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Nishimoto D, Ibusuki R, Shimoshikiryo I, Shibuya K, Tanoue S, Koriyama C, Takezaki T, Oze I, Ito H, Hishida A, Tamura T, Kato Y, Tamada Y, Nishida Y, Shimanoe C, Suzuki S, Nishiyama T, Ozaki E, Tomida S, Kuriki K, Miyagawa N, Kondo K, Arisawa K, Watanabe T, Ikezaki H, Otonari J, Wakai K, Matsuo K. Association Between Awareness of Limiting Food Intake and All-cause Mortality: A Cohort Study in Japan. J Epidemiol 2024; 34:286-294. [PMID: 37926519 PMCID: PMC11078597 DOI: 10.2188/jea.je20220354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Improving diets requires an awareness of the need to limit foods for which excessive consumption is a health problem. Since there are limited reports on the link between this awareness and mortality risk, we examined the association between awareness of limiting food intake (energy, fat, and sweets) and all-cause mortality in a Japanese cohort study. METHODS Participants comprised 58,772 residents (27,294 men; 31,478 women) aged 35-69 years who completed baseline surveys of the Japan Multi-Institutional Collaborative Cohort Study from 2004 to 2014. Hazard ratios (HRs) for all-cause mortality and 95% confidence intervals (CIs) were estimated by sex using a Cox proportional hazard model, with adjustment for related factors. Mediation analysis with fat intake as a mediator was also conducted. RESULTS The mean follow-up period was 11 years, and 2,516 people died. Estimated energy and fat intakes according to the Food Frequency Questionnaire were lower in those with awareness of limiting food intake than in those without this awareness. Women with awareness of limiting fat intake showed a significant decrease in mortality risk (HR 0.73; 95% CI, 0.55-0.94). Mediation analysis revealed that this association was due to the direct effect of the awareness of limiting fat intake and that the total effect was not mediated by actual fat intake. Awareness of limiting energy or sweets intake was not related to mortality risk reduction. CONCLUSION Awareness of limiting food intake had a limited effect on reducing all-cause mortality risk.
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Affiliation(s)
- Daisaku Nishimoto
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
- School of Health Sciences, Faculty of Medicine, Kagoshima University
| | - Rie Ibusuki
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Ippei Shimoshikiryo
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
- Environmental Epidemiology Section, Health and Environmental Risk Division, National Institute for Environmental Studies
| | | | - Shiroh Tanoue
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Chihaya Koriyama
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Toshiro Takezaki
- Community Medicine Support Center, Kagoshima University Hospital
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yasufumi Kato
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University
| | | | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | - Satomi Tomida
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka
| | - Naoko Miyagawa
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
- Department of Public Health, Shiga University of Medical Science
| | - Keiko Kondo
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Watanabe
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences
| | - Jun Otonari
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University Hospital
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine
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Nazari M, Mirzaie K, Keshavarz S. Association between Lifelines Diet Score (LLDS) and some novel anthropometric indices, including Body Roundness Index (BRI), A Body Shape Index (ABSI), Visceral Adiposity Index (VAI), and Body Adiposity Index (BAI), in Iranian women: a cross-sectional study. BMC Womens Health 2024; 24:172. [PMID: 38475785 DOI: 10.1186/s12905-024-03013-2] [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: 11/08/2023] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Anthropometry is a reliable method to assess obesity status, and previous studies have shown the association of several dietary quality scores with obesity using anthropometric indices. This study aimed to evaluate the association between LLDS and anthropometric measurements. METHODS A total of 217 women between the ages of 18 and 48 participated in the study. Anthropometric values, biochemical tests, and body composition were assessed for each participant using standard protocols and methods. The LLDS was determined based on 12 components using a reliable and valid food frequency questionnaire (FFQ) that contained 147 items. RESULTS We detected a marginally significant inverse association between the LLDS and VAI scores in the second tertile. Study participants in the second tertile of LLDS had lower odds of having high VAI than those in the reference tertile after adjusting for age, energy intake, physical activity, education, and economic status (OR: -0.16; 95% CI: -0.8, 0.06; P = 0.06). There was no statistically significant trend for the association between LLDS and all assessed anthropometric indices, including BRI, ABSI, VAI, and BAI, across tertiles of LLDS in the crude and all adjusted models (P-trend > 0.05). CONCLUSIONS There was no significant association between LLDS and some novel anthropometric indices, including BRI, ABSI, VAI, and BAI. However, after adjusting for probable confounders, a marginally significant inverse association between LLDS and VAI was detected.
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Affiliation(s)
- Matin Nazari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Khadijeh Mirzaie
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyedali Keshavarz
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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Bianco R, Speciani MC, Parpinel M, Tesi M, Ferraroni M, Edefonti V. Are Major a Posteriori Dietary Patterns Reproducible in the Italian Population? A Systematic Review and Quantitative Assessment. Adv Nutr 2024; 15:100165. [PMID: 38145798 PMCID: PMC10818059 DOI: 10.1016/j.advnut.2023.100165] [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: 04/14/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 12/27/2023] Open
Abstract
Although a posteriori dietary patterns (DPs) naturally reflect actual dietary behavior in a population, their specificity limits generalizability. Among other issues, the absence of a standardized approach to analysis have further hindered discovery of genuinely reproducible DPs across studies from the same/similar populations. A systematic review on a posteriori DPs from principal component analysis or exploratory factor analysis (EFA) across study populations from Italy provides the basis to explore assessment and drivers of DP reproducibility in a case study of epidemiological interest. First to our knowledge, we carried out a qualitative (i.e., similarity plots built on text descriptions) and quantitative (i.e., congruence coefficients, CCs) assessment of DP reproducibility. The 52 selected articles were published in 2001-2022 and represented dietary habits in 1965-2022 from 70% of the Italian regions; children/adolescents, pregnancy/breastfeeding women, and elderly were considered in 15 articles. The included studies mainly derived EFA-based DPs on food groups from food frequency questionnaires and were of "good quality" according to standard scales. Based on text descriptions, the 186 identified DPs were collapsed into 113 (69 food-based and 44 nutrient-based) apparently different DPs (39.3% reduction), later summarized along with the 3 "Mixed-Salad/Vegetable-based Patterns," "Pasta-and-Meat-oriented/Starchy Patterns," and "Dairy Products" and "Sweets/Animal-based Patterns" groups, by matching similar food-based and nutrient-based groups of collapsed DPs. Based on CCs (215 CCs, 68 DPs, 18 articles using the same input lists), all pairs of DPs showing the same/similar names were at least "fairly similar" and ∼81% were "equivalent." The 30 "equivalent" DPs ended up into 6 genuinely different DPs (80% reduction) that targeted fruits and (raw) vegetables, pasta and meat combined, and cheese and deli meats. Such reduction reflects the same study design, list of input variables, and DP identification method followed across articles from the same groups. This review was registered at PROSPERO as CRD42022341037.
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Affiliation(s)
- Rachele Bianco
- Department of Medicine (DMED), Università degli Studi di Udine, Udine, Italy
| | - Michela C Speciani
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro," Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Maria Parpinel
- Department of Medicine (DMED), Università degli Studi di Udine, Udine, Italy
| | - Matteo Tesi
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro," Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Monica Ferraroni
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro," Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Valeria Edefonti
- Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro," Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
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Ahmadabad AD, Jahangiry L, Gilani N, Farhangi MA, Mohammadi E, Ponnet K. Lifestyle patterns, nutritional, and metabolic syndrome determinants in a sample of the older Iranian population. BMC Geriatr 2024; 24:36. [PMID: 38191298 PMCID: PMC10775447 DOI: 10.1186/s12877-024-04659-1] [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: 07/08/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Chronic diseases and metabolic disorders are prevalent health concerns that often escalate with increasing age and thus affect older individuals. The proportion of the elderly population in Iran increased from 7.22% in 2006 to 12.0% in 2023. The current study aimed to evaluate lifestyle patterns and lifestyle risk factors among patients with metabolic syndrome (MetS) based on dietary, physical activity, and smoking, as well as MetS components. METHODS This cross-sectional study included 582 older people with MetS living in Yazd, Iran. Latent class analysis (LCA) was used to determine the lifestyle behaviors of diet patterns, smoking, and physical activity. Dietary intake was measured using a validated food frequency questionnaire, and dietary patterns were identified using principal component analysis (PCA). Clinical measurements of MetS components were examined using relevant guidelines. RESULTS The mean age of the participants was 72.71 years (SD = 5.57). Using PCA, two dietary patterns were identified: traditional patterns (e.g., fruits, fish, poultry, vegetables, meats, salt, and sugar sweetened beverages) and high-fat patterns (e.g., high-fat dairy). Applying LCA identified two classes of lifestyle patterns. About 35% (n = 204) of the participants were categorized in a low-risk class (I) and characterized by physical activity (0.93%, n = 190), a traditional pattern for diet (61%, n = 122), and zero probability of smoking. About 65% (n = 378) of the patients were categorized in high-risk class (II) and characterized by low physical activity levels (69%, n = 261), cigarette smoking (71.6%, n = 271), and a high-fat dietary pattern (56.9%, n = 215). CONCLUSION The results of our study indicated two distinct classes within the patients. In class I, aging patients with MetS exhibited characteristics such as engagement in physical activity and having a traditional pattern for diet. Class II, with a higher prevalence of lifestyle risk factors, included individuals who engaged in cigarette smoking, displayed low physical activity (69%), and having a high-fat diet. The combination of these lifestyle factors exposed them to a heightened risk of developing MetS. The findings could guide healthcare professionals to be aware of the associations between different lifestyle risk factors and to focus on multiple behaviors at the same time.
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Affiliation(s)
- Ali Dehghani Ahmadabad
- Department of Geriatric Health, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Jahangiry
- Department of Health education and promotion, Faculty of health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Eesa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Koen Ponnet
- Faculty of Social Sciences, Imec-Mict-Ghent University, Ghent, Belgium
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Zupo R, Donghia R, Castellana F, Bortone I, De Nucci S, Sila A, Tatoli R, Lampignano L, Sborgia G, Panza F, Lozupone M, Colacicco G, Clodoveo ML, Sardone R. Ultra-processed food consumption and nutritional frailty in older age. GeroScience 2023; 45:2229-2243. [PMID: 36826622 PMCID: PMC10651811 DOI: 10.1007/s11357-023-00753-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Frailty is a multidisciplinary public health issue and nutrition is key concern. Given the scientific consistency about inflammation as shared pathway to poor nutrition and frailty, food processing seems a suitable target to gain evidence in frailty prevention nutrition settings. This study aimed to assess diet in relation to nutritional frailty using the NOVA classification. Browsing the dataset of the Salus in Apulia, 2185 older adults were found to have completed the nutritional assessment, providing eligible data for this study goal. A validated construct, based on the co-presence of physical frailty by CHS criteria plus nutritional imbalance, was applied to characterize nutritional frailty phenotypes. Using the NOVA classification, daily food and beverage intakes from an 85-item self-administered FFQ were assigned to three categories, and effect sizes were tested among groups according to nutritional frailty status (presence/absence). Raw and adjusted logistic regression models were run to assess associations between NOVA food categories by quintiles of daily exposure (very-low, low, mild, moderate, high) and nutritional frailty. Nutritional frailty prevalence was 27%, being more frequent in males. Eating more unprocessed or minimally processed foods was inversely related to nutritional frailty, even after adjustment (OR: 0.10, 95%CI 0.07-0.16), showing a downward ORs behavior toward lower consumption quintiles. Listing in the quintile of moderate consumption of processed foods meant a nearly 50% increase in nutritional frailty probability (OR: 1.46, 95%CI 1.03-2.06), while the probability was double for the highest quintile against the lowest (OR: 3.22, 95%CI 2.27-4.58). A growing probability of nutritional frailty was found for increasing consumption of ultra-processed foods, but significance was lacking. The contribution of food processing to poor nutrition needs to be considered when promoting a better understanding of effective nutritional screening in aging. Therefore, food processing should be accounted for when composing diet guidelines for the older population within the framework of multidisciplinary efforts to ease the frailty healthcare burden.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Pisa, Italy
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Sborgia
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Colacicco
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari Aldo Moro, Bari, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- Local Healthcare Authority of Taranto, Taranto, Italy
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Zupo R, Moroni A, Castellana F, Gasparri C, Catino F, Lampignano L, Perna S, Clodoveo ML, Sardone R, Rondanelli M. A Machine-Learning Approach to Target Clinical and Biological Features Associated with Sarcopenia: Findings from Northern and Southern Italian Aging Populations. Metabolites 2023; 13:metabo13040565. [PMID: 37110223 PMCID: PMC10142879 DOI: 10.3390/metabo13040565] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Epidemiological and public health resonance of sarcopenia in late life requires further research to identify better clinical markers useful for seeking proper care strategies in preventive medicine settings. Using a machine-learning approach, a search for clinical and fluid markers most associated with sarcopenia was carried out across older populations from northern and southern Italy. A dataset of adults >65 years of age (n = 1971) made up of clinical records and fluid markers from either a clinical-based subset from northern Italy (Pavia) and a population-based subset from southern Italy (Apulia) was employed (n = 1312 and n = 659, respectively). Body composition data obtained by dual-energy X-ray absorptiometry (DXA) were used for the diagnosis of sarcopenia, given by the presence of either low muscle mass (i.e., an SMI < 7.0 kg/m2 for males or <5.5 kg/m2 for females) and of low muscle strength (i.e., an HGS < 27 kg for males or <16 kg for females) or low physical performance (i.e., an SPPB ≤ 8), according to the EWGSOP2 panel guidelines. A machine-learning feature-selection approach, the random forest (RF), was used to identify the most predictive features of sarcopenia in the whole dataset, considering every possible interaction among variables and taking into account nonlinear relationships that classical models could not evaluate. Then, a logistic regression was performed for comparative purposes. Leading variables of association to sarcopenia overlapped in the two population subsets and included SMI, HGS, FFM of legs and arms, and sex. Using parametric and nonparametric whole-sample analysis to investigate the clinical variables and biological markers most associated with sarcopenia, we found that albumin, CRP, folate, and age ranked high according to RF selection, while sex, folate, and vitamin D were the most relevant according to logistics. Albumin, CRP, vitamin D, and serum folate should not be neglected in screening for sarcopenia in the aging population. Better preventive medicine settings in geriatrics are urgently needed to lessen the impact of sarcopenia on the general health, quality of life, and medical care delivery of the aging population.
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Affiliation(s)
- Roberta Zupo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | - Alessia Moroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy
| | - Feliciana Catino
- Department of Innovation and Smart City, Municipality of Taranto, 74121 Taranto, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan, 20133 Milan, Italy
| | - Maria Lisa Clodoveo
- Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
| | | | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- IRCCS Mondino Foundation, 27100 Pavia, Italy
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De Nucci S, Zupo R, Donghia R, Castellana F, Lofù D, Aresta S, Guerra V, Bortone I, Lampignano L, De Pergola G, Lozupone M, Tatoli R, Sborgia G, Tirelli S, Panza F, Di Noia T, Sardone R. Dietary profiling of physical frailty in older age phenotypes using a machine learning approach: the Salus in Apulia Study. Eur J Nutr 2023; 62:1217-1229. [PMID: 36484807 PMCID: PMC10030526 DOI: 10.1007/s00394-022-03066-9] [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: 03/07/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Growing awareness of the biological and clinical value of nutrition in frailty settings calls for further efforts to investigate dietary gaps to act sooner to achieve focused management of aging populations. We cross-sectionally examined the eating habits of an older Mediterranean population to profile dietary features most associated with physical frailty. METHODS Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1502 older adults (65 +). CHS criteria were applied to classify physical frailty, and a validated Food Frequency Questionnaire to assess diet. The population was subdivided by physical frailty status (frail or non-frail). Raw and adjusted logistic regression models were applied to three clusters of dietary variables (food groups, macronutrients, and micronutrients), previously selected by a LASSO approach to better predict diet-related frailty determinants. RESULTS A lower consumption of wine (OR 0.998, 95% CI 0.997-0.999) and coffee (OR 0.994, 95% CI 0.989-0.999), as well as a cluster of macro and micronutrients led by PUFAs (OR 0.939, 95% CI 0.896-0.991), zinc (OR 0.977, 95% CI 0.952-0.998), and coumarins (OR 0.631, 95% CI 0.431-0.971), was predictive of non-frailty, but higher legumes intake (OR 1.005, 95%CI 1.000-1.009) of physical frailty, regardless of age, gender, and education level. CONCLUSIONS Higher consumption of coffee and wine, as well as PUFAs, zinc, and coumarins, as opposed to legumes, may work well in protecting against a physical frailty profile of aging in a Mediterranean setting. Longitudinal investigations are needed to better understand the causal potential of diet as a modifiable contributor to frailty during aging.
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Affiliation(s)
- Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy.
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Domenico Lofù
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Simona Aresta
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Vito Guerra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Madia Lozupone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giancarlo Sborgia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Sarah Tirelli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Tommaso Di Noia
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
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Serum levels of IL-6 are associated with cognitive impairment in the salus in apulia population-based study. Heliyon 2023; 9:e13972. [PMID: 36915478 PMCID: PMC10006470 DOI: 10.1016/j.heliyon.2023.e13972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Growing evidence suggests that inflammation contributes to brain aging and neurodegeneration. This study investigates the relationship between global cognitive as well executive function and the inflammatory markers IL-6, CRP, and TNF-α in a population-based study of older adults. A population-based sample, of older people in Southern Italy, was enrolled. We measured serum levels of IL-6, CRP, and TNF-α. We also administered two neuropsychological tests: Mini-Mental State Examination and Frontal Assessment Battery. Rank-based regression models were performed to investigate the relationship between inflammatory markers and cognitive functions, including major demographic and clinical confounders for adjustment. The sample consisted of 1929 subjects aged between 65 and 95 years. Multivariate linear regression analysis revealed that higher serum levels of IL-6 were associated with lower MMSE and FAB scores even after adjustment for demographic data and cardiovascular risk factors. No significant associations were found between cognitive functioning and serum levels of CRP and TNF-α. Our results suggest that higher levels of IL-6 were associated with cognitive impairment in an older adult population of Southern Italy.
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9
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Association of Healthy Eating Index-2015 and Dietary Approaches to Stop Hypertension Patterns with Insulin Resistance in Schoolchildren. Nutrients 2022; 14:nu14204232. [PMID: 36296916 PMCID: PMC9607022 DOI: 10.3390/nu14204232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Diet quality patterns are associated with a lower incidence of insulin resistance (IR) in adults. The aim of this study was to investigate the association between two diet quality indices and IR in schoolchildren and to identify the best diet quality index associated with a lower risk of IR. Methods: A total of 854 schoolchildren (8−13 years) were included in a cross-sectional study, who completed a three-day dietary record to assess their diet. Fasting plasma glucose and insulin were also measured, and anthropometric data were collected. Healthy Eating Index-2015 (HEI-2015), Dietary Approaches to Stop Hypertension (DASH), and adjusted DASH (aDASH) were calculated as diet quality indices. The homeostasis model assessment of insulin resistance (HOMA-IR) was used, and IR was defined as HOMA-IR > 3.16. Results: The prevalence of IR was 5.5%, and it was higher in girls. The mean HEI-2015 and DASH scores were 59.3 and 23.4, respectively, and boys scored lower in both indices. In girls, having a HEI-2015 score above the 33rd percentile was associated with a lower risk of IR (odds ratio [95% CI]: 0.43 [0.19−0.96], p = 0.020). Conclusion: Greater adherence to a healthy dietary pattern, as assessed by a higher HEI-2015 score, was associated with a lower risk of IR in schoolchildren, especially in girls.
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Ma W, Zhang Y, Pan L, Wang S, Xie K, Deng S, Wang R, Guo C, Qin P, Wu X, Wu Y, Zhao Y, Feng Y, Hu F. Association of Egg Consumption with Risk of All-Cause and Cardiovascular Disease Mortality: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies. J Nutr 2022; 152:2227-2237. [PMID: 35524693 DOI: 10.1093/jn/nxac105] [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: 09/30/2021] [Revised: 12/18/2021] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent studies have reported conflicting associations between egg consumption and the risk of all-cause or cardiovascular disease (CVD) mortality, including ischemic heart disease (IHD) mortality and stroke mortality. With accumulating evidence, up-to-date evidence about the association should be synthesized. OBJECTIVES We aimed to assess the association of the risk of all-cause and CVD mortality with egg consumption. METHODS We searched the PubMed, Embase, and Web of Science databases through 3 November, 2021 for observational studies conducted in participants ≥18 y of age and which provided ORs, RRs, or HRs and 95% CIs for ≥3 egg consumption categories or for increased intake of egg addressing the associations of interest. A random-effects model was used to pool the reported risk estimates. Restricted cubic splines were used to examine the dose-response association. RESULTS Twenty-four articles with 48 reports (25 for all-cause mortality, 11 for CVD mortality, 6 for IHD mortality, and 6 for stroke mortality) involving 11,890,695 participants were included. Intake of each 1-egg/d increment was associated with increased risk of all-cause mortality (RR: 1.06; 95% CI: 1.02, 1.10; P = 0.008), but the association was restricted to women, Americans, and studies with adjustments for hyperlipidemia. Egg consumption was linearly associated with CVD mortality only in participants >60 y of age, Americans, studies with follow-up duration ≥15 y, and studies with adjustments for hyperlipidemia (P ≤ 0.018). No significant association was found between egg consumption and IHD or stroke mortality (P ≥ 0.080). CONCLUSIONS Egg consumption was linearly associated with a modestly increased risk of all-cause mortality and, in older participants, Americans, and studies with longer follow-up or adjustments for hyperlipidemia, CVD mortality. These findings suggest that it may be prudent to avoid high egg consumption.
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Affiliation(s)
- Wancheng Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Yanyan Zhang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Li Pan
- Department of Comprehensive Ward, Shenzhen Luohu Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Sijia Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Kui Xie
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Shan Deng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Rui Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Chunjiang Guo
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Pei Qin
- Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Xiaoyan Wu
- Department of Cardiovascular and Cerebrovascular Disease Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
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11
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Bortone I, Zupo R, Castellana F, Aresta S, Lampignano L, Sciarra S, Griseta C, Stallone TA, Sborgia G, Lozupone M, Panza F, Lagravinese G, Battista P, Sardone R. Motoric Cognitive Risk Syndrome, Subtypes and 8-Year All-Cause Mortality in Aging Phenotypes: The Salus in Apulia Study. Brain Sci 2022; 12:brainsci12070861. [PMID: 35884669 PMCID: PMC9313038 DOI: 10.3390/brainsci12070861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background: This study aims to establish the key clinical features of different motoric cognitive risk (MCR) subtypes based on individual quantitative measures of cognitive impairment and to compare their predictive power on survival over an 8-year observation time. Methods: We analyzed data from a population-based study of 1138 subjects aged 65 years and older in south Italy. These individuals were targeted and allocated to subtypes of the MCR phenotype according to the slowness criterion plus one other different cognitive domain for each characterized phenotype (Subjective Cognitive Complaint [SCC]; Global Function [Mini Mental State Examination (MMSE) < 24]; or a combination of both). Clinical evaluation and laboratory assays, along with a comprehensive battery of neuropsychological and physical tests, completed the sample investigation. Results: MCR prevalence was found to be 9.8% (n = 112), 3.6% (n = 41), 3.4% (n = 39) and 1.8% (n = 21) for the MCR, MCR-GlobalFunction, MCR-StructuredSCC and MCR-SCC and GlobalFunction, respectively. Univariate Cox survival analysis showed an association only of the MCR-GlobalFunction subtype with an almost three-fold increased risk of overall death as compared to the other counterparts (HR 2.53, 95%CI 1.28 to 4.99) over an 8-year observation period. Using Generalized Estimating Equations (GEE) for clustered survival data, we found that MCR males had an increased and significant mortality risk with respect to MCR female subjects. Conclusions: MCR phenotypes assigned to the MMSE cognitive domain are more likely to have an increased risk of overall mortality, and gender showed a huge effect on the risk of death for MCR subjects over the 8-year observation.
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Affiliation(s)
- Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
- Correspondence:
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
| | - Simona Aresta
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
| | - Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
| | - Sabrina Sciarra
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
| | - Chiara Griseta
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
| | - Tommaso Antonio Stallone
- General Direction, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy;
| | - Giancarlo Sborgia
- Eye Clinic, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Madia Lozupone
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, 70100 Bari, Italy; (M.L.); (F.P.)
| | - Francesco Panza
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, 70100 Bari, Italy; (M.L.); (F.P.)
| | - Gianvito Lagravinese
- Clinical and Scientific Institutes Maugeri Pavia, Scientific Institute of Bari, IRCCS, 27100 Pavia, Italy; (G.L.); (P.B.)
| | - Petronilla Battista
- Clinical and Scientific Institutes Maugeri Pavia, Scientific Institute of Bari, IRCCS, 27100 Pavia, Italy; (G.L.); (P.B.)
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis” Research Hospital, 70013 Castellana Grotte, Italy; (R.Z.); (F.C.); (S.A.); (L.L.); (S.S.); (C.G.); (R.S.)
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12
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Darooghegi Mofrad M, Naghshi S, Lotfi K, Beyene J, Hypponen E, Pirouzi A, Sadeghi O. Egg and Dietary Cholesterol Intake and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Front Nutr 2022; 9:878979. [PMID: 35711545 PMCID: PMC9195585 DOI: 10.3389/fnut.2022.878979] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
Objective This systematic review and meta-analysis of prospective cohort studies examined the associations between egg and dietary cholesterol intake and the risk of mortality from all causes, including cardiovascular disease (CVD) and cancer. Methods We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until April 2021, as well as references to the relevant articles retrieved. Random-effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CIs) for the highest vs. lowest categories of egg and dietary cholesterol intake. Also, linear and non-linear dose–response analyses were conducted to examine the dose-response relationships. Results We included 55 studies, comprising data from 2,772,486 individuals with 228,425, 71,745, and 67,211 cases of all-cause, CVD, and cancer mortality, respectively. Intake of each additional egg per day was associated with a 7% higher risk of all-cause (1.07, 95% CI: 1.02–1.12, I2 = 84.8%) and a 13% higher risk of cancer mortality (1.13, 95% CI: 1.06–1.20, I2 = 54.2%), but was not associated with CVD mortality (1.00, 95% CI: 0.92–1.09, I2 = 81.5%). Non-linear analyses showed increased risks for egg consumption of more than 1.5 and 0.5 eggs/day, respectively. Each 100 mg/day increment in dietary cholesterol intake was associated with a 6% higher risk of all-cause mortality (1.06, 95% CI: 1.03–1.08, I2 = 34.5%) and a 6% higher risk of cancer mortality (1.06, 95% CI: 1.05–1.07, I2 = 0%), but was not associated with CVD mortality (1.04, 95% CI: 0.99–1.10, I2 = 85.9%). Non-linear analyses demonstrated elevated risks of CVD and cancer mortality for intakes more than 450 and 250 mg/day, respectively. Conclusions and Relevance High-dietary intake of eggs and cholesterol was associated with all-cause and cancer mortality. Little evidence for elevated risks was seen for intakes below 0.5 egg/day or 250 mg/day of dietary cholesterol. Our findings should be considered with caution because of small risk estimates and moderate between-study heterogeneity. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564, PROSPERO, identifier: CRD42021252564.
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Affiliation(s)
- Manije Darooghegi Mofrad
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada
| | - Elina Hypponen
- Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Aliyar Pirouzi
- Cellular and Molecular Department, Gerash University of Medical Sciences, Gerash, Iran
| | - Omid Sadeghi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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13
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Mousavi SM, Zargarzadeh N, Rigi S, Persad E, Pizarro AB, Hasani-Ranjbar S, Larijani B, Willett WC, Esmaillzadeh A. Egg Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-analysis of Prospective Studies. Adv Nutr 2022; 13:1762-1773. [PMID: 35396834 PMCID: PMC9526855 DOI: 10.1093/advances/nmac040] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/09/2022] [Accepted: 04/07/2022] [Indexed: 01/28/2023] Open
Abstract
The association between egg consumption and mortality is extremely debatable. This study aimed to investigate the potential dose-response association of egg consumption with risk of mortality from all causes and cause-specific in the general population. The primary comprehensive literature search was conducted in PubMed/Medline, Scopus, ISI Web of Science, and Embase up to March 2021, as well as reference lists of relevant original papers and key journals. We calculated summary RRs and their 95% CIs for the highest and lowest categories, as well as the linear trend estimation of egg intake, using the random-effects model. Thirty-three (32 publications) cohort studies were included. These studies enrolled 2,216,720 participants and recorded 232,408 deaths from all causes. Comparing highest versus lowest egg intake categories was not associated with the risk of mortality from all causes (RR: 1.02; 95% CI: 0.94, 1.11; n = 25), cardiovascular disease (CVD) (RR: 1.04; 95% CI: 0.87, 1.23, n = 11), coronary heart disease (CHD) (RR: 0.98; 95% CI: 0.84, 1.16; n = 10), stroke (RR: 0.81; 95% CI: 0.64, 1.02; n = 9), and respiratory disease (RR: 0.96; 95% CI: 0.53, 1.71; n = 3); however, it was associated with a higher risk of cancer mortality (RR: 1.20; 95% CI: 1.04, 1.39; n = 13). In the linear dose-response analysis, an additional intake of 1 egg per week was associated with a 2% and 4% increased risk of all-cause and cancer mortality, respectively, and a 4% decreased risk of stroke mortality. The certainty of the evidence was rated as low to moderate. Higher egg consumption was not associated with an increased risk of mortality from all causes, CVD, CHD, stroke, or respiratory disease, whereas an elevated risk was observed for cancer mortality. These findings suggest that eggs be consumed in low to moderate amounts (≤1 egg/d) as part of a healthy diet.
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Affiliation(s)
- Seyed Mohammad Mousavi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Rigi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Emma Persad
- Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | | | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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14
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Tatoli R, Lampignano L, Donghia R, Castellana F, Zupo R, Bortone I, De Nucci S, Campanile G, Lofù D, Vimercati L, Lozupone M, De Pergola G, Panza F, Giannelli G, Di Noia T, Boeing H, Sardone R. Dietary Customs and Social Deprivation in an Aging Population From Southern Italy: A Machine Learning Approach. Front Nutr 2022; 9:811076. [PMID: 35340551 PMCID: PMC8942783 DOI: 10.3389/fnut.2022.811076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022] Open
Abstract
Background Diet and social determinants influence the state of human health. In older adults, the presence of social, physical and psychological barriers increases the probability of deprivation. This study investigated the relationship between social deprivation and eating habits in non-institutionalized older adults from Southern Italy, and identified foods and dietary habits associated with social deprivation. Methods We recruited 1,002 subjects, mean age 74 years, from the large population based Salus in Apulia Study. In this cross-sectional study, eating habits and the level of deprivation were assessed with FFQ and DiPCare-Q, respectively. Results Deprived subjects (n = 441) included slightly more females, who were slightly older and with a lower level of education. They consumed less fish (23 vs. 26 g), fruiting vegetables (87 vs. 102 g), nuts (6 vs. 9 g) and less “ready to eat” dishes (29 vs. 33 g). A Random Forest (RF) model was used to identify a dietary pattern associated with social deprivation. This pattern included an increased consumption of low-fat dairy products and white meat, and a decreased consumption of wine, leafy vegetables, seafood/shellfish, processed meat, red meat, dairy products, and eggs. Conclusion The present study showed that social factors also define diet and eating habits. Subjects with higher levels of deprivation consume cheaper and more readily available food.
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Affiliation(s)
- Rossella Tatoli
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Luisa Lampignano
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Rossella Donghia
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Fabio Castellana
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Roberta Zupo
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Ilaria Bortone
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Sara De Nucci
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Giuseppe Campanile
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Domenico Lofù
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, Section of Occupational Medicine B. Ramazzini, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Madia Lozupone
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giovanni De Pergola
- Unit of Internal Medicine and Geriatrics, National Institute of Gastroenterology "S. de Bellis" Research Hospital, Castellana Grotte, Italy.,Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
| | - Tommaso Di Noia
- Department of Electrical and Information Engineering, Polytechnic of Bari, Bari, Italy
| | - Heiner Boeing
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy.,Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Rodolfo Sardone
- Unit of Digital Health and Health Technology Assessment for "Salus in Apulia Study," National Institute of Gastroenterology, "S. de Bellis" Research Hospital, Castellana Grotte, Italy
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15
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Tatoli R, Lampignano L, Bortone I, Donghia R, Castellana F, Zupo R, Tirelli S, De Nucci S, Sila A, Natuzzi A, Lozupone M, Griseta C, Sciarra S, Aresta S, De Pergola G, Sorino P, Lofù D, Panza F, Di Noia T, Sardone R. Dietary Patterns Associated with Diabetes in an Older Population from Southern Italy Using an Unsupervised Learning Approach. SENSORS 2022; 22:s22062193. [PMID: 35336365 PMCID: PMC8949084 DOI: 10.3390/s22062193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 01/27/2023]
Abstract
Dietary behaviour is a core element in diabetes self-management. There are no remarkable differences between nutritional guidelines for people with type 2 diabetes and healthy eating recommendations for the general public. This study aimed to evaluate dietary differences between subjects with and without diabetes and to describe any emerging dietary patterns characterizing diabetic subjects. In this cross-sectional study conducted on older adults from Southern Italy, eating habits in the “Diabetic” and “Not Diabetic” groups were assessed with FFQ, and dietary patterns were derived using an unsupervised learning algorithm: principal component analysis. Diabetic subjects (n = 187) were more likely to be male, slightly older, and with a slightly lower level of education than subjects without diabetes. The diet of diabetic subjects reflected a high-frequency intake of dairy products, eggs, vegetables and greens, fresh fruit and nuts, and olive oil. On the other hand, the consumption of sweets and sugary foods was reduced compared to non-diabetics (23.74 ± 35.81 vs. 16.52 ± 22.87; 11.08 ± 21.85 vs. 7.22 ± 15.96). The subjects without diabetes had a higher consumption of red meat, processed meat, ready-to-eat dishes, alcoholic drinks, and lower vegetable consumption. The present study demonstrated that, in areas around the Mediterranean Sea, older subjects with diabetes had a healthier diet than their non-diabetic counterparts.
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Affiliation(s)
- Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
- Correspondence: (L.L.); (I.B.)
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
- Correspondence: (L.L.); (I.B.)
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Sarah Tirelli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Annalidia Natuzzi
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 11, 70125 Bari, Italy; (M.L.); (F.P.)
| | - Chiara Griseta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Sabrina Sciarra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Simona Aresta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy;
| | - Paolo Sorino
- Department of Electrical and Information Engineering, Polytechnic of Bari, 70125 Bari, Italy; (P.S.); (D.L.); (T.D.N.)
| | - Domenico Lofù
- Department of Electrical and Information Engineering, Polytechnic of Bari, 70125 Bari, Italy; (P.S.); (D.L.); (T.D.N.)
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 11, 70125 Bari, Italy; (M.L.); (F.P.)
| | - Tommaso Di Noia
- Department of Electrical and Information Engineering, Polytechnic of Bari, 70125 Bari, Italy; (P.S.); (D.L.); (T.D.N.)
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (R.T.); (R.D.); (F.C.); (R.Z.); (S.T.); (S.D.N.); (A.S.); (A.N.); (C.G.); (S.S.); (S.A.); (R.S.)
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16
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Livingstone KM, Milte CM, Torres SJ, Hart MJ, Dingle SE, Shaw JE, Magliano DJ, McNaughton SA. Nineteen-Year Associations between Three Diet Quality Indices and All-Cause and Cardiovascular Disease Mortality: The Australian Diabetes, Obesity, and Lifestyle Study. J Nutr 2022; 152:805-815. [PMID: 34791367 DOI: 10.1093/jn/nxab386] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/15/2021] [Accepted: 11/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and cardiovascular disease (CVD) mortality. OBJECTIVES To examine the association between 3 diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality, and nonfatal CVD events ≤19 y later. METHODS Data on 10,009 adults (mean age 51.8 y; 52% female) from the Australian Diabetes, Obesity, and Lifestyle study were used. An FFQ was used to calculate DGI, DII, and MIND at baseline. Cox proportional hazard models were used to estimate HRs and 95% CI of all-cause mortality, CVD mortality, and nonfatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status. RESULTS Deaths due to all-cause (n = 1955) and CVD (n = 520), and nonfatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4, and 9.6 y, respectively. For all-cause mortality, HRs associated with higher DGI, DII, and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15), and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII, and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24), and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and nonfatal CVD events. CONCLUSIONS A better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, whereas a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean-style diet, and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.
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Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Michael J Hart
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sara E Dingle
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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17
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Zupo R, Castellana F, De Nucci S, De Pergola G, Lozupone M, Bortone I, Castellana M, Sborgia G, Lampignano L, Giannelli G, Panza F, Sardone R. Liver Fibrosis and 8-Year All-Cause Mortality Trajectories in the Aging Cohort of the Salus in Apulia Study. Biomedicines 2021; 9:1617. [PMID: 34829846 PMCID: PMC8615636 DOI: 10.3390/biomedicines9111617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022] Open
Abstract
Age is a major contributor to the liver fibrosis rate and its adverse health-related outcomes, including mortality, but older populations are still under-explored. We investigated multimorbidity and inflammatory biomarkers in relation to the increasing liver fibrosis risk to delineate 8-year all-cause mortality trajectories in 1929 older adults from the population-based Salus in Apulia Study. Liver fibrosis risk was assumed using the fibrosis-4 (FIB-4) score, assigned to three liver fibrosis risk groups (low, intermediate, high). In the secondary analyses, the APRI score was also calculated to allow for comparisons. Male subjects (prevalence difference: -13.49, 95% confidence interval (CI): -18.96 to -8.03), a higher multimorbidity burden (effect size, ES: -0.14, 95% CI: -0.26 to -0.02), a higher prevalence of physical frailty (ES: 6.77, 95% CI: 0.07 to 13.47), and a more pronounced inflammatory pattern as indicated by tumor growth factor-α circulating levels (ES: -0.12, 95% CI: -0.23 to -0.01) were significantly more common in the highest-risk FIB-4 score group. Liver function characterized by lipid profile and platelet levels worsened with increasing FIB-4 risk score. The 8-year risk of death was nearly double in subjects in the highest-risk FIB-4 score group, even after controlling for possible confounders. Furthermore, a steeper mortality curve was clearly observed for FIB-4 scores as compared with the APRI scoring system with respect to liver fibrosis risk. In conclusion, using a scoring tool based on simple routine biomarkers to detect liver fibrosis risk may enhance biological knowledge of age-related outcomes of chronic liver disease and be helpful in the clinical setting to identify subjects at risk for adverse health-related outcomes, including mortality.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Madia Lozupone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Marco Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Giancarlo Sborgia
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70124 Bari, Italy;
| | - Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (F.C.); (S.D.N.); (M.L.); (I.B.); (M.C.); (L.L.); (F.P.)
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18
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Zupo R, Castellana F, Guerra V, Donghia R, Bortone I, Griseta C, Lampignano L, Dibello V, Lozupone M, Coelho-Júnior HJ, Solfrizzi V, Giannelli G, De Pergola G, Boeing H, Sardone R, Panza F. Associations between nutritional frailty and 8-year all-cause mortality in older adults: The Salus in Apulia Study. J Intern Med 2021; 290:1071-1082. [PMID: 34437740 DOI: 10.1111/joim.13384] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Preventive nutritional management of frailty, a multidimensional intermediate status in the ageing process, may reduce the risk of adverse health-related outcomes. We investigated the ability of a measure combining physical frailty with nutritional imbalance, defined as nutritional frailty, to predict all-cause mortality over a period of up to 8 years. METHODS We analysed data on 1,943 older adults from the population-based 'Salus in Apulia Study'. Physical frailty was operationalized using Cardiovascular Health Study criteria and cognitive frailty by combining physical frailty with cognitive impairment. A novel five-item construct was built to assess the extent of nutritional imbalance identified with a machine learning algorithm. Cox models and Kaplan-Meier survival probability analyses of physical frailty, nutritional imbalance (two or more of the following: low body mass index, low skeletal muscle index, ≥2.3 g/day sodium intake, <3.35 g/day potassium intake and <9.9 g/day iron intake), cognitive frailty and the novel nutritional frailty phenotype (physical frailty plus nutritional imbalance) were applied to assess all-cause mortality risk, adjusted for age, sex, education and multimorbidity. RESULTS The overall prevalence of nutritional frailty was 4.52% (95% confidence interval, CI:3.55-5.44), being more frequent in males. Subjects with nutritional frailty were at higher risk for all-cause mortality [hazard ratio (HR):2.31; 95%CI:1.41-3.79] than those with physical frailty (HR:1.45,95% CI:1.0-2.02), nutritional imbalance (HR:1.39; 95%CI:1.05-1.83) and cognitive frailty (HR:1.06; 95%CI:0.56-2.01). CONCLUSIONS Efforts to identify, manage and prevent frailty should include the nutritional domain. The nutritional frailty phenotype may highlight major nutritional determinants that could drive survival and health trajectories in older adults.
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Affiliation(s)
- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Vito Guerra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Chiara Griseta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | | | - Vincenzo Solfrizzi
- "C. Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Gianluigi Giannelli
- Scientific Direction, Research Hospital, National Institute of Gastroenterology "Saverio de Bellis", Castellana Grotte, Bari, Italy
| | - Giovanni De Pergola
- Scientific Direction, Research Hospital, National Institute of Gastroenterology "Saverio de Bellis", Castellana Grotte, Bari, Italy
| | - Heiner Boeing
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy.,German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
| | - Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, 70013 Bari, Italy
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Baranowski T, Thompson D, Hughes SO, O’Connor TM. Precision Food Parenting: A Proposed Conceptual Model and Research Agenda. Nutrients 2021; 13:3650. [PMID: 34684651 PMCID: PMC8538596 DOI: 10.3390/nu13103650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (D.T.); (S.O.H.); (T.M.O.)
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20
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Liver frailty and all-cause mortality in the older participants of the Salus in Apulia Study. GeroScience 2021; 44:835-845. [PMID: 34378088 DOI: 10.1007/s11357-021-00434-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/05/2021] [Indexed: 12/24/2022] Open
Abstract
The liver contribution to the biological network underlying physical frailty in aging is underestimated. How best to measure this contribution magnitude and impact on health risk trajectories in frail individuals is not yet entirely clear. We analyzed the association of a novel liver frailty phenotype with the risk of death in older participants of the Salus in Apulia Study cohort. Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1929 older adults (65 +). Physical frailty was classified by Cardiovascular Health Study criteria, and liver fibrosis risk by fibrosis-4 (FIB-4). The liver frailty phenotype was defined as physical frailty plus high-risk liver fibrosis (score > 2.67). Physical frailty, high-risk liver fibrosis, and liver frailty subjects were compared to subjects without these conditions (non-frail). Proportional Cox regression tested the adjusted association between liver frailty and all-cause mortality for each category. The liver frailty prevalence was relatively low (3.8%), but higher in men (58.1%). Compared to non-frail older subjects, liver frailty subjects were significantly older (effect size (ES) - 1.11, 95% confidence interval (CI) - 1.35 to - 0.87), with a lower education (ES 0.48, 95%CI 0.24 to 0.71) and higher multimorbidity (ES 15.81, 95%CI 4.20 to 27.41). Cox multivariate analyses showed a two-fold increased risk of overall mortality (hazard ratio 2.09, 95%CI 1.16-3.74) even after the adjustment for age, sex, education, and alcohol consumption. The liver frailty phenotype runs twice the risk of overall mortality compared with the non-frail population. This clinical tool, validated in a Southern Italian population, is based on simple sets of measures that can conveniently be assessed also in the primary care setting.
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21
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Bortone I, Griseta C, Battista P, Castellana F, Lampignano L, Zupo R, Sborgia G, Lozupone M, Moretti B, Giannelli G, Sardone R, Panza F. Physical and cognitive profiles in motoric cognitive risk syndrome in an older population from Southern Italy. Eur J Neurol 2021; 28:2565-2573. [PMID: 33899997 DOI: 10.1111/ene.14882] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE In older age, physical and cognitive declines have been shown to occur simultaneously or consequent to one another, and several operational definitions have been proposed to consider the co-presence of the two declines; for example, "Motoric cognitive risk syndrome" (MCR) has been proposed as a definition for the coexistence of slow gait plus subjective cognitive complaints. Given the increasing interest in MCR and its potential role as both biomarker and therapeutic target, we aimed to estimate its prevalence in a large cohort of non-demented older subjects, and to examine the associations between physical status, global cognitive dysfunction, and impairment in various cognitive domains in MCR. METHODS A population-based sample of 1041 older people in Southern Italy (mean age 75.15 years) was enrolled. We defined MCR using slowness and a single question for subjective cognitive complaints. We also administered a comprehensive neuropsychological test battery, together with tests assessing physical function. RESULTS The prevalence of MCR was 9.9% (95% confidence interval 8.2-11.9). MCR was associated with decreased processing speed and executive function after adjusting for all relevant confounders. However, we found no significant association of MCR with decreased global cognition and immediate/delayed free recall of verbal memory. MCR was also associated with increased exhaustion, low muscle strength, and low physical activity, and increased levels of C-reactive protein and interleukin-6. CONCLUSIONS The present findings on MCR prevalence and associated cognitive and physical domains and inflammatory biomarkers may help to uncover altered pathways and therapeutic targets for intervention during the long preclinical phase of neurodegenerative dementia.
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Affiliation(s)
- Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Chiara Griseta
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Petronilla Battista
- Global Brain Health Institute, University of California, San Francisco, CA, USA
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Giancarlo Sborgia
- Eye Clinic, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Madia Lozupone
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro,", Bari, Italy
| | - Biagio Moretti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro,", Bari, Italy
| | - Gianluigi Giannelli
- National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy
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22
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Zupo R, Castellana F, Panza F, Lampignano L, Murro I, Di Noia C, Triggiani V, Giannelli G, Sardone R, De Pergola G. Adherence to a Mediterranean Diet and Thyroid Function in Obesity: A Cross-Sectional Apulian Survey. Nutrients 2020; 12:E3173. [PMID: 33081337 PMCID: PMC7603040 DOI: 10.3390/nu12103173] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022] Open
Abstract
Much research suggests that Mediterranean eating habits and lifestyle contribute to counteract the risk of chronic diseases while promoting longevity, but little information is available on the effects of the Mediterranean diet (Med-Diet) on thyroid function, particularly among overweight/obese subjects. Nevertheless, consistent data reported a slight increase in serum levels of the thyroid-stimulating hormone (TSH) and a higher rate of conversion of thyroxine (T4) to triiodothyronine (T3) in obesity. This cross-sectional study was aimed at investigating the relationship between adherence to the Med-Diet and circulating thyroid hormones in a cohort of overweight/obese subjects from Apulia (Southern Italy). Methods: We studied 324 consecutive outpatient subjects (228 women and 96 men, age range 14-72 years) taking no drug therapy and showing normal levels of thyroid hormones, but complicated by overweight and obesity (body mass index (BMI) ≥ 25 Kg/m2). The PREDIMED (PREvención con DIeta MEDiterránea) questionnaire was cross-sectionally administered to assess the adherence to the Med-Diet, and hormonal, metabolic, and routine laboratory parameters were collected. Results: Higher adherence to Med-Diet was found to be inversely related to free T3 (p < 0.01) and T4 (p < 0.01) serum levels. Considering each item in the PREDIMED questionnaire, people consuming at least four spoonfuls of extra-virgin olive oil (EVOO) per day, as well as those consuming at least two servings of vegetables per day, had lower free T3 levels (p 0.033 and p 0.021, respectively). Furthermore, consuming at least four spoonfuls of EVOO per day was found to be associated to lower free T4 serum concentrations (p 0.011). Multinomial logistic regression models, performed on tertiles of thyroid hormones to further investigate the relationship with Med-Diet, corroborated the significance only for free T4. Conclusion: Increased adherence to the Med-Diet was independently associated to a slightly reduced thyroid function, but still within the reference range for free T3 and T4 serum levels. This first finding in this field opens up a research line on any underlying biological interplay.
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Affiliation(s)
- Roberta Zupo
- Population Health Unit—“Salus in Apulia Study”—National Institute of Gastroenterology—Research Hospital, IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy; (F.C.); (F.P.); (L.L.); (R.S.); (G.D.P.)
| | - Fabio Castellana
- Population Health Unit—“Salus in Apulia Study”—National Institute of Gastroenterology—Research Hospital, IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy; (F.C.); (F.P.); (L.L.); (R.S.); (G.D.P.)
| | - Francesco Panza
- Population Health Unit—“Salus in Apulia Study”—National Institute of Gastroenterology—Research Hospital, IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy; (F.C.); (F.P.); (L.L.); (R.S.); (G.D.P.)
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Luisa Lampignano
- Population Health Unit—“Salus in Apulia Study”—National Institute of Gastroenterology—Research Hospital, IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy; (F.C.); (F.P.); (L.L.); (R.S.); (G.D.P.)
| | - Isanna Murro
- Department of Biomedical Science and Human Oncology, School of Medicine, Policlinico, University of Bari, 70124 Bari, Italy; (I.M.); (C.D.N.)
| | - Carmen Di Noia
- Department of Biomedical Science and Human Oncology, School of Medicine, Policlinico, University of Bari, 70124 Bari, Italy; (I.M.); (C.D.N.)
| | - Vincenzo Triggiani
- Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, 70124 Bari, Italy;
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Rodolfo Sardone
- Population Health Unit—“Salus in Apulia Study”—National Institute of Gastroenterology—Research Hospital, IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy; (F.C.); (F.P.); (L.L.); (R.S.); (G.D.P.)
| | - Giovanni De Pergola
- Population Health Unit—“Salus in Apulia Study”—National Institute of Gastroenterology—Research Hospital, IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy; (F.C.); (F.P.); (L.L.); (R.S.); (G.D.P.)
- Department of Biomedical Science and Human Oncology, School of Medicine, Policlinico, University of Bari, 70124 Bari, Italy; (I.M.); (C.D.N.)
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23
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Castellana F, Zupo R, Bortone I, Giannelli G, Donghia R, Lampignano L, Griseta C, De Pergola G, Boeing H, Cisternino AM, Logroscino G, Sardone R, Guerra V. Traditional Old Dietary Pattern of Castellana Grotte (Apulia) Is Associated with Healthy Outcomes. Nutrients 2020; 12:E3097. [PMID: 33053620 PMCID: PMC7600964 DOI: 10.3390/nu12103097] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There is still room for further studies aimed at investigating the most widespread diets in the Mediterranean area. The objective of the study is to analyze the relation of food group intake to clinical chemical indicators of health, and also to compare the food group intake with healthy well-known diet indices. METHODS Lifestyle, dietary, and clinical data collected in 2005/2006 and 2012/2018 from Castellana Grotte, located in the rural area of Apulia, were analyzed. The study populations included newly recruited subjects at each time period (n = 1870) as well as subjects examined twice and compared over time regarding health indicators (n = 734). Diet was assessed through a validated food frequency questionnaire. Three healthy diet indices were calculated and related to 29 food groups. We also performed prospective regression of food group consumption with health indicators. RESULTS The diet over the time period of observation was very stable and consisted of a high proportion of vegetables, fruit and grains. No major changes in body mass index (BMI) and blood pressure were observed. Consumption of low-fat dairy, juices, olive oil, and water were related to reductions in weight gain, systolic blood pressure, high-density lipoprotein (HDL)-cholesterol and cholesterol (total and HDL) levels, in that order. Over the time periods we observed only a slight decrease of adherence to the Meddietscore. The correlations of the healthy diet indices with food groups revealed some differences among the indices, mostly regarding the intake of fruit and vegetables. CONCLUSIONS The dietary pattern of Apulia is in line with many principles of a healthy diet and the cohort population seems to be less liable to undergo a transition to a westernized diet.
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Affiliation(s)
- Fabio Castellana
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Roberta Zupo
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Ilaria Bortone
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Rossella Donghia
- Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.D.); (V.G.)
| | - Luisa Lampignano
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Chiara Griseta
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Giovanni De Pergola
- Clinical Nutrition Unit, Department of Biomedical Science and Human Oncology, School of Medicine, University of Bari, Policlinico, 70124 Bari, Italy;
| | - Heiner Boeing
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
- German Institute of Human Nutrition Potsdam-Rehbrücke, 14558 Nuthetal, Germany
| | - Anna Maria Cisternino
- Clinical Nutrition Unit, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy;
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Rodolfo Sardone
- Population Health Unit—“Salus in Apulia Study” National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.Z.); (I.B.); (L.L.); (C.G.); (H.B.); (R.S.)
| | - Vito Guerra
- Unit of Epidemiology and Biostatistics, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy; (R.D.); (V.G.)
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Havaš Auguštin D, Šarac J, Lovrić M, Živković J, Malev O, Fuchs N, Novokmet N, Turkalj M, Missoni S. Adherence to Mediterranean Diet and Maternal Lifestyle during Pregnancy: Island-Mainland Differentiation in the CRIBS Birth Cohort. Nutrients 2020; 12:nu12082179. [PMID: 32708050 PMCID: PMC7469061 DOI: 10.3390/nu12082179] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022] Open
Abstract
Maternal nutrition and lifestyle in pregnancy are important modifiable factors for both maternal and offspring's health. Although the Mediterranean diet has beneficial effects on health, recent studies have shown low adherence in Europe. This study aimed to assess the Mediterranean diet adherence in 266 pregnant women from Dalmatia, Croatia and to investigate their lifestyle habits and regional differences. Adherence to the Mediterranean diet was assessed through two Mediterranean diet scores. Differences in maternal characteristics (diet, education, income, parity, smoking, pre-pregnancy body mass index (BMI), physical activity, contraception) with regards to location and dietary habits were analyzed using the non-parametric Mann-Whitney U test. The machine learning approach was used to reveal other potential non-linear relationships. The results showed that adherence to the Mediterranean diet was low to moderate among the pregnant women in this study, with no significant mainland-island differences. The highest adherence was observed among wealthier women with generally healthier lifestyle choices. The most significant mainland-island differences were observed for lifestyle and socioeconomic factors (income, education, physical activity). The machine learning approach confirmed the findings of the conventional statistical method. We can conclude that adverse socioeconomic and lifestyle conditions were more pronounced in the island population, which, together with the observed non-Mediterranean dietary pattern, calls for more effective intervention strategies.
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Affiliation(s)
- Dubravka Havaš Auguštin
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
- Centre for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia
- Correspondence: (D.H.A.); (J.Š.)
| | - Jelena Šarac
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
- Centre for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia
- Correspondence: (D.H.A.); (J.Š.)
| | - Mario Lovrić
- Department of Translational Medicine, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia; (M.L.); (J.Ž.); (O.M.)
- Know-Center, 8010 Graz, Austria
| | - Jelena Živković
- Department of Translational Medicine, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia; (M.L.); (J.Ž.); (O.M.)
| | - Olga Malev
- Department of Translational Medicine, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia; (M.L.); (J.Ž.); (O.M.)
- Division of Zoology, Department of Biology, Faculty of Science, University of Zagreb, 10000 Zagreb, Croatia
| | - Nives Fuchs
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
| | - Natalija Novokmet
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
| | - Mirjana Turkalj
- Department of Pulmonology and Allergology for Infants and Young Children, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia;
- Department of Nursing, Catholic University of Croatia, 10000 Zagreb, Croatia
- School of Medicine, “J. J. Strossmayer” University, 31000 Osijek, Croatia
| | - Saša Missoni
- Institute for Anthropological Research, 10000 Zagreb, Croatia; (N.F.); (N.N.); (S.M.)
- Centre for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia
- School of Medicine, “J. J. Strossmayer” University, 31000 Osijek, Croatia
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