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Polić N, Matulić V, Dragun T, Matek H, Marendić M, Efendić IŽ, Russo A, Kolčić I. Association between Mediterranean Diet and Advanced Glycation End Products in University Students: A Cross-Sectional Study. Nutrients 2024; 16:2483. [PMID: 39125363 PMCID: PMC11313892 DOI: 10.3390/nu16152483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
The aim of this study was to evaluate the association between the Mediterranean diet (MD) and the accumulation of advanced glycation end products (AGEs) measured by skin autofluorescence. This cross-sectional study included 1016 healthy students from the University of Split, Croatia. Participants completed a self-administered questionnaire. Adherence to the MD was assessed using the Mediterranean Diet Serving Score (MDSS), and tissue AGEs accumulation was measured using the AGE Reader mu (DiagnOptics). Multivariate linear regression was used in the analysis. Students' age and female gender were associated with higher levels of AGEs, which was likewise found for greater coffee intake, adequate olive oil consumption, smoking, and lower levels of physical activity. Higher consummation of vegetables and eating breakfast regularly were associated with lower AGEs levels. The overall MD adherence was not associated with AGEs, possibly due to very low overall compliance to the MD principles among students (8.3% in women and 3.8% in men). Health perception was positively associated with the MD and nonsmoking and negatively with the perceived stress level, while AGEs did not show significant association with self-rated students' health. These results indicate that various lifestyle habits are associated with AGEs accumulation even in young and generally healthy people. Hence, health promotion and preventive measures are necessary from an early age.
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Affiliation(s)
- Nikolina Polić
- General Hospital Šibenik, Ul. Stjepana Radića 83, 22000 Šibenik, Croatia;
| | - Viviana Matulić
- Department of Obstetrics and Gynecology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia;
| | - Tanja Dragun
- Department of Physiology, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia;
| | - Helena Matek
- Family Medicine Practice, Ulica Stjepana Radića 83, 22000 Šibenik, Croatia;
| | - Mario Marendić
- University Department of Health Studies, University of Split, Ul. Ruđera Boškovića 35, 21000 Split, Croatia;
| | | | - Andrea Russo
- Faculty of Maritime Studies, University of Split, Ruđera Boškovića 37, 21000 Split, Croatia;
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
- Andrija Stampar Teaching Institute of Public Health, Mirogojska Cesta 16, 10000 Zagreb, Croatia
- Psychiatric Clinic Sveti Ivan, Jankomir 11, 10090 Zagreb, Croatia
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Jureško I, Pleić N, Gunjača I, Torlak V, Brdar D, Punda A, Polašek O, Hayward C, Zemunik T, Babić Leko M. The Effect of Mediterranean Diet on Thyroid Gland Activity. Int J Mol Sci 2024; 25:5874. [PMID: 38892060 PMCID: PMC11172479 DOI: 10.3390/ijms25115874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
The main goal of this research was to determine whether there is a correlation between adherence to the Mediterranean diet (assessed by the Mediterranean Diet Serving Score (MDSS)) and parameters indicating thyroid gland activity, such as concentration of thyroid-stimulating hormone (TSH), thyroid hormones (free triiodothyronine (fT3), free thyroxine (fT4)), thyroglobulin (Tg), antibodies to thyroid proteins (thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb)), and calcitonin (CT) in plasma and serum samples. An additional objective was to investigate whether there are differences in the values of the MDSS among clinical groups (euthyroid individuals, euthyroid individuals with positive TgAb and/or TPOAb, and hypothyroid and hyperthyroid participants). This cross-sectional study included 4620 participants over 18 years of age from the islands of Korčula and Vis, and the mainland city of Split. The MDSS was assessed from a food frequency questionnaire (FFQ). MDSS values were significantly higher in females compared to males and showed a positive association with the age of the participants. There was no significant difference in the MDSS values among the examined clinical groups. In the group of subjects with euthyroidism, a significant positive association was found between fT3 and the MDSS, while in the group of subjects with subclinical hypothyroidism, a significant positive association was observed between the MDSS and both fT3 and fT4. CT levels were also positively associated with the MDSS. Considering the significant positive association of the MDSS and both fT3 and fT4 levels in patients with subclinical hypothyroidism, the results of this study could be used to create guidelines for selecting an appropriate, potentially protective diet for these patients.
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Affiliation(s)
- Iva Jureško
- Department of Biology and Human Genetics, School of Medicine, University of Split, 21 000 Split, Croatia
| | - Nikolina Pleić
- Department of Biology and Human Genetics, School of Medicine, University of Split, 21 000 Split, Croatia
| | - Ivana Gunjača
- Department of Biology and Human Genetics, School of Medicine, University of Split, 21 000 Split, Croatia
| | - Vesela Torlak
- Department of Nuclear Medicine, University Hospital of Split, 21 000 Split, Croatia
| | - Dubravka Brdar
- Department of Nuclear Medicine, University Hospital of Split, 21 000 Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital of Split, 21 000 Split, Croatia
| | - Ozren Polašek
- Department of Public Health, School of Medicine, University of Split, Šoltanska 2, 21 000 Split, Croatia
- Algebra University College, 10 000 Zagreb, Croatia
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK;
| | - Tatijana Zemunik
- Department of Biology and Human Genetics, School of Medicine, University of Split, 21 000 Split, Croatia
- Department of Nuclear Medicine, University Hospital of Split, 21 000 Split, Croatia
| | - Mirjana Babić Leko
- Department of Biology and Human Genetics, School of Medicine, University of Split, 21 000 Split, Croatia
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Damigou E, Faka A, Kouvari M, Anastasiou C, Kosti RI, Chalkias C, Panagiotakos D. Adherence to a Mediterranean type of diet in the world: a geographical analysis based on a systematic review of 57 studies with 1,125,560 participants. Int J Food Sci Nutr 2023; 74:799-813. [PMID: 37771002 DOI: 10.1080/09637486.2023.2262781] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
This systematic review aimed to assess the level and time-trends of adherence to Mediterranean-type diets (MTD) among the general population, globally. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a comprehensive literature search of the MEDLINE and Scopus databases was carried out, until 04/09/2023, based on specific criteria. Fifty-seven studies with 1,125,560 apparently healthy adults from Europe (n = 37), US (n = 8), Asia (n = 8), Australia (n = 4) and Africa (n = 1) were included. Adherence to an MTD was moderate with a significant decline observed in the last decade. European countries, mainly driven by Mediterranean countries, showed higher adherence than other regions. Geographical analysis revealed that adherence to an MTD is related to both geographic location and socioeconomic status throughout the world.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Antigoni Faka
- Department of Geography, School of Environmental Sciences, Harokopio University, Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Costas Anastasiou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly Trikala, Greece
| | - Christos Chalkias
- Department of Geography, School of Environmental Sciences, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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Calella P, Gallè F, Cerullo G, Postiglione N, Ricchiuti R, Liguori G, D'Angelo S, Valerio G. Adherence to Mediterranean Diet among athletes participating at the XXX summer universiade. Nutr Health 2023; 29:645-651. [PMID: 35388722 DOI: 10.1177/02601060221089118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: A well-balanced diet is essential in sport. Due to its typical content in high-quality proteins, low glycemic index foods, and unsaturated fats, Mediterranean Diet (MD) may represent a good choice to cover nutritional needs of athletes. The aim of this study was to explore how the dietary habits of elite athletes, such as those competing at the XXX Summer Universiade, comply with the MD model. A comparison between athletes coming from the Mediterranean and non-Mediterranean countries was also assessed. Methods: The Mediterranean Diet Serving Score (MDSS) questionnaire was administered to a sample of 433 university student athletes from all over of the world to evaluate the level of adherence to the MD pattern and possible differences between geographical areas. Results: The total sample showed a medium adherence to the MD, with a mean MDSS of 15.73 ± 3.71 out of a total of 23 points. A satisfactory consumption of fruits and vegetables was reported. Athletes from Northern European countries had a lower MD pattern adherence than the other ones. Conclusions: These findings suggest that the MD model is common among elite athletes, and it may be promoted as a healthy dietary pattern in the sport setting.
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Affiliation(s)
- Patrizia Calella
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Giuseppe Cerullo
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Nunzia Postiglione
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Roberta Ricchiuti
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Stefania D'Angelo
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
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Kocaadam-Bozkurt B, Bozkurt O. Relationship between adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and awareness of reducing the ecological footprint. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:430-440. [PMID: 36726049 DOI: 10.1080/09603123.2023.2172384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
This study evaluated the relationship between adherence to the Mediterranean diet (MD), sustainable and healthy eating behaviors, and awareness of reducing the ecological footprint. It was conducted with 1333 adults (38.2% male, 61.8% female, mean age 24.2 ± 7.5 years). The questionnaire included socio-demographic characteristics, anthropometric measurements, the Awareness Scale for Reducing Ecological Footprint (ASREF), the Sustainable and Healthy Eating (SHE) Behaviors Scale, and Mediterranean Diet Adherence Scale (MEDAS). 40.2% of the participants adhered to the MD (≥7 scores). Obese individuals' total scores on MEDAS, SHE Behaviors Scale, and ASREF were the lowest (p < 0.05). In regression analysis, education duration, SHE Behaviors Scale total score, and BMI affected the ASREF score (p < 0.05). The education duration, SHE Behaviors Scale scores, and ASREF scores were higher in those in MD-adherence group (p < 0.05). In conclusion, adherence to the MD was associated with higher sustainable and healthy eating behaviors and higher awareness of ecological footprint reduction.
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Affiliation(s)
- Betül Kocaadam-Bozkurt
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Erzurum Technical University, Erzurum, Turkey
| | - Osman Bozkurt
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Erzurum Technical University, Erzurum, Turkey
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Kendel Jovanović G, Janković S, Pavičić ŽeŽelj S. The effect of nutritional and lifestyle education intervention program on nutrition knowledge, diet quality, lifestyle, and nutritional status of Croatian school children. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2023.1019849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
IntroductionNutrition education during adolescence has proven effective in increasing knowledge, attitudes, and practices in the diet. The Mediterranean diet has proven health benefits and is proposed as a model of a sustainable diet that is beneficial for health and the environment. Its promotion with the educational program can have a significant effect on improvements in nutrition knowledge, diet quality, and nutritive status of adolescents for their healthy adulthood.ObjectiveThis study aimed to investigate the effect of the educational program on the nutrition knowledge, diet quality, lifestyle, and nutritional status of school children from the littoral part of Croatia.MethodsAn education-based intervention study was carried out on 2,709 schoolchildren aged 10–12 years (educated/control group: 2617/92). The questionnaire about sociodemographic, anthropometric, dietary, physical activity, screen time, sleep habits, and nutrition knowledge was assessed at the baseline and after a 6- to 9-month follow-up for the medium-term effect of education. Nutrition knowledge was provided after 3 weeks for the short-term education effect assessment.ResultsEducated schoolchildren achieved a significant increase in nutrition knowledge (+75.5%), expressed as a short-term effect of the education and maintained at the 6- to 9-month follow-up (+66.8%, p < 0.001). Follow-up of children significantly improved their nutritional status (underweight −56.6%, normal weight 24.8%, overweight −22.1%, and obesity −57.5%) and physical activity engagement (+13.2%). The proportion of children with a diet highly adhering to the Mediterranean diet significantly doubled (+105.0). Those children with the highest nutrition knowledge at the follow-up significantly improved their nutritional status (+218.9%), participated in organized sports (+204.7%), and had a diet that highly adhered to the MD (+291.8%).ConclusionA significantly good medium-term effect of education-based nutrition and lifestyle intervention program on nutrition knowledge, diet quality, lifestyle, and nutritional status of schoolchildren aged 10–12 years was shown. The educational program promoted a Mediterranean diet and lifestyle as a healthy and sustainable way of living, important for children's future health and wellbeing. New research-based approaches are needed for making children more aware and capable of handling the complexity of sustainable living.
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Mieziene B, Emeljanovas A, Novak D, Kawachi I. Social Capital Promotes a Healthier Diet among Young Adults by Reducing Psychological Distress. Nutrients 2022; 14:nu14235187. [PMID: 36501217 PMCID: PMC9737172 DOI: 10.3390/nu14235187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Studies have revealed the links between social capital and diet. However, the mediating role of psychological distress in this relationship has been understudied. This study aims to identify direct and indirect relationships between social capital and adherence to the Mediterranean diet among Lithuanian young adults and identify the mediating role of psychological distress in this relationship. Data were collected from 1336 young adults, aged 18-36 years; 40.5% were males. MEDAS was used to measure adherence to a healthy diet. Social capital was measured by eight separate items in terms of family support, social support, social cohesion, social trust, communication, collaboration, participation, and distant communication. Kessler's six-item scale was used to assess psychological distress. Higher family support (β = 0.105), higher social participation (β = 0.294), and lower psychological distress (β = 0.073) directly predicted higher adherence to the Mediterranean diet. Social capital was indirectly related to adherence to the Mediterranean diet, with standardized effect sizes of 0.02-0.04, indicating small effect sizes. Thus, psychological distress mediates the relationship between social capital and a healthy diet. Given that social capital is related to psychological health and both directly and indirectly predicts healthy behavior in young adults, further longitudinal and experimental research is required to measure the effects of the intervention on incorporating, facilitating, encouraging, and implementing measures to strengthen the social connection between people and groups of people within the community, neighborhood, and organizations.
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Affiliation(s)
- Brigita Mieziene
- Department of Physical and Social Education, Lithuanian Sports University, 44221 Kaunas, Lithuania
- Correspondence:
| | - Arunas Emeljanovas
- Department of Physical and Social Education, Lithuanian Sports University, 44221 Kaunas, Lithuania
| | - Dario Novak
- The Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Effects of Cardiac Rehabilitation and Diet Counselling on Adherence to the Mediterranean Lifestyle in Patients after Myocardial Infarction. Nutrients 2022; 14:nu14194048. [PMID: 36235701 PMCID: PMC9572874 DOI: 10.3390/nu14194048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 02/06/2023] Open
Abstract
Adherence to the Mediterranean lifestyle—as captured by the Medlife Index Questionnaire (i.e., encompassing a Mediterranean diet as well as other aspects of healthy living, such as food preparation, physical activity, and socializing)—has been associated with reduced cardiovascular events in healthy individuals. In the present study, we sought to determine the adherence to, and the effect of comprehensive cardiac rehabilitation on, Mediterranean lifestyle adherence in patients after myocardial infarction. We included 121 patients (mean age, 55 years; women, 37%) undergoing comprehensive cardiac rehabilitation—i.e., exercise training 3 times per week for 12 weeks plus dedicated workshops promoting the Mediterranean lifestyle. Before and after cardiac rehabilitation, patients completed the Medlife Index Questionnaire. High baseline adherence was associated with favourable glucose (5.39 vs. 6.1 mmol/L; p < 0.001), triglycerides (1.1 vs. 1.5 mmol/L; p = 0.002), and HDL cholesterol levels (1.32 vs. 1.12 mmol/L; p = 0.032). More importantly, the Medlife Score significantly improved following comprehensive cardiac rehabilitation in patients with low baseline adherence (from 13.8 to 16.7 points; p < 0.001), but not in patients with high baseline adherence (from 19.4 to 18.8 points; p = 0.205). Our findings suggested that Mediterranean lifestyle promotion during cardiac rehabilitation improved adherence to the Mediterranean lifestyle, especially in low-adherence patients.
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Mieziene B, Burkaite G, Emeljanovas A, Tilindiene I, Novak D, Kawachi I. Adherence to Mediterranean diet among Lithuanian and Croatian students during COVID-19 pandemic and its health behavior correlates. Front Public Health 2022; 10:1000161. [PMID: 36187633 PMCID: PMC9523256 DOI: 10.3389/fpubh.2022.1000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/19/2022] [Indexed: 01/26/2023] Open
Abstract
Maintaining healthy behavior, especially in times of crisis like the COVID-19 pandemic, is particularly important for staying healthy. Nutrition is an everyday behavior and along with other health-related behaviors is associated with many health outcomes. The aim of this study was to assess and compare adherence to the Mediterranean diet (MedDiet) and particular food choices among the Mediterranean and non-Mediterranean populations of university students and identify its lifestyle correlates at the outburst of the COVID-19 pandemic. In total, self-reported data on health-related behavior and sociodemographic characteristics were collected from 1,388 study participants, 66.4% were Lithuanians, and 33.6% were Croatians. Results revealed that vegetables, olive oil, fruits, nuts, legumes, and fish were remarkably underconsumed among university students in the Mediterranean and non-Mediterranean countries during the COVID-19 pandemic, and the composite diet is similar between countries. The higher adherence to MedDiet is associated with physical activity (β = 0.15) and non-smoking (β = 0.08). In times of crisis, public health entities should provide knowledge, skills, and tools for healthy nutrition specifying them by age and subpopulation. Interventions at the university should be implemented to build infrastructure and provide an access to health behavior-friendly environments.
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Affiliation(s)
- Brigita Mieziene
- Department of Physical and Social Education, Lithuanian Sports University, Kaunas, Lithuania,*Correspondence: Brigita Mieziene
| | - Greta Burkaite
- Department of Physical and Social Education, Lithuanian Sports University, Kaunas, Lithuania
| | - Arunas Emeljanovas
- Department of Physical and Social Education, Lithuanian Sports University, Kaunas, Lithuania
| | - Ilona Tilindiene
- Department of Physical and Social Education, Lithuanian Sports University, Kaunas, Lithuania
| | - Dario Novak
- Department of General and Applied Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States
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Gerić M, Matković K, Gajski G, Rumbak I, Štancl P, Karlić R, Bituh M. Adherence to Mediterranean Diet in Croatia: Lessons Learned Today for a Brighter Tomorrow. Nutrients 2022; 14:nu14183725. [PMID: 36145100 PMCID: PMC9504207 DOI: 10.3390/nu14183725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
Non-communicable diseases (NCD) and lifestyle, particularly diet, have a close relationship. Based on the recent statistics, Croatian men and women lead in European overweight lists, which implies pessimistic prognosis in terms of incidence and prevalence of NCDs in the future. One of the possible solutions to overcome weight problems is turn to traditional balanced and sustainable diets, such as the Mediterranean diet. In this study, we assessed adherence towards Mediterranean diet using a validated questionnaire in an online survey and associated adherence scores with several demographic and anthropometric data. Based on the results of a validated Mediterranean Diet Adherence Screener (N = 3326), we assessed the adherence score to be 7.6 ± 2.5. The score tended to depend on sex, residence, age, education, income, and body mass index (BMI); indeed, women, residents of a coastal part of the country, older volunteers, those possessing a higher education degree, those with higher income, and those with lower BMI were associated with higher scores. As income was one of the significant findings related to higher adherence scores, we developed a dietary plan complying with Mediterranean diet principles that, on average, costed less than the average traditional balanced diet menu. Taken together, this study brought new findings regarding target groups who need to be encouraged to make lifestyle changes, and highlighted the first steps on how to make them.
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Affiliation(s)
- Marko Gerić
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10 000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-14682500
| | - Katarina Matković
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10 000 Zagreb, Croatia
| | - Goran Gajski
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10 000 Zagreb, Croatia
| | - Ivana Rumbak
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10 000 Zagreb, Croatia
| | - Paula Štancl
- Faculty of Science, University of Zagreb, 10 000 Zagreb, Croatia
| | - Rosa Karlić
- Faculty of Science, University of Zagreb, 10 000 Zagreb, Croatia
| | - Martina Bituh
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10 000 Zagreb, Croatia
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Marinac Pupavac S, Kenðel Jovanović G, Linšak Ž, Glad M, Traven L, Pavičić Žeželj S. The influence on fish and seafood consumption, and the attitudes and reasons for its consumption in the Croatian population. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.945186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Fish makes an important part of the Mediterranean diet, which has been scientifically proven to help preserve human health by protecting against major chronic and inflammatory diseases. Eating fish and seafood is very important, not only for its proven health benefits but also for its positive impact on the environment. Due to many fish and seafood significant positive effects on human health, this study aimed to investigate the socio-demographic factors associated with the consumption of fish and seafood in the population of Primorsko-goranska County in Croatia. Another aim was to determine people's attitudes, choices, and reasons for the consumption of fish and seafood. Self-reported data from 2,910 participants were used. According to the European dietary recommendations for fish consumption, the participants were divided into two groups; the very low to low fish consumption group and the moderate to high fish consumption group, in order to examine the differences in socio-demographic and lifestyle variables, and their attitudes, opinions, and reasons for fish and seafood consumption. More fish and seafood were consumed by women, the elderly, the more educated, non-smokers, and more physically active participants. Age, the highest level of education, and a diet even moderately adherent to the Mediterranean diet was found to significantly increase the likelihood of recommended fish consumption. Participants considered the best reasons to consume more fish lower prices, buy much more locally produced fishery products, and prefer to eat wild-caught fish rather than farmed fish. The study has found a slight increase in fish consumption, although still lower than the European average. It also showed significant socio-demographic associations, also the reasons and attitudes toward higher fish and seafood consumption of the Croatian population. The obtained research data are valuable for planning future public health programs in Croatia aimed at greater consumption of fish and seafood, as well as their promotion as an important part of a sustainable diet.
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Interconnectedness between periodontitis stage, oral hygiene habits, adherence to the Mediterranean diet and nutritional status in Dalmatian kidney transplant recipients: a cross-sectional study. Sci Rep 2022; 12:11614. [PMID: 35803958 PMCID: PMC9270487 DOI: 10.1038/s41598-022-15589-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
The aim of this cross-sectional study was to determine the associations between the Mediterranean diet (MeDi), nutritional status parameters, muscle strength, and periodontal status in Dalmatian kidney transplant recipients (KTRs). 89 KTRs were included in this analysis, 40 (45%) women, with a mean age of 61 years (IQR = 13) and a mean time since kidney transplantation of 5 years (IQR = 6.6). An OHIP-14 questionnaire and questionnaire-based periodontal history were obtained from all participants, a comprehensive periodontal examination was performed. Body composition data, anthropometric and clinical parameters were collected for each study participant. The Mediterranean Diet Serving Score (MDSS) was used to assess MeDi adherence, and handgrip strength was measured with a hand dynamometer. Our results showed low adherence to MeDi in KTRs (28%) and almost 50% of KTRs suffer from severe forms of periodontitis. We also found a low OHIP-14 score and poor oral hygiene habits. KTRs with a less severe form of periodontitis had higher muscle mass and handgrip strength. MDSS score was associated with a higher number of teeth, and everyday cereal intake was inversely associated with the periodontitis stage. Our results demonstrate the associations between nutritional status, muscle strength, dietary habits, and periodontal health in Dalmatian KTRs.
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Mediterranean Diet Adherence and Nutritional Status in Dalmatian Diabetic Hypertensive Patients Regarding Presence of Chronic Kidney Disease—Is There Any Difference? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042293. [PMID: 35206484 PMCID: PMC8872492 DOI: 10.3390/ijerph19042293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 01/27/2023]
Abstract
In recent years, the Mediterranean diet has emerged as one of the dietary patterns that could have positive effects on overall health as well in the treatment of non-communicable chronic diseases. The aim of this cross-sectional study was to determine differences in adherence to the Mediterranean diet (MeDi) and nutritional status in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) regarding the presence of chronic kidney disease (CKD). Two hundred and forty-eight Dalmatian diabetic hypertensive patients (DDHP) were included, and 164 (66.1%) of them had CKD. Data about anthropometric parameters, clinical and laboratory parameters, as well as lifestyle questionnaire and Mediterranean Diet Serving Score (MDSS) were collected for each study participant. Furthermore, body composition was assessed using MC-780 Multi Frequency Segmental Body Mass Analyzer (Tanita). Body mass index (BMI) as well as waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Results showed that only 8.9% of DDHP were adherent to the MeDi without significant differences regarding the presence of CKD. Therefore, only 9.1% of participants with CKD were adherent to the MeDi. Dietary recommendations were received by 52.8% of DDHP and 49.4% with CKD, while only 12.8% of those with CKD were adherent to the given recommendations. The results showed that 88.3% of DDHP and 87.8% of the DDHP with CKD were overweight or obese. Statically significant lower frequency of nut intake suggested by the MeDi was found in those participants with CKD (p = 0.02). Therefore, the significant associations between adherence to each MeDi component as well as MDSS score with the development of CKD among all study subjects were not found. In conclusion, the results showed a low level of nutritional care in our region and low adherence to MeDi among DDHP. According to the results, there is an urgent need to improve nutritional care in our region, with a special focus on the MeDi for this especially vulnerable population of patients.
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Matana A, Franić I, Radić Hozo E, Burger A, Boljat P. Adherence to the Mediterranean Diet among Children and Youth in the Mediterranean Region in Croatia: A Comparative Study. Nutrients 2022; 14:nu14020302. [PMID: 35057484 PMCID: PMC8780278 DOI: 10.3390/nu14020302] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 02/06/2023] Open
Abstract
The Mediterranean diet (MD) is considered one of the healthiest dietary patterns. The aim of this study was to assess MD adherence in children and youth living in the Mediterranean region in Croatia and evaluate the differences in adherence to the MD among different educational stages. In total, 2722 individuals aged 2 to 24 years were enrolled in this study. Subjects were divided into different groups according to the Croatian educational system. Mediterranean Diet Quality Index (KIDMED) was used to assess adherence to the MD. In the total sample, the adherence to the MD was poor in 19.2%, average in 60.8%, and good in 20.1% of the study participants. The prevalence rate of poor adherence to the MD increased with higher educational stage, i.e., the highest prevalence rate of poor MD adherence was observed for college students (39.3%). Children having a higher number of snacks on days-off, those with lower physical activity, and not having breakfast together with a family are more likely to have poor MD adherence, while children having a higher number of snacks on working days are less likely to have a poor MD. The results of this study showed low adherence to the principles of the MD, confirming the need for improvement of adherence to the MD pattern in the studied population.
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Affiliation(s)
- Antonela Matana
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
- Correspondence:
| | - Ivana Franić
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
| | - Endica Radić Hozo
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
| | - Ante Burger
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
| | - Petra Boljat
- Elementary School Žnjan-Pazdigrad, Pazdigradska 1, 21000 Split, Croatia;
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Obeid CA, Gubbels JS, Jaalouk D, Kremers SPJ, Oenema A. Adherence to the Mediterranean diet among adults in Mediterranean countries: a systematic literature review. Eur J Nutr 2022; 61:3327-3344. [PMID: 35451614 PMCID: PMC9026058 DOI: 10.1007/s00394-022-02885-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/31/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM While the Mediterranean diet (MD) is promoted in non-Mediterranean countries, inhabitants of Mediterranean countries seem to be shifting away from this healthy diet. The aim of this study is to provide an overview of MD adherence in the general adult population of Mediterranean countries. METHODS A systematic review was conducted following the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and registered in the Prospero database (CRD42020189337). Literature was searched in PubMed, Web of Science and PsycINFO databases for studies published from 2010 up to and including 2021. The following inclusion criteria were used: age 18 years and older, sample size > 1000 participants, and using a validated MD adherence score. Studies that only included participants with nutrition-related or other severe chronic disorders, as well as studies that only included specific subpopulations (e.g., pregnant women), were excluded in order to focus on the general adult population. A quality analysis of the included studies was done using the NCCMT scale. RESULTS A total of 50 studies were included. The number of participants in the included studies ranged between 1013 and 94,113. Most of the included studies pertained to the European Mediterranean countries, with fewer studies from the Middle Eastern and North African Mediterranean countries. The vast majority of the included studies reported low or moderate MD adherence, both based on the mean adherence as well as the low or moderate adherence category often being the most prevalent. There were no clear differences noted between sex and age groups. The quality assessment generally showed weak or moderate scores. CONCLUSIONS Mediterranean populations have been showing moderate adherence to MD in the past 10 years, indicating room for improving adherence to the MD in countries of its origin.
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Affiliation(s)
- Cecile A. Obeid
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands ,grid.440405.10000 0001 0747 2412Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, PO Box 72, Zouk Mikael, Lebanon
| | - Jessica S. Gubbels
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Doris Jaalouk
- College of Arts and Sciences, American University of Iraq Baghdad (AUIB), Airport Road, Baghdad, Iraq
| | - Stef P. J. Kremers
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Anke Oenema
- grid.412966.e0000 0004 0480 1382Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
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16
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Bučan Nenadić D, Kolak E, Selak M, Smoljo M, Radić J, Vučković M, Dropuljić B, Pijerov T, Babić Cikoš D. Anthropometric Parameters and Mediterranean Diet Adherence in Preschool Children in Split-Dalmatia County, Croatia-Are They Related? Nutrients 2021; 13:nu13124252. [PMID: 34959811 PMCID: PMC8706144 DOI: 10.3390/nu13124252] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
Obesity is a rapidly growing problem in European countries, Croatia being among them. According to the latest CroCOSI data, every third child in Croatia aged 8.0–8.9 years is overweight or obese. The Mediterranean diet (MeDi) and its impact on nutritional status and health has been the focus of recent research. Therefore, the aim of this cross-sectional, observational study was to determine the nutritional status and adherence to the MeDi of preschool children in Split, Croatia. We included 598 preschool children aged 3 to 7 years and, for each child, parents completed a lifestyle questionnaire and the Mediterranean Diet Quality Index (KIDMED) in order to assess adherence to the MeDi. The anthropometric assessment included the measurement of weight, height, mid-upper arm circumference (MUAC), waist circumference (WC) and the z-score was calculated. According to the z-score, 420 (70.2%) children had a healthy body weight with 54 (9%) underweight and 124 (20.8%) overweight or obese children. Almost half (49%) of the study participants had a low KIDMED index score, indicating a low MeDi adherence, 37% had an average score, while only 14% had high MeDi compliance. Statistically significant negative correlations between MUAC and WC and the consumption of a second daily serving of fruit (p = 0.04) as well as a daily serving of vegetables (p = 0.03) were found. In conclusion, low compliance to the MeDi principles in preschool children is concerning. Considering the beneficial effects of the MeDi on overall health, further education, and the adoption of healthy eating habits in preschool children in this Mediterranean region are required.
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Affiliation(s)
- Dora Bučan Nenadić
- Department of Nutrition and Dietetics, University Hospital Centre Split, 21000 Split, Croatia;
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
- Correspondence: (D.B.N.); (E.K.)
| | - Ela Kolak
- Department of Nutrition and Dietetics, University Hospital Centre Split, 21000 Split, Croatia;
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
- Correspondence: (D.B.N.); (E.K.)
| | - Marija Selak
- Department of Nutrition and Dietetics, University Hospital Centre Split, 21000 Split, Croatia;
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
| | - Matea Smoljo
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
| | - Josipa Radić
- Department of Nephrology and Dialysis, University Hospital Centre Split, 21000 Split, Croatia; (J.R.); (M.V.)
- Department of Internal Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Marijana Vučković
- Department of Nephrology and Dialysis, University Hospital Centre Split, 21000 Split, Croatia; (J.R.); (M.V.)
| | - Bruna Dropuljić
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
| | - Tanja Pijerov
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
| | - Dora Babić Cikoš
- Croatian Association of Nutritionists, 10000 Zagreb, Croatia; (M.S.); (B.D.); (T.P.); (D.B.C.)
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Grahovac M, Kumric M, Vilovic M, Martinovic D, Kreso A, Ticinovic Kurir T, Vrdoljak J, Prizmic K, Božić J. Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes. World J Diabetes 2021; 12:1942-1956. [PMID: 34888018 PMCID: PMC8613665 DOI: 10.4239/wjd.v12.i11.1942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/01/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, American Diabetes Association started to strongly advocate the Mediterranean diet (MD) over other diets in patients with diabetes mellitus (DM) because of its beneficial effects on glycemic control and cardiovascular (CV) risk factors. Tissue levels of advanced glycation endproducts (AGEs) emerged as an indicator of CV risk in DM. Skin biopsy being invasive, the use of AGE Reader has been shown to reflect tissue AGEs reliably.
AIM To examine the association between adherence to MD and AGEs in patients with DM type II.
METHODS This cross-sectional study was conducted on 273 patients with DM type II. A survey questionnaire was composed of 3 separate sections. The first part of the questionnaire included general data and the habits of the participants. The second part aimed to assess the basic parameters of participants’ diseases and associated conditions. The third part of the questionnaire was the Croatian version of the 14-item MD service score (MDSS). AGEs levels and associated CV risk were measured using AGE Reader (DiagnOptics Technologies BV, Groningen, The Netherlands).
RESULTS A total of 27 (9.9%) patients fulfilled criteria for adherence to MD, with a median score of 8.0 (6.0-10.0). Patients with none/limited CV risk had significantly higher percentage of MD adherence in comparison to patients with increased/definite CV risk (15.2% vs 6.9%, P = 0.028), as well as better adherence to guidelines for nuts (23.2% vs 12.6%, P = 0.023) and legumes (40.4% vs 25.9%, P = 0.013) consumption. Higher number of patients with glycated hemoglobin (HbA1c) < 7% adhered to MD when compared to patients with HbA1c > 7% (14.9% vs 7.3%, P = 0.045). Moreover, those patients followed the MDSS guidelines for eggs (33.0% vs 46.8%, P = 0.025) and wine (15.6% vs 29.8%, P = 0.006) consumption more frequently. MDSS score had significant positive correlation with disease duration (r = 0.179, P = 0.003) and negative correlation with body mass index (BMI) values (r = -0.159, P = 0.008). In the multiple linear regression model, BMI (β ± SE, -0.09 ± 0.04, P = 0.037) and disease duration (β ± SE, 0.07 ± 0.02, P < 0.001) remained significant independent correlates of the MDSS score. Patients with HbA1c > 7% think that educational programs on nutrition would be useful for patients in significantly more cases than patients with HbA1c < 7% (98.9% vs 92.6%, P = 0.009).
CONCLUSION Although adherence to MD was very low among people with diabetes, we demonstrated that adherence to MD is greater in patients with lower CV risk, longer disease duration, and well-controlled glycaemia.
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Affiliation(s)
- Marko Grahovac
- Department of Pharmacology, University of Split School of Medicine, Split 21000, Croatia
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Ante Kreso
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
- Department of Endocrinology, University Hospital of Split, Split 21000, Croatia
| | - Josip Vrdoljak
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Karlo Prizmic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Joško Božić
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
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18
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Pribisalić A, Popović R, Salvatore FP, Vatavuk M, Mašanović M, Hayward C, Polašek O, Kolčić I. The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia. Nutrients 2021; 13:nu13113802. [PMID: 34836057 PMCID: PMC8624926 DOI: 10.3390/nu13113802] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18–98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0–24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007–2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (−8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p < 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (−35.1%), fish (−23.4%), white meat (−11.6%), cereals (−10.9%), and dairy products (−9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake.
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Affiliation(s)
- Ajka Pribisalić
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (A.P.); (O.P.)
| | - Romana Popović
- NUTRITIUS—Nutrition Counseling, Primorska 30, 20000 Dubrovnik, Croatia;
| | | | - Maja Vatavuk
- Department of Cardiac Surgery, University Hospital of Split, 21000 Split, Croatia;
| | - Marija Mašanović
- Department for Social Medicine, Division for Health Promotion, Public Health Institute of Dubrovnik Neretva County, Dr. A. Šercera 4a, pp 58, 20001 Dubrovnik, Croatia;
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH8 9YL, UK;
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (A.P.); (O.P.)
- Algebra LAB, Algebra University College, Ilica 242, 10000 Zagreb, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (A.P.); (O.P.)
- Algebra LAB, Algebra University College, Ilica 242, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-91-576-2263
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Mediterranean Diet Adherence and Nutritional Status in Dalmatian Kidney Transplant Recipients-Are They Related? Nutrients 2021; 13:nu13093246. [PMID: 34579123 PMCID: PMC8471203 DOI: 10.3390/nu13093246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 01/29/2023] Open
Abstract
The aim of this study was to evaluate adherence to Mediterranean diet (MeDi) and possible correlation of MeDi adherence and nutritional status parameters in Dalmatian kidney transplant recipients (KTRs). One hundred and sixteen KTRs were included in this study. Data about Mediterranean Diet Serving Score (MDSS), body mass composition, anthropometric parameters, clinical and laboratory parameters were collected for each study participant. The results showed 25% adherence to the MeDi in Dalmatian KTRs. MDSS showed association with higher serum albumin and phosphorus level and higher skeletal muscle mass. Also, significant association between diabetic status and MDSS was found. Adherence to olive oil intake suggested by the MeDi showed significant association with lower level of triglycerides and adherence to nuts suggestions was associated with lower level of fat mass. Following MeDi recommendations for consumption of other foods (cereals, potato, eggs, vegetables, fruits and dairy) were also associated with body mass composition parameters and laboratory findings. In conclusion, low adherence to the MeDi in Dalmatian KTRs raises high concerns. The results showed that MeDi can have favorable effects on nutritional status in KTRs. A structured nutritional approach is needed to enhance adherence to the MeDi and prevent possible adverse effects in this patient population.
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Grace-Farfaglia P. Self-Reported Diet and Health Outcomes of Participants of the CCSVI-Tracking Survey Study. Nutrients 2021; 13:1891. [PMID: 34072860 PMCID: PMC8230225 DOI: 10.3390/nu13061891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Of the 1575 participants of the CCSVI-Tracking Survey, 475 patients recorded their quality of life and EDSS outcomes for at least 2 months. Self-reported use of complementary and conventional therapies included diet, use of drug therapy, symptoms, quality of life, and mobility. Analysis included comparing outcomes related to different diets within and between groups. Adherence to the MS diet was not associated with a greater quality of life, less disability, a lower Symptom Score, or faster walking speed compared to other diets. Alternately, the participants from the Mediterranean diet region as a whole (µ = 32.65 (SD = 11.37, SEM = 2.37, p = 0.05) had a significantly greater QoL (µ = 60, p = 0.05) and a lower MS symptom score, µ = 32.65 (11.37), p = 0.0029. A decline of symptoms was observed in all diet groups over 3 months with the most dramatic decline observed in participants from the Eastern Mediterranean diet region. The main effect for the within-subjects factor was significant, F(3, 1056) = 55.95, p < 0.001, indicating that there were significant differences between the groups.
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Affiliation(s)
- Patricia Grace-Farfaglia
- Department of Health Science, Rocky Mountain University of Health Professions, Provo, UT 84606, USA;
- Department of Health Science, College of Health Professions, Sacred Heart University, Fairfield, CT 06825, USA
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Quarta S, Massaro M, Chervenkov M, Ivanova T, Dimitrova D, Jorge R, Andrade V, Philippou E, Zisimou C, Maksimova V, Smilkov K, Ackova DG, Miloseva L, Ruskovska T, Deligiannidou GE, Kontogiorgis CA, Sánchez-Meca J, Pinto P, García-Conesa MT. Persistent Moderate-to-Weak Mediterranean Diet Adherence and Low Scoring for Plant-Based Foods across Several Southern European Countries: Are We Overlooking the Mediterranean Diet Recommendations? Nutrients 2021; 13:nu13051432. [PMID: 33922771 PMCID: PMC8145023 DOI: 10.3390/nu13051432] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/15/2023] Open
Abstract
The Mediterranean diet (MD) has been sponsored worldwide as a healthy and sustainable diet. Our aim was to update and compare MD adherence and food choices across several Southern European countries: Spain (SP), Portugal (PT), Italy (IT), Greece (GR), and Cyprus (CY) (MED, Mediterranean), and Bulgaria (BG) and the Republic of North Macedonia (NMK) (non-MED, non-Mediterranean). Participants (N = 3145, ≥18 y) completed a survey (MeDiWeB) with sociodemographic, anthropometric, and food questions (14-item Mediterranean Diet Adherence Screener, 14-MEDAS). The MED and non-MED populations showed moderate (7.08 ± 1.96) and weak (5.58 ± 1.82) MD adherence, respectively, with significant yet small differences across countries (SP > PT > GR > IT > CY > BG > NMK, p-value < 0.001). The MED participants scored higher than the non-MED ones for most of the Mediterranean-typical foods, with the greatest differences found for olive oil (OO) and white meat preference. In most countries, ≥70% of the participants reported quantities of red meat, butter, sweet drinks, and desserts below the recommended cutoff points, whereas <50% achieved the targets for plant-based foods, OO, fish, and wine. Being a woman and increasing age were associated with superior adherence (p-value < 0.001), but differences were rather small. Our results suggest that the campaigns carried out to support and reinforce the MD and to promote plant-based foods have limited success across Southern Europe, and that more hard-hitting strategies are needed.
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Affiliation(s)
- Stefano Quarta
- Laboratory of Biochemistry and Molecular Biology, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy;
| | - Marika Massaro
- National Research Council (CNR), Institute of Clinical Physiology, 73100 Lecce, Italy;
| | - Mihail Chervenkov
- Faculty of Veterinary Medicine, University of Forestry, 1797 Sofia, Bulgaria;
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
| | - Teodora Ivanova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Dessislava Dimitrova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Rui Jorge
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Vanda Andrade
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus; (E.P.); (C.Z.)
- Department of Nutritional Sciences, King’s College London, London SE1 9NH, UK
| | - Constantinos Zisimou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus; (E.P.); (C.Z.)
| | - Viktorija Maksimova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Katarina Smilkov
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Darinka Gjorgieva Ackova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Lence Miloseva
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Tatjana Ruskovska
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Georgia Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Julio Sánchez-Meca
- Department of Basic Psychology & Methodology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain;
| | - Paula Pinto
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Correspondence: (P.P.); (M-T.G.-C.); Tel.: +34-(968)396-276 (M-T.G.-C.)
| | - María-Teresa García-Conesa
- Research Group on Quality, Safety and Bioactivity of Plant Foods, Centro de Edafología y Biología Aplicada del Segura-Consejo Superior de Investigaciones Científicas (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, 30100 Murcia, Spain
- Correspondence: (P.P.); (M-T.G.-C.); Tel.: +34-(968)396-276 (M-T.G.-C.)
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22
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Marendić M, Polić N, Matek H, Oršulić L, Polašek O, Kolčić I. Mediterranean diet assessment challenges: Validation of the Croatian Version of the 14-item Mediterranean Diet Serving Score (MDSS) Questionnaire. PLoS One 2021; 16:e0247269. [PMID: 33647026 PMCID: PMC7920370 DOI: 10.1371/journal.pone.0247269] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
Mediterranean diet (MD) is among the most commonly investigated diets and recognized as one of the healthiest dietary patterns. Due to its complexity, geographical and cultural variations, it also represents a challenge for quantification. The aim of this cross-sectional study was to assess reliability and validity of the Croatian version of the 14-item Mediterranean Diet Serving Score (MDSS), using the Mediterranean Diet Adherence Screener (MEDAS) as the referent test. We included the exploratory sample of 360 medical students, and a confirmatory sample of 299 health studies students from the University of Split, Croatia. Test-retest reliability and validity of the MDSS were tested using intra-class correlation coefficients (ICC), while Cohen's kappa statistic was used to test correct classification of subjects into MD adherent/non-adherent category. A very good reliability was shown for the overall MDSS score (ICC = 0.881 [95% CI 0.843-0.909]), and a moderate reliability for the binary adherence (κ = 0.584). Concurrent validity of the MDSS was also better when expressed as a total score (ICC = 0.544 [0.439-0.629]) as opposed to the adherence (κ = 0.223), with similar result in the confirmatory sample (ICC = 0.510 [0.384-0.610]; κ = 0.216). Disappointingly, only 13.6% of medical students were adherent to the MD according to MDSS, and 19.7% according to the MEDAS questionnaire. Nevertheless, MDSS score was positively correlated with age (ρ = 0.179: P = 0.003), self-assessed health perception (ρ = 0.123; P = 0.047), and mental well-being (ρ = 0.139: P = 0.022). MDSS questionnaire is a short, reliable and reasonably valid instrument, and thus useful for assessing the MD adherence, with better results when used as a numeric score, even in the population with low MD adherence.
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Affiliation(s)
- Mario Marendić
- University Department of Health Studies, University of Split, Split, Croatia
- University Postgraduate Doctoral Study Program Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | - Nikolina Polić
- Institute of Emergency Medicine of Split-Dalmatia County, Split, Croatia
| | | | | | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Split, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Split, Croatia
- * E-mail:
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23
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Dragun R, Veček NN, Marendić M, Pribisalić A, Đivić G, Cena H, Polašek O, Kolčić I. Have Lifestyle Habits and Psychological Well-Being Changed among Adolescents and Medical Students Due to COVID-19 Lockdown in Croatia? Nutrients 2020; 13:E97. [PMID: 33396690 PMCID: PMC7830522 DOI: 10.3390/nu13010097] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/18/2020] [Accepted: 12/27/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate dietary habits, sleep and psychological well-being of adolescents and medical students during COVID-19 lockdown in Split, Croatia. METHODS We surveyed 1326 students during 2018 and 2019, and compared their responses with 531 students enrolled in May 2020. Perceived stress, quality of life (QoL), happiness, anxiety, and optimism were assessed as proxies of psychological well-being, using general linear modelling. RESULTS We found no substantial differences in dietary pattern between pre-lockdown and lockdown periods, including the overall Mediterranean diet (MD) adherence. However, the MD pattern changed, showing increased adherence to the MD pyramid for fruit, legumes, fish, and sweets, while cereals, nuts, and dairy intake decreased during COVID-19 lockdown. A third of students reported weight loss during lockdown, 19% reported weight gain, while physical activity remained rather stable. The most prominent change was feeling refreshed after a night's sleep, reported by 31.5% of students during lockdown vs. 8.5% before; median length of sleep duration increased by 1.5 h. Lockdown significantly affected QoL, happiness, optimism (all p < 0.001), and perceived stress in students (p = 0.005). MD adherence was positively correlated with QoL and study time, and negatively with TV and mobile phone use in pre-lockdown period (all p < 0.001). Interestingly, higher MD adherence was correlated with less perceived hardship and greater happiness and QoL during lockdown. CONCLUSION These insights provide valuable information for tailored interventions aimed at maintaining healthy lifestyle in young population. Given the numerous beneficial effects associated with MD adherence, modification of lifestyle through application of lifestyle medicine deserves a priority approach.
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Affiliation(s)
- Ružica Dragun
- University Postgraduate Doctoral Study Program Evidence-Based Medicine, University of Split School of Medicine, 21000 Split, Croatia; (R.D.); (N.N.V.)
| | - Nikolina Nika Veček
- University Postgraduate Doctoral Study Program Evidence-Based Medicine, University of Split School of Medicine, 21000 Split, Croatia; (R.D.); (N.N.V.)
| | - Mario Marendić
- University Department for Health Studies, University of Split, 21000 Split, Croatia;
| | - Ajka Pribisalić
- Department of Public Health, University of Split School of Medicine, 21000 Split, Croatia; (A.P.); (O.P.)
| | - Gabrijela Đivić
- ENT Clinic, University Clinical Hospital Mostar, Bijeli Brijeg B.B., 88000 Mostar, Bosnia and Herzegovina;
| | - Hellas Cena
- Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, 27100 Pavia, Italy
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, 21000 Split, Croatia; (A.P.); (O.P.)
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, 21000 Split, Croatia; (A.P.); (O.P.)
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24
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Simunovic M, Supe-Domic D, Karin Z, Degoricija M, Paradzik M, Skrabic R, Jukic A, Bozic J, Skrabic V. The Relationship of Vitamin D Status, Adherence to the Mediterranean Diet, and Physical Activity in Obese Children and Adolescents. J Med Food 2020; 24:385-393. [PMID: 32783677 DOI: 10.1089/jmf.2020.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency is associated with a range of chronic diseases, including childhood obesity. Prevalence of vitamin D deficiency in obese children and adolescents ranges from 6.5% to 57%. This cross-sectional study included 92 obese patients with body mass index z-score >2 and 39 subjects in the control group. Anthropometric and laboratory patient assessment were performed, including the fasting 25-hydroxyvitamin D (25(OH)D). Adherence to the Mediterranean diet was assessed by Mediterranean Diet Quality Index for children and adolescents (KIDMED index), while physical activity was evaluated by Physical Activity Questionnaire (PAQ). Serum levels of 25(OH)D were significantly lower in obese subjects compared to the control group (52.0 ± 17.93 vs. 64.09 ± 25.82 nmol/L, P = .003). The subgroup of obese patients with metabolic syndrome (MS) had significantly lower levels of serum vitamin D when compared to the subgroup of obese patients without MS and the control group (46.99 ± 17.11 vs. 54.58 ± 17.93 vs. 64.09 ± 25.82 nmol/L, P = .003). Obese patients with MS had lower PAQ score when compared to obese without MS and the control group (2.32 ± 0.55 vs. 2.49 ± 0.67 vs. 2.85 ± 0.63 nmol/L, P = .002), while no significant differences were observed in the KIDMED index (4.23 ± 1.81 vs. 4.21 ± 2.13 vs. 4.87 ± 2.29, P = .251), respectively. PAQ score was in positive correlation with serum levels of 25(OH)D (r = 0.305, P < .001). This study demonstrated that obese children and adolescents have significantly lower values of serum 25(OH)D. The positive correlation between vitamin D and PAQ score points to the importance of physical activity in the prevention of further cardiovascular complications and MS.
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Affiliation(s)
- Marko Simunovic
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Zeljka Karin
- Public Health Institute of Split and Dalmatia County, Split, Croatia
| | - Marina Degoricija
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - Martina Paradzik
- Department of Ophthalmology, University Hospital of Split, Split, Croatia
| | - Roko Skrabic
- University of Split School of Medicine, Split, Croatia
| | - Andrija Jukic
- University of Split School of Medicine, Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Veselin Skrabic
- Department of Pediatrics, University Hospital of Split, Split, Croatia.,Department of Pediatrics, University of Split School of Medicine, Split, Croatia
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25
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Havaš Auguštin D, Šarac J, Lovrić M, Živković J, Malev O, Fuchs N, Novokmet N, Turkalj M, Missoni S. Adherence to Mediterranean Diet and Maternal Lifestyle during Pregnancy: Island-Mainland Differentiation in the CRIBS Birth Cohort. Nutrients 2020; 12:nu12082179. [PMID: 32708050 PMCID: PMC7469061 DOI: 10.3390/nu12082179] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022] Open
Abstract
Maternal nutrition and lifestyle in pregnancy are important modifiable factors for both maternal and offspring's health. Although the Mediterranean diet has beneficial effects on health, recent studies have shown low adherence in Europe. This study aimed to assess the Mediterranean diet adherence in 266 pregnant women from Dalmatia, Croatia and to investigate their lifestyle habits and regional differences. Adherence to the Mediterranean diet was assessed through two Mediterranean diet scores. Differences in maternal characteristics (diet, education, income, parity, smoking, pre-pregnancy body mass index (BMI), physical activity, contraception) with regards to location and dietary habits were analyzed using the non-parametric Mann-Whitney U test. The machine learning approach was used to reveal other potential non-linear relationships. The results showed that adherence to the Mediterranean diet was low to moderate among the pregnant women in this study, with no significant mainland-island differences. The highest adherence was observed among wealthier women with generally healthier lifestyle choices. The most significant mainland-island differences were observed for lifestyle and socioeconomic factors (income, education, physical activity). The machine learning approach confirmed the findings of the conventional statistical method. We can conclude that adverse socioeconomic and lifestyle conditions were more pronounced in the island population, which, together with the observed non-Mediterranean dietary pattern, calls for more effective intervention strategies.
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Affiliation(s)
- Dubravka Havaš Auguštin
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
- Centre for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia
- Correspondence: (D.H.A.); (J.Š.)
| | - Jelena Šarac
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
- Centre for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia
- Correspondence: (D.H.A.); (J.Š.)
| | - Mario Lovrić
- Department of Translational Medicine, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia; (M.L.); (J.Ž.); (O.M.)
- Know-Center, 8010 Graz, Austria
| | - Jelena Živković
- Department of Translational Medicine, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia; (M.L.); (J.Ž.); (O.M.)
| | - Olga Malev
- Department of Translational Medicine, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia; (M.L.); (J.Ž.); (O.M.)
- Division of Zoology, Department of Biology, Faculty of Science, University of Zagreb, 10000 Zagreb, Croatia
| | - Nives Fuchs
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
| | - Natalija Novokmet
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
| | - Mirjana Turkalj
- Department of Pulmonology and Allergology for Infants and Young Children, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia;
- Department of Nursing, Catholic University of Croatia, 10000 Zagreb, Croatia
- School of Medicine, “J. J. Strossmayer” University, 31000 Osijek, Croatia
| | - Saša Missoni
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
- Centre for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia
- School of Medicine, “J. J. Strossmayer” University, 31000 Osijek, Croatia
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26
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Kaličanin D, Brčić L, Ljubetić K, Barić A, Gračan S, Brekalo M, Torlak Lovrić V, Kolčić I, Polašek O, Zemunik T, Punda A, Boraska Perica V. Differences in food consumption between patients with Hashimoto's thyroiditis and healthy individuals. Sci Rep 2020; 10:10670. [PMID: 32606353 PMCID: PMC7327046 DOI: 10.1038/s41598-020-67719-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/12/2020] [Indexed: 12/23/2022] Open
Abstract
Food is considered as important environmental factor that plays a role in development of Hashimoto's thyroiditis (HT). The goal of our study was to identify food groups, assessed by food frequency questionnaire, that differ in consumption frequency between 491 patients with HT and 433 controls. We also analysed association of food groups with the wealth of HT-related clinical traits and symptoms. We found significantly increased consumption of animal fat (OR 1.55, p < 0.0001) and processed meat (OR 1.16, p = 0.0012) in HT cases, whereas controls consumed significantly more frequently red meat (OR 0.80, p < 0.0001), non-alcoholic beverages (OR 0.82, p < 0.0001), whole grains (OR 0.82, p < 0.0001) and plant oil (OR 0.87, p < 0.0001). We also observed association of plant oil consumption with increased triiodothyronine levels in HT patients (β = 0.07, p < 0.0001), and, association of olive oil consumption with decreased systolic blood pressure (β = − 0.16, p = 0.001) in HT patients on levothyroxine (LT4) therapy. Analysis of food consumption between HT patients with and without LT4 therapy suggest that patients do not tend to modify their diet upon HT diagnosis in our population. Our study may be of relevance to nutritionists, nutritional therapists and clinicians involved in developing dietary recommendations for HT patients.
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Affiliation(s)
- Dean Kaličanin
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Luka Brčić
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Katija Ljubetić
- Department of Clinical Nutrition, Faculty of Health Studies, University of Rijeka, 51000, Rijeka, Croatia
| | - Ana Barić
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Sanda Gračan
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Marko Brekalo
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Vesela Torlak Lovrić
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, 21000, Split, Croatia
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, 21000, Split, Croatia
| | - Tatijana Zemunik
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Vesna Boraska Perica
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia.
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27
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Veček NN, Mucalo L, Dragun R, Miličević T, Pribisalić A, Patarčić I, Hayward C, Polašek O, Kolčić I. The Association between Salt Taste Perception, Mediterranean Diet and Metabolic Syndrome: A Cross-Sectional Study. Nutrients 2020; 12:nu12041164. [PMID: 32331287 PMCID: PMC7230181 DOI: 10.3390/nu12041164] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022] Open
Abstract
Metabolic syndrome (MetS) is a widespread disorder and an important public health challenge. The purpose of this study was to identify the association between salt taste perception, Mediterranean diet and MetS. This cross-sectional study included 2798 subjects from the general population of Dalmatia, Croatia. MetS was determined using the Joint Interim Statement definition, and Mediterranean diet compliance was estimated using Mediterranean Diet Serving Score. Salt taste perception was assessed by threshold and suprathreshold testing (intensity and hedonic perception). Logistic regression was used in the analysis, adjusting for important confounding factors. As many as 44% of subjects had MetS, with elevated waist circumference as the most common component (77%). Higher salt taste sensitivity (lower threshold) was associated with several positive outcomes: lower odds of MetS (OR = 0.69; 95% CI 0.52–0.92), lower odds for elevated waist circumference (0.47; 0.27–0.82), elevated fasting glucose or diabetes (0.65; 0.45–0.94), and reduced HDL cholesterol (0.59; 0.42–0.84), compared to the higher threshold group. Subjects with lower salt taste threshold were more likely to consume more fruit, and less likely to adhere to olive oil and white meat guidelines, but without a difference in the overall Mediterranean diet compliance. Salt taste intensity perception was not associated with any of the investigated outcomes, while salty solution liking was associated with MetS (OR = 1.85, CI 95% 1.02–3.35). This study identified an association between salt taste perception and MetS and gave a new insight into taste perception, nutrition, and possible health outcomes.
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Affiliation(s)
- Nikolina Nika Veček
- University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia; (N.N.V.); (R.D.); (A.P.)
| | - Lana Mucalo
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Ružica Dragun
- University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia; (N.N.V.); (R.D.); (A.P.)
| | - Tanja Miličević
- Department of Endocrinology and Diabetology, University Hospital Center Split, Šoltanska 1, 21 000 Split, Croatia;
| | - Ajka Pribisalić
- University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia; (N.N.V.); (R.D.); (A.P.)
| | - Inga Patarčić
- Bioinformatics and Omics Data Science Platform, Berlin Institute for Medical Systems Biology, Max-Delbrück Center for Molecular Medicine, 13092 Berlin, Germany;
| | - Caroline Hayward
- MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh EH4 2XU, UK;
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia;
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia;
- Correspondence:
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28
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Barnaba L, Intorre F, Azzini E, Ciarapica D, Venneria E, Foddai MS, Maiani F, Raguzzini A, Polito A. Evaluation of adherence to Mediterranean diet and association with clinical and biological markers in an Italian population. Nutrition 2020; 77:110813. [PMID: 32450332 DOI: 10.1016/j.nut.2020.110813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/22/2020] [Accepted: 03/07/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the overall diet quality of an Italian population through the use of the Mediterranean Diet Serving Score (MDSS) and its relation to clinical and biochemical nutritional markers. METHODS The study was conducted on healthy participants ages 18 to 86 y living in central Italy. Adherence to the Mediterranean food pattern was evaluated by a semiquantitative food frequency, using the MDSS. Anthropometric measurements and biochemical analyses of nutritional interest were performed according to the standardized procedure. RESULTS The sample included a total of 349 participants (121 men and 228 women) with an average age of 54 ± 15 y and a body mass index of 27.4 ± 4.8 kg/m2, underlining an overweight status in both men and women. The mean educational level was medium-high in both sexes, whereas the occupation level was higher in women than in men (P = 0.001). The mean MDSS score was 14.4 ± 4.1 out of a total of 24 points. The adherence was higher in women (score 14.7 ± 3.9) than men (score 13.9 ± 4.4), although there were no significant differences (P = 0.25). No statistical differences in MDSS were found in relation to body mass index and educational level, whereas a higher MDSS score was observed in the older age group (P < 0.05). A positive correlation among MDSS, high-density lipoprotein cholesterol, and vitamin C has been found (P < 0.05), whereas there was a negative correlation with uric acid and triacylglycerols (P < 0.05). A logistic regression analysis highlighted smoking habit as the only predictive factor for a high adherence to MDSS (P < 0.05). CONCLUSIONS MDSS has a low adherence to the Mediterranean diet, particularly in the youngest age group and smokers. The index shows a correlation with some parameters of nutritional interest and further larger cohorts studies are needed to confirm our findings.
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Affiliation(s)
- Lorenzo Barnaba
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy.
| | - Federica Intorre
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Elena Azzini
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Donatella Ciarapica
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Eugenia Venneria
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Maria Stella Foddai
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Francesca Maiani
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Anna Raguzzini
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Angela Polito
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
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29
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Kenđel Jovanović G, Pavičić Žeželj S, Klobučar Majanović S, Mrakovcic-Sutic I, Šutić I. Metabolic syndrome and its association with the Dietary Inflammatory Index (DII) ® in a Croatian working population. J Hum Nutr Diet 2019; 33:128-137. [PMID: 31602707 DOI: 10.1111/jhn.12695] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a global public health concern, although its association with the inflammatory potential of the diet is still indefinite. The main objective of the present study was to investigate the association of MetS and its components with the inflammatory potential of the diet in a Croatian working population with sedentary occupations. METHODS In a cross-sectional study, Croatian workers (n = 366) self-administrated questionnaires for sociodemographic and health-related data. Their anthropometric measurements and fasting blood samples were collected for evaluation of MetS. The inflammatory potential of the diet was assessed with a Dietary Inflammatory Index (DII)® , scored using dietary data collected from a food frequency questionnaire. Multivariable logistic regression analysis, adjusted for sex, age, body mass index, education, smoking, physical activity and energy intake, was used to establish the association between DII and MetS. RESULTS MetS prevalence was 25% and was significantly associated with a pro-inflammatory diet [mean (SD) 3.28 (1.45); P < 0.01]. The pro-inflammatory diet was statistically associated with women, university degree, moderate physical activity, snacking between meals, central obesity, hypertriglyceridaemia, hypertension, low high-density lipoprotein-cholesterol, MetS prevalence and lower adherence to a Mediterranean diet. Multivariable logistic regression analysis showed a statistically positive association for a one-unit increase in the DII and MetS prevalence (odds ratio = 2.31; 95% confidence interval = 1.61-3.31; P < 0.01) and hypertension (odds ratio = 1.28; 95% confidence interval = 1.01-1.64; P = 0.04). CONCLUSIONS Further longitudinal studies in different parts of Croatia, including inflammation biomarkers, are needed to enable a more defined view of the inflammatory potential of a diet and its association with various inflammatory-based health conditions. The results obtained in the present study indicate the need for the development of anti-inflammatory dietary interventions for population health protection.
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Affiliation(s)
- G Kenđel Jovanović
- Department of Health Ecology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia
| | - S Pavičić Žeželj
- Department of Health Ecology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia
| | - S Klobučar Majanović
- Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - I Mrakovcic-Sutic
- Department of Physiology, Immunology and Pathophysiology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - I Šutić
- Department of Family Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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Obradovic Salcin L, Karin Z, Miljanovic Damjanovic V, Ostojic M, Vrdoljak A, Gilic B, Sekulic D, Lang-Morovic M, Markic J, Sajber D. Physical Activity, Body Mass, and Adherence to the Mediterranean Diet in Preschool Children: A Cross-Sectional Analysis in the Split-Dalmatia County (Croatia). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183237. [PMID: 31487822 PMCID: PMC6765942 DOI: 10.3390/ijerph16183237] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/27/2019] [Accepted: 08/30/2019] [Indexed: 01/29/2023]
Abstract
Physical activity, body mass, and dietary habits are known to be important determinants of overall health status, but there is an evident lack of studies that examine these issues specifically in preschool children. The aim of this study was to identify associations that may exist between adhering to the Mediterranean diet (MD), levels of physical activity (PA), and body composition indices in apparently healthy preschool children from southern Croatia. Participants were 5- to 6-year-old preschoolers from the Mediterranean part of the country (the Split-Dalmatia County; n = 260, 126 females). Adherence to the MD was observed by the Mediterranean Diet Quality Index (KIDMED), PA level was evaluated by the Preschool-age Children’s Physical Activity Questionnaire (Pre-PAQ), and responses were collected from the parents. The participants’ waist circumferences (in cm), waist-to-hip ratios, and body mass index (in kg/m2, and in a z-score calculated relative to the normative value for age and sex) were used as indicators of body composition. All children were of the same age and tested over a one-month period of the same year as a part of the regular examination undertaken before attending elementary school. With only 6% of the children having a low KIDMED score, adherence to the MD was high. MD adherence was higher in girls (Chi-square = 15.31, p < 0.01) and children who live on the coast of the Adriatic Sea (Chi-square = 18.51, p < 0.01). A mixed effects logistic regression (with kindergarten as random factor) identified sedentary activity to be negatively associated with MD adherence (OR per point: 0.65, 95% CI: 0.44–0.91). High adherence to the MD in the studied sample may be attributed to regulated feeding in kindergarten. Considering that most Croatian elementary schools do not provide food to their students, MD adherence should be investigated later in life and also in other parts of the country where the MD is culturally less prevalent.
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Affiliation(s)
- Lejla Obradovic Salcin
- Clinic for Physical Medicine and Rehabilitation, University Hospital Mostar, Bosnia and Herzegovina, 88000 Mostar, Bosnia and Herzegovina
- Faculty of Health Sciences, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Zeljka Karin
- Teaching Institute of Public Health of Split Dalmatian County, 21000 Split, Croatia
| | - Vesna Miljanovic Damjanovic
- Clinic for Physical Medicine and Rehabilitation, University Hospital Mostar, Bosnia and Herzegovina, 88000 Mostar, Bosnia and Herzegovina
- Faculty of Health Sciences, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Marko Ostojic
- Clinic for Physical Medicine and Rehabilitation, University Hospital Mostar, Bosnia and Herzegovina, 88000 Mostar, Bosnia and Herzegovina
| | - Andrea Vrdoljak
- Teaching Institute of Public Health of Split Dalmatian County, 21000 Split, Croatia
| | - Barbara Gilic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia.
| | - Maja Lang-Morovic
- Croatian Institute of Public Health, Health Promotion Division, 10000 Zagreb, Croatia
| | - Josko Markic
- Department of Pediatrics, University Hospital of Split, 21000 Split, Croatia
- School of Medicine, University of Split, 21000 Split, Croatia
| | - Dorica Sajber
- Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia
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Windhager S, Mitteroecker P, Rupić I, Lauc T, Polašek O, Schaefer K. Facial aging trajectories: A common shape pattern in male and female faces is disrupted after menopause. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:678-688. [PMID: 31189026 PMCID: PMC6771603 DOI: 10.1002/ajpa.23878] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Despite variation in lifestyle and environment, first signs of human facial aging show between the ages of 20-30 years. It is a cumulative process of changes in the skin, soft tissue, and skeleton of the face. As quantifications of facial aging in living humans are still scarce, we set out to study age-related changes in three-dimensional facial shape using geometric morphometrics. MATERIALS AND METHODS We collected surface scans of 88 human faces (aged 26-90 years) from the coastal town Split (Croatia) and neighboring islands. Based on a geometric morphometric analysis of 585 measurement points (landmarks and semilandmarks), we modeled sex-specific trajectories of average facial aging. RESULTS Age-related facial shape change was similar in both sexes until around age 50, at which time the female aging trajectory turned sharply. The overall magnitude of facial shape change (aging rate) was higher in women than men, especially in early postmenopause. Aging was generally associated with a flatter face, sagged soft tissue ("broken" jawline), deeper nasolabial folds, smaller visible areas of the eyes, thinner lips, and longer nose and ears. In postmenopausal women, facial aging was best predicted by the years since last menstruation and mainly attributable to bone resorption in the mandible. DISCUSSION With high spatial and temporal resolution, we were able to extract a shared facial aging pattern in women and men, and its divergence after menopause. This fully quantitative three-dimensional analysis of human facial aging may not only find applications in forensic and ancient human facial reconstructions, but shall include lifestyle and endocrinological measures, and also reach out to studies of social perception.
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Affiliation(s)
- Sonja Windhager
- Department of Theoretical BiologyUniversity of ViennaAustria
| | | | | | - Tomislav Lauc
- Dental Clinic ApolonijaZagrebCroatia
- Study of Anthropology, Faculty of Social Sciences and HumanitiesUniversity of ZagrebCroatia
- Faculty of Dental Medicine and HealthUniversity of OsijekCroatia
- Department for Orthodontics, Faculty of DentistryUniversity of OsijekCroatia
| | - Ozren Polašek
- Department of Public HealthSchool of Medicine, University of SplitCroatia
- Gen‐info Ltd.ZagrebCroatia
| | - Katrin Schaefer
- Department of Evolutionary AnthropologyUniversity of ViennaAustria
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Tomas Ž, Škarić‐Jurić T, Zajc Petranović M, Jalšovec M, Rajić Šikanjić P, Smolej Narančić N. Waist to height ratio is the anthropometric index that most appropriately mirrors the lifestyle and psychological risk factors of obesity. Nutr Diet 2019; 76:539-545. [DOI: 10.1111/1747-0080.12520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Željka Tomas
- Institute for Anthropological Research Zagreb Croatia
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Associations between Adherence to the Mediterranean Diet and Lifestyle Assessed with the MEDLIFE Index among the Working Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102126. [PMID: 30261698 PMCID: PMC6210311 DOI: 10.3390/ijerph15102126] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 12/11/2022]
Abstract
The adherence to the Mediterranean diet is beneficial for cardiovascular diseases prevention. The study aim is to use Mediterranean lifestyle (MEDLIFE) questionnaire for estimation of Mediterranean lifestyle habits among the working population and to establish MEDLIFE score correlation with the risk factors for cardiovascular diseases. In the study has participated 366 workers from Croatia, which fulfilled MEDLIFE and validated food frequency questionnaire (FFQ) questionnaire. The multivariate logistic regression was performed to evaluate the association between MEDLIFE index, workers’ obesity and cardiovascular diseases risk. The lowest adherence to Mediterranean lifestyle was associated to younger, low education, body fat above acceptable ranges and unfavorable lipid profile. Significant association to Mediterranean lifestyle was more among women (p = 0.002), middle aged (p = 0.02), highly physically active (p = 0.009) and those who play collective sports >2 h/w (p = 0.001), having body fat within acceptable range (p = 0.003), total cholesterol less (p = 0.03) and high-density lipoproteins (HDL-C) (p = 0.04) more than recommended. Inverse significant association was for high educational level (p = 0.02). The Mediterranean lifestyle adherence is associated to lower risk factors for cardiovascular diseases among studied working population. MEDLIFE index revealed that physical activity and conviviality are better ingrained among younger population but not the Mediterranean diet.
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Rehberg J, Stipčić A, Ćorić T, Kolčić I, Polašek O. Mortality patterns in Southern Adriatic islands of Croatia: a registry-based study. Croat Med J 2018; 59:118-123. [PMID: 29972734 PMCID: PMC6045898 DOI: 10.3325/cmj.2018.59.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To investigate the mortality patterns on the Southern Adriatic islands of Croatia and compare them with those in two, mainly coastal, mainland counties. Methods In this registry-based study we used the official mortality register data to analyze the mortality patterns on seven Croatian islands (Brač, Hvar, Korčula, Lastovo, Mljet, Šolta, and Vis) and Pelješac peninsula in the 1998-2013 period and calculated the average lifespan, life expectancy, and standardized mortality ratios (SMR). We compared the leading causes of death with those in the mainland population of two southernmost Croatian counties. Results The average lifespan of the island population was 3-10 years longer for men and 2-7 years longer for women than that on the mainland. All-cause SMRs were significantly lower for both men and women on Korčula, Brač, Mljet, and Pelješac but significantly higher for women on Šolta (1.22; 95% confidence intervals 1.07-1.38). The leading causes of death on the islands were cardiovascular diseases, with higher percentages in men and lower in women in comparison with those on the mainland. There were no substantial differences in the life expectancy at birth. Conclusions Despite longer lifespan, lack of differences in life expectancy at birth suggests that the recent generations of islanders no longer show beneficial mortality patterns, possibly due to diminishing adherence to the Mediterranean diet and lifestyle. Restoring the traditional lifestyles is a public health priority, with the ultimate aim of reducing inequalities and improving the health of island inhabitants.
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Affiliation(s)
| | | | | | | | - Ozren Polašek
- Ozren Polašek, University of Split School of Medicine, Šoltanska 2, 21220 Split, Croatia,
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Relja A, Miljković A, Gelemanović A, Bošković M, Hayward C, Polašek O, Kolčić I. Nut Consumption and Cardiovascular Risk Factors: A Cross-Sectional Study in a Mediterranean Population. Nutrients 2017; 9:E1296. [PMID: 29182576 PMCID: PMC5748747 DOI: 10.3390/nu9121296] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/11/2017] [Accepted: 11/22/2017] [Indexed: 12/14/2022] Open
Abstract
Nuts are often considered beneficial for health, yet few studies have examined determinants of their intake and the associations between nut consumption and various cardiovascular disease risk factors. The aim of this study was to identify factors associated with nut intake in a Mediterranean population, in Croatia, and to investigate the association of nut intake and various cardiovascular risk factors. METHODS Subjects from the Island of Vis, Island of Korčula and the City of Split were included in this cross-sectional study (n = 4416 in total; 4011 without known cardiovascular disease). Survey responses, medical records and clinically relevant measurements were utilized. Multivariate ordinal and logistic regression models were used in the analysis, adjusting for known confounding factors. RESULTS As low as 5% of all subjects reported daily, and 11% reported weekly, nut consumption. The characteristics associated with more frequent nut intake were female gender (Odds ratio (OR) = 1.39; 95% confidence interval (CI) 1.19-1.62), highest level of education (1.42; 1.15-1.76) and material status (1.58; 1.29-1.93), smoking abstinence (1.21; 1.04-1.42 in never-smokers and 1.22; 1.02-1.46 in ex-smokers), Mediterranean diet adherence (1.87; 1.62-2.15), and absence of central obesity (1.29; 1.09-1.53), absence of diabetes (1.30; 1.02-1.66) and metabolic syndrome (1.17; 1.01-1.36). Subjects who consumed nuts had more favorable waist-to-height (overall p = 0.036) and waist-to-hip ratios (0.033), lesser odds of elevated fibrinogen (p < 0.001 in both weekly and monthly nut consumers) and reduced high-density lipoprotein (HDL) cholesterol (p = 0.026), compared to non-consumers. CONCLUSIONS It appears that frequent nut consumption is an integral part of a healthy lifestyle and better socioeconomic status. A beneficial association of nut intake with cardiovascular risk factors was confirmed in this study.
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Affiliation(s)
- Ajka Relja
- School of Medicine, University of Split, 21000 Split, Croatia.
| | - Ana Miljković
- School of Medicine, University of Split, 21000 Split, Croatia.
| | | | - Maria Bošković
- Department of Biology, University of Zagreb Faculty of Science, 10000 Zagreb, Croatia.
| | - Caroline Hayward
- Institute of Genetics & Molecular Medicine, MRC Human Genetics Unit, University of Edinburgh, Edinburgh EH8 9YL, UK.
| | - Ozren Polašek
- School of Medicine, University of Split, 21000 Split, Croatia.
| | - Ivana Kolčić
- School of Medicine, University of Split, 21000 Split, Croatia.
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