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Ortega Martínez de Victoria E, Pané Vila A, Jiménez Pineda A. Obesity in Spain: an open book that must be read. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024:S1885-5857(24)00155-5. [PMID: 38750932 DOI: 10.1016/j.rec.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Emilio Ortega Martínez de Victoria
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi Sunyer (FCRB-IDIBAPS), Barcelona, Spain.
| | - Adriana Pané Vila
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi Sunyer (FCRB-IDIBAPS), Barcelona, Spain
| | - Amanda Jiménez Pineda
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi Sunyer (FCRB-IDIBAPS), Barcelona, Spain
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Bryl A, Mrugacz M, Falkowski M, Zorena K. A Mediterranean Diet May Be Protective in the Development of Diabetic Retinopathy. Int J Mol Sci 2023; 24:11145. [PMID: 37446322 DOI: 10.3390/ijms241311145] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The Mediterranean diet is recognized as one of the healthiest available dietary patterns. This perception results from its beneficial effects on the cardiovascular system and, also, on hypertension, diabetes, and cancer compared with other diets. Its impact on the course of diabetes is assessed in the available scientific literature; however, little information is available about its impact on diabetic retinopathy. The MD is characterized mainly by the consumption of fish, seafood, foods of plant origin, and fresh fruit and vegetables. It is also recommended to consume legumes, which are a source of folic acid, magnesium, iron, and dietary fiber. High consumption of nuts and unrefined grains is also recommended in the MD. Marine fish provide polyunsaturated acids from the omega-3 group. Olive oil plays a very important role, especially olive oil obtained from mechanical pressing. Additionally, olive oil contains vitamins E, K, and polyphenols. Polyphenols, which are present in a diverse range of vegetables, fruits, and seeds, have the ability to decrease oxidative stress, inflammation, and insulin resistance. Resveratrol is naturally found in grape skins and seeds, as well as in peanuts and berries, and is a constituent of red wine. Resveratrol can inhibit increased vascular leakage and loss of pericytes and regulate the level of VEGF protein in the retina, thus inhibiting the development of DR. Consumption of fruits, vegetables, fish, and olive oil may be correlated with a lower risk of diabetic retinopathy. This paper presents the definition of the Mediterranean diet and its influence on the course of diabetes and diabetic retinopathy.
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Affiliation(s)
- Anna Bryl
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Małgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Mariusz Falkowski
- PhD Studies, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environmental Microbiology, Medical University of Gdansk, 80-211 Gdansk, Poland
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Kotzakioulafi E, Bakaloudi DR, Chrysoula L, Theodoridis X, Antza C, Tirodimos I, Chourdakis M. High Versus Low Adherence to the Mediterranean Diet for Prevention of Diabetes Mellitus Type 2: A Systematic Review and Meta-Analysis. Metabolites 2023; 13:779. [PMID: 37512486 PMCID: PMC10386129 DOI: 10.3390/metabo13070779] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
Diabetes mellitus type 2 (DMT-2) presents with a growing incidence, and its complications contribute mainly to cardiovascular disease and overall mortality. DMT-2 prevention and early stage management include lifestyle modification by adopting healthy eating patterns and increasing physical activity levels. The Mediterranean diet (MD) is associated with beneficial effects on human health and has been found effective for preventing and managing DMT-2. The purpose of this meta-analysis is to investigate whether the level of MD adherence plays a role in DMT-2 prevention and to what extent. A systematic literature search in PubMed, EMBASE, Web of Science Core Collection, Scopus, and Google Scholar databases was conducted until November 2022, and related observational studies fulfilling the eligibility criteria were included. The literature search concluded with 24 studies in the qualitative analysis and 23 studies in the quantitative analysis. Of those, 18 cohort studies were eligible for meta-analysis with hazard ratio as effect size and five studies providing odds ratio as effect size. The cohort studies included 248,140 participants with a mean follow-up of 10.8 years (3 to 22 years). Individuals with high adherence to MD presented an 11% and 18% decrease in risk and odds, respectively, of developing DMT-2 compared to those with low MD adherence (HR 0.89, 95%CI 0.83 to 0.95) and (OR 0.82, 95%CI 0.72 to 0.93). In studies where the follow-up was longer than 10 years, the 12% decrease in the risk of developing DMT-2 remained (HR 0.88 95%CI 0.84 to 0.92), whereas in studies where follow-up was less than 10 years, no difference between groups with different levels of adherence was found. Long-term high MD adherence is associated with a reduced risk of developing DMT-2, but further studies are needed to confirm these results.
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Affiliation(s)
- Evangelia Kotzakioulafi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Xenophon Theodoridis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Christina Antza
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, 56403 Thessaloniki, Greece
| | - Ilias Tirodimos
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Muscogiuri G, Verde L, Sulu C, Katsiki N, Hassapidou M, Frias-Toral E, Cucalón G, Pazderska A, Yumuk VD, Colao A, Barrea L. Mediterranean Diet and Obesity-related Disorders: What is the Evidence? Curr Obes Rep 2022; 11:287-304. [PMID: 36178601 PMCID: PMC9729142 DOI: 10.1007/s13679-022-00481-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Obesity is a chronic disease, a major public health problem due to its association with non-communicable diseases and all-cause mortality. Indeed, people with obesity are at increased risk for a variety of obesity-related disorders including hypertension, dyslipidemia, type 2 diabetes mellitus, cardiovascular disease, and several cancers. Many popular diets with very different macronutrient composition, including the Mediterranean diet (MD), have been used, proposed, and studied for prevention and management of obesity. In particular, MD has been the subject of countless studies over the years and now boasts a large body of scientific literature. In this review, we aimed to update current knowledge by summarizing the most recent evidence on the effect of MD on obesity and obesity-related disorders. RECENT FINDINGS The negative effects of obesity are partly reversed by substantial weight loss that can be achieved with MD, especially when low-calorie and in combination with adequate physical activity. In addition, the composition of MD has been correlated with an excellent effect on reducing dyslipidemia. It also positively modulates the gut microbiota and immune system, significantly decreasing inflammatory mediators, a common ground for many obesity-related disorders. People with obesity are at increased risk for a variety of medical disorders including hypertension, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. Therefore, there is an inevitable need for measures to manage obesity and its related disorders. At this point, MD has been proposed as a valuable nutritional intervention. It is characterized by a high consumption of vegetables, fruit, nuts, cereals, whole grains, and extra virgin olive oil, as well as a moderate consumption of fish and poultry, and a limited intake of sweets, red meat, and dairy products. MD proves to be the healthiest dietary pattern available to tackle obesity and prevent several non-communicable diseases, including cardiovascular disease and type 2 diabetes.
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Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Naples, Italy.
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy.
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy.
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
| | - Cem Sulu
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Niki Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Evelyn Frias-Toral
- School of Medicine, Universidad Católica Santiago de Guayaquil, Av. Pdte. Carlos Julio Arosemena Tola, Guayaquil, 090615, Ecuador
| | - Gabriela Cucalón
- Escuela Superior Politécnica del Litoral, ESPOL, Lifescience Faculty, ESPOL Polytechnic University, Campus Gustavo Galindo Km. 30.5 Vía Perimetral, P.O. Box 09-01-5863, Guayaquil, Ecuador
| | - Agnieszka Pazderska
- Division of Endocrinology, Metabolism, and Diabetes-Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 34098, Turkey
| | - Volkan Demirhan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Endocrinology Unit, University Federico II, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Naples, Italy.
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Naples, 80143, Italy.
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Cea-Soriano L, Pulido J, Franch-Nadal J, Santos JM, Mata-Cases M, Díez-Espino J, Ruiz-García A, Regidor E. Mediterranean diet and diabetes risk in a cohort study of individuals with prediabetes: propensity score analyses. Diabet Med 2022; 39:e14768. [PMID: 34897805 DOI: 10.1111/dme.14768] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/29/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
AIMS Randomized controlled trials have demonstrated the efficacy of several dietary patterns plus physical activity to reduce diabetes onset in people with prediabetes. However, there is no evidence on the effect from the Mediterranean diet on the progression from prediabetes to diabetes. We aimed to evaluate the effect from high adherence to Mediterranean diet on the risk of diabetes in individuals with prediabetes. METHODS Prospective cohort study in Spanish Primary Care setting. A total of 1184 participants with prediabetes based on levels of fasting plasma glucose and/or glycated hemoglobin were followed up for a mean of 4.2 years. A total of 210 participants developed diabetes type 2 during the follow up. Hazard ratios of diabetes onset were estimated by Cox proportional regression models associated to high versus low/medium adherence to Mediterranean diet. Different propensity score methods were used to control for potential confounders. RESULTS Incidence rate of diabetes in participants with high versus low/medium adherence to Mediterranean diet was 2.9 versus 4.8 per 100 persons-years. The hazard ratios adjusted for propensity score and by inverse probability weighting (IPW) had identical magnitude: 0.63 (95% confidence interval, 0.43-0.93). The hazard ratio in the adjusted model using propensity score matching 1:2 was 0.56 (95% confidence interval, 0.37-0.84). CONCLUSIONS These propensity score analyses suggest that high adherence to Mediterranean diet reduces diabetes risk in people with prediabetes.
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Affiliation(s)
- Lucía Cea-Soriano
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- redGDPS Foundation, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - José Pulido
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Josep Franch-Nadal
- redGDPS Foundation, Madrid, Spain
- Barcelona City Research Support Unit/University Institute for Research in Primary Care Jordi Gol, Barcelona, Spain
- CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Juana M Santos
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manel Mata-Cases
- redGDPS Foundation, Madrid, Spain
- Barcelona City Research Support Unit/University Institute for Research in Primary Care Jordi Gol, Barcelona, Spain
- CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
- La Mina Primary Care Center, Barcelona, Spain
| | - Javier Díez-Espino
- redGDPS Foundation, Madrid, Spain
- Tafalla Health Center, Navarra, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
- Navarra Institute for Health Research (IDiSNA), Pamplona, Spain
| | - Antonio Ruiz-García
- redGDPS Foundation, Madrid, Spain
- Centro de Salud Universitario Pinto, Madrid, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- redGDPS Foundation, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Falguera M, Castelblanco E, Rojo-López MI, Vilanova MB, Real J, Alcubierre N, Miró N, Molló À, Mata-Cases M, Franch-Nadal J, Granado-Casas M, Mauricio D. Mediterranean Diet and Healthy Eating in Subjects with Prediabetes from the Mollerussa Prospective Observational Cohort Study. Nutrients 2021; 13:252. [PMID: 33467197 PMCID: PMC7830064 DOI: 10.3390/nu13010252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
We aimed to assess differences in dietary patterns (i.e., Mediterranean diet and healthy eating indexes) between participants with prediabetes and those with normal glucose tolerance. Secondarily, we analyzed factors related to prediabetes and dietary patterns. This was a cross-sectional study design. From a sample of 594 participants recruited in the Mollerussa study cohort, a total of 535 participants (216 with prediabetes and 319 with normal glucose tolerance) were included. The alternate Mediterranean Diet score (aMED) and the alternate Healthy Eating Index (aHEI) were calculated. Bivariable and multivariable analyses were performed. There was no difference in the mean aMED and aHEI scores between groups (3.2 (1.8) in the normoglycemic group and 3.4 (1.8) in the prediabetes group, p = 0.164 for the aMED and 38.6 (7.3) in the normoglycemic group and 38.7 (6.7) in the prediabetes group, p = 0.877 for the aHEI, respectively). Nevertheless, women had a higher mean of aMED and aHEI scores in the prediabetes group (3.7 (1.9), p = 0.001 and 40.5 (6.9), p < 0.001, respectively); moreover, they had a higher mean of aHEI in the group with normoglycemia (39.8 (6.6); p = 0.001). No differences were observed in daily food intake between both study groups; consistent with this finding, we did not find major differences in nutrient intake between groups. In the multivariable analyses, the aMED and aHEI were not associated with prediabetes (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.75-1.87; p = 0.460 and OR: 1.32, 95% CI: 0.83-2.10; p = 0.246, respectively); however, age (OR: 1.04, 95% CI: 1.02-1.05; p < 0.001), dyslipidemia (OR: 2.02, 95% CI: 1.27-3.22; p = 0.003) and body mass index (BMI) (OR: 1.09, 95% CI: 1.05-1.14; p < 0.001) were positively associated with prediabetes. Physical activity was associated with a lower frequency of prediabetes (OR: 0.48, 95% CI: 0.31-0.72; p = 0.001). In conclusion, subjects with prediabetes did not show a different dietary pattern compared with a normal glucose tolerance group. However, further research is needed on this issue.
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Affiliation(s)
- Mireia Falguera
- Primary Health Care Centre Cervera, Gerència d’Atenció Primaria, Institut Català de la Salut, 25200 Lleida, Spain;
- Department of Medicine, Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain; (M.B.V.); (N.A.)
| | - Esmeralda Castelblanco
- Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain; (E.C.); (M.I.R.-L.)
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain; (J.R.); (M.M.-C.); (J.F.-N.)
| | - Marina Idalia Rojo-López
- Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain; (E.C.); (M.I.R.-L.)
| | - Maria Belén Vilanova
- Department of Medicine, Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain; (M.B.V.); (N.A.)
- Primary Health Care Centre Igualada Nord, Consorci Sanitari de l’Anoia, Institut Català de la Salut, 08700 Barcelona, Spain
| | - Jordi Real
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain; (J.R.); (M.M.-C.); (J.F.-N.)
- DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Nuria Alcubierre
- Department of Medicine, Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain; (M.B.V.); (N.A.)
| | - Neus Miró
- Primary Health Care Centre Tàrrega, Gerència d’Atenció Primaria, Institut Català de la Salut, 25300 Lleida, Spain;
| | - Àngels Molló
- Primary Health Care Centre Guissona, Gerència d’Atenció Primaria, Institut Català de la Salut, 25210 Lleida, Spain;
| | - Manel Mata-Cases
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain; (J.R.); (M.M.-C.); (J.F.-N.)
- DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Josep Franch-Nadal
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain; (J.R.); (M.M.-C.); (J.F.-N.)
- DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Primary Health Care Centre Raval Sud, Gerència d’Atenció Primaria Barcelona, Institut Català de la Salut, 08001 Barcelona, Spain
| | - Minerva Granado-Casas
- Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain; (E.C.); (M.I.R.-L.)
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain; (J.R.); (M.M.-C.); (J.F.-N.)
- DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRBLleida, University of Lleida, 25198 Lleida, Spain
| | - Didac Mauricio
- Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau & Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain; (E.C.); (M.I.R.-L.)
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain; (J.R.); (M.M.-C.); (J.F.-N.)
- Faculty of Medicine, University of Vic (UVIC/UCC), 08500 Vic, Spain
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Colles A, Bruckers L, Den Hond E, Govarts E, Morrens B, Schettgen T, Buekers J, Coertjens D, Nawrot T, Loots I, Nelen V, De Henauw S, Schoeters G, Baeyens W, van Larebeke N. Perfluorinated substances in the Flemish population (Belgium): Levels and determinants of variability in exposure. CHEMOSPHERE 2020; 242:125250. [PMID: 31896205 DOI: 10.1016/j.chemosphere.2019.125250] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 10/18/2019] [Accepted: 10/27/2019] [Indexed: 05/22/2023]
Abstract
Because of their dirt-, water- and oil-repelling properties, per- and polyfluoroalkyl substances (PFASs) are frequently used in a broad variety of consumer products. They have been detected in human samples worldwide. In Flanders, Belgium, the Flemish Environment and Health Studies (FLEHS) measured the levels of five PFAS biomarkers in four different age groups of the Flemish population and identified determinants of variability in exposure. Cord plasma or peripheric serum samples and questionnaire data were available for 220 mother-newborn pairs (2008-2009), 269 mother-newborn pairs (2013-2014), 199 adolescents (14-15 years old, 2010), 201 adults (20-40 years old, 2008-2009) and 205 adults (50-65 years old, 2014). Measured levels of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) in Flanders are in the middle or low range compared to concentrations reported in other Western countries. Levels of perfluorobutanesulfonic acid (PFBS) were below the quantification limit in 98%-100% of the samples. Despite decreasing levels in time for PFOS and PFOA, 77% of the adults (2014) had serum levels exceeding HBM-I values of 5 μg/L for PFOS and 2 μg/L for PFOA. Beside age, sex, fish consumption, parity and breastfeeding, the multiple regression models identified additionally consumption of offal and locally grown food, and use of cosmetics as possible exposures and menstruation as a possible route of elimination. Better knowledge on determinants of exposure is essential to lower PFASs exposure.
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Affiliation(s)
- Ann Colles
- VITO - Health, Boeretang 200, 2400, Mol, Belgium.
| | - Liesbeth Bruckers
- Hasselt University, Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Agoralaan - Gebouw D, 3590, Diepenbeek, Belgium
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Eva Govarts
- VITO - Health, Boeretang 200, 2400, Mol, Belgium
| | - Bert Morrens
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium
| | - Thomas Schettgen
- Institut für Arbeits-, Sozial- und Umweltmedizin, Pauwelsstrasse 30, 52074, Aachen, Germany
| | | | - Dries Coertjens
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium
| | - Tim Nawrot
- Hasselt University, Centre of Environmental Sciences, Agoralaan - Gebouw D, 3590, Diepenbeek, Belgium
| | - Ilse Loots
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2-4, 2000, Antwerp, Belgium
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000, Antwerp, Belgium
| | - Stefaan De Henauw
- University of Ghent, Department of Public Health, C. Heymanslaan 10 - 4K3, 9000, Ghent, Belgium
| | | | - Willy Baeyens
- Vrije Universiteit Brussel (VUB), Department of Analytical, Environmental and Geochemistry (AMGC), Pleinlaan 2, 1050, Brussels, Belgium
| | - Nicolas van Larebeke
- Vrije Universiteit Brussel (VUB), Department of Analytical, Environmental and Geochemistry (AMGC), Pleinlaan 2, 1050, Brussels, Belgium
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Salas-Salvadó J, Becerra-Tomás N, Papandreou C, Bulló M. Dietary Patterns Emphasizing the Consumption of Plant Foods in the Management of Type 2 Diabetes: A Narrative Review. Adv Nutr 2019; 10:S320-S331. [PMID: 31728494 PMCID: PMC6855981 DOI: 10.1093/advances/nmy102] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/03/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022] Open
Abstract
The prevalence of type 2 diabetes (T2D) is increasing worldwide. This complex and multifactorial metabolic condition affects both the quality and expectancy of life in adults. Therefore, appropriate lifestyle strategies are needed in order to reduce the burden of T2D. Dietary patterns characterized by a high consumption of fruits, vegetables, whole grains, legumes, nuts, and seeds, and a minimal consumption of animal products, have been suggested as a dietary approach to prevent and control T2D and related micro- and macrovascular complications. This narrative review summarizes epidemiologic and clinical trial evidence on the role of the most widely studied dietary patterns that emphasize the consumption of plant foods [vegetarian, vegan, Mediterranean, and DASH (Dietary Approaches to Stop Hypertension) diets] in the management of T2D and its complications. Furthermore, their potential underlying mechanisms are discussed. Dietary patterns emphasizing the consumption of plant foods appear to confer beneficial effects on glycemic control in different diabetic populations. Several components of these dietary patterns might confer benefits on glycemia and counterbalance the detrimental effects of animal-based foods. The limited evidence on T2D-related complications makes it difficult to draw solid conclusions.
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Affiliation(s)
- Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Address correspondence to JS-S (e-mail: )
| | - Nerea Becerra-Tomás
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Christopher Papandreou
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Mónica Bulló
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Institute of Health Carlos III, Madrid, Spain
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9
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Bibiloni MDM, Bouzas C, Abbate M, Martínez-González MA, Corella D, Salas-Salvadó J, Zomeño MD, Vioque J, Romaguera D, Martínez JA, Wärnberg J, López-Miranda J, Estruch R, Bueno-Cavanillas A, Alonso-Gómez Á, Tinahones F, Serra-Majem L, Martín V, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Ros E, Fernández-Carrión R, Garcia-Rios A, Zulet MA, Asensio A, Schröder H, Fitó M, Becerra-Tomás N, Basora J, Cenoz JC, Diez-Espino J, Toledo E, Tur JA. Nutrient adequacy and diet quality in a Mediterranean population with metabolic syndrome: A cross-sectional study. Clin Nutr 2019; 39:853-861. [PMID: 30952534 DOI: 10.1016/j.clnu.2019.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 02/08/2019] [Accepted: 03/14/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND & AIMS Few studies have compared micronutrient intake and fulfilment of average requirements (EAR) in non-diabetic, pre-diabetic and diabetic adults at high cardiovascular risk. We assessed these variables in a large sample of participants in the PREDIMED-PLUS randomized trial of primary cardiovascular prevention with diet and physical activity. DESIGN Baseline assessment of nutritional adequacy in n = 5792 men and women, aged 55-75 years, with overweight/obesity and some metabolic syndrome features. METHODS Participants were categorised as non-diabetic (n = 2390), pre-diabetic (n = 1322) or diabetic (n = 2080) by standard criteria. Food and nutrient intake were assessed using a validated food frequency questionnaire. Micronutrients examined were vitamins B1, B2, B3, B6, B12, A, C, D, E and folic acid; Ca, K, P, Mg, Fe, Se, Cr, Zn, and iodine. The proportion of micronutrient inadequacy was evaluated using the EAR or adequate intake (AI) cut-offs. Diet quality was also determined using a 17-item energy-restricted Mediterranean diet (MedDiet) questionnaire. RESULTS Compared to non-diabetic participants, those with pre-diabetes had lower intakes of total carbohydrates (CHO) and higher intakes of total fat and saturated fatty acids (SFA) and were more likely to be below EAR for folic, while diabetic participants had lower intakes of total CHO and higher intakes of protein, total fat, monounsaturated fatty acids, SFA and cholesterol and were less likely to be below EAR for vitamins B2, and B6, Ca, Zn and iodine. Diabetic participants disclosed higher adherence to the MedDiet than the other two groups. CONCLUSIONS Older Mediterranean individuals with metabolic syndrome and diabetes had better nutrient adequacy and adherence to the MedDiet than those with pre-diabetes or no diabetes.
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Affiliation(s)
- Maria Del Mar Bibiloni
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Cristina Bouzas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Manuela Abbate
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - M Dolors Zomeño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain; Human Nutrition Unit, Blanquerna-Ramon Llull University, Barcelona, Spain
| | - Jesús Vioque
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain; Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - José López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain; Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Ángel Alonso-Gómez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain; Institute of Biomedicine (IBIOMED), University of León, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain; CIBER Diabetes y enfermedades metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain; Department of Health Sciences, University of Jaen, Jaen, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Rebeca Fernández-Carrión
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Antonio Garcia-Rios
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain
| | - M Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Alberto Asensio
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Nerea Becerra-Tomás
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Josep Basora
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Juan Carlos Cenoz
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Javier Diez-Espino
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Estefanía Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain.
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Raveendran AV, Chacko EC, Pappachan JM. Non-pharmacological Treatment Options in the Management of Diabetes Mellitus. EUROPEAN ENDOCRINOLOGY 2018; 14:31-39. [PMID: 30349592 PMCID: PMC6182920 DOI: 10.17925/ee.2018.14.2.31] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/13/2018] [Indexed: 02/05/2023]
Abstract
The global prevalence of diabetes, especially type 2 diabetes mellitus, has reached epidemic proportions in the last few decades of the 20th century because of the obesity pandemic resulting from adverse lifestyles. Diabetes as a consequence of obesity (diabesity), continues to increase exponentially in the 21st century. Although there are a multitude of drugs for the effective management of diabesity with modest benefits, most patients will require insulin for control of diabetes at some stage that would worsen obesity, and thereby diabesity. Therefore, effective non-pharmacological therapy needs to be expedited in all patients with diabesity. These measures include medical nutrition interventions, change of lifestyles and bariatric surgery. Non-pharmacological interventions are also useful for the effective management of even type 1 diabetes mellitus when used along with insulin therapy especially in those with obesity. This review summarises the current evidence base for the non-pharmacological interventions in the management of diabetes.
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Affiliation(s)
| | - Elias C Chacko
- Department of Endocrinology, Jersey General Hospital, Jersey
| | - Joseph M Pappachan
- Department of Endocrinology, Diabetes & Metabolism, University Hospitals of Morecambe Bay NHS Foundation Trust, UK
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11
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Amor AJ, Pinyol M, Solà E, Catalan M, Cofán M, Herreras Z, Amigó N, Gilabert R, Sala-Vila A, Ros E, Ortega E. Relationship between noninvasive scores of nonalcoholic fatty liver disease and nuclear magnetic resonance lipoprotein abnormalities: A focus on atherogenic dyslipidemia. J Clin Lipidol 2017; 11:551-561.e7. [DOI: 10.1016/j.jacl.2017.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/20/2016] [Accepted: 02/09/2017] [Indexed: 12/12/2022]
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12
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Brugnara L, Murillo S, Novials A, Rojo-Martínez G, Soriguer F, Goday A, Calle-Pascual A, Castaño L, Gaztambide S, Valdés S, Franch J, Castell C, Vendrell J, Casamitjana R, Bosch-Comas A, Bordiú E, Carmena R, Catalá M, Delgado E, Girbés J, López-Alba A, Martínez-Larrad MT, Menéndez E, Mora-Peces I, Pascual-Manich G, Serrano-Ríos M, Gomis R, Ortega E. Low Physical Activity and Its Association with Diabetes and Other Cardiovascular Risk Factors: A Nationwide, Population-Based Study. PLoS One 2016; 11:e0160959. [PMID: 27532610 PMCID: PMC4988632 DOI: 10.1371/journal.pone.0160959] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/27/2016] [Indexed: 12/13/2022] Open
Abstract
Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a population-based, cross-sectional, randomly sampled study conducted in 2009-2010 in Spain. International Physical Activity Questionnaire (SF-IPAQ) was used to assess PA. 4991 individuals (median age 50 years, 57% women) were studied. Prevalence of sedentariness was 32.3% for men and 39% for women (p < 0.0001). Sex differences were particularly notable (age*sex interaction, p = 0.0024) at early and older ages. Sedentary individuals had higher BMI (28 vs. 27 kg/m2) and obesity prevalence (37 vs. 26%). Low PA was present in 44, 43, and 38% of individuals with known diabetes (KDM), prediabetes/unknown-diabetes (PREDM/UKDM), and normal glucose regulation (p = 0.0014), respectively. No difference between KDM and PREDM/UKDM (p = 0.72) was found. Variables independently associated (p < 0.05) with sedentariness were age, sex, BMI, central obesity, Mediterranean diet adherence, smoking habit, HDL-cholesterol, triglycerides and dyslipidemia. Low PA is on the rise in Spain, especially among women. Sedentariness is associated with several cardiovascular risk factors and may be responsible for the increasing prevalence of obesity and diabetes in this country.
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Affiliation(s)
- Laura Brugnara
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Serafín Murillo
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Anna Novials
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gemma Rojo-Martínez
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Hospital Universitario Carlos Haya, Department of Endocrinology and Nutrition, Málaga, Spain
| | - Federico Soriguer
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Hospital Universitario Carlos Haya, Department of Endocrinology and Nutrition, Málaga, Spain
| | - Albert Goday
- Hospital del Mar, Department of Endocrinology and Nutrition, Barcelona, Spain
| | | | - Luis Castaño
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Hospital Universitario de Cruces, UPV-EHU, Diabetes Research Group, Baracaldo, Spain
| | - Sonia Gaztambide
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Hospital Universitario de Cruces, UPV-EHU, Diabetes Research Group, Baracaldo, Spain
| | - Sergio Valdés
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Hospital Universitario Carlos Haya, Department of Endocrinology and Nutrition, Málaga, Spain
| | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, IDIAP, Barcelona, Spain
| | - Conxa Castell
- Public Health Division, Autonomous Government of Catalonia, Barcelona, Spain
| | - Joan Vendrell
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Tarragona, Spain
| | - Roser Casamitjana
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Anna Bosch-Comas
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Elena Bordiú
- Hospital Universitario San Carlos, Madrid, Spain
| | - Rafael Carmena
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Miguel Catalá
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Elias Delgado
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | | | | | - Maria Teresa Martínez-Larrad
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- CIBEROBN—Spanish Biomedical Research Centre in Physiopathology of Obesity
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | | | - Gemma Pascual-Manich
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel Serrano-Ríos
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ramon Gomis
- CIBERDEM—Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Madrid, Spain
- IDIBAPS—August Pi i Sunyer Biomedical Research Institute / Hospital Clínic de Barcelona, Barcelona, Spain
| | - Emilio Ortega
- CIBEROBN—Spanish Biomedical Research Centre in Physiopathology of Obesity
- Department of Endocrinology and Nutrition, ICMDM, Hospital Clinic Barcelona
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Amor AJ, Masana L, Soriguer F, Goday A, Calle-Pascual A, Gaztambide S, Rojo-Martínez G, Valdés S, Gomis R, Ortega E. Estimación del riesgo cardiovascular en España según la guía europea sobre prevención de la enfermedad cardiovascular en la práctica clínica. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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14
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Salas-Salvadó J, Guasch-Ferré M, Lee CH, Estruch R, Clish CB, Ros E. Protective Effects of the Mediterranean Diet on Type 2 Diabetes and Metabolic Syndrome. J Nutr 2015; 146:920S-927S. [PMID: 26962178 PMCID: PMC4807638 DOI: 10.3945/jn.115.218487] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/27/2015] [Accepted: 09/18/2015] [Indexed: 12/18/2022] Open
Abstract
Several studies provide evidence supporting a beneficial effect from the traditional Mediterranean diet (MedDiet) on the risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). This review summarizes the current scientific evidence from epidemiologic studies and clinical trials on the relation between the MedDiet and T2DM and MetS and the possible mechanisms underlying the reported associations. A recent meta-analysis of prospective cohort studies showed that greater adherence to the MedDiet was associated with a significant reduction in the risk of diabetes. The MedDiet has also been found to be beneficial in the prevention of gestational diabetes. Four large prospective studies have observed inverse associations between the MedDiet and MetS or its components. Few randomized controlled trials (RCTs) have evaluated the effect of the MedDiet on T2DM and MetS. Results from the landmark PREvención con DIeta MEDiterránea (PREDIMED) nutrition intervention trial showed that participants assigned to the MedDiet had a significant 30% reduction in the risk of T2DM and that it also promoted the reversion of MetS and its components, hyperglycemia and central obesity. In addition, 5 RCTs showed the beneficial effects of the MedDiet compared with other dietary patterns on glycemic control in patients with T2DM. A recent meta-analysis of RCTs revealed that, compared with a variety of control diets, the MedDiet was associated with beneficial effects on all MetS components. Bioactive components of the MedDiet synergize to affect various metabolic pathways, leading to a reduced cardiometabolic disease risk. The abundance of healthy, nutrient-dense foods that make up the plant-based MedDiet predicts its bioactivity and potential to beneficially influence metabolic pathways that lead to MetS and T2DM, as well as other chronic conditions. Abundant epidemiologic and clinical trial evidence supports the role of the MedDiet on the prevention and management of T2DM and MetS.
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Affiliation(s)
- Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
| | - Marta Guasch-Ferré
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Rovira i Virgili University, Reus, Spain
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
| | - Chih-Hao Lee
- Department of Genetics and Complex Diseases, Division of Biological Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ramón Estruch
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
- Department of Internal Medicine, August Pi i Sunyer Biomedical Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clary B Clish
- Broad Institute of MIT and Harvard, Cambridge, MA; and
| | - Emilio Ros
- Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, August Pi i Sunyer Biomedical Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
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15
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Amor AJ, Masana L, Soriguer F, Goday A, Calle-Pascual A, Gaztambide S, Rojo-Martínez G, Valdés S, Gomis R, Ortega E. Estimating Cardiovascular Risk in Spain by the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. ACTA ACUST UNITED AC 2014; 68:417-25. [PMID: 25444376 DOI: 10.1016/j.rec.2014.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/13/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with moderate risk. METHODS Participants (n=2310, 58% women) aged 40 to 65 years from a national population-based study (Di@bet.es Study) were identified. First, a priori high/very-high risk individuals were identified. Next, total cardiovascular risk (Systematic Coronary Risk Evaluation equation including high-density lipoprotein cholesterol) was used to assess risk of a priori non-high risk individuals. Variables independently associated with moderate versus low-risk were investigated by multiple logistic regression analysis. RESULTS Age-and-sex standardized (direct method) percentages of high/very-high, moderate, and low-risk were 22.8%, 43.5%, and 33.7%, respectively. Most men were at moderate (56.2%), while 55.4% of women were at low risk. Low-density lipoprotein cholesterol (< 70,<100, < 115 mg/dL) and blood pressure (<140/90 mmHg) goals for very-high, high and moderate risk were met in 15%, 26% and 46%, and 77%, 68% and 85% of the individuals, respectively. Body mass index, high triglycerides concentrations, diastolic blood pressure, and low Mediterranean diet adherence (in women) were independently associated with moderate (versus low) risk. CONCLUSIONS Cardiovascular risk in Spain is mainly moderate in men and low in women. Achievement of treatment goals in high-risk individuals should be improved. The prevalence of non-classical cardiovascular risk factors is elevated in subjects at moderate risk, an important aspect to consider in a population-based strategy to decrease cardiovascular disease in the most prevalent group.
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Affiliation(s)
- Antonio Jesús Amor
- Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Luis Masana
- Unidad de Medicina Vascular y Metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Albert Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos , Madrid, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain
| | - Ramón Gomis
- Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Emilio Ortega
- Servicio de Endocrinología y Nutrición, Hospital Clínic, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain.
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16
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Duran A, Sáenz S, Torrejón MJ, Bordiú E, Del Valle L, Galindo M, Perez N, Herraiz MA, Izquierdo N, Rubio MA, Runkle I, Pérez-Ferre N, Cusihuallpa I, Jiménez S, García de la Torre N, Fernández MD, Montañez C, Familiar C, Calle-Pascual AL. Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St. Carlos Gestational Diabetes Study. Diabetes Care 2014; 37:2442-50. [PMID: 24947793 DOI: 10.2337/dc14-0179] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The use of the new International Association of the Diabetes and Pregnancy Study Groups criteria (IADPSGC) for the diagnosis of gestational diabetes mellitus (GDM) results in an increased prevalence of GDM. Whether their introduction improves pregnancy outcomes has yet to be established. We sought to evaluate the cost-effectiveness of one-step IADPSGC for screening and diagnosis of GDM compared with traditional two-step Carpenter-Coustan (CC) criteria. RESEARCH DESIGN AND METHODS GDM risk factors and pregnancy and newborn outcomes were prospectively assessed in 1,750 pregnant women from April 2011 to March 2012 using CC and in 1,526 pregnant women from April 2012 to March 2013 using IADPSGC between 24 and 28 weeks of gestation. Both groups received the same treatment and follow-up regimes. RESULTS The use of IADPSGC resulted in an important increase in GDM rate (35.5% vs. 10.6%) and an improvement in pregnancy outcomes, with a decrease in the rate of gestational hypertension (4.1 to 3.5%: -14.6%, P < 0.021), prematurity (6.4 to 5.7%: -10.9%, P < 0.039), cesarean section (25.4 to 19.7%: -23.9%, P < 0.002), small for gestational age (7.7 to 7.1%: -6.5%, P < 0.042), large for gestational age (4.6 to 3.7%: -20%, P < 0.004), Apgar 1-min score <7 (3.8 to 3.5%: -9%, P < 0.015), and admission to neonatal intensive care unit (8.2 to 6.2%: -24.4%, P < 0.001). Estimated cost savings was of €14,358.06 per 100 women evaluated using IADPSGC versus the group diagnosed using CC. CONCLUSIONS The application of the new IADPSGC was associated with a 3.5-fold increase in GDM prevalence in our study population, as well as significant improvements in pregnancy outcomes, and was cost-effective. Our results support their adoption.
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Affiliation(s)
- Alejandra Duran
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Sofía Sáenz
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - María J Torrejón
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Mercedes Galindo
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Noelia Perez
- Gynecology and Obstetrician Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Miguel A Herraiz
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain Gynecology and Obstetrician Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Nuria Izquierdo
- Gynecology and Obstetrician Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Natalia Pérez-Ferre
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Idalia Cusihuallpa
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Sandra Jiménez
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | | | - María D Fernández
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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17
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Velasco N, Contreras A, Grassi B. The Mediterranean diet, hepatic steatosis and nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care 2014; 17:453-7. [PMID: 25023188 DOI: 10.1097/mco.0000000000000071] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to present the pathophysiological mechanisms and most recent clinical evidence regarding the role of the Mediterranean diet in preventing and treating nonalcoholic fatty liver disease (NAFLD). RECENT FINDINGS Several components of the Mediterranean diet have proven benefits in controlling the pathophysiological mechanisms involved in NAFLD. However, the few clinical studies that have assessed the diet have involved low numbers of patients and lacked methodological rigor. The results of these studies suggest that the Mediterranean diet attenuates the progression of NAFLD once it is established, but does not contribute to preventing the disease in patients at risk. SUMMARY Although there is a lack of clinical evidence derived from studies with high-quality methodology, the pathophysiological mechanisms of NAFLD shared with other associated pathologies suggest that there is a role for the Mediterranean diet in managing NAFLD. Studies with better methodology are needed to confirm the impact of the diet.
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Affiliation(s)
- Nicolás Velasco
- Department of Nutrition, Diabetes and Metabolism, School of Medicine; Pontificia Universidad Católica de Chile, Santiago, Chile
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18
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Koloverou E, Esposito K, Giugliano D, Panagiotakos D. The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants. Metabolism 2014; 63:903-11. [PMID: 24931280 DOI: 10.1016/j.metabol.2014.04.010] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 04/10/2014] [Accepted: 04/16/2014] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The purpose of this work was to meta-analyze prospective studies that have evaluated the effect of a Mediterranean diet on the development of type 2 diabetes. MATERIALS/METHODS PubMed, Embase and the Cochrane Central Register of Controlled Trials databases were searched up to 20 November 2013. English language publications were allocated; 17 original research studies (1 clinical trial, 9 prospective and 7 cross-sectional) were identified. Primary analyses were limited to prospective studies and clinical trials, yielding to a sample of 136,846 participants. A systematic review and a random effects meta-analysis were conducted. RESULTS Higher adherence to the Mediterranean diet was associated with 23% reduced risk of developing type 2 diabetes (combined relative risk for upper versus lowest available centile: 0.77; 95% CI: 0.66, 0.89). Subgroup analyses based on region, health status of participants and number of confounders controlling for, showed similar results. Limitations include variations in Mediterranean diet adherence assessment tools, confounders' adjustment, duration of follow up and number of events with diabetes. CONCLUSIONS The presented results are of major public health importance, since no consensus exists concerning the best anti-diabetic diet. Mediterranean diet could, if appropriately adjusted to reflect local food availability and individual's needs, constitute a beneficial nutritional choice for the primary prevention of diabetes.
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Affiliation(s)
- Efi Koloverou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Katherine Esposito
- Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy
| | - Dario Giugliano
- Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy
| | - Demosthenes Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
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19
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Rojo-Martínez G, Maymó-Masip E, Rodríguez MM, Solano E, Goday A, Soriguer F, Valdés S, Chaves FJ, Delgado E, Colomo N, Hernández P, Vendrell J, Chacón MR. Serum sCD163 levels are associated with type 2 diabetes mellitus and are influenced by coffee and wine consumption: results of the Di@bet.es study. PLoS One 2014; 9:e101250. [PMID: 24978196 PMCID: PMC4076325 DOI: 10.1371/journal.pone.0101250] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 06/04/2014] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Serum levels of soluble TNF-like weak inducer of apoptosis (sTWEAK) and its scavenger receptor CD163 (sCD163) have been linked to insulin resistance. We analysed the usefulness of these cytokines as biomarkers of type 2 diabetes in a Spanish cohort, together with their relationship to food consumption in the setting of the Di@bet.es study. RESEARCH DESIGN AND METHODS This is a cross-sectional, matched case-control study of 514 type 2 diabetes subjects and 517 controls with a Normal Oral Glucose Tolerance Test (NOGTT), using data from the Di@bet.es study. Study variables included clinical and demographic structured survey, food frequency questionnaire and physical examination. Serum concentrations of sTWEAK and sCD163 were measured by ELISA. Linear regression analysis determined which variables were related to sTWEAK and sCD163 levels. Logistic regression analysis was used to estimate odd ratios of presenting type 2 diabetes. RESULTS sCD163 concentrations and sCD163/sTWEAK ratio were 11.0% and 15.0% higher, respectively, (P<0.001) in type 2 diabetes than in controls. Following adjustment for various confounders, the OR for presenting type 2 diabetes in subjects in the highest vs the lowest tertile of sCD163 was [(OR), 2,01 (95%CI, 1,46-2,97); P for trend <0.001]. Coffee and red wine consumption was negatively associated with serum levels of sCD163 (P = 0.0001 and; P = 0.002 for coffee and red wine intake, respectively). CONCLUSIONS High circulating levels of sCD163 are associated with type 2 diabetes in the Spanish population. The association between coffee and red wine intake and these biomarkers deserves further study to confirm its potential role in type 2 diabetes.
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Affiliation(s)
- Gemma Rojo-Martínez
- UGCI de Endocrinología y Nutrición, Instituto de Biomedicina de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
| | - Elsa Maymó-Masip
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - M. Mar Rodríguez
- CIBERObn Fisiopatología, Obesidad y Nutrición, Institut D’investigacio Biomedica De Girona Dr Josep Trueta, Girona, Spain
| | - Esther Solano
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition Hospital del Mar, Parc de Salut Mar, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Federico Soriguer
- UGCI de Endocrinología y Nutrición, Instituto de Biomedicina de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
| | - Sergio Valdés
- UGCI de Endocrinología y Nutrición, Instituto de Biomedicina de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
| | - Felipe Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
- Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, Valencia, Spain
| | - Elías Delgado
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Spain
| | - Natalia Colomo
- UGCI de Endocrinología y Nutrición, Instituto de Biomedicina de Málaga (IBIMA), Hospital Regional Universitario, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
| | - Pilar Hernández
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Matilde R. Chacón
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas CIBERDEM, Barcelona, Spain
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
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20
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Georgoulis M, Kontogianni MD, Yiannakouris N. Mediterranean diet and diabetes: prevention and treatment. Nutrients 2014; 6:1406-23. [PMID: 24714352 PMCID: PMC4011042 DOI: 10.3390/nu6041406] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 03/03/2014] [Accepted: 03/20/2014] [Indexed: 01/04/2023] Open
Abstract
The aim of the present review is to examine current scientific knowledge on the association between the Mediterranean diet and diabetes mellitus (mostly type 2 diabetes). A definition of the Mediterranean diet and the tools widely used to evaluate adherence to this traditional diet (Mediterranean diet indices) are briefly presented. The review focuses on epidemiological data linking adherence to the Mediterranean diet with the risk of diabetes development, as well as evidence from interventional studies assessing the effect of the Mediterranean diet on diabetes control and the management of diabetes-related complications. The above mentioned data are explored on the basis of evaluating the Mediterranean diet as a whole dietary pattern, rather than focusing on the effect of its individual components. Possible protective mechanisms of the Mediterranean diet against diabetes are also briefly discussed.
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Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Street, Athens 17671, Greece.
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Street, Athens 17671, Greece.
| | - Nikos Yiannakouris
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Street, Athens 17671, Greece.
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