Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms

Connecting volatile organic compounds exposure to osteoporosis risk via oxidative stress based on adverse outcome pathway methodology

Existing evidence has demonstrated the association between exposure to volatile organic compounds (VOCs) and osteoporosis (OP) risk, but the underlying mechanistic framework remains unclear. This study aimed to explore potential pathways using adverse outcome pathway (AOP) analysis, and evidence this association in middle-to-old-aged American adults using the updated National Health and Nutrition Examination Survey data. Multivariable-adjusted general linear and weighted quantile sum models were employed to analyze associations of VOC metabolites (VOCMs), representing internal VOCs exposure levels, with OP-related phenotypes. An AOP framework based on network analysis was developed by extracting target genes and phenotypes. Among 3555 American adults aged ≥ 40 years (539 OP participants), we found that increasing urinary 3- and 4-methylhippuric acid, N-acetyl-S-(n-propyl)-l-cysteine (BPMA), and N-acetyl-S-(3-hydroxypropyl)-l-cysteine were associated with elevated OP odds with odds ratios (ORs) (95 % confidence intervals, 95 % CIs) being 1.254 (1.016 to 1.548), 1.182 (1.014 to 1.377), and 1.244 (1.029 to 1.505), respectively, per standard deviation. Urinary BPMA and N-acetyl-S-(2-cyanoethyl)-l-cysteine were inversely associated with lumbar spine bone mineral density (BMD), while urinary N-acetyl-S-(2-hydroxypropyl)-l-cysteine was positively associated with hip BMD. Additionally, OP odds increased by 46.0 % (95 % CI: 3.9 % to 105.1 %) per quartile increment in the VOC mixture. AOP analysis identified 53 target genes and 9 target phenotypes, and 5 of 9 target phenotypes were oxidative stress (OS)-related. Literature and the "AOP 482″ framework implied the core role of OS in the VOC exposure and prevalent OP association, with the interleukin-6 as the molecular initiating event. Our findings provided a theoretical basis for further investigation.

The impact of lifestyle factors across the life course on sarcopenia and physical frailty

PURPOSE OF REVIEW

Muscle health helps maintain locomotor capacity, a key component of intrinsic capacity, which is required for healthy ageing. Sarcopenia is characterized by the age-related decline in muscle mass and strength leading to impaired physical performance, and has been described as a biological substrate of physical frailty. Both sarcopenia and physical frailty share phenotypic features of weakness and slowness, lead to common adverse outcomes, and have potential for reversal through early identification and intervention. The purpose of this review is to present recent evidence for the impact of lifestyle interventions across the life course on sarcopenia and physical frailty.

RECENT FINDINGS

Resistance exercise alone or combined with balance and aerobic training as part of a multicomponent exercise program and high-quality diets incorporating adequate protein remain the mainstay of treatment for sarcopenia and physical frailty. Reducing sedentary time and increasing physical activity, adherence to Mediterranean diet, increasing vegetable and caffeinated beverage intake, cardiovascular risk factor modification, improving sleep hygiene and depressive symptoms may also contribute to slowing down age-related decline in muscle health.

SUMMARY

Lifestyle interventions such as physical activity, diet, sleep and mental health are effective against sarcopenia and physical frailty. Targeting lifestyle modifications in early to midlife may retard further decline in locomotor capacity and optimize intrinsic capacity of older persons, reducing the risk of sarcopenia, physical frailty and their attendant negative health outcomes.

Impact of Mediterranean diet on mortality in vertebral compression fracture patients

BACKGROUND

Vertebral compression fractures (VCF) is a common fragility fracture with high mortality worldwide. The management and prevention of VCF start with a proper nutrition. The Mediterranean diet (MD) is rich in balanced nutrients and has been shown to be beneficial for several chronic diseases. However, the association of adherence to Mediterranean diet (aMED) and prognosis of VCF patients remains unclear.

PURPOSES

To explore the association between aMED and all-cause and cardiovascular disease (CVD)-cause morality in VCF patients.

METHODS

In present study, patients aged ≥ 40 years old and with the VCF patients measurement were extracted from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. The bone mineral density (BMD) dual-energy X-ray absorptiometry (DXA) was used to diagnose VCF. We used the weighted univariable Cox proportional hazards model to screen the covariates related to the prognosis of VCF patients. We utilized the weighted multivariable Cox proportional hazards models to explore the association between aMED and the risk of mortality in VCF patients, and were described as hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses based on different complications were further assessed the association.

RESULTS

A total of 2,730 eligible VCF patients were included. Until 12 December 2019, 218 (7.99%) deaths were documented. After adjusting for all VCFs, we found a high risk of all-cause mortality (HR = 1.75, 95%CI: 1.13-2.73, P = 0.041) and CVD-cause mortality (HR = 2.35, 95%CI: 1.12-4.91, P = 0.038); however, we found no significant association between aMED and all-cause mortality or CVD-cause mortality (all P > 0.05). Compared to patients without VCF and with aMED score ≥ 6, patients with VCF and aMED score < 6 has a higher risk of all-cause (HR = 2.27, 95%CI: 1.25-4.13, P = 0.025) and CVD-cause mortality (HR = 4.25, 95%CI: 1.64-11.06, P = 0.013). Our study also suggested that compared to patients with aMED ≥ 6, those patients with aMED < 6 has high all-cause (HR = 2.26, 95%CI: 1.22-4.17, P = 0.002) and CVD-cause mortality (HR = 3.31, 95%CI: 1.28-8.57, P = 0.018), this results suggested that aMED may have a moderating effect on the association of VCF and mortality. Subgroups analysis shown this moderating effect remain robust, especially in patients with dyslipidemia (HR: 2.49, 95%CI: 1.29-4.80, P = 0.009), CVD (HR: 3.48, 95%CI: 1.56-7.74, P < 0.001) and CKD (HR: 3.64, 95%CI: 1.50-8.78, P < 0.001).

CONCLUSION

We found aMED have a moderating effect on the association between VCF patients and mortality. Our research further supports the importance of the MD as a potentially healthy eating pattern.

Correlation of cognitive impairment with Mediterranean diet and mortality: a prospective cohort study

Background and aim

Long-term adherence to the Mediterranean Diet has been shown to improve cognitive function in patients. However, there is a lack of evidence regarding the impact of the Mediterranean diet and cognitive impairment on long-term mortality outcomes. This study aims to explore whether there is an interaction between the degree of adherence to the Mediterranean diet and cognitive impairment on long-term mortality outcomes.

Methods

The study included 2,520 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. The adherence to the Mediterranean diet was assessed using the 9-point alternative Mediterranean diet index (aMED index). Cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's disease (CERAD), the Animal Fluency Test (AFT), and the Digital Symbol Substitution Test (DSST). By accessing public records from the National Death Index (NDI), NHANES participants' information was linked to death certificate records to determine mortality and causes of death during the follow-up period, up to December 31, 2019, with causes specified according to ICD-10. Participants were categorized based on the median aMED score into low adherence (scores 0-3), moderate adherence (score 4), and high adherence (scores 5-9) groups. Cognitive impairment was assessed by calculating the arithmetic mean of standardized scores (Z-scores) for each cognitive test. Participants with scores below the first quartile of the arithmetic mean were considered to have cognitive impairment. Cox proportional hazards regression models were used to assess the relationship between cognitive impairment, aMED, and all-cause and cardiovascular mortality outcomes. Additionally, the interaction between cognitive impairment and aMED on these outcomes was evaluated.

Results

The study included 2,520 participants, with 481 deaths during the follow-up period, of which 129 (26.8%) were cardiovascular-related. The median aMED score in the population was 4, and 632 individuals (25.1%) were considered to have cognitive impairment. A higher aMED score was associated with a reduced risk of long-term all-cause mortality and cardiovascular-related mortality (HR, 0.65; 95% CI, 0.52-0.81, p < 0.001; HR, 0.73; 95% CI, 0.47-0.91, p = 0.039). Cognitive impairment was associated with an increased risk of long-term all-cause mortality and cardiovascular mortality (HR, 1.78; 95% CI, 1.46-2.18, p < 0.001; HR, 1.80; 95% CI, 1.22-2.64, p = 0.003). Individuals with both lower aMED scores and cognitive impairment had higher risks of all-cause and cardiovascular mortality. Subgroup analysis indicates that only in the cognitive impairment subgroup is a higher Mediterranean diet score associated with a reduced risk of cardiovascular mortality. There is an interaction between lower aMED scores and cognitive impairment in increasing cardiovascular-related mortality (p for interaction = 0.028).

Conclusion

There is an interaction between adherence to the Mediterranean diet and cognitive impairment concerning cardiovascular-related mortality, but not all-cause mortality. Among individuals with cognitive impairment, adherence to the Mediterranean diet has a more significant impact on cardiovascular-related mortality.

Mediterranean Diet and Change in Physical Function Over Time In Older Women

The Mediterranean diet has been linked to preserving physical function, but studies on its impact on physical function decline in older adults have shown mixed results. This longitudinal study used a large sample of community-dwelling older women from the Women's Health Initiative Long Life Study to examine this relationship. We assessed 4516 older women (mean age at baseline = 78.97), including a subsample of 849 women who reported currently having diabetes. Data on physical function, measured by the SF-36 Physical Function subscale, were collected annually from 2012-2019. Adherence to the Mediterranean diet was measured using alternative Mediterranean diet (aMED) scores between 2012 and 2013. Results indicated that higher aMED scores were associated with better physical function at baseline in the general sample (4.89 to 8.23 points) and in the diabetes subsample (5.37 to 8.97 points) over eight years. However, adherence to the Mediterranean diet did not affect the rate of physical function decline. Future research should include longitudinal dietary assessments, a broader age range, and detailed information on diabetes duration.

Dietary therapy to halt the progression of diabetes to diabetic kidney disease

Diabetic Kidney Disease (DKD) is a common and serious complication of diabetes, particularly Type 2 Diabetes Mellitus (T2DM), which significantly contributes to patient morbidity and mortality. The limitations of traditional treatments like ACE inhibitors and ARBs in managing DKD progression highlight the need for innovative therapeutic strategies. This review examines the impact of various dietary patterns, such as the Mediterranean diet, ketogenic diet, intermittent fasting, DASH diet, and vegetarian diet, on the management of DKD. Evidence suggests these diets can halt the progression of DKD, although further research is needed to confirm their long-term effectiveness and safety. Personalized dietary approaches tailored to individual needs may enhance outcomes for DKD patients.

Recent Advances in Aging and Immunosenescence: Mechanisms and Therapeutic Strategies

Cellular senescence is an irreversible state of cell cycle arrest. Senescent cells (SCs) accumulate in the body with age and secrete harmful substances known as the senescence-associated secretory phenotype (SASP), causing chronic inflammation; at the same time, chronic inflammation leads to a decrease in immune system function, known as immunosenescence, which further accelerates the aging process. Cellular senescence and immunosenescence are closely related to a variety of chronic diseases, including cardiovascular diseases, metabolic disorders, autoimmune diseases, and neurodegenerative diseases. Studying the mechanisms of cellular senescence and immunosenescence and developing targeted interventions are crucial for improving the immune function and quality of life of elderly people. Here, we review a series of recent studies focusing on the molecular mechanisms of cellular senescence and immunosenescence, the regulation of aging by the immune system, and the latest advances in basic and clinical research on senolytics. We summarize the cellular and animal models related to aging research, as well as the mechanisms, strategies, and future directions of aging interventions from an immunological perspective, with the hope of laying the foundation for developing novel and practical anti-aging therapies.

Rural Health: Low Obesity Rates Among Students in Portugal's Countryside

Dietary habits significantly influence students' health status, with overweight and obesity posing serious global challenges linked to chronic diseases like type 2 diabetes and cardiovascular conditions. Our cross-sectional study assessed overweight and obesity prevalence among students in Guarda, Portugal, analyzing the nutritional and lifestyle habits of 2083 students aged 6 to 58 years. The sample included 1762 school children and 321 higher education adults, grouped into age intervals: 5-12, 13-19, 20-39, and 40-59 years. BMI analysis revealed obesity rates of 9.1% in children and 9.7% in adults, with younger children, particularly males, showing higher rates compared to older children. Increased physical activity and reduced sedentary time were correlated with a lower BMI. The observed obesity rates suggest that factors such as physical activity levels, traditional dietary patterns, and access to fresh foods in this region of Portugal may contribute to better health outcomes among students.

Targeting Cytokine Dysregulation in Psoriasis: The Role of Dietary Interventions in Modulating the Immune Response

Psoriasis is a chronic immune-mediated skin disease characterized by cytokine dysregulation. Pro-inflammatory mediators, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17, and IL-23, play pivotal roles in the pathogenesis of psoriasis. Emerging evidence suggests that dietary interventions can modulate cytokine activity, providing a complementary approach to standard therapies. This narrative review examines the impact of various dietary strategies, including a Mediterranean diet, ketogenic diet, gluten-free diet, and fasting-mimicking diet, on cytokine profiles and clinical outcomes in psoriasis. Research insights reveal that dietary components such as omega-3 fatty acids, polyphenols, and short-chain fatty acids influence immune signaling pathways. These pathways include nuclear factor-kappa B (NF-κB) and Signal Transducer and Activator of Transcription 3 (STAT3). Additionally, these dietary components promote anti-inflammatory effects mediated by gut microbiota. Clinical studies demonstrate significant reductions in psoriasis severity, improved quality of life, and modulation of key cytokines associated with disease activity. Despite these advancements, significant challenges persist in effectively integrating these findings into clinical practice. These challenges include variability in patient responses, adherence issues, and the need for robust biomarkers to monitor efficacy. Future directions emphasize the potential of personalized nutrition and precision medicine approaches to optimize dietary interventions tailored to individual cytokine profiles and genetic predispositions. Integrating these strategies into psoriasis care could transform treatment paradigms by simultaneously addressing both systemic inflammation and comorbid conditions.

Contributions of Dietary Patterns and Factors to Regulation of Rheumatoid Disease

Rheumatoid arthritis (RA) is a systemic autoimmune disease that commonly causes pain in joints and the progressive destruction of cartilage and bone, which significantly reduces the quality of life and increases the social burden. However, there is still no cure for RA, so it is highly important to explore additional adjuvant treatment methods. Studies have indicated that malnutrition, changes in intestinal microbiota, and changes in immune status caused by dietary imbalance are directly related to the onset of RA, indicating that dietary intervention may offer a simple, economical, and practical avenue to relieve RA. Therefore, in this review, we discuss the pathogenesis of RA and summarize the influence of different dietary patterns on RA. In particular, we pointed out that high-fat, high-sugar, and high-salt diets contribute to RA progression, whereas the Mediterranean diet (MD) is beneficial for preventing RA. Furthermore, the ingredients of food, such as dietary fiber, probiotics, and vitamins, help reduce the level of inflammation and relieve joint pain, which may play critical roles in the treatment of RA. Therefore, dietary intervention provides a potential effective approach for adjuvant therapy of RA.

Inverse associations of the lifestyle critical 9 with cardiorenal syndrome: the mediating role of the dietary inflammatory index

Background

Cardiorenal syndrome (CRS) represents a burgeoning global health concern characterized by its increasing prevalence. Life's Crucial 9 (LC9), an innovative tool for cardiovascular health assessment, and the Dietary Inflammatory Index (DII), which quantifies diet's impact on body inflammation, have not been previously studied in conjunction regarding their association with CRS.

Objective

This study aims to explore the relationship between LC9 and CRS, using data from the National Health and Nutrition Examination Survey (NHANES), and to examine whether DII serves as a mediator in this association.

Methods

This research included data from 25,792 NHANES participants spanning from 2005 to 2018. The study leverages the dataset's comprehensive representativeness and robust statistical power to ensure generalizable and reliable findings. We employed weighted logistic regression to evaluate the association between LC9 scores and CRS presence, conducted subgroup analyses, and performed mediation analysis to investigate the role of DII.

Results

Our analysis demonstrated a significant inverse relationship between LC9 and CRS. Upon controlling for confounders, each 10-point rise in LC9 correlates with a 26% reduction in CRS prevalence (p < 0.001). Additionally, stratifying LC9 into tertiles with T1 as the reference group revealed that T2 (OR = 0.59, 95% CI = 0.48-0.72, p < 0.001) and T3 (OR = 0.57, 95% CI = 0.38-0.88, p < 0.001) exhibited a strong negative correlation trend. The dose-response curve illustrates a linear relationship between LC9 and CRS; as LC9 increases, the occurrence of CRS decreases. DII shows a significant positive connection with CRS (p < 0.001), but DII indicates a decreasing trend when LC9 rises (β = -0.65, p < 0.001). Mediation analysis reveals that DII mediates the association between LC9 and CRS, with a mediation proportion of 12.5% (p < 0.001).

Conclusion

The findings indicate a robust inverse correlation between LC9 scores and CRS incidence, with DII is associated with this relationship. This suggests potential preventive strategies against CRS through lifestyle modifications guided by LC9.

Effect of dietary patterns and nutritional supplementation in the management of endometriosis: a review

Endometriosis is an estrogen-dependent chronic inflammatory disease which causes dysmenorrhea, chronic pelvic pain, and infertility in women of childbearing age, significantly impacting their quality of life and physical and mental health. The etiology of endometriosis remains unclear, with oxidative stress and inflammation currently thought to play pivotal roles in its pathophysiology. Epidemiological studies and clinical trials indicate that varying dietary patterns and specific nutrient supplementation can influence oxidative stress markers and levels of inflammatory factors and related pathways, potentially impacting the progression of endometriosis. In this review, we summarize the roles of oxidative stress and inflammation in endometriosis and thoroughly examine the current understanding of the effect of dietary patterns and nutrient supplementation in treating endometriosis. This study suggests that nutrients may prevent the occurrence of endometriosis by modulating levels of inflammatory factors, regulating angiogenesis, and influencing the metabolism of estrogen pathways. The findings might provide new insights into the treatment of endometriosis patients and the potential benefits of dietary patterns and nutrient supplementation in patients with endometriosis.

Gut microbiota and breast cancer: systematic review and meta-analysis

BACKGROUND

The gastrointestinal microbiota can modulate systemic estrogens, potentially influencing estrogen-induced breast neoplasia development. This study aimed to assess alterations in the gut microbiota in breast cancer patients.

METHODS

A search strategy was developed using the terms: "Microbiota," "Gastrointestinal Microbiome," "Breast Cancer," and synonyms. Ten observational studies were included.

RESULTS

The total sample was 1730 women (929 cases and 801 controls). The meta-analysis of alpha diversity, assessed by the Shannon index, displayed that in the breast cancer group, the diversity of the gut microbiota was reduced compared to controls, with a standardized mean difference (SMD) of - 0.34 (95% CI - 0.59, - 0.10, I2 = 68%, p = 0.007). Regarding the premenopausal population, there was a significant reduction in the breast cancer group (SMD - 0.67, 95% CI - 1.06, - 0.28, I2 = 77%, p = 0.0009). In women with a body mass index (BMI) between overweight or obesity, no statistically significant difference was observed (SMD - 0.20; 95% CI - 0.51, 0.11; I2 52%, p = 0.20). However, in women with a BMI greater than or equal to 18.5 and less than 25.0, there was lower diversity in women with breast cancer compared to controls (SMD - 0.49, 95% CI - 0.94, - 0.04; I2 78%, p = 0.03).

CONCLUSIONS

The study found a significant difference in gut microbiota diversity between women with breast cancer and controls, supporting the growing evidence that the gut microbiota may play a role in mammary carcinogenesis.

Effect of the Mediterranean diet on incidence of heart failure in European countries: a systematic review and meta-analysis of cohort studies

INTRODUCTION

Heart failure (HF) is one of the most common cardiovascular disorders, and its prevalence is increased due to age, genetics, and lifestyle factors. Emerging evidence suggests that the Mediterranean Diet (Med Diet) is linked to lower all-cause mortality in patients with increased cardiovascular disease risk, such as those with HF.

OBJECTIVE

To conduct a systematic review and meta-analysis of observational studies into the relationship between the Med Diet on HF risk.

DESIGN

Several databases (PubMed, Scopus, Web of Science and Cochrane Library) until the 01st of May 2023 were searched. Our research was conducted based on the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were reported as risk ratios (RRs) with their 95% confidence intervals (CIs) as results of multivariate or univariate analyses.

RESULTS

From the original 1206 studies collected, six observational prospective studies were included, with a total of 216,385 European participants without evidence of HF at baseline. Over a mean period of 11 years of follow-up, a 1-point increase in the Med Diet score was associated with a significantly lower risk of HF (RR = 0.940; 95% CI: 0.912-0.969, p < 0.0001; I2 = 42.9%). Categorised by sex, a higher adherence to Med Diet was associated with a significantly lower incidence of HF in women (RR = 0.942; 95% CI: 0.912-0.973, p = 0.001; I2 = 41.8%), but not in men. The overall quality of included studies was good.

CONCLUSIONS

Higher adherence to Med Diet across European countries is associated with lower risk of HF, particularly in women.

Impact of Vegan and Vegetarian Diets on Neurological Health: A Critical Review

BACKGROUND/OBJECTIVES

The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), suggesting a potential protective effect against systemic inflammation and oxidative stress. However, despite these benefits, concerns remain regarding their impact on neurological health due to the possible deficiencies of critical nutrients such as vitamin B12, DHA, EPA, and iron. This review critically evaluates the influence of these dietary patterns on neurological outcomes, emphasizing their nutritional composition, potential deficiencies, and their interplay with inflammation and oxidative stress.

METHODS

A systematic review of the literature published between 2010 and 2023 was conducted, focusing on studies that explore the relationship between vegan and vegetarian diets and neurological health. Key nutrients such as vitamin B12, omega-3 fatty acids, iron, and zinc were analyzed alongside antinutritional factors and their effects on the nervous system.

RESULTS

Evidence suggests that vegan and vegetarian diets, when well planned, can be rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings indicate a potential role in reducing systemic inflammation and oxidative stress, both of which are linked to neurodegenerative diseases. However, deficiencies in critical nutrients such as vitamin B12, DHA, EPA, and iron have been consistently associated with an increased risk of cognitive decline, mood disturbances, and neurodegenerative disorders. Additionally, the presence of antinutritional factors like phytates and oxalates may further impair nutrient absorption, necessitating careful dietary planning and supplementation.

CONCLUSIONS

While plant-based diets provide anti-inflammatory and antioxidant benefits, their neurological implications depend on nutrient adequacy. Proper planning, supplementation, and food preparation techniques are essential to mitigate risks and enhance cognitive health. Further research is needed to explore long-term neurological outcomes and optimize dietary strategies.

The Power of Environment: A Comprehensive Review of the Exposome's Role in Healthy Aging, Longevity, and Preventive Medicine-Lessons from Blue Zones and Cilento

Aging and longevity are shaped by the exposome, a dynamic network of environmental, social, and biological factors. Understanding how these exposures interact with biological mechanisms can inform strategies for healthier aging. Background/Objectives: This review explores the exposome as a dynamic system encompassing both protective and risk factors, with a specific focus on how beneficial environmental exposures, microbiome diversity, lifestyle behaviors, and resilience mechanisms contribute to successful aging. By analyzing high-longevity populations, such as the Blue Zones and Cilento, it aims to identify common determinants of successful aging. Methods: A mixed-method study was conducted, combining a systematic review of the English literature (2003-2024) with a comparative analysis of longevity regions. A structured search was performed in PubMed, Scopus, and Google Scholar using keywords such as "longevity", "Blue Zones", "Cilento", "microbiome", "environmental factors", and related terms. Additionally, qualitative and quantitative analysis were applied to assess key protective factors across different aging models. Results: This study identified key factors contributing to successful aging in longevity hotspots, including sustained exposure to biodiverse natural environments, adherence to Mediterranean or plant-based diet rich in polyphenols and probiotics, regular physical activity, strong social networks, and psychological resilience. A novel aspect of this review is the role of the gut microbiome as a mediator between environmental exposures and immune-metabolic health, influencing inflammation modulation and cellular aging. Despite geographic and cultural differences, case studies reveal a shared pattern of protective factors that collectively enhance lifespan and healthspan. Conclusions: The exposome is a critical determinant of aging trajectories, acting through complex interactions between environmental and biological mechanisms. By integrating insights from high-longevity populations, this mixed-method study proposes a comprehensive framework for optimizing microbiome health, enhancing resilience, and promoting protective environmental exposures. These findings provide a translational perspective to guide future interventions in aging research and global health initiatives.

What Factors Influence Obesity in Spain? A Multivariate Analysis of Sociodemographic, Nutritional, and Lifestyle Factors Affecting Body Mass Index in the Spanish Population

AIM

This cross-sectional study examines sociodemographic, nutritional, and lifestyle factors affecting Body Mass Index (BMI) in the Spanish population, with a particular emphasis on obesity.

METHODS

A sample of 22,181 Spanish residents aged 18 years and older was recruited through digital and physical channels from August 2020 to November 2021. Data were collected using the validated NutSo-HH questionnaire, which includes sections on sociodemographic information, health perceptions, eating habits, and lifestyle factors.

RESULTS

Among respondents, 661 (3%) were underweight (BMI < 18.5 kg/m2), 14,562 (65.7%) were normal weight (18.5 kg/m2 ≤ BMI ≤ 25 kg/m2), 4825 respondents (21.8%) were overweight (25 kg/m2 < BMI ≤ 30 kg/m2), and 2133 (9.6%) were obese (BMI > 30 kg/m2), with significant differences across these groups in relation to diet and lifestyle behaviors. Principal Component Analysis (PCA) was employed to identify the primary variables influencing obesity, revealing that poor dietary habits (frequent consumption of fast food, fried foods, and ultra-processed items) were negatively correlated with healthy behaviors such as regular fish consumption and physical activity. The PCA plot indicated notable distinctions based on educational attainment and age, with individuals with lower educational levels displaying poorer nutritional patterns and younger participants exhibiting higher fast food consumption and poorer sleep quality. Statistical analyses confirmed that sociodemographic factors, including age, education, and income level, significantly influenced BMI. Some differences were also found according to the place of residence.

CONCLUSIONS

These findings underscore the need for targeted interventions that address both sociodemographic and lifestyle factors to mitigate obesity risk in Spain.

Changes in Sexual Functioning in Women with Severe Obesity After Bariatric Surgery: Impact of Postoperative Adherence to Mediterranean Diet

BACKGROUND

This study analyzes the effects of bariatric surgery on female sexual function, assessed using the Female Sexual Function Index (FSFI), and explores the impact of adherence to the Mediterranean diet during the postoperative period.

PATIENTS AND METHODS

A retrospective observational study was conducted using a prospectively collected database, including heterosexual women with morbid obesity undergoing bariatric procedures. The FSFI questionnaire was applied before the intervention and 24 months after surgery. Adherence to the Mediterranean diet was evaluated using the PREDIMED questionnaire.

RESULTS

Among the 240 participants, 70.8% presented preoperative sexual dysfunction, which decreased to 20.5% two years post-surgery. Significant improvements were observed in all FSFI domains except for pain. Good adherence to the Mediterranean diet was associated with higher scores in the lubrication, orgasm, and satisfaction domains.

CONCLUSIONS

Bariatric surgery significantly improves female sexual function, with the Mediterranean diet enhancing these benefits during the postoperative period. Future studies must investigate additional variables such as psychological factors, physical activity, and other lifestyle changes that may also influence sexual function.

Mediterranean Diet and Quality of Life in Adults: A Systematic Review

BACKGROUND/OBJECTIVES

With the increasing life expectancy and, as a result, the aging of the global population, there has been a rise in the prevalence of chronic conditions, which can significantly impact individuals' health-related quality of life, a multidimensional concept that comprises an individual's physical, mental, and social wellbeing. While a balanced, nutrient-dense diet, such as Mediterranean diet, is widely recognized for its role in chronic disease prevention, particularly in reducing the risk of cardiovascular diseases and certain cancers, its potential benefits extend beyond these well-known effects, showing promise in improving physical and mental wellbeing, and promoting health-related quality of life.

METHODS

A systematic search of the scientific literature in electronic databases (Pubmed/Medline) was performed to identify potentially eligible studies reporting on the relation between adherence to the Mediterranean diet and health-related quality of life, published up to December 2024.

RESULTS

A total of 28 studies were included in this systematic review, comprising 13 studies conducted among the general population and 15 studies involving various types of patients. Overall, most studies showed a significant association between adherence to the Mediterranean diet and HRQoL, with the most significant results retrieved for physical domains of quality of life, suggesting that diet seems to play a relevant role in both the general population and people affected by chronic conditions with an inflammatory basis.

CONCLUSIONS

Adherence to the Mediterranean diet provides significant benefits in preventing and managing various chronic diseases commonly associated with aging populations. Furthermore, it enhances the overall health and quality of life of aging individuals, ultimately supporting more effective and less invasive treatment approaches for chronic diseases.

Determinants of adherence to the Mediterranean diet among individuals with type 2 diabetes mellitus living in Mediterranean countries: a systematic review

Background

Patients with type 2 diabetes mellitus (T2DM) are often encouraged to adopt a healthy diet, such as the Mediterranean Diet (MD) yet limited evidence exists about adherence. An increased shift toward a "Western" dietary pattern was observed.

Objective

This systematic review aims to gain insight into the various factors that may enhance or reduce adherence to the MD in patients with T2DM residing in Mediterranean countries.

Method

We retrieved published studies from 2000 to 2023 from PubMed, Cochrane, Embase, CINAHL, Web of Science, Medline, and PsycINFO databases. The criteria for inclusion included individuals residing in Mediterranean countries aged 18+ with T2DM who underwent assessment using a validated MD scoring tool. We included 17 studies, with participant numbers ranging from 106 to 7,447.

Results

Compliance with the MD was moderate, with the most significant determinants of adherence being age, physical activity, body mass index (BMI), marital status, and educational level. However, limited information is available on psychological and economic determinants.

Conclusion

Various factors, especially sociodemographic ones, influence adherence to the MD among patients with T2DM. Future research should explore economic and psychological factors that may significantly impact adherence.

Systematic review register

Prospero: CRD42023396094.

Effects of the Mediterranean Diet on the Components of Metabolic Syndrome Concerning the Cardiometabolic Risk

Metabolic syndrome is a cluster of risk factors, including abdominal obesity, insulin resistance, hypertension, dyslipidemia (intended as an increase in triglyceride levels and a reduction in HDL cholesterol levels), and elevated fasting glucose, that increase the risk of cardiovascular disease and type 2 diabetes. With the rising prevalence of metabolic syndrome, effective dietary interventions are essential in reducing these health risks. The Mediterranean diet, rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil and moderate in fish and poultry, has shown promise in addressing metabolic syndrome and its associated components. This diet's anti-inflammatory and antioxidant properties, primarily due to its unsaturated fats, polyphenols, and fiber, have improved blood pressure, lipid levels, and insulin sensitivity. Adherence to the Mediterranean diet has been linked to reductions in central obesity and insulin resistance, both key elements in managing metabolic syndrome. Regarding lipid management, the Mediterranean diet lowers triglyceride levels and low-density lipoprotein (LDL) cholesterol while raising high-density lipoprotein (HDL) cholesterol, enhancing lipid profiles. It also helps regulate blood glucose levels, reducing the likelihood of developing type 2 diabetes. Additionally, the diet promotes weight loss and improves body composition, particularly by decreasing visceral fat, a primary driver of metabolic syndrome according to IDF classification. The Mediterranean diet offers a holistic approach to managing metabolic syndrome and reducing the risk of related chronic diseases. Its positive impact on metabolic health, combined with lifestyle changes like increased physical activity, provides a sustainable method for addressing the global burden of this syndrome. This review aimed to summarize the positive effects of the Mediterranean diet on the component of the metabolic syndrome with subsequent positive effects on cardiometabolic risk profile.

Adherence to the Mediterranean Diet and the Risk of Head and Neck Cancer: A Systematic Review and Meta-Analysis of Case-Control Studies

BACKGROUND/OBJECTIVES

Head and neck cancer (HNC) is the seventh most common cancer worldwide, with rising incidence rates and significant mortality. While tobacco use, alcohol consumption, and viral infections are established risk factors, the role of dietary patterns, particularly adherence to the Mediterranean diet (MD), in HNC prevention has gained increasing attention. The aim of the current systematic review and meta-analysis is to investigate the association between adherence to the MD and the risk of HNC.

METHODS

A comprehensive search was conducted, following PRISMA guidelines, to identify relevant studies published up to January 2024 that assessed the association between MD adherence and HNC risk in adults. Pooled odds ratios (OR) for a three-unit increase in MD adherence scores and corresponding 95% confidence intervals (CI) were calculated using a random-effects model. Study quality was assessed using the Newcastle-Ottawa Scale (NOS).

RESULTS

Eleven case-control studies comprising 6106 HNC cases and 9166 controls met the inclusion criteria for the systematic review. High adherence to the MD was significantly associated with a reduced risk of HNC (pooled OR = 0.561, 95% CI: 0.368-0.856, p = 0.007, I2 = 92%). Individual component analyses from three studies revealed that higher fruit and vegetable consumption significantly decreased HNC risk, whereas legumes, fish, and low meat intake showed no statistically significant associations.

CONCLUSIONS

Adherence to the Mediterranean diet is associated with a significantly reduced risk of head and neck cancer. These findings support the role of the MD in cancer prevention and highlight the potential benefits of MD adherence in reducing HNC risk. Further prospective studies and randomized controlled trials are needed to confirm these findings and explore the underlying mechanisms.

The Effect of Prebiotics, Alone or as Part of Synbiotics, on Cardiometabolic Parameters in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background/Objectives: This systematic review and meta-analysis aimed to investigate the effect of prebiotics, alone or as part of synbiotics, on cardiometabolic parameters in polycystic ovary syndrome (PCOS) women. Methods: Databases, including PubMed, Scopus, ISI Web of Science, Embase, and the Cochrane Central Register of Controlled Trials, were searched for relevant randomized-controlled trials (RCTs) until 12 December 2024. Changes in mean ± standard deviations were extracted and combined using a random-effects model. Bias was assessed using Cochrane risk of bias and evidence quality with GRADE. Results: Twenty RCTs with 1271 participants were included. Results showed high-quality evidence supporting prebiotics' effects, alone or as part of synbiotics, in reducing body-mass index [n = 853; weighted-mean difference (WMD): -0.510, 95%CI: -0.669, -0.351 kg/m2] and diastolic blood pressure (WMD: -2.218, 95%CI: -4.425, -0.010 mmHg), moderate-quality evidence for weight, waist-to-hip ratio, and triglycerides improvements, and low or very-low-quality evidence for waist circumference (WC), fat mass, fasting plasma glucose, fasting insulin, low-density lipoprotein (LDL), total cholesterol (TC), high sensitive-C reactive protein, total testosterone, follicle-stimulating hormone and free androgen index improvements. Subgroup analyses revealed possible reduction in LDL with prebiotics, as well as possible decreases in WC, TC, and total testosterone with synbiotics. Dietary approaches to stop hypertension diet improved insulin sensitivity. Conclusions: This study suggests that prebiotics may beneficially affect several cardiometabolic parameters in PCOS women. Approximately one-third of the results were based on moderate-to-high-quality evidence. This study highlights the need for future well-designed, larger RCTs with longer treatment duration to strengthen the evidence base and guide clinical decision-making.

The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer's disease: a meta-analysis

Age-related cognitive impairment and dementia pose a significant global health, social, and economic challenge. While Alzheimer's disease (AD) has historically been viewed as the leading cause of dementia, recent evidence reveals the considerable impact of vascular cognitive impairment and dementia (VCID), which now accounts for nearly half of all dementia cases. The Mediterranean diet-characterized by high consumption of fruits, vegetables, whole grains, fish, and olive oil-has been widely recognized for its cardiovascular benefits and may also reduce the risk of cognitive decline and dementia. To investigate the protective effects of the Mediterranean diet on cognitive health, we conducted a systematic literature review using PubMed, Web of Science, and Google Scholar, focusing on studies published between 2000 and 2024. The studies included in the meta-nalysis examined the adherence to the Mediterranean diet and the incidence of dementia and AD. We applied a random-effects model to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs) and assessed heterogeneity through I-square statistics. Forest plots, funnel plots, and Z-score plots were used to visualize study outcomes. Of the 324 full-text records reviewed, 23 studies met the inclusion criteria. The combined HR for cognitive impairment among those adhering to the Mediterranean diet was 0.82 (95% CI 0.75-0.89); for dementia, the HR was 0.89 (95% CI 0.83-0.95); and for AD, the HR was 0.70 (95% CI 0.60-0.82), indicating substantial protective effects. Significant heterogeneity was observed across studies, though Z-score plots suggested sufficient sample sizes to support reliable conclusions for each condition. In conclusion, this meta-analysis confirms that adherence to the Mediterranean diet is associated with an 11-30% reduction in the risk of age-related cognitive disorders, including cognitive impairment, dementia, and AD. These findings underscore the Mediterranean diet's potential as a central element in neuroprotective public health strategies to mitigate the global impact of cognitive decline and dementia and to promote healthier cognitive aging.

The moderating effect of alternate Mediterranean diet on the association between sedentary behavior and insomnia in postmenopausal women

Aim

The study aimed to explore the moderating role of the alternate Mediterranean diet (aMED) adherence on the association between sedentary behavior and insomnia symptoms in postmenopausal women.

Methods

Data regarding postmenopausal women were obtained for this cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2005-2008. Sedentary behavior and insomnia symptoms were assessed using the questionnaire. aMED adherence was evaluated according to 24-h dietary recalls. Weighted univariate logistic regression models were utilized to screen potential covariates. The relationship between sedentary behavior, aMED adherence, and insomnia symptoms was explored using weighted univariate and multivariate logistic regression models. All results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs).

Results

A total of 1,793 postmenopausal women were included in the final analysis. Of them, 643 (37.56%) reported experiencing insomnia symptoms. Among the postmenopausal women, sedentary time of >8 h was associated with insomnia symptoms (OR = 1.41, 95% CI = 1.01-1.96), prolonged nocturnal awakening (OR = 1.38, 95% CI = 1.06-1.79), and undesired early morning awakening (OR = 1.59, 95% CI = 1.09-2.30). No association was observed between adherence to the aMED and insomnia symptoms (OR = 1.05, 95% CI: 0.77-1.44). Among the postmenopausal women with lower adherence to the aMED, the odds of insomnia symptoms were higher in those with sedentary time ≥8 h (OR = 1.63, 95% CI: 1.02-2.62). Similarly, in the participants with low aMED adherence, sedentary time ≥8 h was also associated with prolonged nocturnal awakening (OR = 1.90, 95% CI = 1.27-2.83) and undesired early morning awakening (OR = 1.85, 95% CI = 1.09-3.16).

Conclusion

Adherence to the aMED modulates the association between sedentary behavior and insomnia symptoms in postmenopausal women. Interventions targeting sedentary behavior and dietary patterns may improve sleep quality and overall health in postmenopausal women.

Obesity, dietary interventions and microbiome alterations in the development and progression of prostate cancer

Purpose of review

The role of the microbiome in prostate cancer is an emerging subject of research interest. Certain lifestyle factors, such as obesity and diet, can also impact the microbiome, which has been implicated in many diseases, such as heart disease and diabetes. However, this link has yet to be explored in detail in the context of prostate cancer. The purpose of this review is to explore the cross-talk between obesity, dietary interventions, and microbiome alterations in the development and progression of prostate cancer.

Recent findings

Many possible mechanisms exist linking obesity and dietary interventions to microbiome alterations and prostate cancer. The gut microbiome produces metabolites that could play a role in prostate cancer oncogenesis, including short-chain fatty acids, cholesterol derivatives, and folic acid. The microbiome also plays a pivotal role in the prostate tumor microenvironment (TME), contributing to inflammation, local tissue hypoxia, and epithelial-mesenchymal transition. A bidirectional relationship exists between obesity and the microbiome, and certain diets can enact changes to the microbiome, its associated metabolites, and prostate cancer outcomes.

Summary

Cross-talk exists between obesity, dietary interventions, and the role of the microbiome in the development and progression of prostate cancer. To further our understanding, future human studies in prostate cancer should investigate microbiome changes and incorporate an assessment of microbiome-derived metabolites and cellular/immune changes in the TME.

Impact of adherence to the Mediterranean diet on stroke risk

Stroke is a leading cause of morbidity and mortality worldwide, and dietary patterns have emerged as a significant modifiable factor in stroke prevention. The Mediterranean diet, characterized by high intake of fruits, vegetables, whole grains, nuts, olive oil, and fish, has been widely recognized for its cardiovascular benefits. However, its specific impact on stroke risk requires further elucidation. We conducted a comprehensive meta-analysis of 30 studies, including both cohort and case-control designs, to evaluate the relationship between adherence to the Mediterranean diet and the risk of stroke. A systematic search was performed across multiple databases, and a random-effects model was used to estimate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic, and publication bias was examined through funnel plots and Egger's regression test. Additionally, trial sequential analysis was conducted to determine the adequacy of the sample size. The meta-analysis revealed a significant reduction in stroke risk among individuals adhering to the Mediterranean diet, with a pooled HR of 0.88 (95% CI: 0.84-0.91). Notably, a significant heterogeneity was detected (I2 = 34%). The Z-score plot from trial sequential analysis confirmed that the sample sizes were sufficient to draw definitive conclusions. However, a potential publication bias was identified. The case-control studies confirmed a highly significant effect (HR = 0.54, 95% CI: 0.4-0.73). The funnel plots in both settings hinted at the presence of a potential publication bias, supported by a significant Egger's test. Our findings provide robust evidence supporting the protective effect of the Mediterranean diet against stroke. Despite the presence of some heterogeneity and potential publication bias, the cumulative evidence suggests that promoting the Mediterranean diet could serve as an effective public health strategy for stroke prevention. Further research is recommended to explore the underlying mechanisms and to assess the diet's impact across diverse populations.

Exploring the effect of different diet types on ageing and age-related diseases

In recent times, there has been growing interest in understanding the factors contributing to prolonged and healthy lifespans observed in specific populations, tribes, or countries. Factors such as environmental and dietary play significant roles in shaping the ageing process and are often the focus of inquiries seeking to unravel the secrets behind longevity. Among these factors, diet emerges as a primary determinant, capable of either promoting or mitigating the onset of age-related diseases that impact the ageing trajectory. This review examines the impact of various diet types on ageing and age-related conditions, including cardiovascular disease, cancer, neurodegenerative disorders, and metabolic syndrome. Different dietary patterns, such as the Mediterranean diet, the Japanese diet, vegetarian and vegan diets, as well as low-carbohydrate and ketogenic diets, are evaluated for their potential effects on longevity and health span. Each diet type is characterized by distinct nutritional profiles, emphasizing specific food groups, macronutrient compositions, and bioactive components, which may exert diverse effects on ageing processes and disease risk. Additionally, dietary factors such as calorie restriction, intermittent fasting, and dietary supplementation are explored for their potential anti-ageing and disease-modifying effects. Understanding the influence of various diet types on ageing and age-related diseases can inform personalized dietary recommendations and lifestyle interventions aimed at promoting healthy aging and mitigating age-associated morbidities.

Human gut microbiome, diet, and mental disorders

Diet is one of the most important external factor shaping the composition and metabolic activities of the gut microbiome. The gut microbiome plays a crucial role in host health, including immune system development, nutrients metabolism, and the synthesis of bioactive molecules. In addition, the gut microbiome has been described as critical for the development of several mental disorders. Nutritional psychiatry is an emerging field of research that may provide a link between diet, microbial function, and brain health. In this study, we have reviewed the influence of different diet types, such as Western, Mediterranean, vegetarian, and ketogenic, on the gut microbiota composition and function, and their implication in various neuropsychiatric and psychological disorders.

Lifestyle Factors Associated with Children's and Adolescents' Adherence to the Mediterranean Diet Living in Mediterranean Countries: The DELICIOUS Project

Background/Objectives. Traditional dietary patterns are being abandoned in Mediterranean countries, especially among younger generations. This study aimed to investigate the potential lifestyle determinants that can increase adherence to the Mediterranean diet in children and adolescents. Methods. This study is a cross-sectional analysis of data from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) within the context of the EU-funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean Diet and LIfestyle in Children and adolescents through behavIOUral change actionS). This study comprised information on 2011 children and adolescents aged 6-17 years old collected during 2023. The main background characteristics of both children and parents, including age, sex, education, and family situation, were collected. Children's eating (i.e., breakfast, place of eating, etc.) and lifestyle habits (i.e., physical activity level, sleep, and screen time) were also investigated. The level of adherence to the Mediterranean diet was assessed using the KIDMED index. Logistic regression analyses were performed to test for likelihood of higher adherence to the Mediterranean diet. Results. Major determinants of higher adherence to the Mediterranean diet were younger age, higher physical activity level, adequate sleep duration, and, among dietary habits, having breakfast and eating with family members and at school. Parents' younger age and higher education were also determinants of higher adherence. Multivariate adjusted analyses showed that an overall healthier lifestyle and parents' education were the factors independently associated with higher adherence to the Mediterranean diet. Conclusions. Higher adherence to the Mediterranean diet in children and adolescents living in the Mediterranean area is part of an overall healthy lifestyle possibly depending on parents' cultural background.

Adherence to the Mediterranean diet and risk of stroke in a Chilean population: a case-control study

Introduction

Introduction: Ñuble is the region of Chile with the highest stroke incidence rates in the country. The aim was to estimate the association between adherence to the MED diet and the first ischemic stroke in adult patients living in the Ñuble region. Methods: a case-control hospital-based study. The cases (n = 89) were patients with first ischemic stroke, and controls (n = 178) were admitted to the same hospital during the same month the cases were recruited. We selected two controls for one case and paired them for sex and age (± 5 years). We used the food frequency questionnaire and the adherence Mediterranean diet questionnaire. A descriptive analysis of the variables and a conditional logistic regression to determine the association between variables. Results: 71 % of the sample was ≥ 65 years old and 64 % were male. Cases smoked (11.2 %), consumed at least one drink per month (41.6 %), and had a diagnosis of hypertension (76.4 %) more frequently than controls. In the model adjusted for all variables, it is observed that those who are in quartile 2 of adherence (6-7 points) are 42 % less likely to have a cerebral infarction compared to those who have a lower score (p < 0.005). Conclusions: our findings suggest that moderate adherence to a Mediterranean diet, defined by the PREDIMED score and adjustment for other variables, reduces the probability to first ischemic stroke.

Ten Recommendations for the Next Clinical Trial of the Mediterranean Diet in Inflamm-Aging: Results & Insights from a Scoping Review

Diet is a key modifiable risk factor in many chronic diseases, including age-related diseases. The Mediterranean diet (MedDiet) is an extensively studied dietary pattern which has been proposed as a lifestyle intervention to promote healthy aging in the general population, due to its numerous health benefits. Randomized controlled trials (RCTs) have attempted to explore the mechanism(s) by which the MedDiet exerts its beneficial effects on aging. One proposed mechanism is that the MedDiet helps to slow down a process called 'inflamm-aging', a type of chronic, low-grade inflammation which contributes to aging. To explore the evidence supporting this hypothesized mechanism, we conducted a scoping review of existing RCTs which used a MedDiet intervention and assessed at least one molecular outcome of potential relevance to inflamm-aging. We identified 14 papers representing 12 unique RCTs. Based on our findings, we present 10 recommendations for the next clinical trial of the MedDiet in inflamm-aging.

Joint association of anti-inflammatory diet and vigorous leisure-time physical activity on all-cause and cardiovascular disease mortality in U.S. adults: findings from NHANES, 2007-2014

PURPOSE

Balanced dietary patterns, sufficient physical activity, and other healthy lifestyle behaviors are increasingly recognized as a complimentary strategy for the prevention of cardiovascular disease (CVD). We aim to explore the joint association of anti-inflammatory diet and vigorous leisure-time physical activity (LTPA) on all-cause and CVD mortality.

METHODS

This retrospective cohort study included 16,068 adults from the National Health and Nutrition Examination Survey (2007-2014). Participants were categorized into four lifestyle patterns based on the inflammatory properties of the diet and the degree of vigorous LTPA: pro-inflammatory diet and insufficient vigorous LTPA (pattern 1), anti-inflammatory diet and insufficient vigorous LTPA (pattern 2), pro-inflammatory diet and sufficient vigorous LTPA (pattern 3), anti-inflammatory diet and sufficient vigorous LTPA (pattern 4). Multivariable Cox proportional hazards models were used to estimate the hazards ratio (HR) and 95% confidence intervals (CI).

RESULTS

Compared to pattern 1, pattern 4 showed an obvious lower risk of all-cause (HR, 0.51; 95% CI 0.32-0.81) and CVD mortality (HR, 0.31; 95% CI 0.12-0.80). In addition, pattern 2 also had a significantly decreased all-cause (0.80; 0.69-0.92) and CVD mortality risk (0.71; 0.53-0.95). However, t there was no significant reduction in all-cause mortality (0.75; 0.54-1.06) and CVD mortality (0.60; 0.32-1.13) among pattern 3. Consistent results were obtained in subgroup and sensitivity analyses.

CONCLUSION

Adhering to the anti-inflammatory diet and sufficient vigorous LTPA was associated with lowest all-cause and CVD mortality. Anti-inflammatory diet can counteract the hazards caused by insufficient vigorous LTPA, while sufficient vigorous LTPA fails to offset the detrimental effect of pro-inflammatory diet.

Effect of Dietary Patterns on Vascular Aging Using the Brachial-Ankle Index

The Mediterranean diet (MD) plays an important role in delaying vascular aging. The main objective of this study was to analyze the association between adherence to the MD and vascular aging estimated with brachial-ankle pulse wave velocity (ba-PWV) in a Spanish population sample and the differences by sex.

METHODS

Cross-sectional descriptive study. A total of 3437 subjects from the EVA, MARK and EVIDENT studies participated. The ba-PWV was assessed with the Vasera VS-1500® device. Vascular aging was classified as healthy vascular aging (HVA), normal vascular aging (NVA) and early vascular aging (EVA) and adherence to the MD was assessed with the Mediterranean Diet Adherence Screener questionnaire.

RESULTS

The mean age was 60.15 ± 9.55 (60.09 ± 9.71 in women; 60.20 ± 9.43 in men). Overall, MD adherence was observed in 48.0% of subjects (40% in women; 54% in men). The mean value of ba-PWV was 14.38 ± 2.71 (women 14.24 ± 2.89; men 14.49 ± 2.56). In multinomial logistic regression a positive association was found overall between HVA and NVA (OR = 1.751, 95% CI: 1.411-2.174, p < 0.001) and between HVA and EVA (OR = 1.501, 95% CI:1.295-1.740, p < 0.001); in women between HVA and NVA (OR = 2. 055, 95% CI:1.456-2.901, p < 0.001) and between HVA and EVA (OR = 1.413, 95% CI:1.124-1.776; p = 0.003); and in men between HVA and NVA (OR = 1.551, 95% CI: 1.175-2.047, p = 0.002) and between HVA and EVA (OR = 1.549, 95% CI: 1.275-1.882; p < 0.001).

CONCLUSIONS

The results of this work indicate that greater adherence to the MD is associated with healthier vascular aging.

A pilot randomized controlled trial investigating the effects of an anti-inflammatory dietary pattern on disease activity, symptoms and microbiota profile in adults with inflammatory bowel disease

BACKGROUND/OBJECTIVES

There is a lack of certainty in dietary prescription for individuals with inflammatory bowel disease (IBD) due to heterogeneity in studies to date. The aim of this study was to investigate the efficacy on disease activity of a modified anti-inflammatory dietary pattern purposely designed to reduce intake of food additives (IBD-MAID), compared to standard care, in adults with IBD.

SUBJECT/METHODS

Adults with IBD were randomised to IBD-MAID (meals provided) [n = 29] or general healthy eating (GHE) [n = 29] for 8 weeks. Disease activity, faecal calprotectin (FC), C-reactive protein (CRP), symptoms, and quality of life (S&QOL) were assessed using validated tools.

RESULTS

The IBD-MAID was well tolerated and adhered to (92% adherence). At week 8, there was no statistically significant difference in change from baseline in outcome measures between groups. However, baseline to week 8 analysis indicated: (1) statistically significant improvements in S (p = 0.001) & QOL (p = 0.004), FC (p = 0.007), and Crohn's disease activity (p = 0.03) but not ulcerative colitis, in individuals following the IBD-MAID and (2) statistically significant improvement in QOL in individuals receiving GHE (p = 0.015). Correlation analysis on change from baseline to week 8 revealed a greater decrease in food additives intake was associated with statistically significant improvements in FC, S & QOL and alignment of anti-inflammatory dietary principles with improvements in QOL.

CONCLUSION

The IBD-MAID was well tolerated. The most novel finding pertains to the correlation between reduced food additives intake and improvements in inflammatory markers, S&QOL. Further research is needed to explore the effects of food additives exposure on IBD course.

TRIAL REGISTRATION

12619001500145.

The Interplay of Persistent Organic Pollutants and Mediterranean Diet in Association With the Risk of Gestational Diabetes Mellitus

OBJECTIVE

Certain foods characterizing the alternate Mediterranean diet (aMED) are high in persistent organic pollutants (POPs), which are related to greater gestational diabetes mellitus (GDM) risk. We examined the associations of combined aMED and POP exposure with GDM.

RESEARCH DESIGN AND METHODS

aMED score of 1,572 pregnant women was derived from food frequency questionnaires at early pregnancy within the U.S. Fetal Growth Study and plasma concentrations of 76 POPs, including organochlorine pesticides, polybrominated diphenyl ethers, polychlorinated biphenyls (PCBs), and per- and polyfluoroalkyl substances, were measured. Associations of combined aMED score and exposure to POPs with GDM risk were examined by multivariable logistic regression models.

RESULTS

In 61 of 1,572 (3.88%) women with GDM, 25 of 53 included POPs had a detection rate >50%. Higher POP levels appeared to diminish potential beneficial associations of aMED score with GDM risk, with the lowest GDM risk observed among women with both high aMED score and low POP concentrations. Specifically, adjusted log-odds ratios of GDM risk comparing women with low PCB and high aMED score with those with low aMED score and high PCB concentrations was -0.74 (95% CI -1.41, -0.07). Inverse associations were also observed among women with low aMED score and high TransNo_chlor, PCB182_187, PCB196_203, PCB199, and PCB206. These associations were more pronounced among women with overweight or obesity.

CONCLUSIONS

Pregnant women who consumed a healthy Mediterranean diet but had a low exposure to POP concentrations had the lowest GDM risk. Future endeavors to promote a healthy diet to prevent GDM may consider concurrent POP exposure.

Impact of Nutritional Status on Chemotherapy Related Digestive Toxicity in Women With Breast Cancer

Introduction

Any alteration in nutritional status can compromise the progression of breast cancer, as well as the tolerance and efficacy of chemotherapy. The aims of our study were to assess the nutritional status of breast cancer patients treated with chemotherapy and to identify nutritional factors that may exacerbate chemo-induced digestive toxicity.

Methods

This descriptive cross-sectional study was conducted within the medical oncology department of the National Institute of Salah Azaiez. A Mediterranean Diet Score (MDS) was used to evaluate the level of adherence to the Mediterranean Diet. Nutritional status was assessed using 2 methods; body composition evaluation utilising the TANITA BC 601 impedance metre and High authority of health (HAS) criteria of malnutrition. Digestive effects were assessed with World Health Organization (WHO) grades ranging from 0 to 4. High grades 3 and 4 signified toxic grades.

Results

We enrolled 107 adult women diagnosed with breast cancer undergoing the same chemotherapy protocol. The participants had an average age of 52.56 ± 9.75 years and an average BMI of 29.85 ± 5.72 kg/m2 with 78.5% classified as overweight. Malnutrition was observed in 41% of patients, while sarcopenia was present in 12%. Chemotherapy-related adverse effects were predominantly constipation (80%), diarrhea (73%), nausea (70%) and vomiting (63.4%) with one-third experiencing high-grade toxicity. Strong adherence to Mediterranean Diet was observed in 48.6% of cases and higher MDS scores were inversely correlated with the severity of nausea (P = .01) and constipation (P = .02). Malnutrition was significantly associated with all digestive toxicities except with constipation. Sarcopenia was associated only with vomiting (P = .005).

Conclusion

There is a relationship between nutritional status and digestive toxicity, justifying early nutritional treatment to improve the tolerance and efficacy of chemotherapy.

Global research dynamics in the Mediterranean diet and diabetes mellitus: a bibliometric study from 2014 to 2024

Objective

The Mediterranean diet (MedDiet) has been found to have benefits for diabetes mellitus (DM), but a bibliometric analysis of its association with DM has yet to be conducted. This paper aims to explore the current status and research hotspots on the connection between the Mediterranean diet and DM from 2014 to 2024, providing a reference for future studies.

Methods

We retrieved articles published between 2014 and 2024 from the Web of Science database and analyzed them using R software, VOSviewer, and CiteSpace.

Results

A total of 2,806 articles were included in this study. Research on the relationship between the MedDiet and DM showed a steady increase in publication volume from 2014 to 2019, followed by a sharp rise from 2020 to 2023. Spain was the leading country in terms of publication volume, followed by Italy, the United States, China, and Greece. Spain also led in international collaborations, with CIBER-Centro de Investigación Biomédica en Red and Harvard University being the most prominent collaboration centers. Nutrients was the most frequently published and cited journal in this field. Common keywords in this literature included components such as olive oil, legumes, and red wine. Mechanisms studied in this field primarily focused on antioxidant effects, improvements in insulin sensitivity and secretion, regulation of lipid metabolism, and modulation of gut microbiota.

Conclusion

Research on the beneficial effects of the MedDiet on DM patients has garnered significant attention from researchers worldwide, and it is expected to become a major focus for future DM prevention and treatment. This study provides a comprehensive analysis of the current status and research hotspots regarding the relationship between the MedDiet and DM, offering valuable references for future research.

Adherence to the Mediterranean diet is associated with reduced chronic pancreatitis risk: a longitudinal cohort study

Background: The role of diet on the risk of chronic pancreatitis (CP) is understudied. The health benefits of the Mediterranean diet (MedDiet) pattern have long been recognized, but its association with CP risk is unclear. We aimed to investigate the association between adherence to MedDiet and the incidence of CP in a large-scale cohort. Methods: 190 790 participants from the UK Biobank were involved, all free of CP and with typical diet recall data at recruitment. The diagnosis of CP was ascertained by the combination of hospital inpatient data, primary care data, and death registry data. Multivariable Cox regression models were used to evaluate the associations between MedDiet adherence, measured by the Mediterranean Diet Adherence Screener (MEDAS) continuous score, and the incidence of CP. The mediating role of inflammation (assessed by C-reactive protein) and metabolic status between MedDiet adherence and CP risk was also investigated. Results: During a mean of 10.8 years of follow-up, 214 participants developed CP. Individuals with the highest adherence to MedDiet, defined by continuous MEDAS scores, exhibited significantly lower risk of developing CP (hazard ratio [HR] = 0.57, 95% confidence interval [CI]: 0.40-0.82; p = 0.002) compared to those in the lowest tertiles. Metabolic status mediated 4.74% of the association between MedDiet adherence and CP risk, while the mediating role of C-reactive protein was not significant. Conclusion: Greater Mediterranean diet adherence is associated with reduced chronic pancreatitis risk.

Maternal Dietary Improvement or Leptin Supplementation During Suckling Mitigates the Long-Term Impact of Maternal Obesogenic Conditions on Inflammatory and Oxidative Stress Biomarkers in the Offspring of Diet-Induced Obese Rats

This study investigates the impact of maternal nutrition during lactation on inflammation and oxidative stress in the offspring of diet-induced obese rats, along with the potential benefits of leptin supplementation during suckling. Dams were fed either a standard diet (SD), a western diet (WD) before and during gestation and lactation (WD-dams), or a WD switched to an SD during lactation (Rev-dams). Offspring were supplemented with leptin or vehicle during suckling and then fed an SD or WD until four months. Offspring of the Rev-dams exhibited improved metabolic indicators, including lower body weight, reduced plasma levels of TNF-alpha, a higher adiponectin/leptin (A/L) ratio, enhanced liver antioxidant defenses, and decreased inflammation markers in white adipose tissue (WAT) compared to WD-dams, with sex differences. Leptin supplementation further modulated these markers, reducing oxidative stress in liver and inflammation in WAT and liver (e.g., hepatic Tnfa expression decreased by 45% (males) and 41% (females) in the WD group on an SD), and improving the A/L ratio, with effects varying by maternal conditions and sex. In conclusion, this study underscores the importance of maternal nutrition and leptin intake during suckling in shaping long-term metabolic and inflammatory health in offspring, offering strategies to mitigate the adverse effects of maternal obesity on future generations.

Metabolic Effects of Loquat Juice (Eriobotrya japonica Lindl Mkarkeb Variety) on Lipid Homeostasis, Liver Steatosis, and Oxidative Stress in Hyperlipidemic Mice Fed a High-Fat-High-Fructose Diet

BACKGROUND

Loquat fruit is consumed for its flavorful taste and a rich array of health-promoting compounds like phenolics, flavonoids, and carotenoids. This study aimed at the biochemical characterization of fresh juice from the Moroccan Mkarkeb variety of loquat and evaluating its effects on lipid homeostasis and liver steatosis in hyperlipidemic mice.

METHODS

The biochemical characterization followed AOAC methods. In vivo study involved hyperlipidemic mice fed a high-fat, high-fructose diet for 6 weeks and treated with loquat juice at 3.5 and 7 mL kg-1 or fenofibrate at 4 mg·kg-1. The concentrations of lipids in plasma, liver, adipose tissue, feces, and bile and blood glucose levels were quantified. Liver steatosis was visually examined and confirmed histologically, and liver injury markers (AST, ALT, ALP, LDH, and TB) were measured. Liver oxidative stress was assessed by measuring MDA content and antioxidative enzyme activities.

RESULTS

Our findings indicate that fresh loquat juice is poor in fat and protein and contains moderate sugars with a low energy value (40.82 ± 0.25 kcal/100 g). It is also rich in minerals, vitamin C, phenolic acids, flavonoids, and carotenoids. The juice effectively restored lipid metabolism by enhancing reverse cholesterol transport and lowering LDL-cholesterol, triglycerides, and the atherogenic index. The studied juice decreases blood glucose and prevents weight gain and lipid accumulation in the liver and adipose tissue. The juice prevents lipotoxicity-induced liver injury, corrects toxicity markers, and improves the liver's morphological and histological structures. It also reduces oxidative stress by lowering MDA and activating SOD and catalase.

CONCLUSIONS

The juice holds high nutritional and medicinal value, potentially preventing lipid disorders and cardiovascular issues.

Association of the dietary inflammatory index with complicated diabetic kidney disease in people with diabetes mellitus: evidence from NHANES 2009-2018

AIMS

Diabetic kidney disease (DKD) significantly impairs quality of life in individuals with diabetes mellitus (DM). The influence of the Dietary Inflammatory Index (DII) on DKD, which is associated with adverse health outcomes, is not well-understood.

METHODS

We analyzed 2712 subjects from the National Health and Nutrition Examination Survey (NHANES) spanning 2011-2018, aiming to elucidate the relationship between DII and DKD.

RESULTS

DKD was diagnosed in 1016 participants (37.46%). Elevated DII levels were significantly associated with an increased DKD risk, as evidenced by multivariate logistic regression (Odds Ratio [OR] = 1.40, 95% Confidence Interval [CI] 1.12-1.75, P < 0.05). Further analysis after adjusting for covariates highlighted a notable non-linear correlation between DII and DKD risk, at DII values below 0.45, the risk of DKD increases with higher DII levels, whereas it stabilizes beyond this point. Subgroup analysis additionally revealed that diabetic men have a significantly higher DKD risk compared to women (P < 0.05).

CONCLUSION

Our study indicates a pronounced link between higher DII scores and increased risk of DKD among DM patients. These findings underscore the paramount importance of dietary management in DM treatment, stressing the need for interventions focused on reducing dietary inflammation to decelerate DKD progression.

Diet Quality and Epigenetic Aging in the Women's Health Initiative

BACKGROUND

Higher diet quality scores are associated with a lower risk for many chronic diseases and all-cause mortality; however, it is unclear if diet quality is associated with aging biology.

OBJECTIVE

This study aimed to examine the association between diet quality and a measure of biological aging known as epigenetic aging.

DESIGN

A cross-sectional data analysis was used to examine the association between three diet quality scores based on self-reported food frequency questionnaire data and five measures of epigenetic aging based on DNA methylation (DNAm) data from peripheral blood.

PARTICIPANTS/SETTING

This study included 4,500 postmenopausal women recruited from multiple sites across the United States (1993-98), aged 50 to 79 years, with food frequency questionnaire and DNAm data available from the Women's Health Initiative baseline visit.

MAIN OUTCOME MEASURES

Five established epigenetic aging measures were generated from HumanMethylation450 Beadchip DNAm data, including AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno, AgeAccelGrim, and DunedinPACE.

STATISTICAL ANALYSES PERFORMED

Linear mixed models were used to test for associations between three diet quality scores (Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores) and epigenetic aging measures, adjusted for age, race and ethnicity, education, tobacco smoking, physical activity, Women's Health Initiative substudy from which DNAm data were obtained, and DNAm-based estimates of leukocyte proportions.

RESULTS

Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores were all inversely associated with AgeAccelPheno, AgeAccelGrim, and DunedinPACE (P < 0.05), with the largest effects with DunedinPACE. A one standard deviation increment in diet quality scores was associated with a decrement (β ± SE) in DunedinPACE z score of -0.097 ± 0.014 (P = 9.70 x 10-13) for Healthy Eating Index, -0.107 ± 0.014 (P = 1.53 x 10-14) for Dietary Approaches to Stop Hypertension, and -0.068 ± 0.013 (P = 2.31 x 10-07) for the alternate Mediterranean diet.

CONCLUSIONS

In postmenopausal women, diet quality scores were inversely associated with DNAm-based measures of biological aging, particularly DunedinPACE.

The Dual Burden: Exploring Cardiovascular Complications in Chronic Kidney Disease

Chronic kidney disease (CKD) represents a significant global health challenge, affecting millions of individuals and leading to substantial morbidity and mortality. This review aims to explore the epidemiology, cardiovascular complications, and management strategies associated with CKD, emphasizing the importance of preventing cardiovascular disease and early intervention. CKD is primarily driven by conditions such as diabetes mellitus, hypertension, and cardiovascular diseases, which often coexist and exacerbate renal impairment. Effective management requires a multifaceted approach, including lifestyle modifications, pharmacological interventions, and regular monitoring. Dietary changes, such as sodium restriction and a controlled intake of phosphorus and potassium, play a vital role in preserving renal function. Pharmacological therapies, particularly angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and emerging agents like SGLT2 inhibitors, have shown efficacy in slowing disease progression and improving patient outcomes. Furthermore, patients undergoing dialysis face increased cardiovascular risk, necessitating comprehensive management strategies to address both renal and cardiac health. As the landscape of CKD treatment evolves, ongoing research into novel therapeutic options and personalized medical approaches are essential. This review underscores the urgent need for awareness, education, and effective preventive measures to mitigate the burden of CKD and enhance the quality of life for affected individuals.

Mediterranean Diet Pattern: Potential Impact on the Different Altered Pathways Related to Cardiovascular Risk in Advanced Chronic Kidney Disease

BACKGROUND

Cardiovascular disease (CVD) remains the most common cause of mortality in chronic kidney disease (CKD) patients. Several studies suggest that the Mediterranean diet reduces the risk of CVD due to its influence on endothelial function, inflammation, lipid profile, and blood pressure. Integrating metabolomic and proteomic analyses of CKD could provide insights into the pathways involved in uremia-induced CVD and those pathways modifiable by the Mediterranean diet.

METHODS

We performed metabolomic and proteomic analyses on serum samples from 19 patients with advanced CKD (aCKD) and 27 healthy volunteers. The metabolites were quantified using four different approaches, based on their properties. Proteomic analysis was performed after depletion of seven abundant serum proteins (Albumin, IgG, antitrypsin, IgA, transferrin, haptoglobin, and fibrinogen). Integrative analysis was performed using MetaboAnalyst 4.0 and STRING 11.0 software to identify the dysregulated pathways and biomarkers.

RESULTS

A total of 135 metabolites and 75 proteins were differentially expressed in aCKD patients, compared to the controls. Pathway enrichment analysis showed significant alterations in the innate immune system pathways, including complement, coagulation, and neutrophil degranulation, along with disrupted linoleic acid and cholesterol metabolism. Additionally, certain key metabolites and proteins were altered in aCKD patients, such as glutathione peroxidase 3, carnitine, homocitrulline, 3-methylhistidine, and several amino acids and derivatives.

CONCLUSIONS

Our findings reveal significant dysregulation of the serum metabolome and proteome in aCKD, particularly in those pathways associated with endothelial dysfunction and CVD. These results suggest that CVD prevention in CKD may benefit from a multifaceted approach, including dietary interventions such as the Mediterranean diet.

European Association for the Study of Obesity (EASO) Position Statement on Medical Nutrition Therapy for the Management of Individuals with Overweight or Obesity and Cancer

Obesity, a prevalent and multifactorial disease, is linked to a range of metabolic abnormalities, including insulin resistance, dyslipidemia, and chronic inflammation. These imbalances not only contribute to cardiometabolic diseases but also play a significant role in cancer pathogenesis. The rising prevalence of obesity underscores the need to investigate dietary strategies for effective weight management for individuals with overweight or obesity and cancer. This European Society for the Study of Obesity (EASO) position statement aimed to summarize current evidence on the role of obesity in cancer and to provide insights on the major nutritional interventions, including the Mediterranean diet (MedDiet), the ketogenic diet (KD), and the intermittent fasting (IF), that should be adopted to manage individuals with overweight or obesity and cancer. The MedDiet, characterized by high consumption of plant-based foods and moderate intake of olive oil, fish, and nuts, has been associated with a reduced cancer risk. The KD and the IF are emerging dietary interventions with potential benefits for weight loss and metabolic health. KD, by inducing ketosis, and IF, through periodic fasting cycles, may offer anticancer effects by modifying tumor metabolism and improving insulin sensitivity. Despite the promising results, current evidence on these dietary approaches in cancer management in individuals with overweight or obesity is limited and inconsistent, with challenges including variability in adherence and the need for personalized dietary plans.

Mediterranean diet and atrial fibrillation: a case-control study from China

Objective

The aim of this study was to assess the association between adherence to Mediterranean diet and the presence of atrial fibrillation (AF) in a Northern Chinese population.

Methods

This study was a single center, case-control study. A total of 952 low risk participants in Beijing Anzhen Hospital from 2016 to 2021 were collected, including 476 patients with first diagnosed of atrial fibrillation and 476 age and sex matched controls. According to the food frequency questionnaire (FFQ), the alternate Mediterranean diet score (AMED) was calculated, which was 0-9 points, indicating the adherence to the Mediterranean diet from low to high.

Results

The average age of the participants was 57.6 ± 9.1 years old, and 70.2% were men. After analyzing every component of AMED, vegetable consumption shows a negative correlation with the risk of AF, whereas alcohol consumption demonstrates a positive correlation with it (OR = 0.61, 95% CI 0.44-0.80, p < 0.001; OR = 1.99, 95% CI 1.48-2.58, p < 0.001). All patients were grouped according to AMED score. A significant inverse association between AMED and the risk of AF was observed. Compared with participants with AMED<4, the multivariable-adjusted ORs of AF were 0.75 (95% CI 0.55-1.06) for AMED 4-5 and 0.61 (95% CI 0.43-0.89) for AMED ≥6, with a trend in risk (p = 0.008). Results were consistent in stratified analyses of gender, age, BMI and smoking.

Conclusion

The Mediterranean diet was inversely associated with the risk of AF in this Northern Chinese population.

Metabolic and lifestyle factors accelerate disease onset and alter gut microbiome in inflammatory non-communicable diseases

BACKGROUND

Biomedical and lifestyle factors in Western populations have significantly shifted in recent decades, influencing public health and contributing to the increasing prevalence of non-communicable diseases (NCDs) that share inflammation as common pathology.

METHODS

We investigated the relationship between these factors and 11 NCDs in the cross-sectional FoCus cohort (n = 1220), using logistic regression models. Associations with age-at-disease-onset were specifically analyzed for type 2 diabetes (T2D, low-grade chronic inflammation) and inflammatory bowel disease (IBD, high-grade chronic inflammation) in disease-specific cohorts (FoCus-T2D, n = 514; IBD-KC, n = 1110). Important factors for disease risk were identified using Cox-PH-regression models and time-to-event analysis. We further explored the interaction between identified risk factors and gut microbiome composition using linear models.

RESULTS

Lifestyle factors were clearly linked to disease phenotypes, particularly in T2D and IBD. Still, some factors affected only the age-at-onset, but not disease prevalence. High-quality nutrition significantly delayed onset for both IBD and T2D (IBD: HR = 0.81 [0.66; 0.98]; T2D: HR = 0.45 [0.28; 0.72]). Smoking accelerated T2D onset (HR = 1.82 [1.25; 2.65]) but delayed onset in ulcerative colitis (UC: HR = 0.47 [0.28; 0.79]). Higher microbiota diversity delayed IBD onset (Shannon: HR = 0.58 [0.49; 0.71]) but had no effect on T2D. The abundance of specific microbial genera was strongly associated with various biomedical and lifestyle factors in T2D and IBD. In unaffected controls, these effects were smaller or reversed, potentially indicating a greater susceptibility of the gut microbiome to negative influences in T2D and IBD.

CONCLUSIONS

The dual insights into age-at-disease-onset and gut microbiota composition in disease emphasize the role of certain biomedical and lifestyle factors, e.g., nutrition quality, in disease prevention and management. Understanding these relationships provides a foundation for developing targeted strategies to mitigate the impact of metabolic and inflammatory diseases through lifestyle modifications and gut health management.

Protective Effect of Extra Virgin Olive Oil on Cancers, Gastrointestinal Cancers, and All-Cause Mortality: A Competing Risk Analysis in a Southern Italian Cohort

BACKGROUND/OBJECTIVES

This study investigates the association between extra virgin olive oil (EVOO) consumption and mortality risk in a cohort of Italian adults adhering to the Mediterranean diet.

METHODS

In a 17-year follow-up study involving participants from Castellana Grotte, Italy (2005-2023), we analyzed dietary intake and mortality data. Participants were categorized into three EVOO consumption groups: <30 g/day, 30-50 g/day, and >50 g/day. Mortality Hazard Ratios (HR) and Subdistribution Hazard Ratios (SHR) were calculated to assess the relationship between EVOO intake and all-cause and cancer mortality.

RESULTS

Higher EVOO consumption was associated with significantly reduced cancer and all-cause mortality. Specifically, the daily intake of 30-50 g of EVOO was linked to a 24% lower risk of all-cause mortality (HR 0.77; 95% CI 0.63-0.93), while the consumption of more than 50 g/day was associated with a 20% reduction (HR 0.80; 95% CI 0.65-0.98). The most pronounced benefit was observed for gastrointestinal cancers, with a 60% lower mortality risk for those consuming over 50 g/day (SHR 0.39; 95% CI 0.21-0.73). A 50% reduction in mortality risk from other cancers was also noted for the highest consumption category (SHR 0.50; 95% CI 0.31-0.81).

CONCLUSIONS

The findings support the beneficial role of EVOO in reducing cancer mortality, particularly with higher consumption levels. The results underscore EVOO's potential as a dietary intervention for cancer prevention, aligning with the Mediterranean diet's overall health benefits. Further research is needed to confirm these findings and explore the underlying mechanisms.