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Echeverría G, Samith B, von Schultzendorf A, Pinto V, Martínez X, Sara D, Calzada M, Pacheco J, Plaza G, Scott F, Romero J, Mateo C, Julio MV, Utreras-Mendoza Y, Binder MV, Gutiérrez F, Riquelme ME, Cuevas M, Willatt R, Sánchez O, Keilendt A, Butrón P, Jarufe A, Huete I, Tobar J, Martin S, Alfaro V, Olivos M, Pedrals N, Bitran M, Ávalos I, Ruini C, Ryff C, Pérez D, Berkowitz L, Rigotti A. Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial). Contemp Clin Trials Commun 2023; 35:101167. [PMID: 37538196 PMCID: PMC10393605 DOI: 10.1016/j.conctc.2023.101167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/06/2023] [Accepted: 06/18/2023] [Indexed: 08/05/2023] Open
Abstract
Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.
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Affiliation(s)
- Guadalupe Echeverría
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Bárbara Samith
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Andrea von Schultzendorf
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Victoria Pinto
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Carrera de Nutrición y Dietética, Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Ximena Martínez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Daniela Sara
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Mariana Calzada
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Josefina Pacheco
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Gianella Plaza
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Francesca Scott
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Javiera Romero
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Camila Mateo
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - María Verónica Julio
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Yildy Utreras-Mendoza
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - María Victoria Binder
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Florencia Gutiérrez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - María Emilia Riquelme
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Margarita Cuevas
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Rosario Willatt
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Omayra Sánchez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Aracelli Keilendt
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Patricia Butrón
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Alessandra Jarufe
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Isidora Huete
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Josefina Tobar
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Sofía Martin
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Valentina Alfaro
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Matilde Olivos
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Nuria Pedrals
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Marcela Bitran
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | | | - Chiara Ruini
- Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - Carol Ryff
- Institute on Aging and Department of Psychology, University of Wisconsin-Madison, Madison, WI, 53706-1611, USA
| | - Druso Pérez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Loni Berkowitz
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
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Megawati G, Indraswari N, Johansyah AA, Kezia C, Herawati DMD, Gurnida DA, Musfiroh I. Comparison of hs-CRP in Adult Obesity and Central Obesity in Indonesia Based on Omega-3 Fatty Acids Intake: Indonesian Family Life Survey 5 (IFLS 5) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6734. [PMID: 37754594 PMCID: PMC10530835 DOI: 10.3390/ijerph20186734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023]
Abstract
Obesity and central obesity are associated with dire conditions, such as metabolic syndrome, in which low-grade inflammation plays a part. C-reactive protein (CRP) is an inflammatory marker found to be elevated in those conditions. Omega-3 fatty acids work against inflammation and lower CRP levels in obese individuals. This study compared high-sensitivity CRP (hs-CRP) in adult obesity and central obesity in Indonesia based on omega-3 fatty acid intake using Indonesian Family Life Survey (IFLS) 5 data. Secondary data from household questionnaires were obtained from the IFLS 5 online database. Data from 3152 subjects were used; 76.65% of the subjects were female, with a mean age of 45.27 ± 15.77 years. Subjects were classified into five modified categories of obesity and central obesity based on body mass index (BMI) and waist circumference (WC). Omega-3 fatty acid intake was categorized into "low" and "adequate" based on dietary recommendations from the Mediterranean Diet Foundation (2011). There is a significant difference in hs-CRP based on modified obesity categories (p < 0.05). There was no significant difference in hs-CRP between low and adequate omega-3 intake (p > 0.05). These data suggest that hs-CRP is related to overweight, obesity, and central obesity. Meanwhile, omega-3 fatty acids are unrelated to hs-CRP. Further studies are needed to confirm these results.
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Affiliation(s)
- Ginna Megawati
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia;
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Noormarina Indraswari
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | | | - Capella Kezia
- Medical Undergraduate Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | | | - Dida Achmad Gurnida
- Department of Child Health, Faculty of Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung 40161, Indonesia
| | - Ida Musfiroh
- Department of Pharmaceutical Analysis dan Medicinal Chemistry, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, Indonesia
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Figueroa C, Echeverría G, Villarreal G, Martínez X, Ferreccio C, Rigotti A. Introducing Plant-Based Mediterranean Diet as a Lifestyle Medicine Approach in Latin America: Opportunities Within the Chilean Context. Front Nutr 2021; 8:680452. [PMID: 34249989 PMCID: PMC8266999 DOI: 10.3389/fnut.2021.680452] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
Latin America is experiencing a significant epidemiological and nutritional transition, with a trend toward higher incidence of food-related chronic diseases. In this context, Lifestyle Medicine (LM) is a growing field focused on assisting individuals in adopting healthy behaviors for the prevention and treatment of these chronic diseases, including, among other pillars, a great emphasis on healthy eating. There is also a growing interest worldwide in environmental sustainability of dietary patterns, with increasing concern about their effects on planetary health. In this context, whole-food, plant-based diets -such as the Mediterranean diet (MD)- have emerged as a solution for both healthier eating and lowering environmental impact. Yet in order to be effective at these goals and achieve a high adherence to any nutritional prescription, the sociocultural reality of the community or population where we aim to practice must also be taken into account. In this review, we specifically highlight the plant-based MD as a LM-contextualized dietary pattern that is adaptable, applicable, and sustainable within the Chilean context and has the potential to address the current trend of chronic diseases in our country.
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Affiliation(s)
- Catalina Figueroa
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Guadalupe Echeverría
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Grisell Villarreal
- Magíster en Nutrición, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ximena Martínez
- Magíster en Nutrición, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catterina Ferreccio
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Echeverría G, Tiboni O, Berkowitz L, Pinto V, Samith B, von Schultzendorff A, Pedrals N, Bitran M, Ruini C, Ryff CD, Del Rio D, Rigotti A. Mediterranean Lifestyle to Promote Physical, Mental, and Environmental Health: The Case of Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8482. [PMID: 33207718 PMCID: PMC7696560 DOI: 10.3390/ijerph17228482] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 12/12/2022]
Abstract
Chile is currently experiencing a progressive epidemiological transition towards chronic diseases. In this country, >50% of annual deaths are attributed to cardiovascular disease and cancer. Moreover, health surveys have shown high prevalence of obesity, diabetes, hypertension, and elevated cardiovascular disease risk. In addition, mental health issues are also frequent among Chilean adults. On the other hand, the agri-food system contributes to 21-37% of greenhouse gases emissions worldwide. Overall, current health and food chain situation calls out for design and implementation of evidence-based feasible and effective nutritional interventions needed to promote physical and mental health along with addressing food sustainability in Chile. Nowadays, the Mediterranean diet is recognized as one of the healthiest dietary patterns based on observational and interventional studies linked to a wide variety of health outcomes. However, a Mediterranean lifestyle goes well beyond food intake: it includes promotion of psychosocial resources, community life as well as cultural traditions. Indeed, Mediterranean lifestyle is a true modus vivendi that integrally promotes physical, mental, and social well-being. In addition, the Mediterranean diet stands out for its environmental sustainability because it is characterized mainly as a plant-based dietary pattern with low carbon and water footprints. Remarkably, Central Chile has a Mediterranean-like setting with plant and animal food production and availability patterns comparable to those present in countries located around the Mediterranean Sea. Therefore, this article reviews how promotion of Mediterranean lifestyle adherence in Chile offers great potential for management of the ongoing epidemiological transition to chronic diseases as well to promote psychological well-being within a unique food system and dietary sustainability vision for this Latin American country.
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Affiliation(s)
- Guadalupe Echeverría
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (G.E.); (L.B.); (B.S.); (N.P.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
| | - Ornella Tiboni
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
| | - Loni Berkowitz
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (G.E.); (L.B.); (B.S.); (N.P.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
| | - Victoria Pinto
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
| | - Bárbara Samith
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (G.E.); (L.B.); (B.S.); (N.P.)
| | - Andrea von Schultzendorff
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
| | - Nuria Pedrals
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (G.E.); (L.B.); (B.S.); (N.P.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
| | - Marcela Bitran
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
- Centro de Educación Médica y de Ciencias de la Salud, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile
| | - Chiara Ruini
- Department of Psychology, University of Bologna, 40126 Bologna, Italy;
| | - Carol D. Ryff
- Institute on Aging and Department of Psychology, University of Wisconsin-Madison, Madison, WI 53706-1611, USA;
| | - Daniele Del Rio
- Department of Food and Drugs, University of Parma, 43121 Parma, Italy;
| | - Attilio Rigotti
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (G.E.); (L.B.); (B.S.); (N.P.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago CP 83300024, Chile; (O.T.); (V.P.); (A.v.S.); (M.B.)
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Papadaki A, Nolen-Doerr E, Mantzoros CS. The Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults. Nutrients 2020; 12:nu12113342. [PMID: 33143083 PMCID: PMC7692768 DOI: 10.3390/nu12113342] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/20/2022] Open
Abstract
The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to examine the MD’s effect on metabolic syndrome (MetSyn) incidence, components and risk factors (primary outcomes), and incidence and/or mortality from MetSyn-related comorbidities and receipt of pharmacologic treatment for MetSyn components and comorbidities (secondary outcomes). We searched Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science for controlled trials published until June 2019, comparing the MD with no treatment, usual care, or different diets in adults. Studies not published in English and not promoting the whole MD were excluded. Two authors independently extracted data and assessed risk of bias using the Cochrane Collaboration’s and Risk of Bias in non-randomised studies (ROBINS-I) tools. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects meta-analyses, subgroup analyses and meta-regressions were performed, and heterogeneity was quantified using the I2 statistic. We identified 2654 reports and included 84 articles reporting 57 trials (n = 36,983). In random effects meta-analyses, the MD resulted in greater beneficial changes in 18 of 28 MetSyn components and risk factors (body weight, body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR) index, total-, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, alanine transaminase, hepatic fat mass, C-reactive protein, interleukin-6, tumour necrosis factor-a, and flow-mediated dilatation) and lower risk of cardiovascular disease incidence (risk ratio (RR) = 0.61, 95% confidence intervals (CI) 0.42–0.80; I2 = 0%), and stroke (RR = 0.67, 95% CI 0.35–0.98; I2 = 0%). Only six studies reported effects on pharmacotherapy use, and pooled analysis indicated no differences between diet groups. Lack of consistency in comparator groups and other study characteristics across studies resulted in high heterogeneity for some outcomes, which could not be considerably explained by meta-regressions. However, a consistent direction of beneficial effect of the MD was observed for the vast majority of outcomes examined. Findings support MD’s beneficial effect on all components and most risk factors of the MetSyn, in addition to cardiovascular disease and stroke incidence. More studies are needed to establish effects on other clinical outcomes and use of pharmacotherapy for MetSyn components and comorbidities. Despite the high levels of heterogeneity for some outcomes, this meta-analysis enabled the comparison of findings across studies and the examination of consistency of effects. The consistent direction of effect, suggesting the MD’s benefits on metabolic health, supports the need to promote this dietary pattern to adult populations.
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Affiliation(s)
- Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Eric Nolen-Doerr
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
- Department of Endocrinology, Boston VA Healthcare System, Boston, MA 02130, USA
| | - Christos S. Mantzoros
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
- Department of Endocrinology, Boston VA Healthcare System, Boston, MA 02130, USA
- Correspondence: ; Tel.: +1-(0)617-667-8636
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Hernáez Á, Castañer O, Tresserra-Rimbau A, Pintó X, Fitó M, Casas R, Martínez-González MÁ, Corella D, Salas-Salvadó J, Lapetra J, Gómez-Gracia E, Arós F, Fiol M, Serra-Majem L, Ros E, Estruch R. Mediterranean Diet and Atherothrombosis Biomarkers: A Randomized Controlled Trial. Mol Nutr Food Res 2020; 64:e2000350. [PMID: 32918853 DOI: 10.1002/mnfr.202000350] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/03/2020] [Indexed: 01/03/2023]
Abstract
SCOPE To assess whether following a Mediterranean diet (MedDiet) improves atherothrombosis biomarkers in high cardiovascular risk individuals. METHODS AND RESULTS In 358 random volunteers from the PREvención con DIeta MEDiterránea trial, the 1-year effects on atherothrombosis markers of an intervention with MedDiet, enriched with virgin olive oil (MedDiet-VOO; n = 120) or nuts (MedDiet-Nuts; n = 119) versus a low-fat control diet (n = 119), and whether large increments in MedDiet adherence (≥3 score points, versus compliance decreases) and intake changes in key food items are associated with 1-year differences in biomarkers. Differences are observed between 1-year changes in the MedDiet-VOO intervention and control diet on the activity of platelet activating factor acetylhydrolase in high-density lipoproteins (HDLs) (+7.5% [95% confidence interval: 0.17; 14.8]) and HDL-bound α1 -antitrypsin levels (-6.1% [-11.8; -0.29]), and between the MedDiet-Nuts intervention and the control arm on non-esterified fatty acid concentrations (-9.3% [-18.1; -0.53]). Large MedDiet adherence increments are associated with less fibrinogen (-9.5% [-18.3; -0.60]) and non-esterified fatty acid concentrations (-16.7% [-31.7; -1.74]). Increases in nut, fruit, vegetable, and fatty fish consumption, and decreases in processed meat intake are linked to enhancements in biomarkers. CONCLUSION MedDiet improves atherothrombosis biomarkers in high cardiovascular risk individuals.
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Affiliation(s)
- Álvaro Hernáez
- Cardiovascular Risk, Nutrition and Aging Research Unit, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, 08003, Spain.,CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain
| | - Olga Castañer
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain
| | - Anna Tresserra-Rimbau
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.,Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain.,Institut d'Investigació Pere Virgili (IISPV), Reus, 43204, Spain
| | - Xavier Pintó
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, 08907, Spain
| | - Montserrat Fitó
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain
| | - Rosa Casas
- Cardiovascular Risk, Nutrition and Aging Research Unit, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, 08003, Spain.,CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Miguel Ángel Martínez-González
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, 31009, Spain.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Dolores Corella
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Department of Preventive Medicine, Universidad de Valencia, Valencia, 46100, Spain
| | - Jordi Salas-Salvadó
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain.,Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain.,Institut d'Investigació Pere Virgili (IISPV), Reus, 43204, Spain
| | - José Lapetra
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Department of Family Medicine. Research Unit., Distrito Sanitario Atención Primaria Sevilla, Sevilla, 41013, Spain
| | - Enrique Gómez-Gracia
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Department of Preventive Medicine and Public Health, Universidad de Málaga, Málaga, 29010, Spain
| | - Fernando Arós
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Department of Cardiology, Hospital Universitario de Álava, Vitoria, 01009, Spain
| | - Miquel Fiol
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, Palma de Mallorca, 07120, Spain
| | - Lluis Serra-Majem
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas, 35016, Spain
| | - Emilio Ros
- Cardiovascular Risk, Nutrition and Aging Research Unit, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, 08003, Spain.,CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona, 08036, Spain
| | - Ramón Estruch
- Cardiovascular Risk, Nutrition and Aging Research Unit, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, 08003, Spain.,CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Internal Medicine Service, Hospital Clínic, Barcelona, 08036, Spain
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7
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Promoting and Implementing the Mediterranean Diet in the Southern Hemisphere: the Chilean Experience. Eur J Clin Nutr 2020; 72:38-46. [PMID: 30487560 DOI: 10.1038/s41430-018-0307-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Increasing scientific evidence shows that the Mediterranean lifestyle -including a characteristic dietary pattern as well as psychosocial and cultural features- has beneficial effects on human health. However, production and use of some of the distinctive components (e.g., olive oil, red wine, nuts, legumes, fish and seafood) of the Mediterranean diet (MedDiet) are not exclusively confined to the Mediterranean Basin, but are also found in other world regions, including California, Southwestern Australia, South Africa, and Chile. Central Chile exhibits a Mediterranean climate and Chilean agriculture and culinary traditions show striking similarities to Mediterranean countries. Using a MedDiet index adapted to food habits in Chile, we found that only 10% of the adult population displays this healthy eating behavior. Furthermore, high scores in the MedDiet index correlate with lower prevalence of overweight, obesity, and metabolic syndrome in Chilean adults. High adherence to a Mediterranean-like diet is also associated with better psychological wellbeing. Finally, a pilot study investigating the effects of a Mediterranean diet in Chile -as part of a 'food-at-work intervention'- showed a significant improvement in diet quality which was associated with a 35% reduction in the prevalence of the metabolic syndrome. Increased appreciation and application of a Mediterranean-like dietary pattern may therefore improve health and quality of life in the population of Chile, where non-communicable chronic diseases are increasingly common.
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8
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The effect of grape products containing polyphenols on C-reactive protein levels: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2020; 125:1230-1245. [DOI: 10.1017/s0007114520003591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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9
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Abstract
BACKGROUND Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and its use can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This review aimed to quantify the acute effects of different doses of alcohol over time on blood pressure and heart rate in an adult population. OBJECTIVES Primary objective To determine short-term dose-related effects of alcohol versus placebo on systolic blood pressure and diastolic blood pressure in healthy and hypertensive adults over 18 years of age. Secondary objective To determine short-term dose-related effects of alcohol versus placebo on heart rate in healthy and hypertensive adults over 18 years of age. SEARCH METHODS The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to March 2019: the Cochrane Hypertension Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), in the Cochrane Library; MEDLINE (from 1946); Embase (from 1974); the World Health Organization International Clinical Trials Registry Platform; and ClinicalTrials.gov. We also contacted authors of relevant articles regarding further published and unpublished work. These searches had no language restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing effects of a single dose of alcohol versus placebo on blood pressure (BP) or heart rate (HR) in adults (≥ 18 years of age). DATA COLLECTION AND ANALYSIS Two review authors (ST and CT) independently extracted data and assessed the quality of included studies. We also contacted trial authors for missing or unclear information. Mean difference (MD) from placebo with 95% confidence interval (CI) was the outcome measure, and a fixed-effect model was used to combine effect sizes across studies. MAIN RESULTS: We included 32 RCTs involving 767 participants. Most of the study participants were male (N = 642) and were healthy. The mean age of participants was 33 years, and mean body weight was 78 kilograms. Low-dose alcohol (< 14 g) within six hours (2 RCTs, N = 28) did not affect BP but did increase HR by 5.1 bpm (95% CI 1.9 to 8.2) (moderate-certainty evidence). Medium-dose alcohol (14 to 28 g) within six hours (10 RCTs, N = 149) decreased systolic blood pressure (SBP) by 5.6 mmHg (95% CI -8.3 to -3.0) and diastolic blood pressure (DBP) by 4.0 mmHg (95% CI -6.0 to -2.0) and increased HR by 4.6 bpm (95% CI 3.1 to 6.1) (moderate-certainty evidence for all). Medium-dose alcohol within 7 to 12 hours (4 RCTs, N = 54) did not affect BP or HR. Medium-dose alcohol > 13 hours after consumption (4 RCTs, N = 66) did not affect BP or HR. High-dose alcohol (> 30 g) within six hours (16 RCTs, N = 418) decreased SBP by 3.5 mmHg (95% CI -6.0 to -1.0), decreased DBP by 1.9 mmHg (95% CI-3.9 to 0.04), and increased HR by 5.8 bpm (95% CI 4.0 to 7.5). The certainty of evidence was moderate for SBP and HR, and was low for DBP. High-dose alcohol within 7 to 12 hours of consumption (3 RCTs, N = 54) decreased SBP by 3.7 mmHg (95% CI -7.0 to -0.5) and DBP by 1.7 mmHg (95% CI -4.6 to 1.8) and increased HR by 6.2 bpm (95% CI 3.0 to 9.3). The certainty of evidence was moderate for SBP and HR, and low for DBP. High-dose alcohol ≥ 13 hours after consumption (4 RCTs, N = 154) increased SBP by 3.7 mmHg (95% CI 2.3 to 5.1), DBP by 2.4 mmHg (95% CI 0.2 to 4.5), and HR by 2.7 bpm (95% CI 0.8 to 4.6) (moderate-certainty evidence for all). AUTHORS' CONCLUSIONS: High-dose alcohol has a biphasic effect on BP; it decreases BP up to 12 hours after consumption and increases BP > 13 hours after consumption. High-dose alcohol increases HR at all times up to 24 hours. Findings of this review are relevant mainly to healthy males, as only small numbers of women were included in the included trials.
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Affiliation(s)
- Sara Tasnim
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
| | - Chantel Tang
- Faculty of Health Sciences, McGill University, Montreal, Canada
| | - Vijaya M Musini
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
| | - James M Wright
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
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10
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Restani P, Fradera U, Ruf JC, Stockley C, Teissedre PL, Biella S, Colombo F, Lorenzo CD. Grapes and their derivatives in modulation of cognitive decline: a critical review of epidemiological and randomized-controlled trials in humans. Crit Rev Food Sci Nutr 2020; 61:566-576. [PMID: 32208848 DOI: 10.1080/10408398.2020.1740644] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
With an increase in life expectancy, the incidence of chronic degenerative pathologies such as dementia has progressively risen. Cognitive impairment leads to the gradual loss of skills, which results in substantial personal and financial cost at the individual and societal levels. Grapes and wines are rich in healthy compounds, which may help to maintain homeostasis and reduce the risk of several chronic illnesses, including dementia. This review analyzed papers that were systematically searched in PubMed, MEDLINE, Embase, and CAB-Abstract, using the association between grapes (or their derivatives) and their effects on cognitive functions in humans. Analysis was restricted to epidemiological and randomized-controlled studies. Consumption of grape juice (200-500 mL/day) and/or light-to-moderate wine (one to four glasses/day) was generally associated with improved cognitive performance, while the results for other alcoholic beverages were controversial and inconclusive. Bioactive molecules contained in grapes and wine were also considered, with particular attention paid to resveratrol. Due to the relatively high doses required (150-1000 mg/day) for bioactivity coupled with its low bioavailability, resveratrol is only one of the possible grape-derived compounds that may partly underpin the beneficial effects of grapes on the central nervous system.
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Affiliation(s)
- Patrizia Restani
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Ursula Fradera
- Deutsche Weinakademie, Bodenheim, Germany.,Wine Information Council, Brussels, Belgium
| | - Jean-Claude Ruf
- Scientific Coordinator at OIV - International Organisation of Vine and Wine, Paris, France
| | - Creina Stockley
- School of Agriculture, Food and Wine, The University of Adelaide, South Australia, Australia
| | - Pierre-Louis Teissedre
- Unité de recherche OEnologie, Université de Bordeaux, EA 4577, USC 1366 INRA, ISVV, Villenave d'Ornon cedex, France.,INRA, ISVV, USC 1366 OEnologie, Villenave d'Ornon, France
| | - Simone Biella
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Francesca Colombo
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Chiara Di Lorenzo
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
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11
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Arouca A, Michels N, Moreno LA, González-Gil EM, Marcos A, Gómez S, Díaz LE, Widhalm K, Molnár D, Manios Y, Gottrand F, Kafatos A, Kersting M, Sjöström M, de la O A, Ferrari M, Huybrechts I, Gonzalez-Gross M, De Henauw S. Associations between a Mediterranean diet pattern and inflammatory biomarkers in European adolescents. Eur J Nutr 2018; 57:1747-1760. [PMID: 28421282 DOI: 10.1007/s00394-017-1457-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 04/12/2017] [Indexed: 12/11/2022]
Abstract
AIM To test whether the Mediterranean diet score and each food-subgroup is associated with inflammatory biomarkers in European adolescents. METHODS In 464 adolescents (13-17 years) of the European HELENA study, data were available on body composition, inflammation markers, and food intake determined by two computerized 24-h recalls. The Mediterranean diet score and its food-subgroups (Vegetables, Fruits and Nuts, Pulses, Cereal and Roots, Monounsaturated/Saturated fat ratio, Dairy, Fish, Meat and Alcohol) were evaluated. A set of inflammation-related biomarkers was measured: IL-1, IL-2, IL-4, IL-5, IL-6, IL-10, TGFβ-1, TNF-α, sVCAM-1, sICAM1, sE-selectin, white blood cells, lymphocytes, CD3, CRP, GGT, ALT, and homocysteine. Multivariate and multiple linear regression analyses were adjusted for age, sex, country, socioeconomic status, paternal and maternal education, adiposity, and smoking habits. RESULTS The Mediterranean diet score was positively associated with CRP, and negatively with sVCAM-1. The subgroups showed the following positive/negative associations: Vegetables with IL-10(+), CRP(+), CD3(+), ALT(+), lymphocytes(+), sE-selectin(-); Fruits and Nuts with IL-4(-), TNF-alpha; Pulses with IL-5(+), IL-6(+), IL-2(-); Cereals and Roots with IL-6(-), IL-10(-); Monounsaturated/Saturated-fat ratio with IL-6(+), TGFβ-1(+), sVCAM-1(+boys, -girls), homocysteine(-); Dairy with IL-1(+), IL-5(+), IL-6(+), IL-10(+), TGFβ-1(+), homocysteine(-); Fish with homocysteine(-); Meat with IL-2(+), IL-10(+); Alcohol with CRP(+), lymphocytes(-). Sex differences were found. CONCLUSION Some specific food-inflammation associations were found, suggesting that diet is to a certain extent already related to inflammation in adolescents and can be used in disease prevention. Also some counterintuitive results were found, which might be due to grouping very different foods into a single group, besides considering that the human body may respond differently depending on the interaction between diet, lifestyle, genetics, biochemical individuality, age and sex.
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Affiliation(s)
- Aline Arouca
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, Block K3, 4th floor, 9000, Ghent, Belgium.
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, Block K3, 4th floor, 9000, Ghent, Belgium
| | - Luis A Moreno
- Faculty of Health Sciences, GENUD: "Growth, Exercise, Nutrition and Development Research Group", Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Saragossa, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Esther M González-Gil
- Faculty of Health Sciences, GENUD: "Growth, Exercise, Nutrition and Development Research Group", Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Saragossa, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Ascensión Marcos
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Madrid, Spain
| | - Sonia Gómez
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Madrid, Spain
| | - Ligia Esperanza Díaz
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Madrid, Spain
| | - Kurt Widhalm
- Department of Nutrition and Metabolism at the University of Vienna, Vienna, Austria
| | - Dénes Molnár
- Department of Pediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - Mathilde Kersting
- Research Institute of Child Nutrition Dortmund, Pediatric University Clinic, Ruhr-University Bochum, Bochum, Germany
| | - Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences, Karolinska Institutet, Huddinge, Sweden
| | - Alejandro de la O
- Department of Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Marika Ferrari
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, Block K3, 4th floor, 9000, Ghent, Belgium
- International Agency for Research on Cancer, Lyon, France
| | - Marcela Gonzalez-Gross
- Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, Block K3, 4th floor, 9000, Ghent, Belgium
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12
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Bailey MA, Holscher HD. Microbiome-Mediated Effects of the Mediterranean Diet on Inflammation. Adv Nutr 2018; 9:193-206. [PMID: 29767701 PMCID: PMC5952955 DOI: 10.1093/advances/nmy013] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/07/2017] [Accepted: 03/01/2018] [Indexed: 12/11/2022] Open
Abstract
The Mediterranean diet pattern is increasingly associated with improved metabolic health. Two mechanisms by which consuming a Mediterranean diet pattern may contribute to improved metabolic health are modulation of the gastrointestinal (GI) microbiota and reduction of metabolic endotoxemia. Metabolic endotoxemia, defined as a 2- to 3-fold increase in circulating levels of bacterial endotoxin, has been proposed as a cause of inflammation during metabolic dysfunction. As the largest source of endotoxins in the human body, the GI microbiota represents a crucial area for research on strategies for reducing endotoxemia. Diets high in saturated fat and low in fiber contribute to metabolic endotoxemia through several mechanisms, including changes in the GI microbiome and bacterial fermentation end products, intestinal physiology and barrier function, and enterohepatic circulation of bile acids. Thus, the Mediterranean diet pattern, rich in unsaturated fats and fiber, may be one dietary strategy to reduce metabolic endotoxemia. Preclinical studies have demonstrated the differential effects of dietary saturated and unsaturated fats on the microbiota and metabolic health, but human studies are lacking. The role of dietary fiber and the GI microbiome in metabolic endotoxemia is underinvestigated. Clinical research on the effects of different types of dietary fat and fiber on the GI microbiota and GI and systemic inflammation is necessary to determine efficacious dietary strategies for reducing metabolic endotoxemia, inflammation, and subsequent metabolic disease.
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Affiliation(s)
| | - Hannah D Holscher
- Division of Nutritional Sciences
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL
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13
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Sureda A, Bibiloni MDM, Julibert A, Bouzas C, Argelich E, Llompart I, Pons A, Tur JA. Adherence to the Mediterranean Diet and Inflammatory Markers. Nutrients 2018; 10:E62. [PMID: 29320413 PMCID: PMC5793290 DOI: 10.3390/nu10010062] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 12/22/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023] Open
Abstract
The aim was to assess inflammatory markers among adults and adolescents in relation to the adherence to the Mediterranean diet. A random sample (219 males and 379 females) of the Balearic Islands population (12-65 years) was anthropometrically measured and provided a blood sample to determine biomarkers of inflammation. Dietary habits were assessed and the adherence to the Mediterranean dietary pattern calculated. The prevalence of metabolic syndrome increased with age in both sexes. The adherence to the Mediterranean diet in adolescent males was 51.3% and 45.7% in adults, whereas in females 53.1% and 44.3%, respectively. In males, higher adherence to the Mediterranean diet was associated with higher levels of adiponectin and lower levels of leptin, tumor necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1 (PAI-1) and high-sensitivity C-reactive protein (hs-CRP) in adults, but not in young subjects. In females, higher adherence was associated with lower levels of leptin in the young group, PAI-1 in adults and hs-CRP in both groups. With increasing age in both sexes, metabolic syndrome increases, but the adherence to the Mediterranean diet decreases. Low adherence to the Mediterranean dietary pattern (MDP) is directly associated with a worse profile of plasmatic inflammation markers.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Maria del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Alicia Julibert
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
| | - Emma Argelich
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
| | - Isabel Llompart
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
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14
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Huang Y, Li Y, Zheng S, Yang X, Wang T, Zeng J. Moderate alcohol consumption and atherosclerosis. Wien Klin Wochenschr 2017; 129:835-843. [DOI: 10.1007/s00508-017-1235-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/08/2017] [Indexed: 12/20/2022]
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15
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Richter CK, Skulas-Ray AC, Kris-Etherton PM. Recent findings of studies on the Mediterranean diet: what are the implications for current dietary recommendations? Endocrinol Metab Clin North Am 2014; 43:963-80. [PMID: 25432391 DOI: 10.1016/j.ecl.2014.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
There is evidence from epidemiologic studies and clinical trials demonstrating that the Mediterranean dietary pattern reduces the risk of many chronic diseases, including cardiovascular disease (CVD), and the attendant risk factors. A Mediterranean-style diet reflects most food and nutrient goals in current dietary guidelines. Minor modifications to reduce sodium and saturated fat intake can be made to further meet recommendations. Including the Mediterranean diet in the list of recommended evidence-based dietary patterns offers an additional strategy for improving dietary habits, which may help individuals achieve better long-term adherence to dietary guidelines and sustain optimal reductions in CVD risk.
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Affiliation(s)
- Chesney K Richter
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA 16802, USA
| | - Ann C Skulas-Ray
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA 16802, USA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA 16802, USA.
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16
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Korre M, Tsoukas MA, Frantzeskou E, Yang J, Kales SN. Mediterranean Diet and Workplace Health Promotion. CURRENT CARDIOVASCULAR RISK REPORTS 2014; 8:416. [PMID: 25328563 PMCID: PMC4192546 DOI: 10.1007/s12170-014-0416-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Analytical and experimental studies confirm relationships between the consumption of certain foods and cardiovascular disease, diabetes, and cancer. Mediterranean diet patterns have long been associated with a reduced risk of major diseases and many favorable health outcomes. Data from observational, longitudinal, and randomized controlled trials have demonstrated that Mediterranean-style diets can improve body mass index and body weight, reduce the incidence of diabetes mellitus and metabolic syndrome risk factors, decrease cardiovascular morbidity and coronary heart disease mortality, as well as decrease all-cause mortality. Recently, efforts have attempted to improve dietary habits in the workplace, by modifying food selection, eating patterns, meal frequency, and the sourcing of meals taken during work. Evidence supporting the Mediterranean diet and the potential cardioprotective role of healthier diets in the workplace are reviewed here, and promising strategies to improve metabolic and cardiovascular health outcomes are also provided.
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Affiliation(s)
- Maria Korre
- Environmental & Occupational Medicine & Epidemiology, Harvard School of Public Health, Boston, MA USA
- Occupational Medicine, The Cambridge Health Alliance, Harvard Medical School, Cambridge, MA USA
| | - Michael A. Tsoukas
- Division of Endocrinology and Metabolism, McGill University Health Center, Montreal, Quebec Canada
| | - Elpida Frantzeskou
- Occupational Medicine Department, Evangelismos Hospital, Medical School, University of Athens, Athens, Greece
| | - Justin Yang
- Environmental & Occupational Medicine & Epidemiology, Harvard School of Public Health, Boston, MA USA
- Occupational Medicine, The Cambridge Health Alliance, Harvard Medical School, Cambridge, MA USA
- Department of Internal Medicine, St Elizabeth’s Medical Center, Tufts Medical School, Brighton, MA USA
| | - Stefanos N. Kales
- Environmental & Occupational Medicine & Epidemiology, Harvard School of Public Health, Boston, MA USA
- Occupational Medicine, The Cambridge Health Alliance, Harvard Medical School, Cambridge, MA USA
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Fawehinmi TO, Ilomäki J, Voutilainen S, Kauhanen J. Alcohol consumption and dietary patterns: the FinDrink study. PLoS One 2012; 7:e38607. [PMID: 22719905 PMCID: PMC3373562 DOI: 10.1371/journal.pone.0038607] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 05/07/2012] [Indexed: 11/19/2022] Open
Abstract
The aim of this population-based study was to investigate differences in dietary patterns in relation to the level of alcohol consumption among Finnish adults. This study was part of the FinDrink project, an epidemiologic study on alcohol use among Finnish population. It utilized data from the Kuopio Ischaemic Heart Disease Risk Factor Study. A total of 1720 subjects comprising of 816 men and 904 women aged 53–73 years were included in the study in 1998–2001. Food intake was collected via a 4-day food diary method. Self-reported alcohol consumption was assessed with quantity-frequency method based on the Nordic Alcohol Consumption Inventory. Weekly alcohol consumption was categorized into three groups: non-drinkers (<12 grams), moderate drinkers (12–167.9 grams for men, 12–83.9 grams for women) and heavy drinkers (≥168 grams for men, ≥84 grams for women). Data were analyzed for men and women separately using multiple linear regression models, adjusted for age, occupational status, marital status, smoking, body mass index and leisure time physical activity. In women, moderate/heavy drinkers had lower fibre intake and moderate drinkers had higher vitamin D intake than non-drinkers. Male heavy drinkers had lower fibre, retinol, calcium and iron intake, and moderate/heavy drinkers had higher vitamin D intake than non-drinkers. Fish intake was higher among women moderate drinkers and men moderate/heavy drinkers than non-drinkers. In men, moderate drinkers had lower fruit intake and heavy drinkers had lower milk intake than non-drinkers. Moderate drinkers had higher energy intake from total fats and monosaturated fatty acids than non-drinkers. In contrast, energy intake from carbohydrates was lower among moderate/heavy drinkers than non-drinkers. In conclusion, especially male heavy drinkers had less favorable nutritional intake than moderate and non-drinkers. Further studies on the relationship between alcohol consumption and dietary habits are needed to plan a comprehensive dietary intervention programs in future.
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Affiliation(s)
- Timothy O Fawehinmi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
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Abstract
OBJECTIVE To place the Mediterranean diet (MedDi) in the context of the cultural history of the Middle East and emphasise the health effects of some of the biblical seven species - wheat, barley, grapes, figs, pomegranates, olives and date honey. DESIGN Review of the literature concerning the benefits of these foods. SETTING Middle East and Mediterranean Basin. SUBJECTS Mediterranean populations and clinical studies utilising the MedDi. RESULTS AND CONCLUSIONS The MedDi has been associated with lower rates of CVD, and epidemiological evidence promotes the benefits of consuming fruit and vegetables. Recommended foods for optimal health include whole grain, fish, wine, pomegranates, figs, walnuts and extra virgin olive oil. The biblical traditional diet, including the seven species and additional Mediterranean fruits, has great health advantages, especially for CVD. In addition to the diet, lifestyle adaptation that involves increasing physical activity and organised meals, together with healthy food choices, is consistent with the traditional MedDi. The MedDi is a manageable, lifestyle-friendly diet that, when fortified with its biblical antecedent attributes, may prove to be even more enjoyable and considerably healthier in combating the obesogenic environment and in decreasing the risks of the non-communicable diseases of modern life than conventional, modern dietary recommendations. The biblical seven species, together with other indigenous foods from the Middle East, are now scientifically recognised as healthy foods, and further improve the many beneficial effects of the MedDi.
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Kohatsu W. The Antiinflammatory Diet. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Concepto de dieta mediterránea: ¿un grupo de alimentos saludables, una dieta o una panacea publicitaria? Med Clin (Barc) 2011; 136:594-9. [DOI: 10.1016/j.medcli.2009.09.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 09/07/2009] [Accepted: 09/10/2009] [Indexed: 11/19/2022]
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Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 2011; 342:d636. [PMID: 21343206 PMCID: PMC3043110 DOI: 10.1136/bmj.d636] [Citation(s) in RCA: 515] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2010] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline (1950 to October 2009) and Embase (1980 to October 2009) without limits. STUDY SELECTION Two reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected. RESULTS Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits). Alcohol significantly increased levels of high density lipoprotein cholesterol (pooled mean difference 0.094 mmol/L, 95% confidence interval 0.064 to 0.123), apolipoprotein A1 (0.101 g/L, 0.073 to 0.129), and adiponectin (0.56 mg/L, 0.39 to 0.72). Alcohol showed a dose-response relation with high density lipoprotein cholesterol (test for trend P = 0.013). Alcohol decreased fibrinogen levels (-0.20 g/L, -0.29 to -0.11) but did not affect triglyceride levels. Results were similar for crossover and before and after studies, and across beverage types. CONCLUSIONS Favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.
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Affiliation(s)
- Susan E Brien
- Department of Community Health Sciences, Faculty of Medicine, Calgary Institute for Population and Public Health, University of Calgary, Alberta, Canada T2N 4Z6
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Pino M, Ricoy MC, Portela J. Diseño, implementación y evaluación de un programa de educación para la salud con personas mayores. CIENCIA & SAUDE COLETIVA 2010; 15:2965-72. [DOI: 10.1590/s1413-81232010000600035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Accepted: 04/04/2008] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Desde el análisis de los hábitos que perjudican la salud de las personas mayores de 65 años, diseñar, implementar y evaluar un programa de educación para la salud. MÉTODOS: Se abordó una investigación evaluativa desde un estudio de casos múltiples en tres centros de salud del Noroeste de España combinando el enfoque cuantitativo con el cualitativo. Los instrumentos de recogida de información utilizados fueron el cuestionario y la entrevista. RESULTADOS: El consumo de medicamentos en los mayores es elevado así como la automedicación. Un pequeño grupo fuma y consume alcohol. Más de la cuarta parte son sedentarios y su índice de masa corporal medio es de 30,55. La implementación del programa ha repercutido de forma significativa sobre su calidad de vida. Las personas mayores tienen arraigadas prácticas malsanas. El logro de contenidos educativos alcanzado mejoró gratamente su calidad de vida. Con todo, presentan reticencia para asumir nuevos hábitos de salud aunque les favorezcan.
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Cundiff DK, Agutter PS, Malone PC, Pezzullo JC. Diet as prophylaxis and treatment for venous thromboembolism? Theor Biol Med Model 2010; 7:31. [PMID: 20701748 PMCID: PMC2925348 DOI: 10.1186/1742-4682-7-31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 08/11/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Both prophylaxis and treatment of venous thromboembolism (VTE: deep venous thrombosis (DVT) and pulmonary emboli (PE)) with anticoagulants are associated with significant risks of major and fatal hemorrhage. Anticoagulation treatment of VTE has been the standard of care in the USA since before 1962 when the U.S. Food and Drug Administration began requiring randomized controlled clinical trials (RCTs) showing efficacy, so efficacy trials were never required for FDA approval. In clinical trials of 'high VTE risk' surgical patients before the 1980s, anticoagulant prophylaxis was clearly beneficial (fatal pulmonary emboli (FPE) without anticoagulants = 0.99%, FPE with anticoagulants = 0.31%). However, observational studies and RCTs of 'high VTE risk' surgical patients from the 1980s until 2010 show that FPE deaths without anticoagulants are about one-fourth the rate that occurs during prophylaxis with anticoagulants (FPE without anticoagulants = 0.023%, FPE while receiving anticoagulant prophylaxis = 0.10%). Additionally, an FPE rate of about 0.012% (35/28,400) in patients receiving prophylactic anticoagulants can be attributed to 'rebound hypercoagulation' in the two months after stopping anticoagulants. Alternatives to anticoagulant prophylaxis should be explored. METHODS AND FINDINGS The literature concerning dietary influences on VTE incidence was reviewed. Hypotheses concerning the etiology of VTE were critiqued in relationship to the rationale for dietary versus anticoagulant approaches to prophylaxis and treatment.Epidemiological evidence suggests that a diet with ample fruits and vegetables and little meat may substantially reduce the risk of VTE; vegetarian, vegan, or Mediterranean diets favorably affect serum markers of hemostasis and inflammation. The valve cusp hypoxia hypothesis of DVT/VTE etiology is consistent with the development of VTE being affected directly or indirectly by diet. However, it is less consistent with the rationale of using anticoagulants as VTE prophylaxis. For both prophylaxis and treatment of VTE, we propose RCTs comparing standard anticoagulation with low VTE risk diets, and we discuss the statistical considerations for an example of such a trial. CONCLUSIONS Because of (a) the risks of biochemical anticoagulation as anti-VTE prophylaxis or treatment, (b) the lack of placebo-controlled efficacy data supporting anticoagulant treatment of VTE, (c) dramatically reduced hospital-acquired FPE incidence in surgical patients without anticoagulant prophylaxis from 1980 - 2010 relative to the 1960s and 1970s, and (d) evidence that VTE incidence and outcomes may be influenced by diet, randomized controlled non-inferiority clinical trials are proposed to compare standard anticoagulant treatment with potentially low VTE risk diets. We call upon the U. S. National Institutes of Health and the U.K. National Institute for Health and Clinical Excellence to design and fund those trials.
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Affiliation(s)
| | - Paul S Agutter
- Theoretical Medicine and Biology Group, 26 Castle Hill, Glossop, Derbyshire, SK13 7RR, UK
| | | | - John C Pezzullo
- Department of Medicine, Georgetown University, Washington, DC, USA
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Oliveira A, Rodriguez-Artalejo F, Lopes C. Alcohol Intake and Systemic Markers of Inflammation--Shape of the Association According to Sex and Body Mass Index. Alcohol Alcohol 2010; 45:119-25. [DOI: 10.1093/alcalc/agp092] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guerrero RF, Puertas B, Fernández MI, Palma M, Cantos-Villar E. Induction of stilbenes in grapes by UV-C: Comparison of different subspecies of Vitis. INNOV FOOD SCI EMERG 2010. [DOI: 10.1016/j.ifset.2009.10.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
AbstractObjectiveTo evaluate the feasibility of diet mediterranisation, in a food-at-work context, and its consequence on metabolic syndrome in a mid-age unselected healthy male population group.DesignOne-year longitudinal intervention study. Physical exercise was not modified.SettingAll workers of the Santiago division of ‘Maestranza Diesel’, a metal-mechanic company servicing the mining industry, were invited to participate.SubjectsInitially, 145 workers of a total of 171, of average age 39 years, accepted to participate (sixteen women and 129 men). A subgroup of ninety-six men fully completed the controls programmed for the intervention study. Losses from the original group correspond to missing one control (sixteen), leaving the company (eleven) or blood sampling discomfort (six). The women and sixteen male workers, hired post study initiation, did participate but were excluded from this 12-month analysis.ResultsDiet mediterranisation was successful, reflected in the daily food consumption at the canteen and the evolution of the Mediterranean diet score (MDS) from 4·8 ± 1·4 to 7·4 ± 1·5 (limits 0–14). Some metabolic syndrome components showed statistically significant improvement and also statistically significant correlation with the MDS: waist circumference, HDL-cholesterol, systolic and diastolic blood pressure. After 12 months, the reversion rate for metabolic syndrome was 48 % (12/23) with an incidence rate of 4·1 % for new cases (3/73). In total, metabolic syndrome decreased from 24·0 % to 15·6 % (23/96 to 15/96) (P = 0·029).ConclusionsDiet mediterranisation is feasible in a food-at-work intervention, affecting lunch consumption at the workers canteen and overall consumption evaluated with MDS, together with a significant reduction in metabolic syndrome.
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Guerrero RF, García-Parrilla MC, Puertas B, Cantos-Villar E. Wine, Resveratrol and Health: A Review. Nat Prod Commun 2009. [DOI: 10.1177/1934578x0900400503] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Several studies have cited the Mediterranean diet as an example of healthy eating. In fact, the Mediterranean diet has become the reference diet for the prevention of cardiovascular disease. Red wine seems to be an essential component of the diet, since moderate consumption of wine is associated with lower risk and mortality from cardiovascular disease. Evidence is also accumulating that wine helps prevent the development of certain cancers. Of all the many components of wine, resveratrol, which is a natural component specifically present in wine, has been identified as being mainly responsible for these health-promoting properties. Many valuable properties such as cardioprotective and anticarcinogenic activity have been attributed to resveratrol; however, its bioavailability is quite low. The bioactivity of metabolites derived from resveratrol, and the accumulation of resveratrol in vital organs are still under study, but there are high expectations of positive results. Other stilbene compounds are also considered in this review, despite being present in undetectable or very small quantities in wine. The present paper reviews all aspects of the health properties of wine, bioactive compounds found in wine, and their concentrations, bioavailability and possible synergistic effects.
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Affiliation(s)
- Raúl F. Guerrero
- IFAPA, Rancho de la Merced, Apto. 589, Crta. Trebujena, Km 3.2, 11.471 Jerez de la Frontera (Cádiz), Spain
| | - Maria C. García-Parrilla
- Área de Nutrición y Bromatología, Facultad de Farmacia, c/P García Glez n° 2, Seville 41012, Spain
| | - Belén Puertas
- IFAPA, Rancho de la Merced, Apto. 589, Crta. Trebujena, Km 3.2, 11.471 Jerez de la Frontera (Cádiz), Spain
| | - Emma Cantos-Villar
- IFAPA, Rancho de la Merced, Apto. 589, Crta. Trebujena, Km 3.2, 11.471 Jerez de la Frontera (Cádiz), Spain
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Foerster M, Marques-Vidal P, Gmel G, Daeppen JB, Cornuz J, Hayoz D, Pécoud A, Mooser V, Waeber G, Vollenweider P, Paccaud F, Rodondi N. Alcohol drinking and cardiovascular risk in a population with high mean alcohol consumption. Am J Cardiol 2009; 103:361-8. [PMID: 19166690 DOI: 10.1016/j.amjcard.2008.09.089] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 09/12/2008] [Accepted: 09/12/2008] [Indexed: 01/27/2023]
Abstract
Moderate alcohol consumption has been associated with lower coronary artery disease (CAD) risk. However, data on the CAD risk associated with high alcohol consumption are conflicting. The aim of this study was to examine the impact of heavier drinking on 10-year CAD risk in a population with high mean alcohol consumption. In a population-based study of 5,769 adults (aged 35 to 75 years) without cardiovascular disease in Switzerland, 1-week alcohol consumption was categorized as 0, 1 to 6, 7 to 13, 14 to 20, 21 to 27, 28 to 34, and > or =35 drinks/week or as nondrinkers (0 drinks/week), moderate (1 to 13 drinks/week), high (14 to 34 drinks/week), and very high (> or =35 drinks/week). Blood pressure and lipids were measured, and 10-year CAD risk was calculated according to the Framingham risk score. Seventy-three percent (n = 4,214) of the participants consumed alcohol; 16% (n = 909) were high drinkers and 2% (n = 119) very high drinkers. In multivariate analysis, increasing alcohol consumption was associated with higher high-density lipoprotein cholesterol (from a mean +/- SE of 1.57 +/- 0.01 mmol/L in nondrinkers to 1.88 +/- 0.03 mmol/L in very high drinkers); triglycerides (1.17 +/- 1.01 to 1.32 +/- 1.05 mmol/L), and systolic and diastolic blood pressure (127.4 +/- 0.4 to 132.2 +/- 1.4 mm Hg and 78.7 +/- 0.3 to 81.7 +/- 0.9 mm Hg, respectively) (all p values for trend <0.001). Ten-year CAD risk increased from 4.31 +/- 0.10% to 4.90 +/- 0.37% (p = 0.03) with alcohol use, with a J-shaped relation. Increasing wine consumption was more related to high-density lipoprotein cholesterol levels, whereas beer and spirits were related to increased triglyceride levels. In conclusion, as measured by 10-year CAD risk, the protective effect of alcohol consumption disappears in very high drinkers, because the beneficial increase in high-density lipoprotein cholesterol is offset by the increases in blood pressure levels.
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Affiliation(s)
- Maryline Foerster
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
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Ros E. Dieta mediterránea y enfermedad cardiovascular. HIPERTENSION Y RIESGO VASCULAR 2008. [DOI: 10.1016/s1889-1837(08)71725-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Leighton F, Urquiaga I. Changes in Cardiovascular Risk Factors Associated with Wine Consumption in Intervention Studies in Humans. Ann Epidemiol 2007. [DOI: 10.1016/j.annepidem.2007.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Steffen LM, Folsom AR, Cushman M, Jacobs DR, Rosamond WD. Greater Fish, Fruit, and Vegetable Intakes Are Related to Lower Incidence of Venous Thromboembolism. Circulation 2007; 115:188-95. [PMID: 17179018 DOI: 10.1161/circulationaha.106.641688] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background—
Little is known about the role of dietary intake in the development of deep vein thrombosis or pulmonary embolus (venous thromboembolism [VTE]). Homocysteine, factor VIII, and von Willebrand factor levels, risk factors for VTE, are influenced by dietary intake. We tested the hypothesis that foods rich in B vitamins and ω-3 fatty acids are negatively associated and meat intake is positively associated with incidence of VTE.
Methods and Results—
In a prospective study over 12 years, 14 962 middle-aged adults participating in the Atherosclerosis Risk in Communities study were followed up for incident VTE. All hospitalizations were identified, and 196 VTEs were validated by chart review. A food frequency questionnaire assessed dietary intake at baseline and year 6. In separate proportional hazards regression analyses, risk of developing VTE was computed across quintiles of selected nutrients, major food groups, and the Western diet pattern, with adjustment for demographic and lifestyle factors, body mass index, and diabetes. Hazard ratios and 95% confidence intervals of VTE incidence across quintiles of fruit and vegetable intake were 1.0 (reference), 0.73 (0.48 to 1.11), 0.57 (0.37 to 0.90), 0.47 (0.29 to 0.77), and 0.59 (0.36 to 0.99) (
P
trend
=0.03). Eating fish 1 or more times per week was associated with 30% to 45% lower incidence of VTE for quintiles 2 to 5 compared with quintile 1, suggestive of a threshold effect. Hazard ratios of VTE across quintiles of red and processed meat intake were 1.0, 1.24 (0.78 to 1.98), 1.21 (0.74 to 1.98), 1.09 (0.64 to 1.87), and 2.01 (1.15 to 3.53) (
P
trend
=0.02). Hazard ratios were attenuated only slightly after adjustment for factors VIIc and VIIIc and von Willebrand factor.
Conclusions—
A diet including more plant food and fish and less red and processed meat is associated with a lower incidence of VTE.
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Affiliation(s)
- Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S Second St, Suite 300, Minneapolis, MN 55454, USA.
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Basu H, Pernecky S, Sengupta A, Liepa GU. Coronary heart disease: How do the benefits of ω-3 fatty acids compare with those of aspirin, alcohol/red wine, and statin drugs? J AM OIL CHEM SOC 2006. [DOI: 10.1007/s11746-006-5153-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis 2006; 189:19-30. [PMID: 16530201 DOI: 10.1016/j.atherosclerosis.2006.02.012] [Citation(s) in RCA: 470] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2005] [Revised: 01/06/2006] [Accepted: 02/01/2006] [Indexed: 11/28/2022]
Abstract
Greater fish oil consumption has been associated with reduced CVD risk, although the mechanisms are unclear. Plant-source oil omega-3 fatty acids (ALA) have also been studied regarding their cardiovascular effect. We conducted a systematic review of randomized controlled trials that evaluated the effect of consumption of fish oil and ALA on commonly measured serum CVD risk factors, performing meta-analyses when appropriate. Combining 21 trials evaluating lipid outcomes, fish oil consumption resulted in a summary net change in triglycerides of -27 (95% CI -33, -20)mg/dL, in HDL cholesterol of +1.6 (95% CI +0.8, +2.3)mg/dL, and in LDL cholesterol of +6 (95% CI +3, +8)mg/dL. There was no effect of fish oil on total cholesterol. Across studies, higher fish oil dose and higher baseline levels were associated with greater reductions in serum triglycerides. Overall, the 27 fish oil trials evaluating Hgb A(1c) or FBS found small non-significant net increases compared to control oils. Five studies of ALA were inconsistent in their effects on lipids, Hgb A(1c) or FBS. Four studies investigating the effects of omega-3 fatty acids on hs-CRP were also inconsistent and non-significant. The evidence supports a dose-dependent beneficial effect of fish oil on serum triglycerides, particularly among people with more elevated levels. Fish oil consumption also modestly improves HDL cholesterol, increases LDL cholesterol levels, but does not appear to adversely affect glucose homeostasis. The evidence regarding the effects of omega-3 fatty acids on hs-CRP is inconclusive, as are data on ALA.
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Affiliation(s)
- Ethan M Balk
- Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, Boston, MA 02111, USA.
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Lichtenstein AH, Matthan NR, Jalbert SM, Resteghini NA, Schaefer EJ, Ausman LM. Novel soybean oils with different fatty acid profiles alter cardiovascular disease risk factors in moderately hyperlipidemic subjects. Am J Clin Nutr 2006; 84:497-504. [PMID: 16960162 DOI: 10.1093/ajcn/84.3.497] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A variety of soybean oils were developed with improved oxidative stability and functional characteristics for use as alternatives to partially hydrogenated fat. OBJECTIVE The objective was to assess the effect of selectively bred and genetically modified soybean oils with altered fatty acid profiles, relative to common soybean and partially hydrogenated soybean oils, on cardiovascular disease risk factors. DESIGN Thirty subjects (16 women and 14 men) aged >50 y with LDL-cholesterol concentrations >130 mg/dL at screening consumed 5 experimental diets in random order for 35 d each. Diets contained the same foods and provided 30% of energy as fat, of which two-thirds was either soybean oil (SO), low-saturated fatty acid soybean oil (LoSFA-SO), high-oleic acid soybean oil (HiOleic-SO), low-alpha-linolenic acid soybean oil (LoALA-SO), or partially hydrogenated soybean oil (Hydrog-SO). RESULTS Plasma phospholipid patterns reflected the predominant fat in the diet. LDL-cholesterol concentrations were 3.66 +/- 0.67(b), 3.53 +/- 0.77(b), 3.70 +/- 0.66(b), 3.71 +/- 0.64(a,b), and 3.92 +/- 0.70(a) mol/L; HDL-cholesterol concentrations were 1.32 +/- 0.32(a,b), 1.32 +/- 0.35(b), 1.36 +/- 0.33(a), 1.32 +/- 0.33(b), and 1.32 +/- 0.32(a,b) mol/L for the SO, LoSFA-SO, HiOleic-SO, LoALA-SO, and Hydrog-SO diets, respectively (values with different superscript letters are significantly different, P < 0.05). No significant effects were observed on VLDL-cholesterol, triacylglycerol, lipoprotein(a), and C-reactive protein concentrations or on ratios of LDL cholesterol to apolipoprotein B (apo B) and HDL cholesterol to apo A-I. Total cholesterol:HDL cholesterol was lower after subjects consumed the unhydrogenated soybean oils than after they consumed the Hydrog-SO diet. CONCLUSIONS All varieties of soybean oils resulted in more favorable lipoprotein profiles than did the partially hydrogenated form. These soybean oils may provide a viable option for reformulation of products to reduce the content of trans fatty acids.
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Affiliation(s)
- Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory and the Lipid Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
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Serra-Majem L, Roman B, Estruch R. Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev 2006; 64:S27-47. [PMID: 16532897 DOI: 10.1111/j.1753-4887.2006.tb00232.x] [Citation(s) in RCA: 345] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The Mediterranean Diet has been associated with greater longevity and quality of life in epidemiological studies, the majority being observational. The application of evidence-based medicine to the area of public health nutrition involves the necessity of developing clinical trials and systematic reviews to develop sound recommendations. The purpose of this study was to analyze and review the experimental studies on Mediterranean diet and disease prevention. A systematic review was made and a total of 43 articles corresponding to 35 different experimental studies were selected. Results were analyzed for the effects of the Mediterranean diet on lipoproteins, endothelial resistance, diabetes and antioxidative capacity, cardiovascular diseases, arthritis, cancer, body composition, and psychological function. The Mediterranean diet showed favorable effects on lipoprotein levels, endothelium vasodilatation, insulin resistance, metabolic syndrome, antioxidant capacity, myocardial and cardiovascular mortality, and cancer incidence in obese patients and in those with previous myocardial infarction. Results disclose the mechanisms of the Mediterranean diet in disease prevention, particularly in cardiovascular disease secondary prevention, but also emphasize the need to undertake experimental research and systematic reviews in the areas of primary prevention of cardiovascular disease, hypertension, diabetes, obesity, infectious diseases, age-related cognitive impairment, and cancer, among others. Interventions should use food scores or patterns to ascertain adherence to the Mediterranean diet. Further experimental research is needed to corroborate the benefits of the Mediterranean diet and the underlying mechanisms, and in this sense the methodology of the ongoing PREDIMED study is explained.
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Affiliation(s)
- Lluís Serra-Majem
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain.
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Desroches S, Archer WR, Paradis ME, Dériaz O, Couture P, Bergeron J, Bergeron N, Lamarche B. Baseline plasma C-reactive protein concentrations influence lipid and lipoprotein responses to low-fat and high monounsaturated fatty acid diets in healthy men. J Nutr 2006; 136:1005-11. [PMID: 16549465 DOI: 10.1093/jn/136.4.1005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To date, no studies have compared the effects of consuming a low-fat diet and a high monounsaturated fatty acid (MUFA) diet, under unrestricted energy intake conditions, on plasma C-reactive protein (CRP) concentrations. Men [n = 61; 37.5 +/- 11.5 y old (mean +/- SD), mean BMI 29.0 +/- 5.0 kg/m2] were randomly assigned to consume ad libitum a moderately low-fat diet (25.8% of energy intake from fat) or a high-fat diet rich in MUFA (40.1% of energy intake from fat, 22.5% from MUFA) for 6-7 wk. Plasma CRP concentrations were measured using a highly sensitive assay. Neither diet affected the plasma CRP concentration. However, baseline CRP concentrations predicted lipoprotein/lipid responsiveness to the experimental diets. After intake of the low-fat diet, plasma total and VLDL-triglyceride (TG) concentrations were increased in the subgroup with high CRP concentrations (P < 0.05 and P < 0.01, respectively) whereas they were reduced in the subgroup with low CRP concentrations at baseline (P < 0.01 for both). The high-MUFA diet reduced plasma TG, VLDL-TG, and VLDL cholesterol only in the subgroup with low CRP at baseline (P < 0.0001). In conclusion, the low-fat diet and the high-MUFA diet did not affect plasma CRP concentrations. However, baseline plasma CRP concentrations may modulate the diet-induced changes in plasma lipid and lipoprotein concentrations.
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Affiliation(s)
- Sophie Desroches
- Institute on Nutraceuticals and Functional Foods, Laval University, QC, Canada
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Ikonomidis I. Does alcohol affect CRP levels? Am Heart J 2005. [DOI: 10.1016/j.ahj.2005.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Avellone G, Di Garbo V, Campisi D, De Simone R, Raneli G, Scaglione R, Licata G. Effects of moderate Sicilian red wine consumption on inflammatory biomarkers of atherosclerosis. Eur J Clin Nutr 2005; 60:41-7. [PMID: 16132058 DOI: 10.1038/sj.ejcn.1602265] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of the study is to evaluate the effect of moderate Sicilian red wine consumption on cardiovascular risk factors and, in particular, on some inflammatory biomarkers. METHODS A total of 48 subjects of both sexes who were nondrinkers or rare drinkers of moderate red wine were selected and randomly subdivided into two groups assigned to receive with a crossover design a Sicilian red wine (Nero d'Avola or Etna Torrepalino) during meals: Group A (n = 24), in whom the diet was supplemented for 4 weeks with 250 ml/day of red wine, followed by 4 weeks when they returned to their usual wine intake; and Group B (n = 24), in whom the usual wine intake was maintained for 4 weeks, followed by 4 weeks when the diet was supplemented with 250 ml/day of red wine. The following were values measured in all tests: blood glucose, total and HDL-cholesterol and triglycerides, LDL-cholesterol, LDL/HDL ratio, apolipoproteins A1 and B, Lp(a), plasma C-reactive protein, TGFbeta1, D-Dimer, Factor VII , PAl Ag, t-PA Ag, fibrinogen, oxidized LDL Ab, total plasma antioxidant capacity. RESULTS At the end of the red wine intake period, LDL/HDL, fibrinogen, factor VII, plasma C-reactive protein and oxidized LDL Ab were significantly decreased, while HDL-C, Apo A1,TGFbeta1, t-PA, PAI and total plasma antioxidant capacity were significantly increased. CONCLUSIONS Our results show a positive effect of two Sicilian red wines on many risk factors and on some inflammatory biomarkers, suggesting that a moderate consumption of red wine in the adult population is a positive component of the Mediterranean diet.
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Affiliation(s)
- G Avellone
- Institute of Clinical Medicine, University of Palermo, Palermo, Italy.
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Hansen AS, Marckmann P, Dragsted LO, Finné Nielsen IL, Nielsen SE, Grønbaek M. Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease. Eur J Clin Nutr 2005; 59:449-55. [PMID: 15674304 DOI: 10.1038/sj.ejcn.1602107] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Some epidemiological studies found a lower risk of cardiovascular disease among wine drinkers than among drinkers of other types of ethanol. This difference might be due to an effect of nonalcohol compounds in wine on important cardiovascular risk factors. The objective of this study was to compare the effect of red wine, nonalcohol compounds of red wine and placebo on established cardiovascular risk factors. DESIGN A parallel, four-armed intervention study. SUBJECTS A total of 69 healthy 38-74-y-old men and women. INTERVENTIONS Subjects were randomised to either 1: red wine (males: 300 ml/day, 38.3 g alcohol/day, female subjects: 200 ml/day, 25.5 g alcohol/day), 2: water + red grape extract tablets (wine-equivalent dose), 3: water + red grape extract tablets (half dose), or 4: water + placebo tablets for a period of 4 weeks. No other sources of alcohol or anthocyanin were allowed. Plasma high-density lipoprotein (HDL)-cholesterol (HDL-C), low-density lipoprotein (LDL)-cholesterol (LDL-C), HDL-C/LDL-C-ratio, very-low-density lipoprotein (VLDL)-triacylglycerol, total cholesterol, fibrinogen, factor VII coagulant activity (FVIIc), blood pressure, and body weight were determined before and after intervention. RESULTS Wine consumption was associated with a significant 11-16% increase in fasting HDL-C and 8-15% decrease in fasting fibrinogen relative to not drinking wine. There were no significant treatment effects on fasting LDL-C, HDL-C/LDL-C-ratio, VLDL-triacylglycerol, total cholesterol, FVIIc, or blood pressure. Drinking wine was associated with relative body weight increments closely corresponding to the energy contributed by the alcohol component. CONCLUSION Moderate red wine consumption for 4 weeks is associated with desirable changes in HDL-C and fibrinogen compared with drinking water with or without red grape extract. The impact of wine on the measured cardiovascular risk factors thus seems primarily explained by an alcohol effect. Our finding suggests that the putative difference in cardiac risk associated with wine vs other alcoholic beverages might be rather explained by other life-style confounders than by red wine contents of nonalcohol components.
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Affiliation(s)
- A S Hansen
- Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Copenhagen, Denmark
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Levitan EB, Ridker PM, Manson JE, Stampfer MJ, Buring JE, Cook NR, Liu S. Association between consumption of beer, wine, and liquor and plasma concentration of high-sensitivity C-reactive protein in women aged 39 to 89 years. Am J Cardiol 2005; 96:83-8. [PMID: 15979440 DOI: 10.1016/j.amjcard.2005.03.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2004] [Revised: 03/03/2005] [Accepted: 03/03/2005] [Indexed: 10/25/2022]
Abstract
Although cross-sectional studies have shown an inverse or U-shaped relation between alcohol consumption and plasma concentration of high-sensitivity C-reactive protein (hs-CRP), the associations between specific types of alcoholic beverages--beer, wine, and liquor--and hs-CRP concentrations are less clear. Plasma concentrations of hs-CRP were measured in 11,815 participants in the Women's Health Study who had never used postmenopausal hormones. Alcohol intake was measured using a semiquantitative food-frequency questionnaire. Alcohol consumption had an inverse association with geometric mean hs-CRP concentrations (nondrinkers 1.43 mg/L, 0.1 to 6 g alcohol/day 1.37 mg/L, 6.1 to 12 g alcohol/day 1.29 mg/L, >12 g alcohol/day 1.28 mg/L, p for trend = 0.003). In age-adjusted analyses, beverage preference was a significant predictor of geometric mean hs-CRP concentration. However, after adjustment for body mass index (BMI), beer drinkers who consumed 6.1 to 12 g alcohol/day had a geometric mean hs-CRP concentration of 1.03 mg/L, wine drinkers 1.09 mg/L, liquor drinkers 1.28 mg/L, and combination drinkers 1.09 mg/L (p = 0.43). The association between alcohol and hs-CRP concentration appears to be mediated primarily by ethanol and was independent of the type of alcoholic beverage consumed once BMI was taken into account.
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Affiliation(s)
- Emily B Levitan
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Abstract
PURPOSE OF REVIEW Polyphenols are the most abundant dietary antioxidants and research on their role in the prevention of degenerative diseases has developed quickly over these last few years. This paper reviews the recent studies on the prevention of cardiovascular diseases by polyphenols, focusing on human studies. RECENT FINDINGS A large number of recent intervention studies have shown that several biomarkers of cardiovascular risk are influenced by the consumption of polyphenol-rich foods. Effects on biomarkers of oxidative stress, lipemia and inflammation appear so far inconclusive. More consistent effects have been observed on endothelial function and haemostasis and support a reduction of risk by polyphenols in agreement with the few epidemiological studies already published. All clinical studies have used foods or beverages containing a mixture of different polyphenols and the exact nature of the most active compounds remains largely unknown. Absorption, metabolism and elimination vary widely between polyphenols. These data on bioavailability should be taken into account to improve the experimental design and the interpretation of the observed effects. SUMMARY Future intervention studies should include a detailed assessment of the bioavailability of polyphenols. Beyond clinical trials carried out with polyphenol-rich foods, more studies with pure polyphenols will also be needed to establish their role in the prevention of cardiovascular diseases.
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Affiliation(s)
- Claudine Manach
- Unité des Maladies Métaboliques et Micronutriments, INRA, 63122 Saint-Genès Champanelle, France
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Greenfield JR, Samaras K, Hayward CS, Chisholm DJ, Campbell LV. Beneficial postprandial effect of a small amount of alcohol on diabetes and cardiovascular risk factors: modification by insulin resistance. J Clin Endocrinol Metab 2005; 90:661-72. [PMID: 15522927 DOI: 10.1210/jc.2004-1511] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Moderate alcohol consumption protects against type 2 diabetes and cardiovascular disease. Because humans spend most of their time in the postprandial state, we examined the effect of 15 g alcohol on postprandial metabolic factors in 20 postmenopausal women over 6 h. We measured 1) glucose, insulin, lipids, C-reactive protein, and adiponectin levels; 2) augmentation index by applanation tonometry; and 3) energy expenditure and substrate oxidation by indirect calorimetry. Subjects received low carbohydrate (LC; visits 1 and 2) and high carbohydrate (HC; visits 3 and 4) high fat meals with and without alcohol. Alcohol augmented the postprandial increment in insulin (P = 0.07) and reduced the postprandial increment in glucose (P = 0.04) after the LC meal only. Triglycerides were increased by alcohol after the LC (P = 0.002) and HC (P = 0.008) meals. Total and high-density lipoprotein cholesterol, fatty acids, and total adiponectin responses were unaffected. C-reactive protein levels decreased postprandially; reductions were enhanced by alcohol after the HC meal, but were attenuated after the LC meal. Postprandial reductions in the augmentation index were increased by alcohol after the LC meal only (P = 0.007). Alcohol enhanced the postprandial increase in energy expenditure 30-60 min after the LC meal (increase, 373 +/- 49 vs. 236 +/- 32 kcal/d; P = 0.02) and HC meal (increase, 362 +/- 36 vs. 205 +/- 34 kcal/d; P = 0.0009), but suppressed fat and carbohydrate oxidation. Some of our findings may be mechanisms for lower diabetes and cardiovascular risks in moderate drinkers.
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Affiliation(s)
- Jerry R Greenfield
- Diabetes and Obesity Research Program, Garvan Institute of Medical Research, Sydney, Australia
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Mezzano D, Leighton F. Haemostatic Cardiovascular Risk Factors: Differential Effects of Red Wine and Diet on Healthy Young. PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2005; 33:472-8. [PMID: 15692263 DOI: 10.1159/000083848] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Two groups (21 healthy young male each) received either Mediterranean-type diet (MD) or high-fat diet(HFD) during 90 days. Between days 30-60, both diets were supplemented with 240 ml/day of red wine. MD alone was associated with: lower plasma fibrinogen (p=0.03), factor VIIc (p=0.034) and factor VIIIc (p=0.0057); higher levels of protein S (p=0.013); longer BT (p=0.017); and marginal increases in platelet serotonin aggregation and secretion after stimulation with epinephrine. Red wine supplementation in both diets, resulted in lower plasma fibrinogen (p=0.001) and factor VIIc (p=0.05), and in increased t-PA (p=0.01) and PAI-1 (p=0.0003). The effects of wine on antithrombin III (p=0.01) were divergent, with a decrease in the HFD group and an increase in the MD group. No effects of diet or wine were detected in plasma proteins C and S, BT or VWF:Ag. Wine supplementation also resulted in a significant increase in ex vivo platelet aggregation and secretion after stimulation with collagen (1 and 2 g/ml, p<=0.01).MD and moderate consumption of red wine have complementary,mostly beneficial effects on haemostatic CV risk factors. The longer BT in individuals on MD, independently of red wine, would denote less interaction of platelets with the vascular wall, which would be beneficial from the point of view of CV risk. However,the increased platelet aggregation/secretion after wine intake, possibly a "rebound" phenomenon, would be a risk factor for thrombosis.
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Affiliation(s)
- Diego Mezzano
- Department of Hematology-Oncology, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, P. Catholic University of Chile, Santiago, Chile.
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Scott EM, Ariëns RAS, Grant PJ. Genetic and Environmental Determinants of Fibrin Structure and Function. Arterioscler Thromb Vasc Biol 2004; 24:1558-66. [PMID: 15217804 DOI: 10.1161/01.atv.0000136649.83297.bf] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The formation of a fibrin clot is one of the key events in atherothrombotic vascular disease. The structure of the fibrin clot and the genetic and environmental factors that modify it have effects on its biological function. Alterations in fibrin structure and function have implications for the clinical presentation of vascular disease. This review briefly describes the key features involved in the formation of a fibrin clot, its typical structure, and function. This is followed by a review of the current literature on genetic and environmental influences on fibrin structure/function and the relationship to clinical disease. The formation of a fibrin clot is one of the key events in atherothrombotic vascular disease. This review discusses how genetic and environmental factors alter fibrin structure and function and the implications this has for the clinical presentation of vascular disease.
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Affiliation(s)
- Eleanor M Scott
- Academic Unit of Molecular Vascular Medicine, Martin Wing, The General Infirmary at Leeds, Leeds, LS1 3EX, UK
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Abstract
Published health benefits of regular light-to-moderate alcohol consumption include lower myocardial infarction rates, reduced heart failure rates, reduced risk of ischemic stroke, lower risk for dementia, decreased risk of diabetes and reduced risk of osteoporosis. Numerous complimentary biochemical changes have been identified that explain the beneficial effects of moderate alcohol consumption. Heavy alcohol consumption, however, can negatively affect neurologic, cardiac, gastrointestinal, hematologic, immune, psychiatric and musculoskeletal organ systems. Binge drinking is a significant problem even among moderate drinkers and is associated with particularly high social and economic costs. A cautious approach should be emphasized for those individuals who drink even small amounts of alcohol. Physicians can apply the research evidence describing the known risks and benefits of alcohol consumption when counseling their patients regarding alcohol consumption.
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Affiliation(s)
- John B Standridge
- Department of Family Medicine, University of Tennessee College of Medicine, Chattanooga Unit, Chattanooga, TN, USA.
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de Lorgeril M, Salen P. Is alcohol anti-inflammatory in the context of coronary heart disease? BRITISH HEART JOURNAL 2004; 90:355-7. [PMID: 15020492 PMCID: PMC1768158 DOI: 10.1136/hrt.2003.022350] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Although the cardioprotective effect of alcohol has been primarily explained by its effect on blood lipids and platelets, could an anti-inflammatory mechanism be involved?
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Burger M, Mensink G, Brönstrup A, Thierfelder W, Pietrzik K. Alcohol consumption and its relation to cardiovascular risk factors in Germany. Eur J Clin Nutr 2004; 58:605-14. [PMID: 15042128 DOI: 10.1038/sj.ejcn.1601854] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To analyse the association of alcohol consumption and blood lipids, haemostatic factors, and homocysteine in German adults by gender and age groups. DESIGN Cross-sectional population-based survey. SETTING Data from the German National Health Interview and Examination Survey 1998, representative for age, gender, community size, and federal state. SUBJECTS From a sample of 7124 Germans between 18 and 79 y old, 2420 women and 2365 men were selected. Only individuals who were not currently receiving medical treatment or did not have disorders related to cardiovascular disease were selected for this study. RESULTS Using analyses of variance, mean blood levels of total cholesterol, HDL cholesterol, HDL/total cholesterol ratio, total glycerides, fibrinogen, antithrombin III, and homocysteine adjusted for age, socioeconomic status, East/West Germany residence, body mass index, tobacco use, sports activity, and coffee consumption, if appropriate are presented by alcohol consumption groups (0, >0-10, >10-20, >20-30 and >30 g/day). The HDL/total cholesterol ratio increased with higher alcohol groups up to 10-20 g/day (+15%) for women and >30 g/day (+18%) for men, showing the strongest rise among men aged 55-79 y. Fibrinogen decreased with higher alcohol groups up to 10-20 g/day for women and 20-30 g/day for men. Among women, homocysteine levels showed a U-shaped curve with a minimum of 8.49 mmol/l at 10-20 g alcohol/day (-8%, reference: nondrinking), whereas an inverse association was observed for men. CONCLUSIONS Moderate alcohol consumption is associated with favourable levels of several cardiovascular risk factors. The most favourable cardiovascular risk factor profile among women was observed among those drinking 10-20 g alcohol/day. Beneficial effects seem to be more pronounced among older men.
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Affiliation(s)
- M Burger
- Robert Koch-Institute, Department of Epidemiology and Health Reporting, Berlin, Germany.
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Abstract
People with type 2 diabetes are disproportionately affected by cardiovascular disease (CVD), compared with those without diabetes. Traditional risk factors do not fully explain this excess risk, and other "nontraditional" risk factors may be important. This review will highlight the importance of nontraditional risk factors for CVD in the setting of type 2 diabetes and discuss their role in the pathogenesis of the excess CVD morbidity and mortality in these patients. We will also discuss the impact of various therapies used in patients with diabetes on nontraditional risk factors.
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Affiliation(s)
- V Fonseca
- Section of Endocrinology, Department of Medicine, Tulane University Medical Center, New Orleans, Louisiana 70112, USA.
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