Adherence to a Mediterranean Dietary Pattern Is Associated with Higher Quality of Life in a Cohort of Italian Adults

Differences of skin carotenoids and adherence to the Mediterranean Diet pattern in adults from Southern Italy and Dominican Republic

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.

Exploring the Relationship between Mediterranean Diet Adherence and Subjective Well-Being among Greek and Cypriot Adults

Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via an online survey. In total, 936 questionnaires (470: Cyprus, 466: Greece) were analyzed to study the associations between the Mediterranean Diet (MD) (using the 14-item MEDAS score, (14-MEDAS)), subjective well-being (SWB), and several socioeconomic factors. Key remarks of this survey highlight the positive impact of MD adherence on some well-being items. Namely, statistically significant differences were found on the following items: Satisfied with life (p < 0.001), Life worthwhile (p < 0.001), Feeling happy (p < 0.001), worried (p = 0.005), and depressed (p = 0.001), when comparing Low MD adherence (14-MEDAS < 5) to High MD adherence (14-MEDAS > 10). Other lifestyle habits such as spending time with friends and family, spending time in nature, and habitual physical activity were associated with aspects of SWB such as Life satisfaction, Life worthwhile, Feeling happy, and energetic. The findings support adherence to the MD, since it is associated with higher life satisfaction and self-reported happiness in this sample and should be considered when developing health policies on well-being.

Physical Activity, Sun Exposure, Vitamin D Intake and Perceived Stress in Italian Adults

The last decades of global development have, due to rapid urbanization, pressuring entire populations to changes in lifestyle and dietary habits, led to an increase in the prevalence of mental disorders, including stress. This study explored how lifestyle and dietary factors, such as physical activity, sun exposure, and vitamin D intake are related to perceived stress in a Mediterranean-based population. Physical activity level was evaluated using the international physical activity questionnaires (IPAQ), sun exposure was evaluated using the sunlight exposure measurement questionnaire (SEM-Q), and validated food frequency questionnaires (FFQs) were used to assess dietary intakes. The perceived stress of the study participants was evaluated using the perceived stress scale (PSS). Multivariate logistic regression models were used to test for potential associations. In the most adjusted model, an inverse association between physical activity level, sunlight exposure, vitamin D intake, and high perceived stress was found (OR = 0.72, 95% CI: 0.51, 1.00, OR = 0.72, 95% CI: 0.52, 0.99, OR = 0.69, 95% CI: 0.53, 0.89, respectively). However, when stratifying the population by level of physical activity, the retrieved associations with sunlight exposure and dietary vitamin D intake were significant only among those individuals reporting being moderately to highly physically active (OR = 0.16, 95% CI: 0.08, 0.33 and OR = 0.46, 95% CI: 0.28, 0.76, respectively), while results on low physically active participants were null. In conclusion, this study demonstrated that higher dietary intake of vitamin D and sunlight exposure are associated with a lower likelihood of having high perceived stress among physically active individuals.

Mediterranean Dietary Pattern and Cardiovascular Risk in Pregnant Women

Nutrition during pregnancy is one of the most important factors that determine the health of a mother and the proper development of her fetus. The main objective of this study was to analyze the association between adherence to a Mediterranean dietary (MedDiet) pattern and cardiovascular (CV) risk factors in pregnant women. Accordingly, we carried out an observational, population-based study using data from pregnant women present in a hospital during the entire course of their pregnancy. Adherence to the MedDiet was assessed using the MedDiet score questionnaire. Our study identified that 87.25% (95%CI: 83.48-90.27) of the women had a cardiovascular risk in relation to their dietary intake. Women with diet-related CV risk were more likely to smoke (p = 0.004), weighed more at the beginning of pregnancy, engaged in little physical activity, and had lower adherence to the MedDiet pattern than women without a diet-related CV risk. Dietary analysis showed low consumption of cereals, vegetables, and fish, which failed to satisfy the recommended portions in Spain. Adequate adherence to the MedDiet was found for 54.2% of women who were considered to be without CV risk and 45.8% of women with CV risk. Our data suggest that the MedDiet could be improved in relation to the consumption of cereals, vegetables, and fish during pregnancy in order to reduce CV risk.

Healthy and Unhealthy Food Consumption in Relation to Quality of Life among Finnish Female Municipal Employees: A Cross-Sectional Study

Aspects of good quality of life (QoL) have been found to motivate people to make lifestyle changes. There is also evidence that certain dietary patterns are associated with QoL. The aim of this work was to examine whether consumption frequencies of healthy and unhealthy food items are associated with QoL in female employees. A cross-sectional study was conducted among 631 Finnish female employees (mean age 49 years, SD = 10) from 10 municipal work units in 2015. Information about the participants was collected by physical examination, laboratory tests, self-administered questionnaires, including the Food Frequency Questionnaire (FFQ), and from medical history. QoL was assessed with the EUROHIS-Quality of Life 8-item index. A significant positive association was seen between consumption frequency of healthy foods and the EUROHIS-QOL mean score (p = 0.002). The association was small but comprehensive, also involving most dimensions of QoL. The consumption frequency of unhealthy foods was not associated with QoL. These findings are relevant when designing diet counselling, since QoL is an outcome that has been found to motivate people to change their health habits. Recommending abundant use of healthy foods could be a simple and convenient way of diet counselling at many health care appointments, where time consuming approaches are difficult to conduct.

Quality of life in liver transplant recipients during the Corona virus disease 19 pandemic: A multicentre study

BACKGROUND

Liver transplant recipients require specific clinical and psychosocial attention given their frailty. Main aim of the study was to assess the quality of life after liver transplant during the current pandemic.

METHODS

This multicentre study was conducted in clinically stable, liver transplanted patients. Enrollment opened in June and finished in September 2021. Patients completed a survey including lifestyle data, quality of life (Short Form health survey), sport, employment, diet. To examine the correlations, we calculated Pearson coefficients while to compare subgroups, independent samples t-tests and ANOVAs. To detect the predictors of impaired quality of life, we used multivariable logistic regression analysis.

RESULTS

We analysed data from 511 patients observing significant associations between quality of life's physical score and both age and adherence to Mediterranean diet (p < .01). A significant negative correlation was observed between mental score and the sedentary activity (p < .05). Female patients scored significantly lower than males in physical and mental score. At multivariate analysis, females were 1.65 times more likely to report impaired physical score than males. Occupation and physical activity presented significant positive relation with quality of life. Adherence to Mediterranean diet was another relevant predictor. Regarding mental score, female patients were 1.78 times more likely to show impaired mental score in comparison with males. Sedentary activity and adherence to Mediterranean diet were further noteworthy predictors.

CONCLUSIONS

Females and subjects with sedentary lifestyle or work inactive seem to show the worst quality of life and both physical activity and Mediterranean diet might be helpful to improve it.

Cardiometabolic Health Status, Ethnicity and Health-Related Quality of Life (HRQoL) Disparities in an Adult Population: NutrIMDEA Observational Web-Based Study

Precision public health supported on online tools is increasingly emerging as a potential strategy to achieve health promotion and disease prevention. Our aim was to assess the relationships of sociodemographic variables, anthropometric data, dietary habits and lifestyle factors with health-related quality of life (HRQoL), cardiometabolic health status and ethnicity in an online recruited adult population (NutrIMDEA Study). NutrIMDEA Study is a web-based cross-sectional survey that included 17,333 adults. Self-reported sociodemographic characteristics, anthropometric data, clinical and family history of cardiometabolic illnesses, dietary habits, lifestyle factors and HRQoL features were collected. Diseased individuals showed significative poorer MedDiet and worse HRQoL than those in the healthy cardiometabolic status group (p < 0.05). In comparison, European/Caucasian individuals reported a significantly better HRQoL, higher MedDiet and HRQoL values compared with those of other ethnicities (p < 0.05). We obtained a total of 16.8% who reported poor/fair, 56.5% good and 26.6% very good/excellent HRQoL. Respondents with very good/excellent HRQoL showed lower BMI, greater adherence to a Mediterranean diet (MedDiet) and higher physical activity. The results suggest the presence of interactions between the mental and physical components of HRQoL with obesity, sedentarism and dietary intake, which were dependent on disease status and ethnicity. Online HRQoL assessment could contribute to wider implementation of precision public health strategies to promote health targeted interventions with policy implications to community health promotion.

HRQoL and nutritional well-being dissimilarities between two different online collection methods: Value for digital health implementation

Background

Online health data collection has gained a reputation over the last years to record and process information about health issues for implementing digital health.

Objective

The research aim was to appraise two online methods (open and rewarded) to collect information about HRQoL and nutritional well-being and to compare the results between both surveyed populations.

Methods

This cross-sectional study is framed on the NUTRiMDEA project. Online data through two different web-based methods (open survey and rewarded survey) were retrieved to assemble data related to sociodemographic, lifestyle (diet, physical activity and sleep patterns) and general health aspects, as well as HRQoL by an evidence-based form such as the SF-12 questionnaire, the IPAQ survey, and MEDAS-14, participants were adults (>18 years old).

Results

Overall, 17,332 participants responded to the open survey (OS, n = 11,883) or the rewarded survey (RS, n = 5449). About 65.1% of the participants were female, while the mean age was in the range of 40–70 years. There were significant differences ( p < 0.05) between surveyed populations in sociodemographic, lifestyle (diet and physical activity), health and HRQoL data.

Conclusions

This investigation implemented an evidence-based online questionnaire that collected demographic, lifestyle factors, phenotypic and health-related aspects as well as compared differential outcomes in HRQoL and nutritional/lifestyle well-being depending on the online mode data collection. Findings demonstrated dissimilarities in most aspects of health, HRQoL, dietary intake and physical activity records between both populations. Overall, OS sample was characterized as a healthier population with superior lifestyle habits than RS participants.

Quality of life and adherence to mediterranean diet among type 2 diabetes mellitus patients of a primary health care clinic in Hebron city, Palestine

BACKGROUND: Diabetes mellitus (DM) is a lifelong metabolic disease with a high rate of mortality and morbidity. Uncontrolled and untreated diabetes results in serious complications that subsequently cause patients’ quality of life (QoL) to deteriorate. Adherence to Mediterranean diet (MD) may relieve the complications of diabetes, thereby improving the quality of life for these patients. OBJECTIVE: The aim of this study was to assess the QoL of DM patients who adhered to MD. METHODS: In this cross-sectional study, we examined the QoL and MD data of 106 DM II patients being treated at a primary health care clinic in Hebron. We used the SF-36 questionnaire to measure the patients’ QoL and the MEDAS tool to assess their MD adherence. We also recorded their anthropometric measurements, abdominal obesity, lifestyle habits and blood biochemical results. RESULTS: The sample comprised male and female DM II patients between the ages of 35 and 72, with their mean age being 55.8±10.24. Patients’ QoL scores showed a significant relationship with three BMI categories, i.e., total QoL score, physical function, and pain domains (p < 0.05). In terms of diet, high adherence to MD had a positive impact on all domains and on patients’ total QoL with significant differences in physical functioning, emotional well-being, social functioning and pain domains. CONCLUSION: Patients’ QoL domains were relatively low and highly affected by DM II. Patients with greater MD adherence reported higher scores in all QoL domains. Significantly higher scores were noted for the physical, social and pain domains. Hence, MD is a recommended dietary pattern for DM II patients to achieve a better QoL.

Mobility and muscle strength trajectories in old age: the beneficial effect of Mediterranean diet in combination with physical activity and social support

INTRODUCTION

Decline in physical function varies substantially across older individuals due to several extrinsic modifiable factors such as dietary patterns, physical activity and social support. We aimed to determine the association of these factors and their interaction with mobility and muscle strength decline.

METHODS

We analyzed data from 1686 functionally healthy individuals aged 60 + from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The Mediterranean Diet Score (MDS) was calculated based on a validated food frequency questionnaire. Self-reported physical activity was categorized based on current recommendations, and social support was measured according to participants' perceived material and psychological support from relatives and friends. Participants' physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. In order to explore the combined effect of the different exposures, two indicator variables were created by cross-classifying individuals' levels of Mediterranean diet adherence and social support or physical activity.

RESULTS

Participants with a high adherence to Mediterranean diet were primarily < 78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing levels of physical activity (51.5%). A one-point increase in MDS (score range 0-9) was associated with less annual deterioration in walking speed (β*time[year] = 0.001; p = 0.024) and chair-stand time (β*time[year] = -0.014; p = 0.008). The potential protective effect of Mediterranean diet was highest among participants reporting high social support (β*time[year] = -0.065, p = 0.026 for chair stands) and high physical activity (β*time[year] = 0.010, p = 0.001 for walking speed), beyond the effect of each exposure individually.

CONCLUSION

A higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, may contribute to delay the decline in physical function observed with aging.

Social Capital and Self-Perceived Quality of Life-Interrelated Predictors of Mediterranean Diet Adherence in Older Adults

Living a healthy life in a supporting environment are key elements towards higher diet quality in older age. The Mediterranean Diet in Older Adults (MINOA) study collected cross-sectional data from adults ≥65 years old (n = 436) from April 2014 to November 2015 in rural Crete, aiming to understand the interrelations between Mediterranean Diet adherence, Social Capital and Health-Related Quality of Life (HRQL). Multivariate linear regression, carried out using SPSS 20.0, revealed that both Social Capital and HRQL has a positive impact on Mediterranean Diet adherence after adjustment for confounders and independently of each other. Total Social Capital as well as its Value of Life/Social Agency component (β = 0.04 and β = 0.1, p < 0.05, respectively) had a positive relationship with Mediterranean Diet adherence. As far as HRQL is concerned, only the Physical Health components were found to have a positive association with Mediterranean Diet adherence (β = 0.09, p < 0.001). At the same time Total Social Capital was also seen to have a positive relationship with perceived Physical and Mental Health (β = 0.21 and β = 0.28, p < 0.001, respectively). In a population of older adults Social Capital, HRQL and Mediterranean Diet adherence seem to share intricate interrelations that impact both diet quality and quality of life overall.

The Relationship Between Diet and Sleep in Older Adults: a Narrative Review

PURPOSE OF REVIEW

Older adults more frequently experience reduced sleep quality and quantity compared to younger adults. Diet is one modifiable lifestyle factor that may influence sleep outcomes in older adults. The purpose of this review is to synthesise the current literature investigating the impact of diet, including foods and nutrients, on the sleep quality and quantity of older adults.

RECENT FINDINGS

Overall, the observational and intervention studies suggest that following a Mediterranean diet, and the consumption of certain food items (e.g. milk), and nutrients (e.g. vitamin D and vitamin E) may influence (improve or reduce) sleep quality and quantity. This review describes the potential efficacy for dietary factors to improve sleep outcomes in older adults. However, given the heterogeneity of included studies in this review (i.e. aims, methodologies, and outcomes assessed), it is difficult to consolidate the available evidence to make specific recommendations. More targeted research exploring the relationship between diet and sleep in older adults is needed to strengthen the current evidence base.

Diet as a possible influencing factor in thyroid cancer incidence: the point of view of the nutritionist

The incidence of differentiated thyroid cancer has increased in the last decades all over the world. Different environmental factors are possible perpetrators of this exponential growth. Nutritional factors are among the main environmental factors studied for thyroid cancer in recent years. This review aims to overview the main dietary factors involved in thyroid cancer risk, providing specific nutrition recommendations from the endocrinological Nutritionist point of view. Among the single food, fish and shellfish are the primary natural source of iodine, selenium and vitamin D in the human diet. These nutrients are essential for the synthesis of thyroid hormones; however, their consumption is not consistently related to thyroid cancer risk. The high intake of fruit and vegetables, probably due to their vitamin and antioxidant content, shows a weak inverse association with thyroid cancer risk. Alcohol, meat, or other food groups/nutrients showed no significant effect on thyroid cancer. In conclusion, to date, no definite association among dietary factors, specific dietary patterns, and thyroid cancer, and its clinical severity and aggressiveness have been found. However, it is essential to underline that in the future, prospective studies should be carried out to precisely evaluate the qualitative and quantitative intake of nutrients by patients to establish with more confidence a potential correlation between food intake and the occurrence and development of thyroid cancer.

The associations between dietary pattern of chronic obstructive pulmonary disease patients and depression: a cross-sectional study

Background

Chronic obstructive pulmonary disease (COPD) is a common lung disease during middle age which one of its complications is depression. Depression is considered one of the major causes of severe disability worldwide. One of the factors that affect the severity and incidence of this disease is a lifestyle, especially dietary pattern. On the other hand, some studies showed the relationship between dietary patterns and depression. The present study aims to investigate the dietary patterns of people with chronic obstructive pulmonary disease and its association with depression.

Methods

The present cross-sectional study was performed on 220 patients (mean ± SD age = 54.58 ± 5.08) with chronic obstructive pulmonary disease (56.6% men, 43.4% women) from Tabriz, Iran. Questionnaires of general information, food frequency, Beck depression and physical activity were completed. The dominant dietary patterns were determined by factor analysis, and their relationship with depression was discussed by regression analysis.

Results

Three dominant dietary patterns were identified as healthy, unhealthy, and mixed dietary patterns. An inverse relationship was found between healthy and mixed dietary patterns with depression. There is no meaningful connection between unhealthy dietary patterns and depression. Depression had a significant inverse relationship with physical activity. There was no relationship between dietary patterns and Forced Expiratory Volume for 1 s (FEV1) and Forced Vital Capacity (FVC) criteria. A positive and significant relationship was observed between mixed dietary patterns with FEV1/FVC.

Conclusion

Inverse relationships exist between healthy dietary patterns and depression in patients with COPD, and improves the function of the lungs. Further studies are needed to show the exact relationship between diet and COPD depression.

Mediterranean Diet Adherence and Subjective Well-Being in a Sample of Portuguese Adults

The Mediterranean diet (MD) and other lifestyle characteristics have been associated with well-being, a broad multiparameter concept that includes individual's subjective assessment of their own well-being (SWB). Some studies have suggested that diet influences SWB, thus, this work aimed to add novel information on the association of MD and SWB in a sample of Portuguese adults. Data on sociodemographic, economic, lifestyle, diet, and SWB were collected through a self-filled online questionnaire. MD adherence was assessed by the Mediterranean Diet Adherence Screener (MEDAS) score ]. Results showed a moderate adherence to the MD in 490 Portuguese adults (mean MEDAS of 7.4 ± 2.1). A higher MD adherence was found to be significantly positively associated with women, employed individuals, a higher number of meals per day, and those with frequent contact with nature (p-value < 0.0025, using Bonferroni adjustment). As a novelty, this study divided the participants into low SWB, medium SWB, and medium to high SWB profiles (3.9 ± 1.0; 6.2 ± 1.0; 8.2 ± 1.3, respectively; p-value < 0.05), which reported significantly increasing MEDAS scores (6.5 ± 2.1; 7.3 ± 2.1; 7.8 ± 1.9; respectively, p-value < 0.05).

The Mediating and Moderating Effects of Physical Fitness of the Relationship between Adherence to the Mediterranean Diet and Health-Related Quality of Life in University Students

The aim of this study was to estimate the relationship between the adherence to the Mediterranean diet (MD) and health-related quality of life (HRQoL) in university students and to assess whether this relationship is mediated or moderated by cardiorespiratory fitness (CRF) and handgrip strength. A cross-sectional study was performed involving 310 first-year Spanish university students. Adherence to the MD was evaluated with the 14-item Mediterranean Diet Adherence Screener (MEDAS), and the HRQoL was evaluated with the Short Form-12 (SF-12) questionnaire. CRF was assessed by the 20 m shuttle run test, and the handgrip strength was determined by dynamometry. ANCOVA models showed that participants with higher CRF and handgrip strength levels had significantly higher scores in the physical component summary (PCS) and mental component summary (MCS) of the SF-12 and in the MEDAS questionnaire than those with medium and low scores (p < 0.050). Additionally, the ANCOVA models showed that students with good adherence to the MD showed higher scores in the MCS of HRQoL than those with low adherence (p = 0.044, ES = 0.013), but these results did not appear for the PCS of HRQoL (p = 0.728, ES = 0.001). In the mediation analysis, it was found that CRF and handgrip strength acted as full mediators of the relationship between adherence to the MD and the MCS of HRQoL. In the moderation analysis, it was evidenced that CRF and handgrip strength did not act as moderators in the relationship between adherence to the MD and the MCS of HRQoL. In conclusion, adherence to the MD does not seem to have a direct effect on the MCS of HRQoL because this association seems to be fully mediated by CRF and handgrip strength.

Influence of Self-Efficacy and Motivation to Follow a Healthy Diet on Life Satisfaction of Patients with Cardiovascular Disease: A Longitudinal Study

Today, cardiovascular disease has a great impact on the global population due to its high prevalence. One challenge that cardiovascular patients face to achieve a better prognosis is to follow a healthy diet. This study focused on psychological factors linked to adaptation to a healthy diet in these patients. The main objective was to analyze the interrelationship between motivation to follow a healthy diet and self-efficacy to adhere to the Mediterranean diet with life satisfaction over time. The sample consisted of cardiovascular patients who were assessed at three measurement moments (NT1 = 755; NT2 = 593; NT3 = 323, average interval time: nine months). Correlation analyses showed that self-efficacy, motivation, and life satisfaction followed a pattern of positive relations across the three measurements. A time effect over the study variables was also observed. The results of path analyses showed that self-efficacy positively predicted autonomous motivation, which in turn was associated with patients' life satisfaction. This interrelation was stable over a period of 18 months. Moreover, life satisfaction predicted self-efficacy nine months later. Psychological interventions might be a positive resource for cardiovascular patients, since psychological variables influence their life satisfaction and their subsequent quality of life in their new health condition.

Nutritional Determinants of Quality of Life in a Mediterranean Cohort: The SUN Study

Health related quality of life (HRQoL) is a subjective appreciation of how personal characteristics and health influence well-being. This cross-sectional analysis aimed to quantitatively measure the influence of dietary, lifestyle, and demographic factors on HRQoL. A sub-sample of the Seguimiento Universidad de Navarra (SUN) Project, a Mediterranean cohort, was analyzed (n = 15,674). Through self-administered questionnaires the relationship between HRQoL and dietary patterns (Mediterranean-diet (MedDiet) and provegetarian food pattern (FP) assessment), lifestyles (sleeping hours, physical activity) and demographic characteristics were measured. Multivariate linear regression and flexible regression models were used to estimate the pondered effect of personal factors on Short Form-36 (SF-36) scores. Coefficients for MedDiet and provegetarian scores (β-coefficient for global SF-36 score: 0.32 (0.22, 0.42); 0.09 (0.06, 0.12) respectively for every unit increase), physical activity (β: 0.03 (0.02, 0.03) for every metabolic equivalent of task indexes (MET)-h/week) had a positive association to HRQoL. The female sex (β: −3.28 (−3.68, −2.89)), and pre-existing diseases (diabetes, β: −2.27 (−3.48, −1.06), hypertension β: −1.79 (−2.36, −1.22), hypercholesterolemia β: −1.04 (−1.48, −0.59)) account for lower SF-36 scores. Adherence to MedDiet or provegetarian FP, physical activity and sleep are associated with higher HRQoL, whereas the female sex, “other” (versus married status) and the presence of chronic diseases were associated with lower SF-36 scores in this sample.

Dietary Patterns and Health Outcomes among African American Maintenance Hemodialysis Patients

The association between dietary patterns and health outcomes, such as quality of life (QOL), in maintenance hemodialysis (MHD) patients with certain racial backgrounds has not been studied in detail. QOL is a powerful outcome measure in which dietary patterns could be a modifying factor. This study is a secondary analysis examining the association between dietary patterns and health outcomes in 101 African American (AA) maintenance hemodialysis (MHD) patients participating in the Palm Tocotrienols in Chronic Hemodialysis (PATCH) study. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life 36-item survey (KDQOL-36™). Blood samples were analyzed for lipids, lipoprotein subfractions, and inflammatory markers. Food intake was measured using six non-consecutive 24-h dietary recalls over 15 months. Implausible energy intake reports were screened out by comparing reported energy intake (rEI) with predicted total energy expenditure (pTEE). Cluster analysis, using the k-means algorithm, identified two distinct dietary patterns in the study population: a high “sugar sweetened beverage” pattern (hiSSB) and a low “sugar sweetened beverage pattern” (loSSB). In the hiSSB group, consumption of SSB accounted for ~28% of energy intake, while SSB represented only 9% of energy intake in the loSSB group. The hiSSB group was characterized by a higher intake of total calories, sugar and percentage of kilocalories from carbohydrates, whereas the percentage of kilocalories from protein and fat was lower. While additional micronutrient intakes differed between groups (vitamin C, zinc, chromium), these were significantly lower than recommended values in the entire cohort. Patients in the hiSSB group presented with lower high-density lipoprotein cholesterol (HDL-C), lower large HDL particles and smaller low density lipoprotein (LDL) particle diameters. Antidepressant usage was significantly higher in the hiSSB group. Patients in the hiSSB group scored lower across all five KDQOL domains and scored significantly lower in the mental composite domain. MHD patients following a hiSSB dietary pattern had smaller dense LDL particles, lower HDL-C, and a lower QOL. Suboptimal intakes of fruits, vegetables, and grains as well as key micronutrients were evident in both patterns.

The effect of the Mediterranean diet on cognitive function in patients with Parkinson's disease: A randomized clinical controlled trial

OBJECTIVES

Parkinson's disease (PD) is the second most common neurodegenerative disorder. It is proposed that adherence to the Mediterranean diet might have a beneficial effect on the prevention and treatment of PD and its complications. Thus, the aim of this study was to investigate the effects of the Mediterranean diet on cognitive function in patients with PD.

DESIGN

The study was a single-center, randomized clinical trial. Eighty patients with idiopathic PD were randomly allocated to the Mediterranean diet (n = 40) or control (n = 40) group. Patients in the intervention group received an individualized dietary plan based on Mediterranean diet for 10 weeks. The Persian version of Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive function at baseline and the end of the study.

RESULTS

Thirty-five PD patients with a mean age of 59.3 ± 8.3 and 35 patients with a mean age of 58.6 ± 9.3 finished the study in intervention and control groups, respectively. After the intervention, the mean score of the dimensions of executive function, language, attention, concentration, and active memory and the total score of cognitive assessment significantly increased in the intervention compared with the control group (p < 0.05, for all). Nevertheless, the mean of the other scores including spatial-visual ability, memory learning task, and navigation versus time and place did not significantly change in both intervention and control groups.

CONCLUSIONS

The findings of this study showed that adherence to the Mediterranean diet remarkably increased the dimensions of executive function, language, attention, concentration, and active memory and finally the total score of cognitive assessment in PD patients.

Adherence to the Mediterranean diet pattern among university staff: a cross-sectional web-based epidemiological study in Southern Italy

In this cross-sectional web-survey, carried out in 340 employees (24-67 years) among university staff of Southern Italy, we assessed the adherence to the Mediterranean Diet (MD). Using an online questionnaire based on validated 14-point MD Adherence Screener (MEDAS), the mean of the score was 7.34 (±1.9) for total population independently of sex. In population divided by the cut-off age of 45 years, MD adherence resulted significantly lower in younger respect to older group (p = .003). In multiple regression analyses we observed the direct association between MEDAS score and older age group also after adjustments. Importantly, in all sample the percentage of adherers to recommendations for fruits, nuts and fish resulted outside dietary guidelines. The present findings underscore the need to develop healthy education programmes aimed to improve the consumption of several components of the MD, particularly among young adults, in order to prevent the early onset of chronic non-transmittable diseases.

The Association between Whole Grain Products Consumption and Successful Aging: A Combined Analysis of MEDIS and ATTICA Epidemiological Studies

The quality of carbohydrates in the diet, including whole grains, matters greatly to health. There is emerging evidence supporting various protective effects from whole grain consumption against certain chronic diseases. However, being free of disease is not a requirement for healthy ageing, as many older adults have one or more health conditions but, when well controlled, have little influence on their wellbeing. The present study aimed to evaluate the association between whole grain consumption on successful aging, through an analysis of a sample of n = 3349, over-50-years-old men and women participating in the ATTICA and MEDIS population-based cross-sectional studies. Successful aging was evaluated using the validated successful aging index (SAI, range 0–10) comprising of health-related social, lifestyle and clinical components. High whole grain intake was positively associated with SAI as compared with low (b ± SE: 0.278 ± 0.091, p = 0.002), whereas no significant associations were observed between moderate whole grain consumption and SAI (p > 0.05). Increased whole grain intake has been associated with several health benefits, and, as is shown here, with higher successful aging levels. Therefore, consumption of whole grains should be encouraged, especially by replacing refined grains, without increasing total energy intake.