/T2DM, compared to a low-fat diet but not in the other groups (p = 0.014). The Mediterranean diet, but not the low-fat diet, also reduced uACR only in patients with Obesity/T2DM (p = 0.024). CONCLUSIONS Obesity provided an additive effect to T2DM resulting in a more pronounced decline in kidney function compared to T2DM alone when compared to non-diabetics. In patients with concomitant presence of T2DM and obesity, with more metabolic complications, consumption of a Mediterranean diet seemed more beneficial than a low-fat diet in terms of preserving kidney function. These findings provide valuable insights for tailoring personalized lifestyle modifications in secondary prevention of cardiovascular disease. TRIAL REGISTRATION URL, http://www.cordioprev.es/index.php/en . CLINICALTRIALS gov number, NCT00924937.
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Affiliation(s)
- Alicia Podadera-Herreros
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
| | - Antonio P Arenas-de Larriva
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Francisco M Gutierrez-Mariscal
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Juan F Alcala-Diaz
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Ana Ojeda-Rodriguez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | | | - Magdalena P Cardelo
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | | | - Jose D Torres-Peña
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Raul M Luque
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, University of Córdoba, 14004, Córdoba, Spain
| | - Jose M Ordovas
- Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, 02111, USA
- Precision Nutrition and Obesity Program, IMDEA Alimentación, 28049, Madrid, Spain
| | - Pablo Perez-Martinez
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Javier Delgado-Lista
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jose Lopez-Miranda
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Elena M Yubero-Serrano
- Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba, Reina Sofia University Hospital, 14004 University of Córdoba, Córdoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
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2
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Kechagia I, Tsiampalis T, Damigou E, Barkas F, Anastasiou G, Kravvariti E, Liberopoulos E, Sfikakis PP, Chrysohoou C, Tsioufis C, Pitsavos C, Panagiotakos D. Long-Term Adherence to the Mediterranean Diet Reduces 20-Year Diabetes Incidence: The ATTICA Cohort Study (2002-2022). Metabolites 2024; 14:182. [PMID: 38668310 PMCID: PMC11051724 DOI: 10.3390/metabo14040182] [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: 03/05/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to evaluate the association between adherence to the Mediterranean diet and the 20-year incidence of type II diabetes mellitus (T2DM) among adults from the ATTICA study. This study involved a prospective cohort of 3042 men and women recruited at baseline from the Attica region in Greece. Sociodemographic, anthropometric, lifestyle, and clinical characteristics were evaluated at baseline and follow-up examinations; adherence to the Mediterranean diet was assessed through the MedDietScore (range 0-55); four Mediterranean diet trajectories were identified (i.e., increasing, decreasing, and sustained high and sustained low adherence levels). For the present analysis, data from 2000 individuals with complete information were used (age 43 ± 13 years; 49% men). Over the 20-year period, 26.3% (95%CI 24.4%, 28.3%) of participants developed T2DM; men exhibited a 1.5-times higher incidence compared to women (p < 0.001). Individuals consistently close to the Mediterranean diet throughout the studied period had an improved glycemic and lipidemic profile (at baseline and at 10-y follow-up) (all p-values < 0.001) and showed a 21% reduction in their 20-year risk of developing T2DM compared to those who were consistently away (RR = 0.79, 95%CI 0.47, 0.86). A long-term adherence to the Mediterranean diet is protective against the onset of T2DM and, therefore, could be incorporated in public health actions for the prevention of the disease.
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Affiliation(s)
- Ioanna Kechagia
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676 Athens, Greece
- Department of Clinical Dietetics-Nutrition, HYGEIA Hospital, 15123 Athens, Greece
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676 Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676 Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Georgia Anastasiou
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Petros P. Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17676 Athens, Greece
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Shaw AR, Vidoni ED, Key MN, Yates BA, Thorpe R. Using Focus Groups to Explore Older Black Men's Perception of Dietary Interventions. Am J Mens Health 2024; 18:15579883241241973. [PMID: 38613210 PMCID: PMC11015773 DOI: 10.1177/15579883241241973] [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: 06/05/2023] [Revised: 02/07/2024] [Accepted: 03/10/2024] [Indexed: 04/14/2024] Open
Abstract
Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer's disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted with a total of 10 cognitively normal Black men aged 55 years and older. Survey data were analyzed using a frequency analysis and qualitative data were analyzed using a six-step thematic analysis process. Most men indicated having hypertension (N = 7, 77.8%) and currently not following a dietary eating pattern (N = 8, 88.9%). Emerging themes identified included (1) knowledge of dementia, (2) perceptions of dietary interventions, (3) barriers impacting participation in dietary interventions, and (4) overcoming barriers to engage Black men in dietary interventions. Findings from this study should inform the design of future dietary interventions for AD prevention to enhance participation among older Black men.
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Affiliation(s)
- Ashley R. Shaw
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric D. Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mickeal N. Key
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Brandon A. Yates
- Indiana Center for Musculoskeletal Health, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Roland Thorpe
- Department of Health Behavior and Society, Johns Hopkins University, Baltimore, MD, USA
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4
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Choo JM, Murphy KJ, Wade AT, Wang Y, Bracci EL, Davis CR, Dyer KA, Woodman RJ, Hodgson JM, Rogers GB. Interactions between Mediterranean Diet Supplemented with Dairy Foods and the Gut Microbiota Influence Cardiovascular Health in an Australian Population. Nutrients 2023; 15:3645. [PMID: 37630835 PMCID: PMC10459086 DOI: 10.3390/nu15163645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
The impact of a Mediterranean diet on the intestinal microbiome has been linked to its health benefits. We aim to evaluate the effects of a Mediterranean diet supplemented with dairy foods on the gut microbiome in Australians at risk of cardiovascular disease. In a randomised controlled cross-over study, 34 adults with a systolic blood pressure ≥120 mmHg and with risk factors for cardiovascular disease were randomly allocated to a Mediterranean diet with 3-4 daily serves of dairy foods (Australian recommended daily intake (RDI) of 1000-1300 mg per day (MedDairy)) or a low-fat (LFD) control diet. Between each 8-week diet, participants underwent an 8-week washout period. Microbiota characteristics of stool samples collected at the start and end of each diet period were determined by 16S rRNA amplicon sequencing. MedDairy-associated effects on bacterial relative abundance were correlated with clinical, anthropometric, and cognitive outcomes. No change in the overall faecal microbial structure or composition was observed with either diet (p > 0.05). The MedDairy diet was associated with changes in the relative abundance of several bacterial taxa, including an increase in Butyricicoccus and a decrease in Colinsella and Veillonella (p < 0.05). Increases in Butyricicoccus relative abundance over 8 weeks were inversely correlated with lower systolic blood pressure (r = -0.38, p = 0.026) and positively correlated with changes in fasting glucose levels (r = 0.39, p = 0.019), specifically for the MedDairy group. No significant associations were observed between the altered taxa and anthropometric or cognitive measures (p > 0.05). Compared to a low-fat control diet, the MedDairy diet resulted in changes in the abundance of specific gut bacteria, which were associated with clinical outcomes in adults at risk of CVD.
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Affiliation(s)
- Jocelyn M. Choo
- Microbiome Research and Host Health, Lifelong Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia; (J.M.C.); (G.B.R.)
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Karen J. Murphy
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (A.T.W.); (E.L.B.); (C.R.D.)
- Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia;
| | - Alexandra T. Wade
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (A.T.W.); (E.L.B.); (C.R.D.)
- Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Yanan Wang
- CSIRO MOSH-Future Science Platform, Health & Biosecurity, Adelaide, SA 5001, Australia;
| | - Ella L. Bracci
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (A.T.W.); (E.L.B.); (C.R.D.)
- Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia;
| | - Courtney R. Davis
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (A.T.W.); (E.L.B.); (C.R.D.)
- Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia;
| | - Kathryn A. Dyer
- Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia;
| | - Richard J. Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia;
| | - Jonathan M. Hodgson
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia;
- Medical School, University of Western Australia, 35 Stirling Highway, Perth, WA 6000, Australia
| | - Geraint B. Rogers
- Microbiome Research and Host Health, Lifelong Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia; (J.M.C.); (G.B.R.)
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
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5
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Kotzakioulafi E, Bakaloudi DR, Chrysoula L, Theodoridis X, Antza C, Tirodimos I, Chourdakis M. High Versus Low Adherence to the Mediterranean Diet for Prevention of Diabetes Mellitus Type 2: A Systematic Review and Meta-Analysis. Metabolites 2023; 13:779. [PMID: 37512486 PMCID: PMC10386129 DOI: 10.3390/metabo13070779] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Diabetes mellitus type 2 (DMT-2) presents with a growing incidence, and its complications contribute mainly to cardiovascular disease and overall mortality. DMT-2 prevention and early stage management include lifestyle modification by adopting healthy eating patterns and increasing physical activity levels. The Mediterranean diet (MD) is associated with beneficial effects on human health and has been found effective for preventing and managing DMT-2. The purpose of this meta-analysis is to investigate whether the level of MD adherence plays a role in DMT-2 prevention and to what extent. A systematic literature search in PubMed, EMBASE, Web of Science Core Collection, Scopus, and Google Scholar databases was conducted until November 2022, and related observational studies fulfilling the eligibility criteria were included. The literature search concluded with 24 studies in the qualitative analysis and 23 studies in the quantitative analysis. Of those, 18 cohort studies were eligible for meta-analysis with hazard ratio as effect size and five studies providing odds ratio as effect size. The cohort studies included 248,140 participants with a mean follow-up of 10.8 years (3 to 22 years). Individuals with high adherence to MD presented an 11% and 18% decrease in risk and odds, respectively, of developing DMT-2 compared to those with low MD adherence (HR 0.89, 95%CI 0.83 to 0.95) and (OR 0.82, 95%CI 0.72 to 0.93). In studies where the follow-up was longer than 10 years, the 12% decrease in the risk of developing DMT-2 remained (HR 0.88 95%CI 0.84 to 0.92), whereas in studies where follow-up was less than 10 years, no difference between groups with different levels of adherence was found. Long-term high MD adherence is associated with a reduced risk of developing DMT-2, but further studies are needed to confirm these results.
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Affiliation(s)
- Evangelia Kotzakioulafi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Xenophon Theodoridis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Christina Antza
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, 56403 Thessaloniki, Greece
| | - Ilias Tirodimos
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Thorisdottir B, Arnesen EK, Bärebring L, Dierkes J, Lamberg-Allardt C, Ramel A, Nwaru BI, Söderlund F, Åkesson A. Legume consumption in adults and risk of cardiovascular disease and type 2 diabetes: a systematic review and meta-analysis. Food Nutr Res 2023; 67:9541. [PMID: 37288088 PMCID: PMC10243120 DOI: 10.29219/fnr.v67.9541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 06/09/2023] Open
Abstract
Objectives This study aimed to systematically review the evidence for associations between consumption of legumes and cardiovascular disease (CVD), type 2 diabetes (T2D) and their risk factors among healthy adults. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 16 May 2022 for ≥4 weeks long randomized (RCT) and non-randomized controlled trials and prospective cohort studies with follow-up ≥12 months, assessing legume intake (beans/lentils/peas/soybeans, excluding peanuts and legume-products/protein/powder/flour) as the intervention or exposure. Outcomes were CVD, coronary heart disease (CHD), stroke, T2D and in intervention trials only: changes in blood lipids, glycemic markers, and blood pressure. Risk of bias (RoB) was evaluated with Cochrane's RoB2, ROBINS-I, and US Department of Agriculture (USDA)'s RoB-NObS. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk or weighed mean differences with 95% confidence intervals, heterogeneity quantified as I2. The evidence was appraised according to World Cancer Research Fund's criteria. Results Of the 181 full-text articles assessed for eligibility, 47 were included: 31 cohort studies (2,081,432 participants with generally low legume consumption), 14 crossover RCTs (448 participants), one parallel RCT and one non-randomized trial. Meta-analyses of cohort studies were suggestive of null associations for CVD, CHD, stroke and T2D. Meta-analyses of RCTs suggested a protective effect on total cholesterol (mean difference -0.22 mmol/L), low density lipoprotein (LDL)-cholesterol (-0.19 mmol/L), fasting glucose (-0.19 mmol/L), and HOMA-IR (-0.30). Heterogeneity was high (I2 = 52% for LDL-cholesterol, >75% for others). The overall evidence for associations between consumption of legumes and risk of CVD and T2D was considered limited - no conclusion. Conclusion Legume consumption was not found to influence risk of CVD and T2D in healthy adult populations with generally low legume consumption. However, protective effects on risk factors, seen in RCTs, lend some support for recommending legume consumption as part of diverse and healthy dietary patterns for prevention of CVD and T2D.
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Affiliation(s)
- Birna Thorisdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jutta Dierkes
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | | | - Alfons Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Bright I. Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Söderlund
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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7
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Sood S, Feehan J, Itsiopoulos C, Wilson K, Plebanski M, Scott D, Hebert JR, Shivappa N, Mousa A, George ES, de Courten B. Higher Adherence to a Mediterranean Diet Is Associated with Improved Insulin Sensitivity and Selected Markers of Inflammation in Individuals Who Are Overweight and Obese without Diabetes. Nutrients 2022; 14:nu14204437. [PMID: 36297122 PMCID: PMC9608711 DOI: 10.3390/nu14204437] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
Insulin resistance (IR) and chronic low-grade inflammation are risk factors for chronic diseases including type 2 diabetes (T2D) and cardiovascular disease. This study aimed to investigate two dietary indices: Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII®), and their associations with direct measures of glucose metabolism and adiposity, and biochemical measures including lipids, cytokines and adipokines in overweight/obese adults. This cross-sectional study included 65 participants (males = 63%; age 31.3 ± 8.5 years). Dietary intake via 3-day food diaries was used to measure adherence to MDS (0-45 points); higher scores indicating adherence. Energy-adjusted DII (E-DII) scores were calculated with higher scores indicating a pro-inflammatory diet. IR was assessed using hyperinsulinemic euglycemic clamps, insulin secretion by intravenous glucose tolerance test, adiposity by dual-energy X-ray absorptiometry, and circulating cytokine and adipokine concentrations by multiplex assays. Higher MDS was associated with greater insulin sensitivity (β = 0.179; 95%CI: 0.39, 0.318) after adjusting for age, sex and % body fat, and lower NF-κB, higher adiponectin and adipsin in unadjusted and adjusted models. Higher E-DII score was associated with increased total cholesterol (β = 0.364; 95%CI: 0.066, 0.390) and LDL-cholesterol (β = 0.305; 95%CI: 0.019, 0.287) but not with adiposity, glucose metabolism, cytokines or adipokines. Greater MDS appears to be associated with decreased IR and inflammatory markers in overweight/obese adults.
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Affiliation(s)
- Surbhi Sood
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Footscray, VIC 3011, Australia
| | - Catherine Itsiopoulos
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Kirsty Wilson
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Magdalena Plebanski
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
| | - James R. Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29208, USA
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
| | - Barbora de Courten
- Department of Medicine, Nursing and Health Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
- Correspondence: ; Tel.: +61-3-9925-6474
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Associations of the Mediterranean-Style Dietary Pattern Score with Coronary Artery Calcification and Pericardial Adiposity in a Sample of US Adults. Nutrients 2022; 14:nu14163385. [PMID: 36014891 PMCID: PMC9415980 DOI: 10.3390/nu14163385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Several studies have identified improvements in the risks of cardiovascular disease in adults following a Mediterranean dietary pattern. However, data are scarce on its association with coronary artery calcification (CAC) and pericardial adiposity (PAT) in US adults with and without diabetes. To address this gap, we conducted a case-control study using baseline data from the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study [n = 1255; Type 1 Diabetes (T1D): n = 563; non-Diabetes Mellitus (non-DM): n = 692]. Participants completed a validated food frequency questionnaire, fasting (12 h overnight fast) biochemical analyses, and a physical examination including anthropometric measures. CAC and PAT were measured using electron beam-computed tomography. Logistic regression models were used to examine the associations of the Mediterranean-Style Dietary Pattern Score (MSDPS) with CAC (presence or absence), and linear regression models were applied to PAT analyses. In all of the adjusted models, no significant associations with CAC were found. For PAT, an increasing MSDPS was consistently associated with its lower volume in models adjusted for age, sex, diabetes status, total calories, and body mass index (all p < 0.05). The association between MSDPS and PAT was attenuated after adjusting for serum lipids and physical activity. In conclusion, the baseline data from the CACTI study show that a greater adherence to MSDPS is associated with a lower PAT volume and provide evidence that the Mediterranean dietary pattern is associated with lower cardiovascular risk markers.
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9
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Moussouni A, Sidi-Yakhlef A, Hamdaoui H, Aouar A, Belkhatir D. Prevalence and risk factors of prehypertension and hypertension in Algeria. BMC Public Health 2022; 22:1571. [PMID: 35982441 PMCID: PMC9386961 DOI: 10.1186/s12889-022-13942-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population. METHODS This is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization's (WHO) STEPwise approach. Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model. RESULTS The prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2-37.5%) and 31.6% (95% CI: 30.5-32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older. A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension. CONCLUSION Prehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.
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Affiliation(s)
- Abdellatif Moussouni
- National Center for Prehistoric, Anthropological and Historical Research (CNRPAH, Tlemcen's station), Algeria, 03, Rue Franklin Roosevelt, 16500, Alger, Algeria.
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Anthropology, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria.
| | - Adel Sidi-Yakhlef
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Houari Hamdaoui
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Amaria Aouar
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Djamel Belkhatir
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
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10
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Al-Adwi ME, Al-Haswsa ZM, Alhmmadi KM, Eissa YA, Hamdan A, Bawadi H, Tayyem RF. Effects of different diets on glycemic control among patients with type 2 diabetes: A literature review. Nutr Health 2022; 29:215-221. [PMID: 35795964 DOI: 10.1177/02601060221112805] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Globally, type 2 diabetes mellitus (T2DM) is one of the most common diseases, and the incidence is gradually increasing. Diet management could improve the elevated HbA1c levels. Aim: This review aims to examine the effects of different types of diets on glycemic control in patients with T2DM. Methods: PubMed and Google scholar databases were searched. Reports published from the years 1991 to 2021 that focused on the effect of different diets on diabetes control were selected. Results: All the studies reported that the type of diet can affect insulin secretion and glycemic control in patients with diabetes. The recommended macronutrient distribution for patients with diabetes is 30% of fat, 45-60% of carbohydrates, and 15-35% of protein. Consuming more or less of these macronutrients may lead to changes in glucose metabolism and may affect insulin secretion. In fact, following alow-fat diet improves glycemic control and decreases HbA1c levels. Studies reported that a low-carbohydrate diet had the greatest effect on improving glycemic control and insulin parameters. A low-calorie diet reduced fasting plasma glucose, while a very low-calorie diet resulted in a long-term decrease in HbA1c level. A healthy diet free of processed foods and sugar, and rich in nutrients such as fiber, vitamins, and minerals contributed to maintaining controlled blood sugar and lipid plasma levels. Although studies show a low-salt diet improves blood pressure, which is common inT2DM, other findings show that restricting salt intake is associated with increased sugar consumption. Conclusion: Healthy diet with adequate intake of energy and low-fat and low-sugar foods can enhance the glycemic control and reduce T2DM complications.
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Affiliation(s)
- Maryam E Al-Adwi
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
| | - Zinab M Al-Haswsa
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
| | - Karmen M Alhmmadi
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
| | - Yasmin A Eissa
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
| | - Aya Hamdan
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
| | - Hiba Bawadi
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
| | - Reema F Tayyem
- Department of Human Nutrition, College of Health Science, 61780Qatar University, Doha, Qatar
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11
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Tayyem R, Hamdan A, Alhmmadi K, Eissa Y, Al-Adwi M, Al-Haswsa Z, Bawadi H, Shi Z. Association of Glycemic Control With Different Diets Followed by Patients With Type 2 Diabetes: Findings From Qatar Biobank Data. Front Nutr 2022; 9:813880. [PMID: 35619957 PMCID: PMC9127728 DOI: 10.3389/fnut.2022.813880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Diabetes mellitus type 2 (T2DM) is one of the most common diseases worldwide. Unhealthy dietary habits may lead to T2DM, which is also influenced by the extent of education and knowledge of appropriate diets for this disease. Aim This study aims to highlight the possible association between following different types of diet (low-fat diet, low-calorie diet, low-salt diet, and more than one diet) and glycemic control among Qatari and long-term resident patients with T2DM. Methods This study is secondary data analysis. Qatar Biobank (QBB) data on 2448 T2DM patients aged 18-60 years were obtained. The first group included participants with HbA1C <7%, while the second included those with HbA1c ≥ 7%. Results The results of the association of glycemic control with different diets followed by patients with type 2 diabetes were adjusted in four models. In the 4th model (adjusted for gender, age, sociodemographic, anthropometric, dietary habits, comorbidities, and medications), results showed that poor patients with poor glycemic control have higher odds [OR 1.90; CI (1-3.63)] of following a low-salt diet. The same observation was found in the low-fat diet [OR 1.73; CI (1.06-3.07)]. However, patients following more than one diet showed lower odds of having poor glycemic control for about 32% [OR.69; CI (0.48-0.98)]. Conclusion Diet and lifestyle are vital factors that can affect HbA1C levels. The findings of this secondary analysis showed that better glycemic control of the patients was observed in patients following more than diet from the studied diets.
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Affiliation(s)
- Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
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12
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Sarsangi P, Salehi-Abargouei A, Ebrahimpour-Koujan S, Esmaillzadeh A. Association between Adherence to the Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2022; 13:1787-1798. [PMID: 35472102 PMCID: PMC9526848 DOI: 10.1093/advances/nmac046] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 03/04/2022] [Accepted: 04/21/2022] [Indexed: 01/28/2023] Open
Abstract
Despite earlier meta-analyses on the association between adherence to a Mediterranean diet (MD) and risk of diabetes, there is no comprehensive and updated study assessing this issue. Furthermore, no earlier study has examined the nonlinear dose-response relation between consumption of an MD and risk of diabetes. The current systematic review and meta-analysis was conducted to investigate the linear and nonlinear dose-response relation between MD and incidence of diabetes. Using relevant keywords, electronic searches for prospective studies were conducted in ISI Web of Science, PubMed, and Scopus until January 2022. The reported HRs or ORs in the primary studies were regarded as RRs. The overall effect was calculated using a random-effects model that accounts for between-study variability. The potential nonlinear dose-response associations were tested using a 2-stage hierarchical regression model. Based on 16 prospective studies (with 17 effect sizes), we found that the greatest adherence to the MD was significantly associated with a reduced risk of diabetes (pooled RR: 0.83; 95% CI: 0.77, 0.90; I2 = 79%, P ≤ 0.001). Based on linear dose-response analysis, each 1-score increase in the Mediterranean diet score was associated with a 3% decreased risk of diabetes (HR = 0.97; 95% CI: 0.96, 0.98; P < 0.001). A nonlinear relation (P-nonlinearity = 0.001) was also observed between MD score and risk of type 2 diabetes. Even modest adherence to the MD was linked to a decreased incidence of type 2 diabetes. The protocol is also registered in the International Prospective Register Of Systematic Reviews (PROSPERO) database (https://www.crd.york.ac.uk/PROSPERO/; registration ID: CRD 42021265332).
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Affiliation(s)
- Peyman Sarsangi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Soraiya Ebrahimpour-Koujan
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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13
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Food-Derived Bioactive Molecules from Mediterranean Diet: Nanotechnological Approaches and Waste Valorization as Strategies to Improve Human Wellness. Polymers (Basel) 2022; 14:polym14091726. [PMID: 35566894 PMCID: PMC9103748 DOI: 10.3390/polym14091726] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/15/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023] Open
Abstract
The beneficial effects of the Mediterranean diet (MedDiet), the most widely followed healthy diet in the world, are principally due to the presence in the foods of secondary metabolites, mainly polyphenols, whose healthy characteristics are widely recognized. However, one of the biggest problems associated with the consumption of polyphenols as nutraceutical adjuvant concerns their bioavailability. During the last decades, different nanotechnological approaches have been developed to enhance polyphenol bioavailability, avoiding the metabolic modifications that lead to low absorption, and improving their retention time inside the organisms. This review focuses on the most recent findings regarding the encapsulation and delivery of the bioactive molecules present in the foods daily consumed in the MedDiet such as olive oil, wine, nuts, spice, and herbs. In addition, the possibility of recovering the polyphenols from food waste was also explored, taking into account the increased market demand of functional foods and the necessity to obtain valuable biomolecules at low cost and in high quantity. This circular economy strategy, therefore, represents an excellent approach to respond to both the growing demand of consumers for the maintenance of human wellness and the economic and ecological exigencies of our society.
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14
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Esteves GP, Mazzolani BC, Smaira FI, Mendes ES, de Oliveira GG, Roschel H, Gualano B, Pereira RMR, Dolan E. Nutritional recommendations for patients undergoing prolonged glucocorticoid therapy. Rheumatol Adv Pract 2022; 6:rkac029. [PMID: 35539442 PMCID: PMC9080102 DOI: 10.1093/rap/rkac029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/05/2022] [Indexed: 11/14/2022] Open
Abstract
Glucocorticoid (GC) therapy is a common treatment used in rheumatic and autoimmune diseases, owing to its anti-inflammatory and immunosuppressive effects. However, GC therapy can also induce a number of adverse effects, including muscle and bone loss, hypertension, metabolic perturbations and increased visceral adiposity. We review available evidence in this area and provide nutritional recommendations that might ameliorate these adverse effects. Briefly, optimizing calcium, vitamin D, sodium and protein intake and increasing consumption of unprocessed and minimally processed foods, while decreasing the consumption of ultra-processed foods, might counteract some of the specific challenges faced by these patients. Importantly, we identify a dearth of empirical data on how nutritional intervention might impact health-related outcomes in this population. Further research is required to investigate the clinical and therapeutic efficacy of these theory-based recommendations.
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Affiliation(s)
- Gabriel P Esteves
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Bruna Caruso Mazzolani
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Fabiana Infante Smaira
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Elizabeth Silva Mendes
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Gabriela Guimarães de Oliveira
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
| | - Rosa Maria R Pereira
- Bone Metabolism Laboratory, Rheumatology Division; Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eimear Dolan
- Applied Physiology & Nutrition Research Group; School of Physical Education and Sport; Rheumatology Division; Faculdade de Medicina FMUSP
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15
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Zeraattalab-Motlagh S, Jayedi A, Shab-Bidar S. Mediterranean dietary pattern and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective cohort studies. Eur J Nutr 2022; 61:1735-1748. [PMID: 35001218 DOI: 10.1007/s00394-021-02761-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/25/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Previous meta-analyses assessed the association of adherence to the Mediterranean dietary pattern (MedDiet) with the risk of type 2 diabetes (T2D). Since then, new large-scale cohort studies have been published. In addition, dose-response relation was not previously investigated and the certainty of evidence was not assessed. We aimed to explore the dose-response relationship between adherence to the MedDiet and the risk of T2D. METHODS We did a systematic search using PubMed, Scopus, and ISI Web of Science upto April 2021 for prospective cohort studies of the relationship between adherence to the MedDiet and the risk of T2D in the general population. The summary relative risks (RR) and 95%CI were estimated by applying a random-effects model. RESULTS Fourteen prospective cohort studies (410,303 participants and 41,466 cases) were included. There was an inverse association for the highest versus lowest category of adherence to the MedDiet (RR: 0.79, 95%CI 0.72, 0.88; I2 = 82%, n = 14; Risk difference: - 21 per 1000 person, 95%CI - 28, - 12; GRADE = moderate certainty), and for a 2-point increment in the MedDiet adherence score (RR: 0.86, 95%CI 0.82, 0.91; n = 13). The RR remained significant after controlling for important confounders and in almost all subgroups, especially subgroups defined by geographical region. We observed an inverse linear association between MedDiet adherence score and T2D incidence. CONCLUSION Adherence to the MedDiet was inversely related to T2D risk in a dose-response manner. Adherence to a Mediterranean-style diet may be a good advice for the primary prevention of T2D. REGISTRY AND REGISTRY NUMBER PROSPERO (CRD42021246589).
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Affiliation(s)
- Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
| | - Ahmad Jayedi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran.
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Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, Sacks FM, Thorndike AN, Van Horn L, Wylie-Rosett J. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation 2021; 144:e472-e487. [PMID: 34724806 DOI: 10.1161/cir.0000000000001031] [Citation(s) in RCA: 398] [Impact Index Per Article: 132.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights structural challenges that impede adherence to heart-healthy dietary patterns. Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: (1) adjust energy intake and expenditure to achieve and maintain a healthy body weight; (2) eat plenty and a variety of fruits and vegetables; (3) choose whole grain foods and products; (4) choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms); (5) use liquid plant oils rather than tropical oils and partially hydrogenated fats; (6) choose minimally processed foods instead of ultra-processed foods; (7) minimize the intake of beverages and foods with added sugars; (8) choose and prepare foods with little or no salt; (9) if you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake; and (10) adhere to this guidance regardless of where food is prepared or consumed. Challenges that impede adherence to heart-healthy dietary patterns include targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism. Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.
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Lennerz BS, Mey JT, Henn OH, Ludwig DS. Behavioral Characteristics and Self-Reported Health Status among 2029 Adults Consuming a "Carnivore Diet". Curr Dev Nutr 2021; 5:nzab133. [PMID: 34934897 PMCID: PMC8684475 DOI: 10.1093/cdn/nzab133] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The "carnivore diet," based on animal foods and excluding most or all plant foods, has attracted recent popular attention. However, little is known about the health effects and tolerability of this diet, and concerns for nutrient deficiencies and cardiovascular disease risk have been raised. OBJECTIVES We obtained descriptive data on the nutritional practices and health status of a large group of carnivore diet consumers. METHODS A social media survey was conducted 30 March-24 June, 2020 among adults self-identifying as consuming a carnivore diet for ≥6 mo. Survey questions interrogated motivation, dietary intake patterns, symptoms suggestive of nutritional deficiencies or other adverse effects, satisfaction, prior and current health conditions, anthropometrics, and laboratory data. RESULTS A total of 2029 respondents (median age: 44 y, 67% male) reported consuming a carnivore diet for 14 mo (IQR: 9-20 mo), motivated primarily by health reasons (93%). Red meat consumption was reported as daily or more often by 85%. Under 10% reported consuming vegetables, fruits, or grains more often than monthly, and 37% denied vitamin supplement use. Prevalence of adverse symptoms was low (<1% to 5.5%). Symptoms included gastrointestinal (3.1%-5.5%), muscular (0.3%-4.0%), and dermatologic (0.1%-1.9%). Participants reported high levels of satisfaction and improvements in overall health (95%), well-being (66%-91%), various medical conditions (48%-98%), and median [IQR] BMI (in kg/m2) (from 27.2 [23.5-31.9] to 24.3 [22.1-27.0]). Among a subset reporting current lipids, LDL-cholesterol was markedly elevated (172 mg/dL), whereas HDL-cholesterol (68 mg/dL) and triglycerides (68 mg/dL) were optimal. Participants with diabetes reported benefits including reductions in median [IQR] BMI (4.3 [1.4-7.2]), glycated hemoglobin (0.4% [0%-1.7%]), and diabetes medication use (84%-100%). CONCLUSIONS Contrary to common expectations, adults consuming a carnivore diet experienced few adverse effects and instead reported health benefits and high satisfaction. Cardiovascular disease risk factors were variably affected. The generalizability of these findings and the long-term effects of this dietary pattern require further study.
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Affiliation(s)
- Belinda S Lennerz
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Jacob T Mey
- Integrated Physiology and Molecular Medicine, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Owen H Henn
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
| | - David S Ludwig
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Vitale M, Giosuè A, Vaccaro O, Riccardi G. Recent Trends in Dietary Habits of the Italian Population: Potential Impact on Health and the Environment. Nutrients 2021; 13:476. [PMID: 33572514 PMCID: PMC7911362 DOI: 10.3390/nu13020476] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/25/2022] Open
Abstract
Population growth, globalization, urbanization, and economic pressures are causing changes in food consumption all over the world. The study's aims are (1) to evaluate trends in food habits in Italy to highlight deviations from the traditional Mediterranean diet, (2) to analyze the features of the present Italian diet that should be modified to meet evidence-based global scientific targets for a healthy and sustainable diet proposed by the EAT-Lancet Commission. Trends in food availability for human consumption during the period 2000-2017 were assessed using the food balance sheets (FBSs). Greenhouse gas (GHG) emission was estimated according to life cycle assessment (LCA) analyses. During the study period, the availability of animal fat and beef meat greatly declined (-58% and -32%, respectively), followed by fruit, potatoes, vegetables, milk, and non-tropical oils (-20%, -15%, -13%, -14%, and -11%, respectively). A substantial increase has occurred for tropical oils, fish, and nuts (+156, +26%, and +21%, respectively). In order to meet the targets of consumption proposed by the EAT-Lancet Commission, the consumption of legumes and nuts should be almost doubled, whereas the consumption of meat, eggs, dairy products, animal fat, tropical oils, and sugars should be reduced by proportions ranging from 60% to 90%. If implemented, these changes would reduce the diet-related greenhouse gas emission by nearly 50%. In conclusion, these data call for nutritional education programs and interventions on the food system aimed at promoting a healthier and more environmentally sustainable diet. To this end, the availability and affordability of products with a better impact on human health and the environment should be promoted.
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Affiliation(s)
- Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.V.); (A.G.); (G.R.)
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.V.); (A.G.); (G.R.)
| | - Olga Vaccaro
- Department of Pharmacy, Federico II University, 80131 Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy; (M.V.); (A.G.); (G.R.)
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19
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Dyson P. Mediterranean diets and diabetes. PRACTICAL DIABETES 2021. [DOI: 10.1002/pdi.2318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Pamela Dyson
- OCDEM Oxford University NHS Foundation Trust, Oxford, UK2NIHR Biomedical Research Centre Oxford UK
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20
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Sarkar D, Christopher A, Shetty K. Phenolic Bioactives From Plant-Based Foods for Glycemic Control. Front Endocrinol (Lausanne) 2021; 12:727503. [PMID: 35116002 PMCID: PMC8805174 DOI: 10.3389/fendo.2021.727503] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/21/2021] [Indexed: 12/19/2022] Open
Abstract
Plant-based foods containing phenolic bioactives have human health protective functions relevant for combating diet and lifestyle-influenced chronic diseases, including type 2 diabetes (T2D). The molecular structural features of dietary phenolic bioactives allow antioxidant functions relevant for countering chronic oxidative stress-induced metabolic breakdown commonly associated with T2D. In addition to antioxidant properties, phenolic bioactives of diverse plant foods have therapeutic functional activities such as improving insulin sensitivity, reducing hepatic glucose output, inhibiting activity of key carbohydrate digestive enzymes, and modulating absorption of glucose in the bloodstream, thereby subsequently improving post-prandial glycemic control. These therapeutic functional properties have direct implications and benefits in the dietary management of T2D. Therefore, plant-based foods that are rich in phenolic bioactives are excellent dietary sources of therapeutic targets to improve overall glycemic control by managing chronic hyperglycemia and chronic oxidative stress, which are major contributing factors to T2D pathogenesis. However, in studies with diverse array of plant-based foods, concentration and composition of phenolic bioactives and their glycemic control relevant bioactivity can vary widely between different plant species, plant parts, and among different varieties/genotypes due to the different environmental and growing conditions, post-harvest storage, and food processing steps. This has allowed advances in innovative strategies to screen and optimize whole and processed plant derived foods and their ingredients based on their phenolic bioactive linked antioxidant and anti-hyperglycemic properties for their effective integration into T2D focused dietary solutions. In this review, different pre-harvest and post-harvest strategies and factors that influence phenolic bioactive-linked antioxidant and anti-hyperglycemic properties in diverse plant derived foods and derivation of extracts with therapeutic potential are highlighted and discussed. Additionally, novel bioprocessing strategies to enhance bioavailability and bioactivity of phenolics in plant-derived foods targeting optimum glycemic control and associated T2D therapeutic benefits are also advanced.
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21
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The Beneficial Health Effects of Vegetables and Wild Edible Greens: The Case of the Mediterranean Diet and Its Sustainability. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10249144] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Mediterranean diet (MD) concept as currently known describes the dietary patterns that were followed in specific regions of the area in the 1950s and 1960s. The broad recognition of its positive effects on the longevity of Mediterranean populations also led to the adoption of this diet in other regions of the world, and scientific interest focused on revealing its health effects. MD is not only linked with eating specific nutritional food products but also with social, religious, environmental, and cultural aspects, thus representing a healthy lifestyle in general. However, modern lifestyles adhere to less healthy diets, alienating people from their heritage. Therefore, considering the increasing evidence of the beneficial health effects of adherence to the MD and the ongoing transitions in consumers’ behavior, the present review focuses on updating the scientific knowledge regarding this diet and its relevance to agrobiodiversity. In addition, it also considers a sustainable approach for new marketing opportunities and consumer trends of the MD.
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22
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A Mediterranean Dietary Pattern Predicts Better Sleep Quality in US Women from the American Heart Association Go Red for Women Strategically Focused Research Network. Nutrients 2020; 12:nu12092830. [PMID: 32947817 PMCID: PMC7551612 DOI: 10.3390/nu12092830] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/12/2020] [Accepted: 09/14/2020] [Indexed: 01/27/2023] Open
Abstract
Consumption of a Mediterranean diet has been linked to better sleep health in older, European populations. However, whether this dietary pattern is predictive of sleep quality in US women, a group prone to poor sleep, is unknown. This prospective cohort study of 432 US women (20–76 y; 60% racial/ethnic minority) evaluated whether compliance with a Mediterranean diet at baseline predicted sleep quality at 1-y follow-up. Alternate Mediterranean (aMed) diet scores and habitual sleep quality were computed from the validated Block Brief Food Frequency Questionnaire and Pittsburgh Sleep Quality Index (PSQI), respectively. Linear regression models evaluated prospective associations of the aMed diet pattern and its components with measures of sleep quality, after adjustment for age, BMI, race/ethnicity, education, and health insurance status. Higher baseline aMed scores were associated with lower PSQI scores (β = −0.30 ± 0.10, p < 0.01), indicative of better sleep quality, higher sleep efficiency (β = 1.20 ± 0.35, p < 0.001), and fewer sleep disturbances (β = −0.30 ± 0.12, p = 0.01) at 1-y. Fruit and vegetable consumption also predicted lower PSQI scores, higher sleep efficiency and fewer sleep disturbances (all p < 0.05). Higher legume intake predicted better sleep efficiency (β = 1.36 ± 0.55, p = 0.01). These findings suggest that adherence to a Mediterranean diet pattern should be evaluated as a strategy to promote sleep quality in US women.
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Cano A, Marshall S, Zolfaroli I, Bitzer J, Ceausu I, Chedraui P, Durmusoglu F, Erkkola R, Goulis DG, Hirschberg AL, Kiesel L, Lopes P, Pines A, van Trotsenburg M, Lambrinoudaki I, Rees M. The Mediterranean diet and menopausal health: An EMAS position statement. Maturitas 2020; 139:90-97. [PMID: 32682573 DOI: 10.1016/j.maturitas.2020.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Globally, 985 million women are aged 50 and over, leading to increasing concerns about chronic conditions such as cardiovascular disease, osteoporosis, dementia, and cognitive decline, which can adversely affect quality of life and independent living. AIM To evaluate the evidence from observational studies and randomized trials on the effects of the Mediterranean diet on short- and long-term menopausal health: estrogen deficiency symptoms, cardiovascular disease, osteoporosis, cognitive and mental health, breast cancer, and all-cause mortality. MATERIALS AND METHODS Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS The Mediterranean diet is a non-restrictive dietary pattern common in the olive-growing areas of the Mediterranean basin. It may improve vasomotor symptoms, cardiovascular risk factors such as blood pressure, cholesterol and blood glucose levels, as well as mood and symptoms of depression. Long-term adherence may: improve cardiovascular risk and events, and death; improve bone mineral density; prevent cognitive decline; and reduce the risk of breast cancer and all-cause mortality.
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Affiliation(s)
- Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain.
| | - Skye Marshall
- Nutrition Research Australia, New South Wales, Australia; Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Irene Zolfaroli
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain
| | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital, Basel, Switzerland
| | - Iuliana Ceausu
- Department of Obstetrics and Gynecology I, "Dr. I. Cantacuzino" Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Peter Chedraui
- Instituto de Investigación e Innovación de Salud Integral (ISAIN), Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Fatih Durmusoglu
- Istanbul Medipol International School of Medicine, Istanbul, Turkey
| | - Risto Erkkola
- Department of Obstetrics and Gynecology, University Central Hospital Turku, Finland
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ludwig Kiesel
- Department of Gynecology and Obstetrics, University of Münster, Münster, Germany
| | - Patrice Lopes
- Nantes, France Polyclinique de l'Atlantique Saint Herblain, F 44819 St Herblain France, Université de Nantes F 44093 Nantes Cedex, France
| | - Amos Pines
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Mick van Trotsenburg
- Department of Obstetrics and Gynecology, University Hospital St. Poelten-Lilienfeld, Austria
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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Restani P, Di Lorenzo C, Fradera U, Stockley CS, Teissedre PL, Ruf JC, Iasiello B, Biella S, Colombo F, Kosti RI. Is it scientifically justifiable to exclude wine and/or unfermented grape derivatives from the diet of consumers with or at risk of developing type-2 diabetes? Food Funct 2020; 11:10266-10278. [DOI: 10.1039/d0fo01969k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This narrative review investigates whether low/moderate consumption of wine/grape's derivatives can be part of T2D individuals daily diet.
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Affiliation(s)
- Patrizia Restani
- Dept. Pharmacological and Biomolecular Sciences. Università degliStudi di Milano
- 20133 Milano
- Italy
- CRC “Innovation for well-being and environment” Università degliStudi di Milano
- 20122 Milano
| | - Chiara Di Lorenzo
- Dept. Pharmacological and Biomolecular Sciences. Università degliStudi di Milano
- 20133 Milano
- Italy
| | - Ursula Fradera
- Deutsche Weinakademie
- Platz des Weines 2
- 55294 Bodenheim
- Germany
- Wine Information Council
| | - Creina S. Stockley
- School of Agriculture
- Food and Wine
- The University of Adelaide
- South Australia
- 5005 Australia
| | - Pierre-Louis Teissedre
- Université de Bordeaux
- Unité de Recherche Œnologie
- 33882 Villenave d'Ornon cedex
- France
- INRA
| | - Jean-Claude Ruf
- OIV – International Organisation of Vine and Wine
- 75008 Paris
- France
| | - Barbara Iasiello
- OIV – International Organisation of Vine and Wine
- 75008 Paris
- France
| | - Simone Biella
- Dept. Pharmacological and Biomolecular Sciences. Università degliStudi di Milano
- 20133 Milano
- Italy
| | - Francesca Colombo
- Dept. Pharmacological and Biomolecular Sciences. Università degliStudi di Milano
- 20133 Milano
- Italy
| | - Rena I. Kosti
- University of Thessaly
- School of Physical Education
- Sport Science and Dietetics
- Department of Nutrition & Dietetics
- Trikala
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