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Zhang Q, Huangfu C, Wan Q, Su W, Zhu X, Yu B, Min X, Liu Z. Social capital and healthy eating among two ethnic minority groups in Yunnan Province, Southwest China: the mediating role of social support and nutrition knowledge. Front Nutr 2024; 11:1273851. [PMID: 38883859 PMCID: PMC11176612 DOI: 10.3389/fnut.2024.1273851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
Background Although social capital has been linked to dietary intake particularly in disadvantaged populations, little is known about the mechanisms. This study aimed to investigate whether social support (SS) and nutrition knowledge (NK) mediate the association between social capital and healthy eating habits. Methods A probability sample of two ethnic minority groups in Yunnan Province, Southwest China were included (n = 1,033, mean age 47.5 ± 14.7 years). Bonding and bridging social capital (BOC and BRC) were assessed with the Personal Social Capital Scale (PSCS-16). Dietary data were evaluated with the Chinese Healthy Eating Index (CHEI), a measure of diet quality which reflects adherence to the Chinese Dietary Guidelines. NK and SS were measured with a validated questionnaire and scale, respectively. Structural Equation Modeling was used to calculate the direct, indirect and total effects of social capital on CHEI scores. Results The mean score of CHEI was 57.4 ± 9.8, which was significantly lower in men and older people. Low adherence to dietary guidelines were to observed in the consumption of dairy, beans, nuts, animal-source food vegetables and fruits. BOC and BRC were positively associated with CHEI score (β = 0.37 and 0.38, all p < 0.05). Social support and nutrition knowledge mediated 45.9 and 39.5% of the total effect of social capital on CHEI score, respectively. Conclusion Social capital appears to enhance adherence to dietary guidelines by improving nutrition knowledge and social support. Nutrition promotion programs therefore should consider incorporating strategies that foster social capital development, particularly in disadvantaged populations.
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Affiliation(s)
- Qiang Zhang
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Chunrong Huangfu
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, China
| | - Qingqing Wan
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Weiwei Su
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xiao Zhu
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Bin Yu
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan, China
| | - Xiangdong Min
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Zhitao Liu
- Department of Nutrition and Food Hygiene, Yunnan Center for Disease Control and Prevention, Kunming, China
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Lopes CVA, Dharmayani PNA, Ronto R, Hunter J, Mihrshahi S. Food Choices, Sustainability and Australian Native Foods: Perceptions among University Students. Foods 2024; 13:1677. [PMID: 38890905 PMCID: PMC11172005 DOI: 10.3390/foods13111677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
(1) Background: Urgent changes in our food choices are needed for more sustainable, resilient and equitable food systems. Australian native plant-based foods have both environmental and health benefits. Including these foods in our diet may reduce both the risk of chronic diseases and the impact of climate change. This study explored the perceptions and attitudes towards food choices, sustainability and Australian native plant-based food among university students. (2) Methods: A cross-sectional online survey was completed by 212 university students in Australia from October to December 2022. Questions included information about sociodemographic characteristics, food choices, Australian native foods and the impact on sustainability. Logistic regression was used for analyses. (3) Results: Most participants recognised the impact of food choices on sustainability. There was a significant association between recognition of the impact of food choices on sustainability and the environmental and nutritional benefits of Australian native foods (OR = 2.89, 95% CI 1.29, 6.46, p = 0.010). Students who were familiar with or had tried Australian native plant-based foods were significantly more likely to recognise their environmental and nutritional benefits (p < 0.001). (4) Conclusions: Students who recognise the impact of food choices on sustainability and the benefits of Australian native foods are more likely to include native foods in their diet. More studies are needed to investigate the specific native foods consumed and the barriers and facilitators to the intake of these foods.
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Affiliation(s)
- Carla Vanessa Alves Lopes
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, Sydney, NSW 2109, Australia (S.M.)
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Augimeri G, Soto M, Ceraudo F, Caparello G, Villegas Figueroa M, Cesario M, Caputi LS, Calderón B, Bonofiglio D. Differences of skin carotenoids and adherence to the Mediterranean Diet pattern in adults from Southern Italy and Dominican Republic. J Transl Med 2024; 22:424. [PMID: 38704581 PMCID: PMC11070090 DOI: 10.1186/s12967-024-05224-5] [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: 02/09/2024] [Accepted: 04/20/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The measurement of the skin carotenoids using the Veggie Meter® has emerged as a rapid objective method for assessing fruit and vegetable intake, highly recommended by the Mediterranean Diet (MD), which represents one of the healthiest dietary patterns, worldwide. This study aimed to examine differences in skin carotenoid content and degree of adherence to the MD pattern between two adult populations from Southern Italy and the Dominican Republic. METHODS This cross-sectional study enrolled a total of 995 adults, 601 subjects from Italy and 394 from the Dominican Republic. All participants underwent anthropometric measurements and skin carotenoid assessment by Veggie Meter®. Adherence to the MD and lifestyle were evaluated using the Mediterranean Diet Adherence Screener (MEDAS) and the Mediterranean Lifestyle Index (MEDLIFE) questionnaires. Correlations between the skin carotenoid and MEDAS score were estimated using Pearson's correlation coefficient. Multiple linear regression models were created to determine variables that affect skin carotenoid score for both populations. RESULTS Mean total skin carotenoids were higher in the Italian compared to the Dominican Republic population (342.4 ± 92.4 vs 282.9 ± 90.3; p < 0.005) regardless of sex (women: 318.5 ± 88.9 vs 277.3 ± 91.9, p < 0.005 and men: 371.7 ± 88.3 vs 289.5 ± 88.1, p < 0.005), and remaining statistically significant after age-adjustment of the Dominican Republic sample. Using the MEDAS questionnaire, we found a higher MD adherence score in the Italian than in the Dominican Republic population also after age-adjusting data (7.8 ± 2.1 vs 6.2 ± 3.7; p < 0.005) and even when categorized by sex (Italian vs age-adjusted Dominican Republic women: 7.9 ± 2.1 vs 6.3 ± 2.6; Italian vs age-adjusted Dominican Republic men: 7.7 ± 2.2 vs 6.0 ± 4.7; p < 0.005). Using the MEDLIFE test, total Italians presented a lower score with respect to the age-adjusted Dominican Republic population (3.2 ± 1.2 vs 3.4 ± 1.4; p < 0.05). In multiple regression analysis, skin carotenoids were associated with sex and negatively associated with BMI in the Italian population (sex: β: 54.95; 95% CI: 40.11, 69.78; p < 0.0001; BMI: β: - 1.60; 95% CI: - 2.98,0.86; p = 0.03), while they resulted associated with age and sex in the Dominican Republic population (age: β: 2.76; 95% CI: 1.92, 3.56; p < 0.001; sex: β: 23.29; 95% CI: 5.93, 40.64; p = 0.009). Interestingly, skin carotenoids were positively correlated with MEDAS score in both populations (Italy: r = 0.03, p < 0.0001, Dominican Republic: r = 0.16, p = 0.002). CONCLUSIONS This study provides the assessment of the adherence to the MD and skin carotenoid content in adults living in Southern Italy and the Dominican Republic, showing a higher MD adherence score and a skin carotenoid content in inhabitants from the Mediterranean region. Our findings highlight the need to globally encourage fruit and vegetable intake, particularly in non-Mediterranean area.
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Affiliation(s)
- Giuseppina Augimeri
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende (CS), Italy
| | - Manuel Soto
- Research Unit, Centro Médico de Diabetes, Obesidad y Especialidades (CEMDOE), Clara María Pardo Street, Santo Domingo, 10135, Distrito Nacional, Dominican Republic
| | - Fabrizio Ceraudo
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende (CS), Italy
| | - Giovanna Caparello
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende (CS), Italy
| | - Melisa Villegas Figueroa
- Instituto Tecnológico de Santo Domingo (INTEC), Los Proceres Avenue, Santo Domingo, 10602, Distrito Nacional, Dominican Republic
- UNICARIBE Research Center, University of Calabria, 87036, Rende, Italy
| | - Mirko Cesario
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende (CS), Italy
| | - Lorenzo S Caputi
- UNICARIBE Research Center, University of Calabria, 87036, Rende, Italy
- Surface Nanoscience Group, Department of Physics, University of Calabria, 87036, Rende, Italy
| | - Berniza Calderón
- Research Unit, Centro Médico de Diabetes, Obesidad y Especialidades (CEMDOE), Clara María Pardo Street, Santo Domingo, 10135, Distrito Nacional, Dominican Republic
- Instituto Tecnológico de Santo Domingo (INTEC), Los Proceres Avenue, Santo Domingo, 10602, Distrito Nacional, Dominican Republic
- Sociedad Dominicana de Endocrinología y Nutrición (SODENN), 157 Independencia Avenue, GS Professional Building, Santo Domingo, 10206, Distrito Nacional, Dominican Republic
| | - Daniela Bonofiglio
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036, Arcavacata di Rende (CS), Italy.
- UNICARIBE Research Center, University of Calabria, 87036, Rende, Italy.
- Centro Sanitario, University of Calabria, Via P. Bucci, Arcavacata Di Rende (CS), 87036, Rende, Cosenza, Italy.
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Lotti S, Napoletano A, Tristan Asensi M, Pagliai G, Giangrandi I, Colombini B, Dinu M, Sofi F. Assessment of Mediterranean diet adherence and comparison with Italian dietary guidelines: a study of over 10,000 adults from 2019 to 2022. Int J Food Sci Nutr 2024; 75:336-343. [PMID: 38345046 DOI: 10.1080/09637486.2024.2313979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/30/2024] [Indexed: 05/09/2024]
Abstract
Despite the many well-documented benefits of the Mediterranean diet (MD), many Mediterranean countries seem to be moving away from it. The aim of this study was to investigate the MD adherence in 10,916 adults who completed the validated Medi-Lite questionnaire from January 2019 to December 2022 in Italy, and to assess the consumption of its food groups by comparing them with current national dietary guidelines. The sample showed a good level of MD adherence (12 ± 2.5). However, from 2019 to 2022, a significant (p < 0.001) decline in the adherence level emerged. An overconsumption of fresh red meat, cheese and poultry compared to dietary guidelines was observed. In contrast, an under-consumption of vegetables, bread, legumes, fish and milk and dairy products emerged. In recent years, a decline in MD adherence was observed in Italy, probably determined by an excessive consumption of animal products.
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Affiliation(s)
- Sofia Lotti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antonia Napoletano
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marta Tristan Asensi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Ilaria Giangrandi
- Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
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Ojeda-Granados C, Campisi E, Barchitta M, Agodi A. Genetic, lifestyle and metabolic factors contributing to cardiovascular disease in the Italian population: a literature review. Front Nutr 2024; 11:1379785. [PMID: 38638292 PMCID: PMC11024791 DOI: 10.3389/fnut.2024.1379785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Cardiovascular diseases (CVD) represent a major health problem worldwide. In Italy, despite the decline in CVD mortality and disability-adjusted life years recently observed, CVD remains the leading cause of death. The development of CVD has a complex and multifactorial etiology that involves environmental, lifestyle/behavioral (e.g., unhealthy diet, physical inactivity, smoking, and alcohol abuse), metabolic, and genetic factors. Although a large number of CVD susceptibility genetic variants have been identified, some seem to confer risk according to the genetic background or ethnicity of the population. Some CVD-associated polymorphisms with appreciable frequency in the Italian population may be important contributors to the development and progression of the most prevalent CVD in the population. This literature review aims to provide an overview of the epidemiology of CVD in Italy, as well as to highlight the main genetic, lifestyle/behavioral, and metabolic factors contributing to CVD risk in this population.
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Affiliation(s)
- Claudia Ojeda-Granados
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
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Nucci D, Sommariva A, Degoni LM, Gallo G, Mancarella M, Natarelli F, Savoia A, Catalini A, Ferranti R, Pregliasco FE, Castaldi S, Gianfredi V. Association between Mediterranean diet and dementia and Alzheimer disease: a systematic review with meta-analysis. Aging Clin Exp Res 2024; 36:77. [PMID: 38519775 PMCID: PMC10959819 DOI: 10.1007/s40520-024-02718-6] [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: 10/26/2023] [Accepted: 02/01/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Dementia affects 5-8% of the population aged over 65 years (~50 million worldwide). Several factors are associated with increased risk, including diet. The Mediterranean diet (MedDiet) has shown potential protective effects against several chronic diseases. AIMS This systematic review with meta-analysis aim was to assess the association between adherence to the MedDiet and the risk of dementia in the elderly. METHODS PRISMA-2020 guidelines were followed. PubMed/MEDLINE and Scopus were searched on 17 July 2023. The Newcastle-Ottawa Scale tool was used to assess the risk of bias. The protocol was pre-registered in PROSPERO (registration number: CRD 42023444368). Heterogeneity was assessed using the I2 test. Publication bias was assessed by visual inspection of the funnel plot and by Egger's regression asymmetry test. The final effect size was reported as OR or HR, depending on the study design of the included studies. RESULTS Out of 682 records, 21 were included in the analysis. The pooled OR was 0.89 (95% CI = 0.84-0.94) based on 65,955 participants (I2 = 69.94). When only cohort studies were included, HR was 0.84 (95% CI = 0.76-0.94) based on 55,205 participants (I2 = 89.70). When only Alzheimer Disease was considered OR was 0.73 (95% CI = 0.62-0.85) based on 38,292 participants (I2 = 63.85). DISCUSSION Despite the relatively low risk reduction associated with higher adherence to MedDiet among elderly, it should be considered that this population is the most affected. CONCLUSIONS Adherence to MedDiet could be an effective non-pharmacological measure to reduce the burden of dementia, even among elderly.
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Affiliation(s)
- Daniele Nucci
- Struttura Semplice Dipartimentale Igiene Alimenti E Nutrizione, Dipartimento Di Igiene E Prevenzione Sanitaria, Azienda Di Tutela Della Salute (ATS) Brescia, Via Duca Degli Abruzzi, 15, 25124, Brescia, Italy
| | - Andrea Sommariva
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Luca Mario Degoni
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Giulia Gallo
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Matteo Mancarella
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Federica Natarelli
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Antonella Savoia
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Via Tronto 10/a, 60100, Ancona, Italy
| | - Roberta Ferranti
- Struttura Semplice Dipartimentale Igiene Alimenti E Nutrizione, Dipartimento Di Igiene E Prevenzione Sanitaria, Azienda Di Tutela Della Salute (ATS) Brescia, Via Duca Degli Abruzzi, 15, 25124, Brescia, Italy
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy.
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7
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Gitto S, Golfieri L, Sofi F, Tamè MR, Vitale G, DE Maria N, Marzi L, Mega A, Valente G, Borghi A, Forte P, Cescon M, DI Benedetto F, Andreone P, Petranelli M, Dinu M, Carrai P, Arcangeli G, Grandi S, Lau C, Morelli MC, DE Simone P, Chiesi F, Marra F. Adherence to Mediterranean diet in liver transplant recipients: a cross-sectional multicenter study. Minerva Gastroenterol (Torino) 2024; 70:42-51. [PMID: 37162468 DOI: 10.23736/s2724-5985.22.03290-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Seeing the importance of healthy diet after liver transplant (LT), our study aimed to evaluate the adherence to Mediterranean diet (MD) in a large population of LT recipients. METHODS The present multicenter study was developed in clinically stable, liver transplanted patients, from June to September 2021. Patients completed a survey about adherence to MD, Quality of Life (QoL), sport, and employment. To analyze the correlations, we computed Pearson's coefficients; while to compare subgroups, independent samples t-tests and ANOVAs. We used a multivariable logistic regression analysis to find the predictors of impaired adherence to MD. RESULTS The questionnaire was administered to 511 patients. They were males in 71% of cases with a mean age of 63.1 years (SD±10.8). LT recipients coming from central Italy displayed higher adherence to the MD (M=11.10±1.91) than patients from northern (M=9.94±2.28, P<0.001) or southern Italy (M=10.04±2.16, P<0.001). Patients from central Italy showed a significantly higher consumption of fruit, vegetables, legumes, cereals, olive oil, fish and a significantly lower intake of dairy products than patients resident in the other Italian areas. At multivariate analysis, recipients from central Italy were 3.8 times more likely to report adherence to the MD. Patients with a high physical health score were more adherent to MD, as well as patients transplanted at an earlier time. CONCLUSIONS We demonstrated that place of stay, time from transplant and physical dimension of QoL significantly influences the adherence to MD. Continuous information campaigns about a correct diet and lifestyle would be necessary.
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Affiliation(s)
- Stefano Gitto
- Internal Medicine and Liver Unit, Department of Experimental and Clinical Medicine, University of Florence, Careggi University Hospital, Florence, Italy -
| | - Lucia Golfieri
- Unit of Internal Medicine for the Treatment of Severe Organ Failure, Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, University Hospital of Bologna, Bologna, Italy
| | - Francesco Sofi
- Unit of Clinical Nutrition, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Maria R Tamè
- Division of Gastroenterology, Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, University Hospital of Bologna, Bologna, Italy
| | - Giovanni Vitale
- Unit of Internal Medicine for the Treatment of Severe Organ Failure, Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, University Hospital of Bologna, Bologna, Italy
| | - Nicola DE Maria
- Department of Gastroenterology, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Marzi
- Division of Gastroenterology, Bolzano Regional Hospital, Bolzano, Italy
| | - Andrea Mega
- Division of Gastroenterology, Bolzano Regional Hospital, Bolzano, Italy
| | - Giovanna Valente
- Liver Unit for Transplant Management - SATTE, Department of Medical Sciences, AORN Sant'Anna e San Sebastiano, Caserta, Italy
| | - Alberto Borghi
- Unit of Internal Medicine, Hospital of Faenza, Ravenna, Italy
| | - Paolo Forte
- Unit of Gastroenterology, Careggi University Hospital, Florence, Italy
| | - Matteo Cescon
- Unit of General Surgery and Transplants, University Hospital of Bologna, Bologna, Italy
| | - Fabrizio DI Benedetto
- Unit of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Andreone
- Unit of Internal and Metabolic Medicine, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Petranelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Monica Dinu
- Unit of Clinical Nutrition, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Paola Carrai
- University of Pisa Medical School, Unit of Hepatobiliary Surgery and Liver Transplantation, Pisa, Italy
| | - Giulio Arcangeli
- Unit of Occupational Health, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Silvana Grandi
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics, University of Bologna, Bologna, Italy
| | - Chloe Lau
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Maria Cristina Morelli
- Unit of Internal Medicine for the Treatment of Severe Organ Failure, Surgical Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, University Hospital of Bologna, Bologna, Italy
| | - Paolo DE Simone
- University of Pisa Medical School, Unit of Hepatobiliary Surgery and Liver Transplantation, Pisa, Italy
| | - Francesca Chiesi
- Section of Psychology, Department of Neuroscience, Psychology, Drug, and Child's Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Fabio Marra
- Internal Medicine and Liver Unit, Department of Experimental and Clinical Medicine, University of Florence, Careggi University Hospital, Florence, Italy
- Center for Research, Higher Education and Transfer "DENOThe", University of Florence, Florence, Italy
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Cardamone E, Iacoponi F, Di Benedetto R, Lorenzoni G, Di Nucci A, Zobec F, Gregori D, Silano M. Adherence to Mediterranean Diet and its main determinants in a sample of Italian adults: results from the ARIANNA cross-sectional survey. Front Nutr 2024; 11:1346455. [PMID: 38476598 PMCID: PMC10927747 DOI: 10.3389/fnut.2024.1346455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Over the last years, many Mediterranean countries, including Italy, have witnessed a shift away from the Mediterranean Diet, thus contributing to the high rates of overweight and obesity. The survey "Adherence to Mediterranean Diet in Italy (ARIANNA)" aimed to evaluate the Adherence to Mediterranean Diet (AMD) and its main determinants in the Italian population. Materials and methods This study started on March 2023 and was addressed to adults aged ≥17 years, born and resident in Italy, proficient in Italian. Data are collected electronically through a voluntary, anonymous and self-administered questionnaire on the project website. Univariate and then multivariate logistic regressions were performed to evaluate associations between AMD and demographic characteristics, socio-economic status, health status, and lifestyle. Results On a total of 3,732 completed questionnaires, the 87.70% of the respondents was female and the 71.28% was 17-40 years old. The 83.82% of the respondents had medium AMD, 11.33% low and only 4.85% high. The multivariate analysis revealed that being male (p < 0.001), aged >40 years (p < 0.05), workers (p ≤ 0.001), and unemployed (p < 0.05), determined the probability of having a lower AMD. Vegans and vegetarian's diets positively contributed to a higher AMD (p < 0.001). Discussion These results highlighted a medium AMD in the Italian adult participants and suggested the necessity to implement tailored public health intervention strategies to improve food habits.
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Affiliation(s)
- Erica Cardamone
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
- Department of Medicine—DMED, Università degli Studi di Udine, Udine, Italy
| | - Francesca Iacoponi
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Rita Di Benedetto
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Annalisa Di Nucci
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Marco Silano
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
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D’Elia L, Strazzullo P. Dietary Salt Restriction and Adherence to the Mediterranean Diet: A Single Way to Reduce Cardiovascular Risk? J Clin Med 2024; 13:486. [PMID: 38256620 PMCID: PMC10816989 DOI: 10.3390/jcm13020486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
The dietary restriction of salt intake and the adhesion to Mediterranean dietary patterns are among the most recommended lifestyle modifications for the prevention of cardiovascular diseases. A large amount of evidence supports these recommendations; indeed, several studies show that a higher adherence to Mediterranean dietary patterns is associated with a reduced risk of cardiovascular disease. Likewise, findings from observational and clinical studies suggest a causal role of excess salt intake in blood pressure increase, cardiovascular organ damage, and the incidence of cardiovascular diseases. In this context, it is also conceivable that the beneficial effects of these two dietary patterns overlap because Mediterranean dietary patterns are typically characterized by a large consumption of plant-based foods with low sodium content. However, there is little data on this issue, and heterogeneous results are available on the relationship between adherence to salt restriction and to Mediterranean dietary patterns. Thus, this short review focuses on the epidemiological and clinical evidence of the relationship between the adherence to Mediterranean dietary patterns and dietary salt restriction in the context of cardiovascular risk.
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Affiliation(s)
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples Medical School, 80131 Naples, Italy;
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Su Y, Wu KC, Chien SY, Naik A, Zaslavsky O. A Mobile Intervention Designed Specifically for Older Adults With Frailty to Support Healthy Eating: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e50870. [PMID: 37966877 PMCID: PMC10687683 DOI: 10.2196/50870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/10/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Frailty, a common geriatric syndrome, predisposes older adults to functional decline. No medications can alter frailty's trajectory, but nutritional interventions may aid in supporting independence. OBJECTIVE This paper presents a pilot randomized controlled trial to investigate the feasibility and efficacy of a mobile health intervention, "Olitor," designed to enhance adherence to the Mediterranean diet among older adults with frailty, requiring no external assistance. METHODS The study sample consisted of 15 participants aged 66-77 (mean 70.5, SD 3.96) years randomized into intervention (n=8; 8 females; mean 72.4, SD 4.8 years) and control groups (n=7; 6 females, 1 male; mean 70.0, SD 3.9 years). The intervention involved a patient-facing mobile app called "Olitor" and a secure web-based administrative dashboard. Participants were instructed to use the app at least weekly for 3 months, which provided feedback on their food choices, personalized recipe recommendations, and an in-app messaging feature. Using Mann-Whitney tests to compare change scores and Hedges g statistics to estimate effect sizes, the primary efficacy outcomes were adherence to the Mediterranean diet score and insulin resistance measures. Secondary outcomes included retention as a measure of feasibility, engagement level and user app quality ratings for acceptability, and additional metrics to evaluate efficacy. Models were adjusted for multiple comparisons. RESULTS The findings demonstrated a significant improvement in the Mediterranean diet adherence score in the intervention group compared to the control (W=50.5; adjusted P=.04) with median change scores of 2 (IQR 2-4.25) and 0 (IQR -0.50 to 0.50), respectively. There was a small and insignificant reduction in homeostasis model assessment of insulin resistance measure (W=23; adjusted P=.85). Additionally, there were significant increases in legume intake (W=54; adjusted P<.01). The intervention's effect size was large for several outcomes, such as Mediterranean diet adherence (Hedges g=1.58; 95% CI 0.34-2.67) and vegetable intake (Hedges g=1.14; 95% CI 0.08-2.21). The retention rate was 100%. The app's overall quality rating was favorable with an average interaction time of 12 minutes weekly. CONCLUSIONS This pilot study revealed the potential of the mobile intervention "Olitor" in promoting healthier eating habits among older adults with frailty. It demonstrated high retention rates, significant improvement in adherence to the Mediterranean diet, and increased intake of recommended foods. Insulin resistance showed a minor nonsignificant improvement. Several secondary outcomes, such as lower extremity function and Mediterranean diet knowledge, had a large effect size. Although the app's behavior change features were similar to those of previous digital interventions, the distinctive focus on theory-informed mechanistic measures involved in behavioral change, such as self-regulation, self-efficacy, and expected negative outcomes, may have enhanced its potential. Further investigations in a more diverse and representative population, focusing on individuals with impaired insulin sensitivity, are warranted to validate these preliminary findings. TRIAL REGISTRATION ClinicalTrials.gov NCT05236712; https://clinicaltrials.gov/study/NCT05236712.
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Affiliation(s)
- Yan Su
- College of Nursing & Health Sciences, University of Massachusetts Dartmouth, Darmouth, MA, United States
| | - Kuan-Ching Wu
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Shao-Yun Chien
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Aishwarya Naik
- Human Centered Design and Engeneering, University of Washington, Seattle, WA, United States
| | - Oleg Zaslavsky
- School of Nursing, University of Washington, Seattle, WA, United States
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Domínguez-Martín G, Tárraga-López PJ, López-Gil JF. Cross-Sectional Association between Perceived Physical Literacy and Mediterranean Dietary Patterns in Adolescents: The EHDLA Study. Nutrients 2023; 15:4400. [PMID: 37892475 PMCID: PMC10610224 DOI: 10.3390/nu15204400] [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: 09/02/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
PURPOSE The objective of the current study was to analyze the relationship between perceived physical literacy (PPL) and adherence to the Mediterranean Diet (MedDiet) and its specific components in a sample of Spanish adolescents. METHODS In this cross-sectional study, we examined a sample of 845 adolescents (58.1% boys) aged 12-17 years from the Valle de Ricote (Region of Murcia, Spain). PPL was assessed by the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). To assess adherence to the MedDiet, the Mediterranean Diet Quality Index in children and adolescents (KIDMED) was applied. RESULTS In unadjusted analyses, adolescents with medium or high PPL were more likely to have optimal adherence to the MedDiet (medium PPL: OR = 1.69, 95% CI 1.20-2.40, p-adjusted = 0.003; high PPL: OR = 2.90, 95% CI 2.03-4.17, p-adjusted < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, body mass index, energy intake, overall sleep duration, physical activity, and sedentary behavior (medium PPL: OR = 1.51, 95% CI 1.05-2.19, p-adjusted = 0.003; high PPL: OR = 2.27, 95% CI 1.53-3.39, p-adjusted < 0.001). CONCLUSIONS PPL could play a relevant role in the adoption of healthy eating habits among adolescents. Adolescents with low or medium PPL were less likely to report optimal adherence to the MedDiet. Adolescents with high PPL seem to consume more fruits, vegetables, fish, pulses, nuts, and dairies (for breakfast). Conversely, these adolescents tend to skip breakfast less, as well as to consume less commercially baked goods or pastries at this meal.
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Affiliation(s)
| | - Pedro J. Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Castilla-La Mancha, 02006 Albacete, Spain;
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Yurtdaş Depboylu G, Kaner G, Süer M, Kanyılmaz M, Alpan D. Nutrition literacy status and its association with adherence to the Mediterranean diet, anthropometric parameters and lifestyle behaviours among early adolescents. Public Health Nutr 2023; 26:2108-2117. [PMID: 37622233 PMCID: PMC10564606 DOI: 10.1017/s1368980023001830] [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: 12/06/2022] [Revised: 06/02/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To evaluate nutrition literacy status and its association with adherence to the Mediterranean diet (MD), anthropometric parameters and lifestyle behaviours among early adolescents. DESIGN This is a cross-sectional study. Nutrition literacy was evaluated using the 'Adolescent Nutrition Literacy Scale'. Dietary intake was assessed by 24-h food recall. The 'Mediterranean Diet Quality Index' was used to evaluate adolescents' adherence to the MD. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Body weight, height, waist, hip and neck circumference were measured. SETTING Four secondary schools in İzmir, Türkiye. PARTICIPANTS The study included 1074 secondary school students. RESULTS Adolescents' nutrition literacy was at a moderate level. Nutrition literacy scores were significantly lower in those who skip main meals. Adolescents with high nutrition literacy had higher intakes of fibre, protein, protein, Ca, K, Mg, P, vitamin C, folate and Fe intake than those with low and moderate nutrition literacy (P < 0·05). According to IPAQ, active adolescents had higher nutrition literacy scores than inactive adolescents. There was no significant difference in BMI and anthropometric measurements of the adolescents according to their nutrition literacy level. Linear regression analysis showed that each unit increase in nutrition literacy increased adherence to the MD by 0·286 points (β = 0·286) and decreased total screen time by 0·182 points (β = -0·182). CONCLUSIONS These findings showed that nutrition literacy among early adolescents was not optimal, and a higher nutrition literacy score was significantly associated with higher MD adherence, and healthy eating habits and lifestyle behaviours.
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Affiliation(s)
- Gamze Yurtdaş Depboylu
- Izmir Katip Celebi University, Faculty of Health Sciences, Departments of Nutrition and Dietetics, İzmir35620, Turkey
| | - Gülşah Kaner
- Izmir Katip Celebi University, Faculty of Health Sciences, Departments of Nutrition and Dietetics, İzmir35620, Turkey
| | - Melisa Süer
- Izmir Katip Celebi University, Faculty of Health Sciences, Departments of Nutrition and Dietetics, İzmir35620, Turkey
| | - Mesude Kanyılmaz
- Department of Science Education, Çiğli Akiş Öğütçü Secondary School, İzmir, Turkey
| | - Duygu Alpan
- Department of English Language Teaching, Çiğli Akiş Öğütçü Secondary School, İzmir, Turkey
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González-Sosa S, Ruiz-Hernández JJ, Puente-Fernández A, Robaina-Bordón JM, Conde-Martel A. Adherence to the Mediterranean Diet in medical students. Public Health Nutr 2023; 26:1798-1806. [PMID: 37165862 PMCID: PMC10478057 DOI: 10.1017/s1368980023000964] [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: 10/18/2022] [Revised: 04/03/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE The protective effect of the Mediterranean Diet (MeDi) is undisputed. However, adherence to MeDi has decreased in recent years, particularly in young people. The aim of this study was to evaluate adherence to MeDi in medical students and to assess the influence of knowledge acquisition as well as other factors on dietary compliance. DESIGN A cross-sectional study was conducted on medical students. The data were obtained through anonymous surveys that collected demographic characteristics, medical history, alcohol and tobacco consumption, physical activity and adherence to MeDi – using 14-point Mediterranean Diet Adherence Score (MEDAS) –. Adherence to MeDi and related factors were evaluated by univariate and multivariable analysis. PARTICIPANTS Medical students from the first to the sixth year of the 2018–2019 academic year. SETTING The study was conducted at the university of Las Palmas de Gran Canaria. RESULTS Of 589 respondents (73 % women) mean aged 22 years (range 18–39), 58·9 % showed good adherence to MeDi. Adherence was significantly associated with age (P = 0·017) but not with sex or the presence of comorbidities. Independently, adherence to MeDi was higher in last academic courses (OR = 2·1; 95 % CI = 1·3, 3·2; P = 0·001), in those who consumed alcohol more frequently (OR = 1·5; 95 % CI = 1·0, 2·1; P = 0·039) and in those who practiced more exercise (OR = 1·5; 95 % CI = 1·2, 1·9; P < 0·001). CONCLUSIONS Half of all medical students did not have a good adherence to MeDi. Adherence was higher at older age in higher academic years and related to greater physical activity. It would be convenient to quantify dietary knowledge as well as implement nutritional educational programmes, favouring a healthy lifestyle.
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Affiliation(s)
- Sonia González-Sosa
- Department of Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Barranco La Ballena s/n 35012 Las Palmas, GC, Spain
- Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n. 35016 Las Palmas, GC, Spain
| | - Jose Juan Ruiz-Hernández
- Department of Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Barranco La Ballena s/n 35012 Las Palmas, GC, Spain
- Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n. 35016 Las Palmas, GC, Spain
| | - Alicia Puente-Fernández
- Department of Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Barranco La Ballena s/n 35012 Las Palmas, GC, Spain
- Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n. 35016 Las Palmas, GC, Spain
| | - José María Robaina-Bordón
- Department of Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Barranco La Ballena s/n 35012 Las Palmas, GC, Spain
- Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n. 35016 Las Palmas, GC, Spain
| | - Alicia Conde-Martel
- Department of Internal Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Barranco La Ballena s/n 35012 Las Palmas, GC, Spain
- Faculty of Health Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe, s/n. 35016 Las Palmas, GC, Spain
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Costantino C, Casuccio A, Belluzzo M, Balsamo F, Bonaccorso N, Carubia A, D’Azzo L, Gattuso L, Lo Porto MC, Sciortino M, Vitello T, Tabacchi G, Vitale F, Mazzucco W. Knowledge and adherence to the Mediterranean diet in individuals practicing regular amatorial physical activity: a cross-sectional study conducted in the Metropolitan Area of Palermo, Italy. Front Public Health 2023; 11:1204155. [PMID: 37427285 PMCID: PMC10326436 DOI: 10.3389/fpubh.2023.1204155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Mediterranean Diet (MD) is a universal model of nutrition that prevents several metabolic, cardiovascular, and oncological diseases. Main objective of the present study was to analyze adherence and knowledge regarding MD principles in a sample of individuals practicing amatorial sports from the Metropolitan Area of Palermo. Methods A cross-sectional study was conducted in 10 Sports Centers, between October 2020 and September 2021, through a previously validated anonymous questionnaire structured in five sections including 74 items. Results Overall, 337 subjects answered to the questionnaire. Based on the multivariable analysis conducted, a higher knowledge score (KS) on MD principles was observed among individuals daily consuming vegetables (OR: 3.32; CI95%: 1.82-6.02) and in the ones more adherent to MD principles (OR: 10.15; CI95%:5.47-18.85). More in depth, using MEDAS score to analyze the adherence to MD, a significant lower adherence was observed among overweight/obese (OR: 0.57; CI95%:0.33-0.99) and among employed subjects (OR: 0.52; IC95%: 0.28-0.98); while, a higher adherence was highlighted among daily consumers of vegetables (OR: 2.52; CI95%:1.52-4.17), daily consumers of fruit (OR: 1.77; CI95%:1.08-2.90), and in individuals that have daily breakfast (OR: 4.29; CI95%:1.15-15.96). Discussion In accordance with the WHO Europe Gaining Health Campaign, Public Health Authorities should simplify accessibility to healthy food among general population, promoting principles and accessibility to MD.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Miriam Belluzzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Francesco Balsamo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Nicole Bonaccorso
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Alessandro Carubia
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Luciano D’Azzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Luisa Gattuso
- Emergency Medicine Department, University of Milano Bicocca, Monza, Italy
| | - Maria Chiara Lo Porto
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Martina Sciortino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Tania Vitello
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Garden Tabacchi
- Department of Psychology, Educational Science and Human Movement, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
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López-Gil JF, García-Hermoso A, Smith L, Gallego A, Victoria-Montesinos D, Ezzatvar Y, Hershey MS, Gutiérrez-Espinoza H, Mesas AE, Jiménez-López E, Sánchez-Miguel PA, López-Benavente A, Moreno-Galarraga L, Chen S, Brazo-Sayavera J, Fernandez-Montero A, Alcaraz PE, Panisello Royo JM, Tárraga-López PJ, Kales SN. A Cluster Randomized Controlled Trial of the Archena Infancia Saludable Project on 24-h Movement Behaviors and Adherence to the Mediterranean Diet among Schoolchildren: A Pilot Study Protocol. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040738. [PMID: 37189987 DOI: 10.3390/children10040738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 05/17/2023]
Abstract
Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention's "halo" effect on parents'/guardians' 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6-13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
- One Health Research Group, Universidad de Las Américas, Quito 170124, Ecuador
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Alejandra Gallego
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, 30100 Murcia, Spain
| | | | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
| | - Maria S Hershey
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
| | | | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
| | - Pedro Antonio Sánchez-Miguel
- Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Facultad de Formación del Profesorado, Universidad de Extremadura, 10003 Cáceres, Spain
| | - Alba López-Benavente
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia, 30100 Espinardo, Spain
| | - Laura Moreno-Galarraga
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Javier Brazo-Sayavera
- PDU EFISAL, Centro Universitario Regional Noreste, Universidad de la República (UdelaR), Rivera 40000, Uruguay
- Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013 Seville, Spain
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
| | - Pedro Emilio Alcaraz
- Research Center for High Performance Sport, San Antonio Catholic University of Murcia, 30830 Murcia, Spain
- Faculty of Sport Sciences, San Antonio Catholic University of Murcia, 30107 Murcia, Spain
| | | | - Pedro J Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), 02008 Albacete, Spain
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
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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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Cardamone E, Di Benedetto R, Lorenzoni G, Gallipoli S, Ghidina M, Zobec F, Iacoponi F, Gregori D, Silano M. Adherence to Mediterranean diet in Italy (ARIANNA) cross-sectional survey: study protocol. BMJ Open 2023; 13:e067534. [PMID: 36858465 PMCID: PMC9980321 DOI: 10.1136/bmjopen-2022-067534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
INTRODUCTION There is evidence, although limited, that the Italian population has been no longer following a Mediterranean dietary pattern. The ARIANNA (Adherence to the Mediterranean Diet in Italy) project consists of a survey-based cross-sectional study with the objective of gaining a greater knowledge of adherence to the Mediterranean Diet and its main determinants in different age groups of the Italian population. METHODS/ANALYSIS The ARIANNA study will involve males and females aged ≥7 years, born and resident in Italy, and proficient in Italian. The voluntary enrolment will be in the period between March 2023 and May 2023. The data, which will include sociodemographic factors and dietary habits, will be collected through a web-based questionnaire. Adherence to the Mediterranean Diet will be assessed through the use of two validated score systems: the Mediterranean Diet Quality Index in children and adolescents for participants aged ≤16 years and the Mediterranean Diet Serving Score for participants aged ≥17 years. A review of the scientific literature will be carried out to collect historical data on adherence to the Mediterranean dietary pattern in the Italian population, which will be compared with those collected within this project. ETHICS AND DISSEMINATION The ARIANNA study has been approved by the Ethics Committee of Istituto Superiore di Sanità. The results will be disseminated through peer-reviewed papers, leaflets and documents for the general public. A report will be presented to the national policy makers, to give them the tools to implement appropriate intervention to improve, in necessary, the adherence to Mediterranean dietary pattern in Italy.
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Affiliation(s)
- Erica Cardamone
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Roma, Italy
| | - Rita Di Benedetto
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Roma, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | | | | | - Francesca Iacoponi
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Roma, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco Silano
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Roma, Italy
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Di Nucci A, Scognamiglio U, Grant F, Rossi L. The impact of COVID-19 pandemic on food habits and neophobia in children in the framework of the family context and parents' behaviors: A study in an Italian central region. Front Nutr 2022; 9:1070388. [PMID: 36570161 PMCID: PMC9772991 DOI: 10.3389/fnut.2022.1070388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
Objective This paper aims to evaluate whether changes in lifestyle and eating habits resulting from the Covid-19 emergency have influenced the post-pandemic level of food neophobia and in children living in an Italian central region. Methods A sample of 99 children took part in a retrospective assessment carried out with a self-administrated questionnaire. Pre and post-pandemic evaluation of eating habits, physical activity, and lifestyle indicators was carried out. Food neophobia was evaluated following the Child Food Neophobia Scale (CFNS). Descriptive statistics were produced. A contingency analysis was performed to check associations between variables. Results For a large part of the sample (97%) the selective food refusal did not change during the pandemic period. About 70% of participants did not change their eating habits, with some subgroups reporting an increase in the consumption of fruits (22.2%), vegetables (19.2%), and legumes (21.2%). Relevantly the impact of the pandemic on the sedentary attitude passed from 25.3 to 70.7%. Neophobia was not associated with ponderal status (p-value 0.5). However, in normal-weight children, a high prevalence of intermediate-level neophobia (78.4%) was found. 39.4% of the studied children were involved in meal preparation during social isolation, with an increase in the proportion of children that shared all meals with their family (32.3% vs. 78.8%). Non-coercive parent behaviors in reaction to food refusal were associated with low levels of neophobia (p-value < 0.05). Discussion In this sample, for the effect of parents' attitudes, the pandemic positively affected children's food habits and, consequently, the level of neophobia after the social restrictions. The main implication of the study is the importance of capitalizing on the period of restrictions in order to involve children in meal sharing and food preparation.
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