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Luconi E, Tosi M, Boracchi P, Colonna I, Rappocciolo E, Ferraretto A, Lorenzini EC. Italian and Middle Eastern adherence to Mediterranean diet in relation to Body Mass Index and non-communicable diseases: nutritional adequacy of simulated weekly food plans. J Transl Med 2024; 22:703. [PMID: 39080668 PMCID: PMC11290242 DOI: 10.1186/s12967-024-05325-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/20/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD), known to prevent obesity, overweight and the related non communicable diseases (NCD), is based on typical dishes, foods and on a common cultural milieu. Although MD is the basis of dietary guidelines, the prevalence of obesity, overweight and NCD, is increasing both in Western regions, and even more in Middle Eastern regions (MER). This study aimed to analyze (i) the impact of different levels of adherence to the MD, in Italy and MER, on body mass index (BMI) (ii) the bromatological composition of a simulated 7-days food plan (7-DFP) based on Italian or MER typical meals, following MD criteria and the Italian or MER food base dietary guideline; (iii) the optimization of nutrients impacting on NCD. METHODS The 7-DFPs were implemented using a dietary software. The association between adherence to MD and BMI was evaluated by pooled estimated ORs (with 95% confidence intervals and p-values). Pooled measures were obtained by the methods appropriate for meta-analysis. The different food-based guidelines have been compared. RESULTS The pooled ORs of obese status comparing medium vs. high adherence to MD were: 1.19 (95% C.I.: 0.99; 1.42, p-value = 0.062) and 1.12 (95% C.I.: 0.90; 1.38, p-value = 0.311) for MER and Italy respectively. For the comparison of low vs. high adherence, the pooled ORs were 1.05 (95% C.I.: 0.88; 1.24, p-value = 0.598) for MER, and 1.20 (95% C.I.: 1.02; 1.41, p-value = 0.031) for Italy when outliers are removed. High adherence to the MD resulted as potential protective factor against obesity. In MER 7-DFP: total fats is higher (34.5 E%) vs. Italian 7-DFP (29.4 E%); EPA (20 mg) and DHA (40 mg) are lower than recommended (200 mg each); sugars (12.6 E%) are higher than recommended (< 10 E%). Calcium, Zinc, and vitamin D do not reach target values in both 7-DFPs. CONCLUSION This study highlights that, even when 7-DFPs follow MD and refer to nutrient needs, it is necessary to verify nutrient excesses or deficits impacting on NCD. High MD adherence is protective toward NCDs. MD principles, and energy balance should be communicated according to socioeconomic and educational levels.
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Affiliation(s)
- Ester Luconi
- Department of Biomedical Sciences for Health, via Luigi Mangiagalli 31, Milano, 20133, Italy
| | - Martina Tosi
- Department of Health Sciences, University of Milan, Via di Rudinì 8, Milano, 20146, Italy
| | - Patrizia Boracchi
- Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, Milano, 20157, Italy
| | | | - Emilia Rappocciolo
- Biology and Biochemistry Department, Birzeit University, PO BOX 14, Birzeit, Palestine
| | - Anita Ferraretto
- Department of Biomedical Sciences for Health, via Luigi Mangiagalli 31, Milano, 20133, Italy
| | - Erna C Lorenzini
- Department of Biomedical Sciences for Health, via Luigi Mangiagalli 31, Milano, 20133, Italy.
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Moroni A, Micheletti Cremasco M, Gilli G, Degan R. Workplace Health Promotion in Italian University Employees: Effects on Body Composition and Mediterranean Diet Adherence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1003. [PMID: 39200612 PMCID: PMC11353974 DOI: 10.3390/ijerph21081003] [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: 06/14/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 09/02/2024]
Abstract
As Workplace Health Promotion is spreading among several working environments, the university context seems to be one of the best to apply primary prevention activities. Working in this direction, the University of Torino led the Wellness@Work for UniTo Project (W@W), with the aim of promoting employees' health. Internal university professionals assessed body composition and adherence to the Mediterranean diet (MD), giving on-target advice for improving lifestyle. The aim of this paper is to evaluate the effectiveness of the W@W Project after a 4-month intervention period. This project was addressed to university employees, who could participate on a voluntary basis. Researchers assessed (T1) socio-demographic information and collected anthropometric variables. Body composition was evaluated through Classic and Specific Bioelectrical impedance Vector Analysis (BIVA). Adherence to the MD was assessed through the Medi-Lite questionnaire. After the assessments, participants were given 5-min counselling from internal professionals. After about 4 months, participants were supposed to undergo same assessments (T2). Overall, 479 workers joined the project, and of those, 246 came back for the T2 assessment. Globally, either anthropometric, body composition, or MD variables improved significantly after 4 months, both for male and female samples, suggesting how an easy-to-apply WHP intervention could help to improve workers' health.
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Affiliation(s)
- Alessia Moroni
- Department of Life Sciences and Systems Biology, University of Torino, 10123 Torino, Italy;
- University Service Center in Hygiene and Sport Sciences (SUISM), University of Torino, Via Marenco 32, 10126 Torino, Italy; (G.G.); (R.D.)
| | - Margherita Micheletti Cremasco
- Department of Life Sciences and Systems Biology, University of Torino, 10123 Torino, Italy;
- University Service Center in Hygiene and Sport Sciences (SUISM), University of Torino, Via Marenco 32, 10126 Torino, Italy; (G.G.); (R.D.)
| | - Giorgio Gilli
- University Service Center in Hygiene and Sport Sciences (SUISM), University of Torino, Via Marenco 32, 10126 Torino, Italy; (G.G.); (R.D.)
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy
| | - Raffaella Degan
- University Service Center in Hygiene and Sport Sciences (SUISM), University of Torino, Via Marenco 32, 10126 Torino, Italy; (G.G.); (R.D.)
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Cardamone E, Iacoponi F, Di Benedetto R, Lorenzoni G, Di Nucci A, Zobec F, Gregori D, Silano M. Adherence to Mediterranean Diet and its main determinants in a sample of Italian adults: results from the ARIANNA cross-sectional survey. Front Nutr 2024; 11:1346455. [PMID: 38476598 PMCID: PMC10927747 DOI: 10.3389/fnut.2024.1346455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Over the last years, many Mediterranean countries, including Italy, have witnessed a shift away from the Mediterranean Diet, thus contributing to the high rates of overweight and obesity. The survey "Adherence to Mediterranean Diet in Italy (ARIANNA)" aimed to evaluate the Adherence to Mediterranean Diet (AMD) and its main determinants in the Italian population. Materials and methods This study started on March 2023 and was addressed to adults aged ≥17 years, born and resident in Italy, proficient in Italian. Data are collected electronically through a voluntary, anonymous and self-administered questionnaire on the project website. Univariate and then multivariate logistic regressions were performed to evaluate associations between AMD and demographic characteristics, socio-economic status, health status, and lifestyle. Results On a total of 3,732 completed questionnaires, the 87.70% of the respondents was female and the 71.28% was 17-40 years old. The 83.82% of the respondents had medium AMD, 11.33% low and only 4.85% high. The multivariate analysis revealed that being male (p < 0.001), aged >40 years (p < 0.05), workers (p ≤ 0.001), and unemployed (p < 0.05), determined the probability of having a lower AMD. Vegans and vegetarian's diets positively contributed to a higher AMD (p < 0.001). Discussion These results highlighted a medium AMD in the Italian adult participants and suggested the necessity to implement tailored public health intervention strategies to improve food habits.
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Affiliation(s)
- Erica Cardamone
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
- Department of Medicine—DMED, Università degli Studi di Udine, Udine, Italy
| | - Francesca Iacoponi
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Rita Di Benedetto
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Annalisa Di Nucci
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Marco Silano
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
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Caso D, Canova L, Capasso M, Bianchi M. Integrating the theory of planned behavior and the self-determination theory to promote Mediterranean diet adherence: A randomized controlled trial. Appl Psychol Health Well Being 2024; 16:80-101. [PMID: 37435877 DOI: 10.1111/aphw.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
The Mediterranean diet (MD) is one of the healthiest and most sustainable food regimes. Nevertheless, MD diffusion is still limited, emphasizing the need to understand the psychosocial factors that could predict and promote its adoption. Starting from an integrated model of Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT), the present randomized controlled trial investigated the effect of manipulating motivation (autonomous vs. controlled) on intention and MD adherence behavior. Participants included 726 Italian adults randomly allocated to one of three conditions: autonomous motivation manipulation, controlled motivation manipulation, and control group. TPB variables were measured immediately after manipulation (T1), while MD adherence was evaluated 2 weeks later (T2). Results from multivariate analyses of variance highlighted that participants in the autonomous motivation condition reported higher intention and a more favorable cognitive attitude than control group participants. However, no change in behavior was found. Moreover, a path analysis with mediation effect showed that the impact of autonomous motivation condition versus control group on intention was mediated by cognitive attitude. Findings support the integration of TPB and SDT to encourage intention to adhere to the MD, also suggesting that prompting autonomous motivation may help to promote a greater diffusion of this healthy and sustainable dietary pattern.
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Affiliation(s)
- Daniela Caso
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Luigina Canova
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Miriam Capasso
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Marcella Bianchi
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Damigou E, Faka A, Kouvari M, Anastasiou C, Kosti RI, Chalkias C, Panagiotakos D. Adherence to a Mediterranean type of diet in the world: a geographical analysis based on a systematic review of 57 studies with 1,125,560 participants. Int J Food Sci Nutr 2023; 74:799-813. [PMID: 37771002 DOI: 10.1080/09637486.2023.2262781] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
This systematic review aimed to assess the level and time-trends of adherence to Mediterranean-type diets (MTD) among the general population, globally. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a comprehensive literature search of the MEDLINE and Scopus databases was carried out, until 04/09/2023, based on specific criteria. Fifty-seven studies with 1,125,560 apparently healthy adults from Europe (n = 37), US (n = 8), Asia (n = 8), Australia (n = 4) and Africa (n = 1) were included. Adherence to an MTD was moderate with a significant decline observed in the last decade. European countries, mainly driven by Mediterranean countries, showed higher adherence than other regions. Geographical analysis revealed that adherence to an MTD is related to both geographic location and socioeconomic status throughout the world.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Antigoni Faka
- Department of Geography, School of Environmental Sciences, Harokopio University, Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Costas Anastasiou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly Trikala, Greece
| | - Christos Chalkias
- Department of Geography, School of Environmental Sciences, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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Erdoğan Gövez N, Akpınar Şentüre Ş, Ayten Ş, Köksal E. Evaluation of the Turkey Nutrition and Health Surveys according to the mediterranean adequacy index and sustainability through water footprints. Public Health Nutr 2023; 26:2927-2935. [PMID: 37721220 PMCID: PMC10755400 DOI: 10.1017/s1368980023001957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 08/02/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE Sustainable diet is one of the main factors that support food security, and the Mediterranean diet (MD) one of the sustainable diet models associated with low ecological impact and optimum health results has come to the fore. It was aimed to compare the results of the 2010 and 2017 Turkey Nutrition and Health Studies (TNHS) according to the Mediterranean Adequacy Index (MAI) and in order to evaluate the environmental impact of the current nutritional status in Turkey through water footprints (WF). DESIGN The MAI score was calculated using the published results of the 2010 and 2017 TNHS, and the WF have been calculated as indicators of environmental impact. SETTING Turkey. PARTICIPANTS There are no participants. RESULTS In the TNHS, there was an increase in the amount of energy provided by foods non-MD in 2017 compared to 2010, with a decrease in the total MAI score. The group with the lowest adherence to the MD in both years was the adult group (MAI20102·74 and MAI20172·31), while the group with the highest adherence was the adolescent group (MAI20103·21 and MAI20172·53). The MAI scores of females were higher than those of males in both years. The males aged 19-64 years had the largest (841 m3/year) WF and the females aged 65+ years had the smallest (483 m3/year). The food group that contributed the most to WF was meat and meat products (21·0-35·0 %). CONCLUSIONS Adherence to the MD has decreased due to the increase in the consumption of the Western-type diet in Turkey.
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Affiliation(s)
- Nazlıcan Erdoğan Gövez
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
| | - Şerife Akpınar Şentüre
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
| | - Şerife Ayten
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
| | - Eda Köksal
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
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Lo Moro G, Corezzi M, Bert F, Buda A, Gualano MR, Siliquini R. Mental health and adherence to Mediterranean diet among university students: an Italian cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2451-2461. [PMID: 34519625 DOI: 10.1080/07448481.2021.1970567] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study is aimed to explore severe mental illness (SMI), mental well-being (MWB), and Mediterranean Diet adherence (MedDiet) among university students. PARTICIPANTS University students in Northern Italy (sample size = 502). METHODS Cross-sectional survey was conducted in 2019. The questionnaires included Warwick-Edinburgh Mental Well-Being Scale for MWB, K6 for SMI, Mediterranean Diet Adherence Screener for MedDiet. Multivariable regressions were mainly performed (p < .05 as significant). RESULTS MWB was high in 3.93% of the participants and low in 23.97%. SMI was probable in 21.87%. MedDiet adherence was high in 2.19% and low in 35.06%. Mainly, poor/very poor perceived health, Economics/Legal/Strategic Sciences courses, and not being on time with exams showed associations with both lower MWB and probable SMI. Gender and some lifestyle, dietary, and university factors predicted MedDiet. MWB and MedDiet were positively associated. CONCLUSIONS This study found high levels of mental issues and low MedDiet. Modifiable factors at university level should be investigated to design preventive interventions.
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Affiliation(s)
- Giuseppina Lo Moro
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Michele Corezzi
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Fabrizio Bert
- Department of Public Health Sciences, University of Torino, Torino, Italy
| | - Alessia Buda
- Degree Course in Dietistics, University of Torino, Torino, Italy
| | | | - Roberta Siliquini
- Department of Public Health Sciences, University of Torino, Torino, Italy
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Poklar Vatovec T, Jenko Pražnikar Z, Petelin A. Adherence and Sociodemographic Determinants of Adherence to the Mediterranean Diet among Slovenian Adults and the Elderly. Nutrients 2023; 15:3219. [PMID: 37513637 PMCID: PMC10384731 DOI: 10.3390/nu15143219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The Mediterranean diet (MD) is considered a model for good health, and is promoted worldwide as one of the healthiest dietary patterns. Despite the MD's health benefits, the literature suggests that adherence to the MD tends to be in decline in most populations worldwide, including those in the Mediterranean region. The aim of this study was to investigate adherence to the MD, and its main sociodemographic and lifestyle factors, in the Slovenian population. Using a nationwide cross-sectional food consumption survey (SI.Menu), data were collected from a general questionnaire, from the 14-item MD adherence screener (14-MEDAS score), and from a questionnaire on the dietary habits of 850 adults and elderly people. The mean MEDAS score for the total study sample was 5.6 (SD 2.1), indicating a low adherence to the MD among the Slovenian population. The adherence to the MD was higher among women (OR = 1.534; 95% Cl 1.156-2.034), those with a university degree (OR = 1.527; 1.098-2.125; compared to those with no university degree), those who lived in a suburb or city (OR = 1.511; 1.016-2.249; OR = 1.568; 1.122-2.191; compared with those who lived in a village), non-smokers (OR = 1.561; 1.380-1.830; compared with smokers), and those who lived in the western part of Slovenia (OR = 1.558; 1.170-2.074; compared with those who lived in eastern Slovenia). Adherence to the MD in the Slovenian population is low, and is strongly related to educational level, gender, geographic region, place of residence, and smoking status. The frequency of the consumption of different food groups is also closely related.
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Affiliation(s)
- Tamara Poklar Vatovec
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Zala Jenko Pražnikar
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Ana Petelin
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
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Bastos AA, Félix PV, de Castro MA, Fisberg RM, Yannakoulia M, Ribeiro SML. Response to the critical analysis of the article 'Comparison and convergent validity of five Mediterranean dietary indexes applied to Brazilian adults and older adults: data from a population-based study (2015 ISA-Nutrition)'. J Nutr Sci 2023; 12:e77. [PMID: 37528830 PMCID: PMC10388441 DOI: 10.1017/jns.2023.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 08/03/2023] Open
Affiliation(s)
- Amália Almeida Bastos
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | - Paula Victória Félix
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | | | - Regina Mara Fisberg
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Sandra Maria Lima Ribeiro
- Department of Nutrition, Public Health School, University of Sao Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, Brazil
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Cacciatore S, Calvani R, Marzetti E, Picca A, Coelho-Júnior HJ, Martone AM, Massaro C, Tosato M, Landi F. Low Adherence to Mediterranean Diet Is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project. Nutrients 2023; 15:nu15041026. [PMID: 36839385 PMCID: PMC9959184 DOI: 10.3390/nu15041026] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Muscle strength is a relevant metric of aging. Greater adherence to Mediterranean diet is associated with better health outcomes across all life stages; however, evidence on the relationship between Mediterranean diet and muscle strength in older adults is inconclusive. In this study, we evaluated the relationship between adherence to Mediterranean diet and handgrip strength in a large sample of community-dwelling older adults from the Longevity Check-up 7+ project. A total of 2963 participants (mean age 72.8 ± 5.7 years; 54.4% women) were analyzed. Mediterranean diet adherence was evaluated using a modified Medi-Lite score and categorized as low (≤8), good (9 to 11), or high (≥12). Handgrip strength was categorized as normal or low according to cut-points by the European Working Group on Sarcopenia in Older People 2. Older adults with lower Mediterranean diet adherence had a significantly higher prevalence of probable sarcopenia (25.9%) than those with good (19.1%) or high (15.5%) adherence. The proportion of participants with probable sarcopenia increased with age, but it remained lower in the good and high adherence groups. Logistic regression showed that greater Mediterranean diet adherence was associated with a lower risk of probable sarcopenia. Older age, female sex, and physical inactivity were associated with a greater risk of probable sarcopenia. Our findings emphasize the positive association between healthy lifestyles, including adherence to Mediterranean diet, and physical function in old age.
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Affiliation(s)
- Stefano Cacciatore
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-3015-5669
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
- Department of Medicine and Surgery, LUM University, 70100 Casamassima, Italy
| | - Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Claudia Massaro
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Matteo Tosato
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy
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Recio-Rodriguez JI, Garcia-Ortiz L, Garcia-Yu IA, Lugones-Sanchez C, Olmo EZD, Bolibar B, Casajuana-Closas M, Lopez-Jimenez T, Llobera J, Ramos R, Pombo H, Motrico E, Gil-Girbau M, Lopez-Mendez F, Represas-Carrera F, Maderuelo-Fernandez JA. Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial. BMC Public Health 2022; 22:2127. [PMID: 36401247 PMCID: PMC9675247 DOI: 10.1186/s12889-022-14590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 11/10/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD). METHODS: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45-75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor's office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. RESULTS Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9-17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. CONCLUSIONS A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211.
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Affiliation(s)
- Jose I Recio-Rodriguez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Red de Investigación en Cronicidad, Atención Primaria Y Promoción de La Salud (RICAPPS) (RD21/0016), Facultad de Enfermería Y Fisioterapia (Universidad de Salamanca), Salamanca, Spain.
| | - Luis Garcia-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Departamento de Ciencias Biomédicas Y del Diagnóstico (Universidad de Salamanca), Gerencia Regional de Salud de Castilla Y León (SACyL), 37007, Salamanca, Spain
| | - Irene A Garcia-Yu
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sanchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla Y León (SACyL), Salamanca, Spain
| | - Edurne Zabaleta-Del Olmo
- Nursing Department, Nursing Faculty (Universitat de Girona), Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Gerència Territorial de Barcelona (Institut Català de La Salut), UniversitatAutònoma de Barcelona, Barcelona, Spain
| | - Bonaventura Bolibar
- Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marc Casajuana-Closas
- Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tomas Lopez-Jimenez
- Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Joan Llobera
- Unitat de Recerca, Atenció Primària de Mallorca. Servei de Salut de Les Illes Balears. IdISBa, Palma, Spain
| | - Rafel Ramos
- Fundació Institut Universitari Per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Group of Research in Vascular Health, Unitat de Suport a La Recerca de Girona, Girona Biomedical Research Institute (IdibGi), Girona, Spain
| | - Haizea Pombo
- Bizkaia, Deputy Directorate of Healthcare Assistance, Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation-Biocruces Bizkaia Health Research Institute Innovation Unit, Osakidetza-Servicio Vasco de Salud, Araba, Spain
| | | | - Montserrat Gil-Girbau
- Research and Development Unit, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | - Francisco Represas-Carrera
- Atención Primaria, Área Sanitaria de Vigo, Servicio Gallego de Salud (SERGAS), Grupo I-Saúde (Instituto de Investigación Sanitaria Galicia Sur), Galicia, Spain
| | - Jose A Maderuelo-Fernandez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla Y León (SACyL), Salamanca, Spain
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García-Pérez L, Villodres GC, Muros JJ. Differences in healthy lifestyle habits in university students as a function of academic area. J Public Health (Oxf) 2022:6806167. [DOI: 10.1093/pubmed/fdac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/14/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
It is known that the promotion and acquisition of healthy attitudes is a key factor depending on the academic training provided by the university studies on which students are enrolled.The aim of the present research is to analyse and compare lifestyle habits and health-related quality of life (HRQoL) as a function of academic training.
Methods
A cross-sectional study with a volunteer convenience sample of 707 undergraduate participants aged (21.98 ± 3.50 years). Students were divided into four different groups according to their area of academic training. Socio-demographic variables, adherence to the Mediterranean diet (MD), physical activity (PA) engagement and HRQoL were recorded.
Results
PA and sport science students reported better scores in PA (6342.39 ± 2313.99 metabolic equivalents [METs]; P = 0.000), MD adherence (6.33 ± 2.69; P = 0.000) and HRQoL in physical and mental health (MH; 54.85 ± 9.18; 53.70 ± 13.6; P = 0.000). In contrast, non-health-related sciences (NHRS) students reported the lowest scores on assessed items. Students with a medium/high monthly salary reported better MD adherence (6.16 ± 3.07; P = 0.012). In addition, females reported better scores (6.41 ± 2.65; P = 0.000) than males. Further, males indicated better perceptions of MH (46.52 ± 18.84; P = 0.014). Moreover, university students with a high level of MD adherence were revealed to engage in more PA (5181.17 ± 2813.35 METs; P = 0.000) and have better HRQoL with regards to both physical (54.76 ± 8.84; P = 0.000) and MH (48.11 ± 16.73; P = 0.000).
Conclusions
Outcomes point to differences in MD adherence, PA and HRQoL according to academic training. NHRS students who did not know healthy habits reported lower scores for all studied items. This indicates the need for health interventions at universities.
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Affiliation(s)
- Laura García-Pérez
- Department of Didactics of Corporal Expression, University of Granada , 18071 Granada , Spain
| | | | - José Joaquín Muros
- Department of Didactics of Corporal Expression, University of Granada , 18071 Granada , Spain
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Cecchini AL, Biscetti F, Rando MM, Nardella E, Pecorini G, Eraso LH, Dimuzio PJ, Gasbarrini A, Massetti M, Flex A. Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:10814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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Affiliation(s)
- Andrea Leonardo Cecchini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Federico Biscetti
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Maria Margherita Rando
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Elisabetta Nardella
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giovanni Pecorini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Luis H. Eraso
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Paul J. Dimuzio
- Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Antonio Gasbarrini
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Massimo Massetti
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Andrea Flex
- Internal Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Gerić M, Matković K, Gajski G, Rumbak I, Štancl P, Karlić R, Bituh M. Adherence to Mediterranean Diet in Croatia: Lessons Learned Today for a Brighter Tomorrow. Nutrients 2022; 14:nu14183725. [PMID: 36145100 PMCID: PMC9504207 DOI: 10.3390/nu14183725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Non-communicable diseases (NCD) and lifestyle, particularly diet, have a close relationship. Based on the recent statistics, Croatian men and women lead in European overweight lists, which implies pessimistic prognosis in terms of incidence and prevalence of NCDs in the future. One of the possible solutions to overcome weight problems is turn to traditional balanced and sustainable diets, such as the Mediterranean diet. In this study, we assessed adherence towards Mediterranean diet using a validated questionnaire in an online survey and associated adherence scores with several demographic and anthropometric data. Based on the results of a validated Mediterranean Diet Adherence Screener (N = 3326), we assessed the adherence score to be 7.6 ± 2.5. The score tended to depend on sex, residence, age, education, income, and body mass index (BMI); indeed, women, residents of a coastal part of the country, older volunteers, those possessing a higher education degree, those with higher income, and those with lower BMI were associated with higher scores. As income was one of the significant findings related to higher adherence scores, we developed a dietary plan complying with Mediterranean diet principles that, on average, costed less than the average traditional balanced diet menu. Taken together, this study brought new findings regarding target groups who need to be encouraged to make lifestyle changes, and highlighted the first steps on how to make them.
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Affiliation(s)
- Marko Gerić
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10 000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-14682500
| | - Katarina Matković
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10 000 Zagreb, Croatia
| | - Goran Gajski
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10 000 Zagreb, Croatia
| | - Ivana Rumbak
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10 000 Zagreb, Croatia
| | - Paula Štancl
- Faculty of Science, University of Zagreb, 10 000 Zagreb, Croatia
| | - Rosa Karlić
- Faculty of Science, University of Zagreb, 10 000 Zagreb, Croatia
| | - Martina Bituh
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10 000 Zagreb, Croatia
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Clinical Network for Big Data and Personalized Health: Study Protocol and Preliminary Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116365. [PMID: 35681950 PMCID: PMC9180513 DOI: 10.3390/ijerph19116365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/09/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022]
Abstract
The use of secondary hospital-based clinical data and electronical health records (EHR) represent a cost-efficient alternative to investigate chronic conditions. We present the Clinical Network Big Data and Personalised Health project, which collects EHRs for patients accessing hospitals in Central-Southern Italy, through an integrated digital platform to create a digital hub for the collection, management and analysis of personal, clinical and environmental information for patients, associated with a biobank to perform multi-omic analyses. A total of 12,864 participants (61.7% women, mean age 52.6 ± 17.6 years) signed a written informed consent to allow access to their EHRs. The majority of hospital access was in obstetrics and gynaecology (36.3%), while the main reason for hospitalization was represented by diseases of the circulatory system (21.2%). Participants had a secondary education (63.5%), were mostly retired (25.45%), reported low levels of physical activity (59.6%), had low adherence to the Mediterranean diet and were smokers (30.2%). A large percentage (35.8%) were overweight and the prevalence of hypertension, diabetes and hyperlipidemia was 36.4%, 11.1% and 19.6%, respectively. Blood samples were retrieved for 8686 patients (67.5%). This project is aimed at creating a digital hub for the collection, management and analysis of personal, clinical, diagnostic and environmental information for patients, and is associated with a biobank to perform multi-omic analyses.
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Aureli V, Rossi L. Nutrition Knowledge as a Driver of Adherence to the Mediterranean Diet in Italy. Front Nutr 2022; 9:804865. [PMID: 35387192 PMCID: PMC8978558 DOI: 10.3389/fnut.2022.804865] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background An optimal Nutrition knowledge (NK) among the population could result in greater Adherence to the Mediterranean Diet (AMD), a recognized dietary pattern capable of preventing chronic food-related diseases. This study aimed to evaluate the association between NK and AMD in Italy. Methods A national representative sample of 2,869 adults took part in an assessment that was carried out through a self-administrated questionnaire including sections relating to NK and AMD. AMD was evaluated following the PREDIMED PLUS methodology. Descriptive statistics were provided, and ordinal measures of NK score and AMD were calculated based on quartiles of the quantitative scores. A contingency analysis was performed to check associations between variables. Results In Italy, the average NK score was 50 ± 13.3, equivalent to 56.8% of correct answers. The average value of AMD was 6.8, corresponding to 40% of the maximum score with 31.4% of the population demonstrating low AMD, 31.3% in the lower-middle range, 24% in the medium-high range, and only 13.3% reporting a high AMD. A significant association between NK and AMD was found; respondents who reported the lowest AMD corresponded to those with the lowest NK (36.7%; p < 0.05) and similarly, those with the highest level of adherence to MD also achieved the highest NK scores (41.7%; p < 0.05). Conclusion This study showed that AMD in Italy is generally low, and the strong association between NK and AMD demonstrated that there is a clear connection between a healthy dietary pattern and the nutrition literacy of the population. Those with the highest AMD corresponded to the highest NK and, conversely, those with the lowest AMD displayed the lowest NK. The study also highlighted that socioeconomic aspects were strong determinants of both AMD and NK.
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Affiliation(s)
- Vittoria Aureli
- CREA Council for Agricultural Research and Economics-Research Centre for Food and Nutrition, Rome, Italy
| | - Laura Rossi
- CREA Council for Agricultural Research and Economics-Research Centre for Food and Nutrition, Rome, Italy
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Tatoli R, Lampignano L, Bortone I, Donghia R, Castellana F, Zupo R, Tirelli S, De Nucci S, Sila A, Natuzzi A, Lozupone M, Griseta C, Sciarra S, Aresta S, De Pergola G, Sorino P, Lofù D, Panza F, Di Noia T, Sardone R. Dietary Patterns Associated with Diabetes in an Older Population from Southern Italy Using an Unsupervised Learning Approach. SENSORS 2022; 22:s22062193. [PMID: 35336365 PMCID: PMC8949084 DOI: 10.3390/s22062193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 01/27/2023]
Abstract
Dietary behaviour is a core element in diabetes self-management. There are no remarkable differences between nutritional guidelines for people with type 2 diabetes and healthy eating recommendations for the general public. This study aimed to evaluate dietary differences between subjects with and without diabetes and to describe any emerging dietary patterns characterizing diabetic subjects. In this cross-sectional study conducted on older adults from Southern Italy, eating habits in the “Diabetic” and “Not Diabetic” groups were assessed with FFQ, and dietary patterns were derived using an unsupervised learning algorithm: principal component analysis. Diabetic subjects (n = 187) were more likely to be male, slightly older, and with a slightly lower level of education than subjects without diabetes. The diet of diabetic subjects reflected a high-frequency intake of dairy products, eggs, vegetables and greens, fresh fruit and nuts, and olive oil. On the other hand, the consumption of sweets and sugary foods was reduced compared to non-diabetics (23.74 ± 35.81 vs. 16.52 ± 22.87; 11.08 ± 21.85 vs. 7.22 ± 15.96). The subjects without diabetes had a higher consumption of red meat, processed meat, ready-to-eat dishes, alcoholic drinks, and lower vegetable consumption. The present study demonstrated that, in areas around the Mediterranean Sea, older subjects with diabetes had a healthier diet than their non-diabetic counterparts.
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Affiliation(s)
- Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
- Correspondence: (L.L.); (I.B.)
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
- Correspondence: (L.L.); (I.B.)
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Sarah Tirelli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Annalidia Natuzzi
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 11, 70125 Bari, Italy; (M.L.); (F.P.)
| | - Chiara Griseta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Sabrina Sciarra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Simona Aresta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy;
| | - Paolo Sorino
- Department of Electrical and Information Engineering, Polytechnic of Bari, 70125 Bari, Italy; (P.S.); (D.L.); (T.D.N.)
| | - Domenico Lofù
- Department of Electrical and Information Engineering, Polytechnic of Bari, 70125 Bari, Italy; (P.S.); (D.L.); (T.D.N.)
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 11, 70125 Bari, Italy; (M.L.); (F.P.)
| | - Tommaso Di Noia
- Department of Electrical and Information Engineering, Polytechnic of Bari, 70125 Bari, Italy; (P.S.); (D.L.); (T.D.N.)
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
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Neuvonen E, Lehtisalo J, Solomon A, Antikainen R, Havulinna S, Hänninen T, Laatikainen T, Lindström J, Rautio N, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Ngandu T. Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial: an exploratory analysis of a randomised clinical trial. Aging Clin Exp Res 2022; 34:1793-1805. [PMID: 35182352 PMCID: PMC9283154 DOI: 10.1007/s40520-022-02088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/28/2022] [Indexed: 11/27/2022]
Abstract
Background and aims Psychosocial factors may affect adherence to lifestyle interventions and lifestyle changes. The role of psychosocial factors in dementia prevention needs more research. We aimed at clarify the issue in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Methods The population included 1260 participants aged 60–77 years at risk for cognitive decline, randomised to a multidomain lifestyle intervention or regular health advice for 2 years. Adherence was evaluated as participation in the provided activities and actual lifestyle changes, separately for each domain (diet, exercise, social/cognitive activity, vascular risk management) and combined into multidomain. Psychosocial factors were measured at trial baseline (depressive symptoms; study perception; health-related quality of life, HRQoL) and earlier life (hopelessness; satisfaction with family life, achievements, and financial situation). Results Depressive symptoms, hopelessness, and nonpositive study perception were negatively and HRQoL positively associated with participation in the multidomain intervention. Depressive symptoms, lower HRQoL, hopelessness and dissatisfaction with financial situation were associated with unhealthier lifestyles at baseline. Baseline depressive symptoms and lower HRQoL predicted less improvement in lifestyle, but did not modify the intervention effect on lifestyle change. Discussion and conclusions Several psychosocial factors were associated with participation in lifestyle intervention, while fewer of them contributed to lifestyle changes. Although the intervention was beneficial for lifestyle changes independent of psychosocial factors, those most in need of lifestyle improvement were less likely to be active. Tailoring lifestyle-modifying strategies based on the need for psychosocial support may add efficacy in future trials. Trial Registry ClinicalTrials.gov NCT01041989 2010-01-05 Supplementary Information The online version contains supplementary material available at 10.1007/s40520-022-02088-x.
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Affiliation(s)
- Elisa Neuvonen
- School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
| | - Jenni Lehtisalo
- School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Alina Solomon
- School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Solnavägen 1, 171 77, Solna, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, St Dunstan's Road, London, W6 8RP, UK
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, P.O. Box 10, 90029 OYS, Oulu, Finland
| | - Satu Havulinna
- Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Tuomo Hänninen
- Department of Neurology, Neurocenter, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Kuopio, Finland
| | - Tiina Laatikainen
- Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Tikkamäentie 16, 80210, Joensuu, Finland
| | - Jaana Lindström
- Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Nina Rautio
- Center for Life Course Health Research/Geriatrics, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Hilkka Soininen
- School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Kuopio, Finland
| | - Timo Strandberg
- Center for Life Course Health Research/Geriatrics, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- University of Helsinki and Helsinki University Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland
| | - Jaakko Tuomilehto
- Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
- South Ostrobothnia Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland
- National School of Public Health, Carlos III Health Institute, Monforte de Lemos 5, 28029, Madrid, Spain
- Diabetes Research Group, King Abdulaziz University, P.O. Box 80215, Jiddah, 21589, Saudi Arabia
| | - Miia Kivipelto
- School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Solnavägen 1, 171 77, Solna, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, St Dunstan's Road, London, W6 8RP, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
- Theme Aging, Karolinska University Hospital, Karolinska Vägen 22, 171 64, Solna, Sweden
| | - Tiia Ngandu
- Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Solnavägen 1, 171 77, Solna, Sweden
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19
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Obeid CA, Gubbels JS, Jaalouk D, Kremers SPJ, Oenema A. Adherence to the Mediterranean diet among adults in Mediterranean countries: a systematic literature review. Eur J Nutr 2022; 61:3327-3344. [PMID: 35451614 PMCID: PMC9026058 DOI: 10.1007/s00394-022-02885-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/31/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM While the Mediterranean diet (MD) is promoted in non-Mediterranean countries, inhabitants of Mediterranean countries seem to be shifting away from this healthy diet. The aim of this study is to provide an overview of MD adherence in the general adult population of Mediterranean countries. METHODS A systematic review was conducted following the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and registered in the Prospero database (CRD42020189337). Literature was searched in PubMed, Web of Science and PsycINFO databases for studies published from 2010 up to and including 2021. The following inclusion criteria were used: age 18 years and older, sample size > 1000 participants, and using a validated MD adherence score. Studies that only included participants with nutrition-related or other severe chronic disorders, as well as studies that only included specific subpopulations (e.g., pregnant women), were excluded in order to focus on the general adult population. A quality analysis of the included studies was done using the NCCMT scale. RESULTS A total of 50 studies were included. The number of participants in the included studies ranged between 1013 and 94,113. Most of the included studies pertained to the European Mediterranean countries, with fewer studies from the Middle Eastern and North African Mediterranean countries. The vast majority of the included studies reported low or moderate MD adherence, both based on the mean adherence as well as the low or moderate adherence category often being the most prevalent. There were no clear differences noted between sex and age groups. The quality assessment generally showed weak or moderate scores. CONCLUSIONS Mediterranean populations have been showing moderate adherence to MD in the past 10 years, indicating room for improving adherence to the MD in countries of its origin.
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Affiliation(s)
- Cecile A. Obeid
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands ,grid.440405.10000 0001 0747 2412Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, PO Box 72, Zouk Mikael, Lebanon
| | - Jessica S. Gubbels
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Doris Jaalouk
- College of Arts and Sciences, American University of Iraq Baghdad (AUIB), Airport Road, Baghdad, Iraq
| | - Stef P. J. Kremers
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Anke Oenema
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
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20
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A Generation Shift in Mediterranean Diet Adherence and Its Association with Biological Markers and Health in Dalmatia, Croatia. Nutrients 2021; 13:nu13124564. [PMID: 34960116 PMCID: PMC8705718 DOI: 10.3390/nu13124564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
Previous studies have confirmed the beneficial effect of a Mediterranean diet in mitigating health issues related to cardiovascular disease, diabetes and obesity. However, rapid changes in the traditional way of life and the “westernization” of the diet in Mediterranean populations, especially in younger generations, has led to progressive abandonment of healthy dietary patterns. In order to investigate the generation shift in dietary patterns and lifestyle habits in the Mediterranean part of Croatia, we compared two cohorts of 610 women (266 pregnant and 344 non-pregnant) from the same region, but from different age groups. The MDSS score was derived from food frequency questionnaires. The results showed that the young, reproductively active generation (pregnant women) in Dalmatia, Croatia, although having a higher education and socioeconomic status, exhibits a more adverse eating behaviour (lower adherence to the Mediterranean diet) and lifestyle (excessive smoking in pregnancy) than the older population from the same region. Lower MDSS scores across aggregated age groups in both cohorts showed significant association with higher blood lipid levels and higher smoking frequency. In conclusion, Mediterranean diet adherence is associated with biological markers (age, lipid profile) and lifestyle (smoking) in our study, with a more adverse trend observed in the younger generation.
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21
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Ruggiero E, Esposito S, Costanzo S, Di Castelnuovo A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M. Ultra-processed food consumption and its correlates among Italian children, adolescents and adults from the Italian Nutrition & Health Survey (INHES) cohort study. Public Health Nutr 2021; 24:6258-6271. [PMID: 34289922 PMCID: PMC11148574 DOI: 10.1017/s1368980021002767] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess ultra-processed food (UPF) consumption and its socio-demographic, psychosocial and behavioural correlates in a general population of Italian children, adolescents and adults. DESIGN Cross-sectional telephone-based survey. SETTING Italy, 2010-2013. PARTICIPANTS In total, 9078 participants (5-97 years) from the Italian Nutrition & Health Survey. Dietary intakes were collected by a 1-d 24-h dietary recall. UPF was defined by the NOVA classification and expressed as percentage of total energies. RESULTS Average energy intake from UPF (95 % CI) was 17·3 % (17·1 %, 17·6 %) among adults and 25·9 % (24·8 %, 27·0 %) in children/adolescents. Top sources of UPF were processed meats (32·5 %) and bread substitutes (16·7 %). Among adults, age (β = -3·10; 95 % CI (-4·40, -1·80) for >65 years v. 20-40 years; βs are dimensionless) and residing in Southern Italy (β = -0·73; 95 % CI (-1·32, -0·14) v. Northern) inversely associated with UPF. Screen view during meals was directly linked to UPF, as well as poor self-rated health (β = 5·32; 95 % CI (2·66, 7·99)), adverse life events (β = 2·33; 95 % CI (1·48, 3·18)) and low sleep quality (β = 2·34; 95 % CI (1·45, 3·23)). Boys consumed two-point percent more UPF of the total energy than girls (β = 2·01; 95 % CI (0·20, 3·82)). For all ages, a Mediterranean diet was inversely associated with UPF (β = -4·86; 95 % CI (-5·53, -4·20) for good v. poor adherence in adults and (β = -5·08; 95 % CI (-8·38, -1·77) for kids). CONCLUSIONS UPF contributes a modest proportion of energy to the diets of Italian adults while being one-quarter of the total energies in children/adolescents. UPF was associated with several psychosocial factors and eating behaviours. Increased adherence to Mediterranean diet would possibly result in lower UPF consumption.
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Affiliation(s)
- Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
| | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese-Como, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy
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22
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Fernandez-Lazaro CI, Toledo E, Buil-Cosiales P, Salas-Salvadó J, Corella D, Fitó M, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Martín Sánchez V, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Ros E, Vázquez C, Daimiel L, SanJulián B, García-Gavilán JF, Sorlí JV, Castañer O, Zulet MÁ, Tojal-Sierra L, Pérez-Farinós N, Oncina-Canovas A, Moñino M, Garcia-Rios A, Sacanella E, Bernal-Lopez RM, Santos-Lozano JM, Vázquez-Ruiz Z, Muralidharan J, Ortega-Azorín C, Goday A, Razquin C, Goicolea-Güemez L, Ruiz-Canela M, Becerra-Tomás N, Schröder H, Martínez González MA. Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial. Eur J Nutr 2021; 61:1457-1475. [PMID: 34846603 PMCID: PMC8921156 DOI: 10.1007/s00394-021-02697-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25–1.83; OR12-month: 1.66, 95% CI 1.37–2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07–2.46; OR12-month: 1.62, 95% CI 1.07–2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53–0.79; OR12-month: 0.76, 95% CI 0.62–0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64–0.99; OR12-month: 0.71, 95% CI 0.57–0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. Trial registration ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02697-8.
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Affiliation(s)
- Cesar I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Pilar Buil-Cosiales
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Servicios de Atención Primaria, Navarra Regional Health Service (Osasunbidea), IdiSNA, Pamplona, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071, Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Luís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS and IDISBA, Palma de Mallorca, Spain
| | - Vicente Martín Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat,, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes Y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.,Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Clotilde Vázquez
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Beatriz SanJulián
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain
| | - Jesús F García-Gavilán
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
| | - Jose V Sorlí
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Olga Castañer
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - M Ángeles Zulet
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Lucas Tojal-Sierra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Napoleón Pérez-Farinós
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071, Málaga, Spain
| | | | - Manuel Moñino
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio Garcia-Rios
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Emilio Sacanella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Rosa M Bernal-Lopez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Zenaida Vázquez-Ruiz
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jananee Muralidharan
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
| | - Carolina Ortega-Azorín
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Alberto Goday
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Leire Goicolea-Güemez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Nerea Becerra-Tomás
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Helmut Schröder
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - Miguel A Martínez González
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain. .,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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23
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Apostolaki I, Pepa A, Vlassopoulos A, Kapsokefalou M. Social Capital and Self-Perceived Quality of Life-Interrelated Predictors of Mediterranean Diet Adherence in Older Adults. Nutrients 2021; 13:3100. [PMID: 34578978 PMCID: PMC8465589 DOI: 10.3390/nu13093100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
Living a healthy life in a supporting environment are key elements towards higher diet quality in older age. The Mediterranean Diet in Older Adults (MINOA) study collected cross-sectional data from adults ≥65 years old (n = 436) from April 2014 to November 2015 in rural Crete, aiming to understand the interrelations between Mediterranean Diet adherence, Social Capital and Health-Related Quality of Life (HRQL). Multivariate linear regression, carried out using SPSS 20.0, revealed that both Social Capital and HRQL has a positive impact on Mediterranean Diet adherence after adjustment for confounders and independently of each other. Total Social Capital as well as its Value of Life/Social Agency component (β = 0.04 and β = 0.1, p < 0.05, respectively) had a positive relationship with Mediterranean Diet adherence. As far as HRQL is concerned, only the Physical Health components were found to have a positive association with Mediterranean Diet adherence (β = 0.09, p < 0.001). At the same time Total Social Capital was also seen to have a positive relationship with perceived Physical and Mental Health (β = 0.21 and β = 0.28, p < 0.001, respectively). In a population of older adults Social Capital, HRQL and Mediterranean Diet adherence seem to share intricate interrelations that impact both diet quality and quality of life overall.
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Affiliation(s)
- Ioanna Apostolaki
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
- Department of Social Medicine, Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Aleks Pepa
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
| | - Antonis Vlassopoulos
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
| | - Maria Kapsokefalou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece; (I.A.); (A.P.); (A.V.)
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24
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Bonaccio M, Ruggiero E, Persichillo M, Esposito S, Olivieri M, Di Castelnuovo A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts. Public Health Nutr 2021; 24:3905-3915. [PMID: 33663640 PMCID: PMC8207556 DOI: 10.1017/s1368980021000999] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/09/2021] [Accepted: 03/01/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020). DESIGN Retrospective observational study. SETTING Italy. PARTICIPANTS We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement. RESULTS Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β = -1·94; 95 % CI -2·72, -1·17 for individuals aged >75 years as compared with 18-39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (β = -1·32; 95 % CI -1·80, -0·84), while UPF lowering associated with increased exercise (β = -0·90; 95 % CI -1·46, -0·35) and weight loss (β = -1·05; 95 % CI -1·51, -0·59) during confinement. CONCLUSIONS During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.
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Affiliation(s)
- Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Mariarosaria Persichillo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | | | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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25
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Adherence to the Mediterranean Diet in a Portuguese Immigrant Community in the Central Valley of California. Nutrients 2021; 13:nu13061989. [PMID: 34207909 PMCID: PMC8226530 DOI: 10.3390/nu13061989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 01/25/2023] Open
Abstract
The Mediterranean Diet (MedDiet) is a healthy eating pattern associated with a better quality of life among older adults and reduced risk of non-communicable diseases. Little is known about the MedDiet in immigrant communities from countries in which the MedDiet is a settled cultural heritage. Thus, we examined MedDiet adherence and perceived knowledge, benefits, and barriers to the MedDiet in a Portuguese immigrant community in Turlock, California. A cross-sectional study was conducted with 208 participants in Turlock and Livermore, California, which was used as a reference population. Univariate, multivariable, and logistic regression models were used for data analysis. Compared to the Livermore group, the Turlock group was younger and less educated, but had a higher average MedDiet score and active adherence to a MedDiet (p < 0.001 for both). In the Turlock group, convenience, sensory appeal, and health were observed to be significant barriers to the MedDiet (p < 0.05), while health, weight loss, natural content, familiarity, price, sensory appeal, and mood were significant benefit factors (p < 0.05). In conclusion, participants in Turlock had greater MedDiet adherence despite lower education attainment. Furthermore, the perceived benefits of the MedDiet were key factors in MedDiet perception and adherence in a Portuguese immigrant community.
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26
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Ponzo V, Pellegrini M, D’Eusebio C, Bioletto F, Goitre I, Buscemi S, Frea S, Ghigo E, Bo S. Mediterranean Diet and SARS-COV-2 Infection: Is There Any Association? A Proof-of-Concept Study. Nutrients 2021; 13:nu13051721. [PMID: 34069656 PMCID: PMC8160854 DOI: 10.3390/nu13051721] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of this observational study was investigating the possible correlation between adherence to the Mediterranean diet (MeD) and SARS-COV-2 infection rates and severity among healthcare professionals (HCPs). An online self-administrated questionnaire (evaluating both MeD adherence and dietary habits) was filled out by HCPs working in Piedmont (Northern Italy) from 15 January to 28 February 2021. Out of the 1206 questionnaires collected, 900 were considered reliable and analyzed. Individuals who reported the SARS-COV-2 infection (n = 148) showed a significantly lower MeD score, with a lower adherence in fruit, vegetables, cereals, and olive oil consumption. In a logistic regression model, the risk of infection was inversely associated with the MeD score (OR = 0.88; 95% CI 0.81–0.97) and the consumption of cereals (OR = 0.64; 0.45–0.90). Asymptomatic individuals with SARS-COV-2 infection reported a lower intake of saturated fats than symptomatic; individuals requiring hospitalization were significantly older and reported worse dietary habits than both asymptomatic and symptomatic individuals. After combining all symptomatic individuals together, age (OR = 1.05; 1.01–1.09) and saturated fats intake (OR = 1.09; 1.01–1.17) were associated with the infection severity. HCPs who reported a SARS-COV-2 infection showed a significantly lower MeD score and cereal consumption. The infection severity was directly associated with higher age and saturated fat intake.
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Affiliation(s)
- Valentina Ponzo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Marianna Pellegrini
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Chiara D’Eusebio
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Fabio Bioletto
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Ilaria Goitre
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Silvio Buscemi
- Unit of Clinical Nutrition, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Simone Frea
- Cardiology Unit, Città della Salute e della Scienza Hospital, University of Torino, 10126 Torino, Italy;
| | - Ezio Ghigo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
| | - Simona Bo
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy; (V.P.); (M.P.); (C.D.); (F.B.); (I.G.); (E.G.)
- Correspondence: ; Tel.: +39-011-633-6036
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27
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Ruggiero E, Mignogna C, Costanzo S, Persichillo M, Di Castelnuovo A, Esposito S, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M. Changes in the consumption of foods characterising the Mediterranean dietary pattern and major correlates during the COVID-19 confinement in Italy: results from two cohort studies. Int J Food Sci Nutr 2021; 72:1105-1117. [PMID: 33823720 DOI: 10.1080/09637486.2021.1895726] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We investigated the effect of confinement during the COVID-19 pandemic on the consumption of foods characterising the Mediterranean dietary pattern (MDP) and its major correlates in two Italian population-based cohorts comprising 3161 subjects (mean age 57.7 ± 15.4 y). At population level, 38.8% of participants reported an improvement of diet quality during the first nationwide lockdown. Healthful dietary changes were associated with older age (β = 0.41; 95% confidence interval [CI] 0.08, 0.73 for 56-65 vs. 18-39 y), greater wealth (β = 0.45; 0.01, 0.89 for >40,000 ≤ 60,000 vs. ≤ 10,000 EUR/y), increased physical activity (β = 0.52; 0.22, 0.81) and reduced body weight (β = 0.36; 0.11, 0.62). Switching to healthy eating was also related to increased consumption of organic (β = 1.24; 0.88, 1.60) and locally-grown food (β = 0.74; 0.51, 0.96). The first Italian lockdown led, in a substantial part of the population, to higher intake of foods characterising a MDP; this was also accompanied by healthier lifestyle and more sustainable food choices.
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Affiliation(s)
- Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Cristiana Mignogna
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | | | | | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | | | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy.,Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
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28
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Vettori V, Lorini C, Gibbs HD, Sofi F, Lastrucci V, Sartor G, Fulvi I, Giorgetti D, Cavallo G, Bonaccorsi G. The Nutrition Literacy Assessment Instrument for Italian Subjects, NLit-IT: Exploring Validity and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073562. [PMID: 33808072 PMCID: PMC8036908 DOI: 10.3390/ijerph18073562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
The aim of this study was to test validity and reliability of the adapted version of the Nutrition Literacy Assessment Instrument (NLit) for Italian people (NLit-IT). An observational cross-sectional study was conducted, involving a convenience sample of adults (n = 74). To explore the validity of the tool, we considered both diet quality as an outcome of NL, and health literacy (HL) as a construct that presents similarities and differences with NL. Diet quality was measured by adherence to the Mediterranean Diet (Med diet) through the validated Mediterranean Diet Literature-based adherence score (MEDI-Lite). The relationship between NL level and adherence to Med diet was assessed by linear regression analysis and computing correlations between NLit-IT and MEDI-Lite scores (Spearman's Rho). Additionally, we evaluated the correlation between NLit-IT score and the level of HL (Spearman's Rho). Internal consistency and reliability were measured by Cronbach's alpha and intraclass correlation coefficient (ICC) respectively. Internal consistency (ρT = 0.78; 95% CI, 0.69-0.84) and reliability (ICC = 0.68, 95% CI, 0.46-0.85) were confirmed. In addition, NLit-IT total score was correlated with MEDI-Lite score (Rho = 0.25; p-value = 0.031) and multivariate regression analysis confirmed that NL significantly contributed to MEDI-Lite score (R2 = 0.13; β = 0.13; p-value = 0.008). There was no significant association between the level of HL and NL. In conclusion, NLit-IT showed validity and reliability as a measure of NL for Italian people.
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Affiliation(s)
- Virginia Vettori
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
- Correspondence:
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Heather D. Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, 3901 Rainbow Blvd/MS4013, Kansas City, KS 66160, USA;
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Unit of Clinical Nutrition, University Hospital of Careggi, 50134 Florence, Italy
- Don Carlo Gnocchi Foundation Italy, Onlus IRCCS, 50134 Florence, Italy
| | - Vieri Lastrucci
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
- Global Health Center, Meyer University Hospital, 24 Gaetano Pieraccini Blvd, 50134 Florence, Italy
| | - Gino Sartor
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (G.S.); (D.G.)
| | - Ilaria Fulvi
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Duccio Giorgetti
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (G.S.); (D.G.)
| | - Giuseppe Cavallo
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
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29
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Affiliation(s)
- Silvio Buscemi
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, Palermo, Italy.,Unit of Clinical Nutrition, AOU Policlinico "P. Giaccone", Palermo, Italy
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30
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Greene MW, Roberts AP, Frugé AD. Negative Association Between Mediterranean Diet Adherence and COVID-19 Cases and Related Deaths in Spain and 23 OECD Countries: An Ecological Study. Front Nutr 2021; 8:591964. [PMID: 33748170 PMCID: PMC7973012 DOI: 10.3389/fnut.2021.591964] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 02/10/2021] [Indexed: 12/13/2022] Open
Abstract
In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) emerged in Wuhan, China, sparking the Coronavirus disease 2019 (COVID-19) pandemic. The high prevalence of nutrition-related COVID-19 risk factors including obesity, type 2 diabetes, and hypertension, suggests that healthy dietary approaches may mitigate COVID-19 related outcomes and possibly SARS-CoV-2 infection. Based on the fundamental role of nutrition in immune function and the well-documented association between Mediterranean diet consumption and risk reduction for chronic diseases that are comorbidities in COVID-19 patients, we hypothesized that there would be a relationship between Mediterranean diet adherence and COVID-19 cases and related deaths. In this perspective, we examined the association between regional adherence to a Mediterranean diet and COVID-19 cases and deaths using an ecological study design. We observed that Mediterranean diet adherence was negatively associated with both COVID-19 cases and related deaths across 17 regions in Spain and that the relationship remained when adjusted for factors of well-being. We also observed a negative association between Mediterranean diet adherence and COVID-19 related deaths across 23 countries when adjusted for factors of well-being and physical inactivity. The anti-inflammatory properties of the Mediterranean diet - likely due to the polyphenol content of the diet - may be a biological basis to explain our findings. However, there are confounding factors unrelated to dietary factors driving COVID-19 cases and related deaths across the regions in Spain and the 23 countries examined in our analysis. Our findings will need to be confirmed and further explored in cohort studies.
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Affiliation(s)
- Michael W Greene
- Department of Nutrition, Auburn University, Auburn, AL, United States.,Boshell Diabetes and Metabolic Disease Research Program, Auburn University, Auburn, AL, United States
| | - Alexis P Roberts
- Department of Nutrition, Auburn University, Auburn, AL, United States
| | - Andrew D Frugé
- Department of Nutrition, Auburn University, Auburn, AL, United States.,Boshell Diabetes and Metabolic Disease Research Program, Auburn University, Auburn, AL, United States
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31
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Coelho-Junior HJ, Marzetti E, Picca A, Cesari M, Uchida MC, Calvani R. Protein Intake and Frailty: A Matter of Quantity, Quality, and Timing. Nutrients 2020; 12:E2915. [PMID: 32977714 PMCID: PMC7598653 DOI: 10.3390/nu12102915] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
Frailty is a geriatric syndrome that refers to a state of reduced resiliency to stressful events that occurs in response to physiological and/or psychosocial detriments. Frailty is a predictor of poor prognosis, given that frail older adults are at higher risk of many adverse health-related events. Hence, the identification of potential strategies to prevent the development and progression of frailty is of extreme importance for avoiding its negative outcomes. An adequate protein consumption is advocated as a possible intervention for the management of frailty in older adults due to its effects on muscle mass and physical function. However, empirical evidence is still needed to support this proposition. On the other hand, substantial evidence from observational studies has provided important information on the association between frailty and dietary protein-related parameters. Here, we provide a narrative review of the current literature regarding the association between protein intake (amount (how much?), quality (what type?), and distribution across meals (when?)) and frailty-related parameters. The ultimate aim of this work is to offer practical, evidence-based indications to healthcare professionals responsible for the care of frail older adults.
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Affiliation(s)
- Hélio J. Coelho-Junior
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, 083-851 Campinas-SP, Brazil;
- Mãe Mariana Nursing Home, Rehabilitation Unit, 08562-460 Poá-SP, Brazil
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (R.C.)
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (R.C.)
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20133 Milan, Italy;
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco C. Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, 083-851 Campinas-SP, Brazil;
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (A.P.); (R.C.)
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Dinu M, Pagliai G, Giangrandi I, Colombini B, Toniolo L, Gensini G, Sofi F. Adherence to the Mediterranean diet among Italian adults: results from the web-based Medi-Lite questionnaire. Int J Food Sci Nutr 2020; 72:271-279. [PMID: 32657181 DOI: 10.1080/09637486.2020.1793306] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The adherence to the Mediterranean diet (MD) was assessed in a sample of 1820 non-selected individuals (1099 females and 721 males aged ≥18 years) who have completed the web version of the Medi-Lite score during the year 2019. Adherence to the MD was found to have a normal distribution and, on a scale from 0 to 18, the mean score was 12.2 ± 2.4. Significantly (p < 0.001) higher adherence scores were observed in females compared to males, in elderly people compared to young people, and in individuals with a university degree compared to those with a primary or a secondary school diploma. At the multivariate analysis, female gender, advanced age (>45 years), and higher education level were associated with a higher probability of being in the highest quartile of the Medi-Lite distribution. In conclusion, we found that some sub-groups of our population (males, younger individuals, and those with lower levels of education) need to improve their diet for reaching higher adherence scores to the MD.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Ilaria Giangrandi
- Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
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Coelho-Junior HJ, Calvani R, Picca A, Gonçalves IO, Landi F, Bernabei R, Cesari M, Uchida MC, Marzetti E. Association between Dietary Habits and Physical Function in Brazilian and Italian Older Women. Nutrients 2020; 12:nu12061635. [PMID: 32492947 PMCID: PMC7352596 DOI: 10.3390/nu12061635] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 01/04/2023] Open
Abstract
The present study investigated and compared the patterns of dietary protein intake and physical function in Brazilian and Italian older women. Seventy-five Brazilian older women were recruited in a community senior center. Fifty-three age-matched Italian older women were selected from participants of the Longevity check-up (Lookup) 7+ study. In both samples, physical performance was evaluated by isometric handgrip strength (IHG) and five-time sit-to-stand (5 × STS) tests, while diet was assessed through 24-h recall. Results indicated that Brazilian women had a higher intake of plant-based protein (52.7% vs. 30.5% kcal), while Italian women consumed greater amounts of animal-derived protein (29.7% vs. 41.5% kcal). In Brazilian women, the binary logistic regression analysis indicated that body weight-adjusted protein consumption was associated with IHG adjusted by body mass index and with 5 × STS performance. In the Italian sample, the intake of isoleucine, leucine, and valine was significantly associated with 5 × STS performance. Our findings indicate that Brazilian and Italian community-dwelling older women show different patterns of protein intake, with higher consumption of plant-based protein in the Brazilian sample and higher ingestion of animal-derived protein in the Italian subgroup. These dietary patterns may differentially impact the relationship between physical function and protein intake observed in Brazilian and Italian older women.
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Affiliation(s)
- Hélio J. Coelho-Junior
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (E.M.)
- Applied Kinesiology Laboratory–LCA, School of Physical Education, University of Campinas, Campinas 13083-970, Brazil;
- Mãe Mariana Home, Rehabilitation Unit, Poá 08562-460, Brazil
- Correspondence: (H.J.C.-J.); (R.B.); Tel.: +39-(06)-3015-5559 (R.B.)
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (R.C.); (A.P.)
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (R.C.); (A.P.)
| | - Ivan O. Gonçalves
- Center of Health Sciences, University of Mogi das Cruzes, Mogi das Cruzes 08780-911, Brazil;
| | - Francesco Landi
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (E.M.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (R.C.); (A.P.)
| | - Roberto Bernabei
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (E.M.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (R.C.); (A.P.)
- Correspondence: (H.J.C.-J.); (R.B.); Tel.: +39-(06)-3015-5559 (R.B.)
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20122 Milan, Italy;
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco C. Uchida
- Applied Kinesiology Laboratory–LCA, School of Physical Education, University of Campinas, Campinas 13083-970, Brazil;
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.L.); (E.M.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (R.C.); (A.P.)
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Santulli G, Pascale V, Finelli R, Visco V, Giannotti R, Massari A, Morisco C, Ciccarelli M, Illario M, Iaccarino G, Coscioni E. We are What We Eat: Impact of Food from Short Supply Chain on Metabolic Syndrome. J Clin Med 2019; 8:E2061. [PMID: 31771147 PMCID: PMC6947359 DOI: 10.3390/jcm8122061] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
Food supply in the Mediterranean area has been recently modified by big retail distribution; for instance, industrial retail has favored shipments of groceries from regions that are intensive producers of mass food, generating a long supply chain (LSC) of food that opposes short supply chains (SSCs) that promote local food markets. However, the actual functional role of food retail and distribution in the determination of the risk of developing metabolic syndrome (MetS) has not been studied hitherto. The main aim of this study was to test the effects of food chain length on the prevalence of MetS in a population accustomed to the Mediterranean diet. We conducted an observational study in Southern Italy on individuals adhering to the Mediterranean diet. We examined a total of 407 subjects (41% females) with an average age of 56 ± 14.5 years (as standard deviation) and found that being on the Mediterranean diet with a SSC significantly reduces the prevalence of MetS compared with the LSC (SSC: 19.65%, LSC: 31.46%; p: 0.007). Our data indicate for the first time that the length of food supply chain plays a key role in determining the risk of MetS in a population adhering to the Mediterranean diet.
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Affiliation(s)
- Gaetano Santulli
- Dept. of Medicine, Division of Cardiology, and Dept. of Molecular Pharmacology, Montefiore University Hospital, Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine (AECOM), New York, NY 10461, USA
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
- International Translational Research and Medical Education Consortium (ITME), 80131 Naples, Italy
| | - Valeria Pascale
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Rosa Finelli
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Valeria Visco
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Rocco Giannotti
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Angelo Massari
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84131 Salerno, Italy; (A.M.); (E.C.)
| | - Carmine Morisco
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
| | - Michele Ciccarelli
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Maddalena Illario
- Health’s Innovation, Campania Regional Government, 80132 Naples, Italy;
- Dept. of Public Health, Federico II University, 80131 Naples, Italy
| | - Guido Iaccarino
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
- International Translational Research and Medical Education Consortium (ITME), 80131 Naples, Italy
| | - Enrico Coscioni
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84131 Salerno, Italy; (A.M.); (E.C.)
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Olza J, Martínez de Victoria E, Aranceta-Bartrina J, González-Gross M, Ortega RM, Serra-Majem L, Varela-Moreiras G, Gil Á. Adequacy of Critical Nutrients Affecting the Quality of the Spanish Diet in the ANIBES Study. Nutrients 2019; 11:E2328. [PMID: 31581518 PMCID: PMC6835880 DOI: 10.3390/nu11102328] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 11/16/2022] Open
Abstract
Diet is one of the key modifiable behaviors that can help to control and prevent non-communicable chronic diseases. Therefore, it is important to evaluate the overall diet composition of the population through non-invasive and independent indexes or scores as diet quality indexes (DQIs). The primary aim of the present work was to estimate the adequacy of the intake of critical nutrients in the Spanish "Anthropometry, Intake, and Energy Balance Study" (ANIBES) (n = 2285; 9-75 years), considering, as a reference, the European Food Scientific Authority (EFSA) values for nutrients for the European Union. We also assessed the quality of the diet for adults and older adults using four internationally accepted DQIs, namely the Healthy Diet Indicator (HDI), the Mediterranean Diet Score (MDS), the Mediterranean Diet Score-modified (MDS-mod), and the Mediterranean-Diet Quality Index (MED-DQI), as well as the ANIBES-DQI, stratified by education and income. The ANIBES-DQI was based on compliance with EFSA and Food and Agriculture Organization recommendations for a selected group of nutrients (i.e., total fat, saturated fatty acids (SFAs), simple sugars, fiber, calcium, vitamin C, and vitamin A), with a total range of 0-7. Misreporting was assessed according to the EFSA protocol, which allowed us to assess the DQIs for both the general population and plausible reporters. The majority of the Spanish population had high intakes of SFAs and sugars and low intakes of fiber, folate, and vitamins A and C. In addition, about half of the population had low DQI scores and exhibited low adherence to the Mediterranean diet pattern. Overall, older adults (>65-75 years) showed better DQIs than adults (18-64 years), without major differences between men and women. Moreover, primary education and low income were associated with low MDS and ANIBES-DQI scores. For the ANIBES-DQI, the percentage of the population with low scores was higher in the whole population (69.5%) compared with the plausible energy reporters (49.0%), whereas for medium and high scores the percentages were higher in plausible reporters (41.2% vs. 26.2% and 9.8% vs. 4.3%, respectively). In conclusion, the present study adds support to marked changes in the Mediterranean pattern in Spain, and low education and income levels seem to be associated with a low-quality diet. Additionally, the misreported evaluation in the ANIBES population suggests that this analysis should be routinely included in nutrition surveys to give more precise and accurate data related to nutrient intake and diet quality.
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Affiliation(s)
- Josune Olza
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Sciences, University of Granada, Campus de la Salud, Avda. del Conocimiento, Armilla, 18100 Granada, Spain.
- Instituto de Investigación Biosanitaria ibs.Granada, 18100 Granada, Spain.
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
| | - Emilio Martínez de Victoria
- Department of Physiology, School of Pharmacy Institute of Nutrition and Food Sciences, University of Granada, Campus de la Salud, Avda. del Conocimiento, Armilla, 18100 Granada, Spain.
| | - Javier Aranceta-Bartrina
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, c/Irunlarrea 1, 31008 Pamplona, Spain.
| | - Marcela González-Gross
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, c/Martín Fierro 7, 28040 Madrid, Spain.
| | - Rosa M Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Madrid Complutense University, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain.
| | - Lluis Serra-Majem
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria (IUBS), and Service of Preventive Medicine, Complejo Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain.
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain.
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, Crta. Boadilla Km 53, Boadilla del Monte, 28668 Madrid, Spain.
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Sciences, University of Granada, Campus de la Salud, Avda. del Conocimiento, Armilla, 18100 Granada, Spain.
- Instituto de Investigación Biosanitaria ibs.Granada, 18100 Granada, Spain.
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
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Bonaccio M, Gianfagna F, de Gaetano G, Iacoviello L. Too many individuals are unaware of their blood lipid levels, but might still get health benefit from the Mediterranean diet through lipid-independent mechanisms. Eur J Prev Cardiol 2019; 26:1953-1956. [PMID: 31403885 DOI: 10.1177/2047487319867782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Francesco Gianfagna
- Mediterranea Cardiocentro, Napoli, Italy.,Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy.,Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Shively CA, Appt SE, Vitolins MZ, Uberseder B, Michalson KT, Silverstein-Metzler MG, Register TC. Mediterranean versus Western Diet Effects on Caloric Intake, Obesity, Metabolism, and Hepatosteatosis in Nonhuman Primates. Obesity (Silver Spring) 2019; 27:777-784. [PMID: 31012294 PMCID: PMC7079682 DOI: 10.1002/oby.22436] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/15/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to determine the effects of humanlike Western and Mediterranean diets on caloric intake, obesity, metabolism, and hepatosteatosis in an established nonhuman primate model of obesity, cardiometabolic syndrome, type 2 diabetes, and atherosclerosis. METHODS A 38-month, randomized, preclinical, nonhuman primate primary prevention trial of 38 socially housed, middle-aged adult females was conducted. The monkeys were characterized during a 7-month baseline phase while consuming chow and then randomized to either Western or Mediterranean diets; the groups were balanced on baseline characteristics. Western and Mediterranean diets were formulated to closely reflect human diets, matched on macronutrient content, with protein and fat derived largely from animal sources in the Western diet and plant sources in the Mediterranean diet. Food consumption, activity levels, energy expenditure, body composition, carbohydrate metabolism, and hepatosteatosis were measured during baseline and treatment phases. RESULTS The Western diet increased caloric intake for the first 6 months and body fat, activity, energy expenditure, insulin resistance, and hepatosteatosis after 2.5 years, whereas the Mediterranean diet reduced triglyceride levels. CONCLUSIONS This is the first report of differential caloric intake and obesity with long-term consumption of a Western versus Mediterranean diet under controlled experimental conditions and the first experimental evidence that a Mediterranean diet protects against hepatosteatosis compared with a Western diet.
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Affiliation(s)
- Carol A. Shively
- Department of Pathology and Comparative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Susan E. Appt
- Department of Pathology and Comparative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Mara Z. Vitolins
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Beth Uberseder
- Department of Pathology and Comparative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Kristofer T. Michalson
- Department of Pathology and Comparative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Marnie G. Silverstein-Metzler
- Department of Pathology and Comparative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Thomas C. Register
- Department of Pathology and Comparative Medicine, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
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