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Kwon YJ, Joo YS, Yun HR, Lim LR, Yang J, Lee HS, Kim HM, Lee H, Lee JE, Lee JW. Safety and impact of the Mediterranean diet in patients with chronic kidney disease: a pilot randomized crossover trial. Front Nutr 2024; 11:1463502. [PMID: 39296514 PMCID: PMC11408278 DOI: 10.3389/fnut.2024.1463502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 08/20/2024] [Indexed: 09/21/2024] Open
Abstract
Introduction Emerging evidence highlights the potential advantages of the Mediterranean diet (MD) in preserving kidney function and slowing chronic kidney disease (CKD) progression. However, interventional studies on the MD are scarce in East Asian populations. Methods This randomized crossover trial aimed to assess the safety and short-term impact of the Mediterranean Proper Optimal Balance (MEDi-POB) diet in Korean patients with stage 3-4 CKD. Kidney function was assessed using the estimated glomerular filtration rate, which was calculated using the CKD Epidemiology Collaboration equation. Fifty patients with CKD were randomly assigned to two groups, each starting with a different 4-week intervention, followed by a 4-week washout period, followed by a switch to the other 4-week intervention. During the MEDi-POB intervention, patients received home delivery of meals twice daily, 5 days a week, while the control intervention comprised a conventional diet. Forty-six patients successfully completed the entire 12-week trial. Paired t-tests were conducted to assess mean differences between the two groups. A linear mixed model was used to adjust for sequence and period. Results Dietary fat, fiber, and niacin intake were significantly higher following the MEDi-POB diet than following the control diet (p = 0.001 for fat, p < 0.001 for fiber, and p = 0.007 for niacin). The MEDi-POB diet also yielded slightly increased total CO2 levels (p = 0.043), indicating effective management of metabolic acidosis. Conversely, sodium and copper intake were significantly lower with the MEDi-POB diet (p = 0.032 and p = 0.037, respectively). Caloric intake increased, but body mass index slightly decreased from baseline after consuming the MEDi-POB diet. Dietary potassium intake exhibited a non-significant increase (p = 0.053), and no significant changes in serum (p = 0.883) and urine potassium levels (p = 0.087) occurred. Kidney function remained well-preserved following the MEDi-POB diet. Conclusion These results indicate that the MEDi-POB diet is safe even in patients with advanced CKD, as it does not adversely affect serum and urine potassium levels and helps maintain kidney function.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Young Su Joo
- Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Hae-Ryong Yun
- Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Li Rang Lim
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Mi Kim
- Department of Food and Nutrition, Dongduk Women's University, Seoul, Republic of Korea
- Nutrition R&D Institute, MEDI.SOLA Co., Ltd., Seoul, Republic of Korea
| | - Hyangkyu Lee
- College of Nursing, Mo-Im Kim Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
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Norton C, Clarke E, Marcos-Pardo PJ, Tierney A. Mediterranean Diet in Older Irish Adults: Prevalence, Patterns, Predictors and Pertinence. Nutrients 2024; 16:2615. [PMID: 39203752 PMCID: PMC11357667 DOI: 10.3390/nu16162615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 07/23/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024] Open
Abstract
The Mediterranean diet (MD) shows the strongest evidence in support of healthy aging and prevention of age-related diseases. It is associated with a decreased risk of chronic disease, such as cardiovascular disease, obesity, hypertension, diabetes mellitus and cognitive disease. Given the health-promoting aspects of this diet, we conducted a secondary analysis of data from the LifeAge study ("Promoting the shift: sedentary Lifestyle towards active Ageing-LifeAge" Project No 603121-EPP-1-2018-1-ES-SPO-SCP) with the primary aim to determine the proportion of older Irish adults adhering to the MD and to examine the association between adherence to the MD (assessed using the Mediterranean Diet Adherence Screener (MEDAS) scoring tool) and anthropometric risk factors of non-communicable diseases. Of the 131 eligible participants (71.8% female, n = 94) (medically well, aged > 50 years and physically independent) (mean age = 66.2 ± 6.5 years), the mean cumulative MD score across the cohort was 5.8 ± 2.2, with 41% classified as moderate-to-high MD adherers (scoring > 7 MEDAS). Females had a significantly higher score compared to males (female 6.24 ± 1.98; male 4.86 ± 2.53; p = 0.002). Age (y), waist circumference (cm) and waist-hip ratio (WHR) each had a significant (p < 0.05) weak and negative correlation with MD score (r = -0.193, -0.240, -0.284, respectively). Visceral fat level had a significant (p < 0.05) moderate and negative correlation with MD score (r = -0.327). This analysis is the first to assess adherence to the MD in older Irish adults. MD adherence was lower in the Irish older cohort than that reported in older adults in Mediterranean regions and was adhered to more by females and those with a more favourable anthropometric profile. The health-promoting aspects of the diet are evident in non-Mediterranean regions as is demonstrated by the lesser incidence of some non-communicable diseases in moderate-to-high adherers. With the evidence of the protective effects of the MD, external to Mediterranean regions, it would be helpful to establish limitations to adherence, especially in aging populations living in non-Mediterranean regions.
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Affiliation(s)
- Catherine Norton
- Department of Physical Education & Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland;
- Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Elaine Clarke
- Department of Physical Education & Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland;
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland
| | - Pablo J. Marcos-Pardo
- Department of Education, Faculty of Education Sciences, University of Almería, Carretera Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain;
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Carretera Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain
| | - Audrey Tierney
- Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
- Discipline of Dietetics, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC 3086, Australia
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Kwon YJ, Choi JE, Hong KW, Lee JW. Interplay of Mediterranean-diet adherence, genetic factors, and metabolic dysfunction-associated steatotic liver disease risk in Korea. J Transl Med 2024; 22:591. [PMID: 38918799 PMCID: PMC11197258 DOI: 10.1186/s12967-024-05408-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUNDS Metabolic dysfunction-associated steatotic liver disease (MASLD) has gained attention owing to its severe complications. This study aimed to explore the interaction between Mediterranean-diet (MD) adherence, genetic factors, and MASLD risk in a Korean population. METHODS In total, 33,133 individuals aged 40 years and older from the Korean Genome and Epidemiology Study (KoGES) were analyzed. Participants were assessed for MASLD based on criteria and MD adherence measured by the Korean version of the Mediterranean-Diet Adherence Screener (K-MEDAS). Individuals were categorized into two groups based on their MD adherence: high adherence (K-MEDAS > 6) and low adherence (K-MEDAS < 5). Single nucleotide polymorphism (SNP) genotypes were obtained using the Korea Biobank array. Logistic regression was used to examine the single-marker variants for genetic associations with MASLD prevalence. RESULTS Individuals were categorized into MASLD (10,018 [30.2%]) and non-MASLD (23,115 [69.8%]) groups. A significant interaction was observed between the rs780094 glucokinase regulatory protein (GCKR) gene and K-MEDAS on MASLD (p < 10 - 2 ). Of individuals with K-MEDAS > 6, those carrying the minor allele (C) of the GCKR gene rs780094 exhibited a lower risk of MASLD compared to those without the allele (odds ratio [OR] = 0.88 [0.85-0.91], p-value = 5.54e-13). CONCLUSION The study identified a significant interaction involving the rs780094 variant near the GCKR gene, with carriers of the minor allele exhibiting a lower MASLD risk among those adhering well to the MD. Dietary habits influence the MASLD risk associated with the rs780094 allele, emphasizing the need for personalized nutrition recommendations.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Korea
| | - Ja-Eun Choi
- Institute of Advanced Technology, Theragen Health Co. Ltd., Pangyoyeok-ro, Seongnam-si, Gyeonggi-do, 13493, Republic of Korea
| | - Kyung-Won Hong
- Institute of Advanced Technology, Theragen Health Co. Ltd., Pangyoyeok-ro, Seongnam-si, Gyeonggi-do, 13493, Republic of Korea.
| | - Ji-Won Lee
- Department of Family Medicine, Yonsei University College of Medicine, Severance Hospital, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Natalello G, Bosello SL, Campochiaro C, Abignano G, De Santis M, Ferlito A, Karadağ DT, Padula AA, Cavalli G, D'Agostino MA, Selmi C, Matucci‐Cerinic M, Dagna L, De Luca G. Adherence to the Mediterranean Diet in Italian Patients With Systemic Sclerosis: An Epidemiologic Survey. ACR Open Rheumatol 2024; 6:14-20. [PMID: 37916477 PMCID: PMC10789299 DOI: 10.1002/acr2.11627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/11/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE Systemic sclerosis (SSc) is an orphan disease that can lead to severe involvement of the gastrointestinal tract with a significant impact on patients' quality of life (QoL). The Mediterranean diet (MD) was consistently demonstrated to have beneficial effects on chronic diseases based on biological bases. We aimed to evaluate the adherence to the MD of Italian patients with SSc to preliminarily assess its association with gastrointestinal symptoms and other disease features, mood, and QoL. METHODS In this cross-sectional study, adherence to the MD was measured in 387 patients from four SSc Italian referral centers through the 14-item Mediterranean Diet Adherence Screener (14-MEDAS) questionnaire. We also registered patients' reported outcomes related to the QoL and mood. RESULTS Overall, an optimal adherence to MD was observed in 14.7% of patients with SSc, a moderate adherence in 71.3%, and a low adherence in 14.0%. In univariate analysis, poor adherence to the MD was associated with a more prominent depressive mood, time missed at work, and perception of more severe Raynaud's phenomenon and digital ulcers, whereas the 14-MEDAS score inversely correlated with depression score and reflux. CONCLUSION In our cohort of patients with SSc, overall adherence to MD was moderate. Patients with lower adherence to MD also reported worse outcomes related to QoL and mood. Administration of the 14-MEDAS could be a reasonable choice to assess adherence to the MD in patients with SSc. Future initiatives to study the role of MD in the management of patients with SSc are warranted.
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Affiliation(s)
| | | | - Corrado Campochiaro
- IRCCS San Raffaele Hospital and Vita‐Salute San Raffaele UniversityMilanItaly
| | - Giuseppina Abignano
- San Carlo Hospital, Potenza, Italy, and University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS TrustLeedsUK
| | - Maria De Santis
- IRCCS‐Humanitas Clinical and Research Center and Humanitas UniversityMilanItaly
| | | | - Duygu Temiz Karadağ
- San Carlo Hospital, Potenza, Italy, and Canakkale State HospitalCanakkaleTurkey
| | | | - Giulio Cavalli
- IRCCS San Raffaele Hospital and Vita‐Salute San Raffaele UniversityMilanItaly
| | | | - Carlo Selmi
- IRCCS‐Humanitas Clinical and Research Center and Humanitas UniversityMilanItaly
| | - Marco Matucci‐Cerinic
- Vita‐Salute San Raffaele University, Milan, Italy, and University of Florence and AOUCFlorenceItaly
| | - Lorenzo Dagna
- IRCCS San Raffaele Hospital and Vita‐Salute San Raffaele UniversityMilanItaly
| | - Giacomo De Luca
- IRCCS San Raffaele Hospital and Vita‐Salute San Raffaele UniversityMilanItaly
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Hutchinson JM, Williams TE, Westaway AM, Bédard A, Pitre C, Lemieux S, Dodd KW, Lamarche B, Guenther PM, Haines J, Wallace A, Martin A, Louzada MLDC, Jessri M, Olstad DL, Prowse R, Simpson JR, Vena JE, Kirkpatrick SI. Development of the Canadian Food Intake Screener to assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations. Appl Physiol Nutr Metab 2023; 48:603-619. [PMID: 37094383 DOI: 10.1139/apnm-2023-0019] [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: 04/26/2023]
Abstract
NOVELTY The Canadian Food Intake Screener was developed to rapidly assess alignment of adults' dietary intake over the past month with the Food Guide's healthy food choices recommendations. The screener was developed and evaluated through an iterative process that included three rounds of cognitive interviews in each of English and French, along with ongoing feedback from external advisors and face and content validity testing with a separate panel of content experts. The 16-question screener is intended for use with adults, aged 18-65 years, with marginal and higher health literacy in research and surveillance contexts in which comprehensive dietary assessment is not possible.
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Affiliation(s)
- Joy M Hutchinson
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Tabitha E Williams
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Ailish M Westaway
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
| | - Camille Pitre
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Kevin W Dodd
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC, Canada
- École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval, Québec, QC, Canada
| | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Jess Haines
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Angela Wallace
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Alicia Martin
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, ON, Canada
| | - Maria Laura da Costa Louzada
- Department of Nutrition, School of Public Health; Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems; Centre for Health Services and Policy Research, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
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Bekar C, Goktas Z. Validation of the 14-item mediterranean diet adherence screener. Clin Nutr ESPEN 2023; 53:238-243. [PMID: 36657918 DOI: 10.1016/j.clnesp.2022.12.026] [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: 08/22/2022] [Revised: 12/05/2022] [Accepted: 12/21/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Mediterranean diet (MedDiet) is suggested as a healthy dietary pattern. 14-point Mediterranean Diet Adherence Screener (MEDAS) questionnaire is a valid and rapid tool to estimate the adherence to the Mediterranean diet. The aim of this study was to assess the validity of the 14-point Mediterranean Diet Adherence Screener in Turkish population. METHODS A total of 188 people (%58 females) participated in this study (31.7 ± 10.97 years). Turkish version of the MEDAS questionnaire was applied with 3-day food record, and mean total Mediterranean Diet (MedDiet) score and each of the MedDiet component scores was calculated from both 3-day food records and MEDAS tool. Intra-class correlation coefficient (ICC) was used to evaluate the total score agreement between the two dietary assessment methods, and each of the MedDiet components was estimated using Cohen's kappa. This project was a cross-sectional study. RESULTS There was good correlation between the food record total MEdDiet score and MEDAS-derived MedDiet score (r = 0.750, p < 0.001; ICC = 0.749, 95% CI 0.679-0.806, p < 0.001). Highest concordance was observed for olive oil for cooking (К = 0.763), sugar sweetened beverages (К = 0.666), sweets, pastries (К = 0.753), and sofrito (К = 0.796) while the lowest was for fish and seafood (К = 0.196). Re-test analysis showed a similar mean total MedDiet score for both administrations of MEDAS. CONCLUSIONS The MEDAS is a valid and reliable tool to assess adherence to the Mediterranean diet in Turkish population.
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Affiliation(s)
- Cansu Bekar
- Nutrition and Dietetics Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Zeynep Goktas
- Nutrition and Dietetics Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
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Adherence of Obese Patients from Poland and Germany and Its Impact on the Effectiveness of Morbid Obesity Treatment. Nutrients 2022; 14:nu14183880. [PMID: 36145256 PMCID: PMC9505872 DOI: 10.3390/nu14183880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
This study aimed to investigate and compare the adherence of patients treated for morbid obesity living in Poland and Germany. Methods: A cross-sectional international multicenter survey design was adopted. The study involved 564 adult subjects treated for morbid obesity at selected healthcare facilities in Germany (210 participants) and Poland (354 participants). A validated, custom-made questionnaire based on the literature related to this issue was used. Results: The degree of adherence was higher, but not statistically significant, among Polish patients (83.82% vs. 78.33%, p = 0.26140). Patient adherence was associated with gender, age, level of education, duration of obesity, number of health professionals involved in obesity treatment, and type of obesity treatment (p < 0.05). A positive correlation was observed in the case of age, level of education, and a growing number of health professionals involved in obesity treatment, whereas a negative correlation was observed in the case of the duration of obesity. Patients who underwent bariatric surgery significantly more often followed medical recommendations regarding lifestyle changes, compared to obese participants treated only conservatively. Adherence in the field of obesity treatment significantly increases the percentage of total weight loss and excess weight loss due to applied obesity treatment among both Polish and German groups (p < 0.001). Both the percentage of total weight loss and that of excess weight loss were significantly higher in the group of adherent patients compared to the nonadherent patients (p < 0.00001). The levels of perceived anxiety, stress, and depression were significantly higher in nonadherent patients in both countries. Conclusions: These findings confirm the role of adherence in the effective and satisfactory treatment of morbid obesity. There is a great need to improve patient adherence to overcome the consequences of the obesity pandemic.
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Cho AR, Hong KW, Kwon YJ, Choi JE, Lee HS, Kim HM, Bae SJ, Ahn SG, Jeong J, Lee JW. Effects of Single Nucleotide Polymorphisms and Mediterranean Diet in Overweight or Obese Postmenopausal Women With Breast Cancer Receiving Adjuvant Hormone Therapy: A Pilot Randomized Controlled Trial. Front Nutr 2022; 9:882717. [PMID: 35845810 PMCID: PMC9284001 DOI: 10.3389/fnut.2022.882717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022] Open
Abstract
Background and Aims Weight management is recommended in overweight or obese breast cancer patients, as they have an increased risk of cancer recurrence and poor prognosis. Furthermore, identifying the relationships between genetic factors and nutrition could help suggest possible individualized nutritional solutions in weight management. The objective of this pilot randomized controlled trial was to investigate the influence of two obesity-associated single nucleotide polymorphisms and the Mediterranean diet intervention on weight loss and modification of nutrient intake and metabolic parameters in overweight or obese, postmenopausal, breast cancer patients receiving adjuvant hormone therapy. Methods Seventy-eight breast cancer patients were randomly assigned to the Mediterranean diet (MeDiet) group or control group, and seventy-one were finally analyzed. Body composition, nutrient intake, and metabolic parameters were assessed at baseline and after the 8-week intervention. Fat mass and obesity-associated (FTO) rs7185735 and melanocortin-4 receptor (MC4R) rs476828 variants were genotyped. Results We found that both variants did not influence weight loss or improvement of metabolic parameters within the Mediterranean diet intervention. Intake of saturated fatty acid (SFA) and trans fat was significantly increased in C carriers compared with the TT genotype of MC4R rs476828 only in the control group (p = 0.002 for SFA; p = 0.016 for trans fat), whereas no significant difference was observed between genotypes in the MeDiet group. There were statistically significant interactions between MC4R rs476828 and dietary intervention for changes in SFA intake (p = 0.009) and trans fat intake (p = 0.049). Conclusion Our data suggest that considering the effects of genotype may be more necessary when the Mediterranean diet is not followed and that this diet may have a protective role against the effects of certain genotypes. Further studies are required to determine the potential mechanism of the observed gene-diet interaction. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT04045392].
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Affiliation(s)
- A-Ra Cho
- Chaum Life Center, CHA University, Seoul, South Korea
| | - Kyung-Won Hong
- Theragen Etex Bio Institute Co., Ltd., Suwon, South Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Ja-Eun Choi
- Theragen Etex Bio Institute Co., Ltd., Suwon, South Korea
| | - Hye-Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyung-Mi Kim
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, South Korea
| | - Soong June Bae
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Gwe Ahn
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Joon Jeong,
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Ji-Won Lee,
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Kwon YJ, Sung DI, Lee JW. Association among Premenstrual Syndrome, Dietary Patterns, and Adherence to Mediterranean Diet. Nutrients 2022; 14:nu14122460. [PMID: 35745189 PMCID: PMC9230049 DOI: 10.3390/nu14122460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 01/27/2023] Open
Abstract
Premenstrual syndrome (PMS) adversely affects the physiological and psychological health and quality of life of women. Mediterranean diet (MD) could be helpful for managing and preventing PMS, but evidence on the association between dietary patterns and PMS in Asian women is limited. This study aimed to investigate the association of dietary patterns and adherence to MD with PMS in Korean women. This cross-sectional study recruited 262 women aged 20-49 years via an online survey. PMS was diagnosed using the American College of Obstetricians and Gynecologists diagnostic criteria. MD adherence was assessed using the Korean version of the Mediterranean Diet Adherence Screener. Mediterranean Diet Score (MDS) was classified into tertiles (T) (T1: 0-3, T2: 4-5, and T3: ≥6). Dietary pattern was assessed with the Food Frequency Questionnaire. Multiple logistic regression analyses were conducted to evaluate the association between dietary pattern scores and PMS prevalence. The proportion of PMS was significantly lower in MDS tertile (T) 3 than in T1 (55.4% in T3 vs. 74.4% in T1, p = 0.045). After adjusting for confounders, participants in the highest tertile of the bread/snack pattern had a higher risk of PMS (odds ratio [95% CI]: 2.59 [1.32-5.06]), while traditional dietary pattern and meat/alcohol pattern were not associated with PMS. In conclusion, we found that low adherence to MD and higher bread/snack dietary pattern were associated with increased risk of PMS, respectively.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea;
| | - Da-In Sung
- Department of Medicine, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-102-949-5645
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Bakaloudi DR, Chrysoula L, Leonida I, Kotzakioulafi E, Theodoridis X, Chourdakis M. Impact of the level of adherence to the Mediterranean Diet on blood pressure: A systematic review and meta-analysis of observational studies. Clin Nutr 2021; 40:5771-5780. [PMID: 34773865 DOI: 10.1016/j.clnu.2021.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND High blood pressure (BP) constitutes a common and serious medical condition which is rising globally, and is among preventable factors for cardiovascular, renal, brain and other diseases. Modifiable risk factors of high BP include unhealthy dietary patterns, presence of obesity, excess alcohol consumption and lack of physical activity. Data in regard to the different types of diets show that Mediterranean diet (MD) is associated with healthy levels of BP. In this study we aimed to investigate the impact of the level of adherence to MD in BP. AIMS-METHODS A systematic literature search (up to 08.2021) in PubMed, Scopus, Embase, Web of Science, Cochrane and Google Scholar databases was conducted, and 54 observational studies were included. RESULTS Systolic blood pressure (SBP) was found to be lower in the high adherence to MD group SMD: -0.08, (95%CI: -0.15, -0.02) whereas no differences regarding diastolic blood pressure (DBP) were observed between the high and low adherence to MD groups [SMD: -0.07, (95%CI: -0.13, 0.00)]. Mean DBP of all included studies for both high and low adherence groups were in healthy levels (<90 mmHg). CONCLUSIONS Higher adherence to MD could positively influence SBP, but further research is needed in this field due to the heterogeneous definitions of low/high adherence and the type of studies used (observational).
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ioannis Leonida
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Evangelia Kotzakioulafi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Xenophon Theodoridis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
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Son DH, Kwon YJ, Lee HS, Kim HM, Lee JW. Effects of a Calorie-Restricted Mediterranean-Style Diet on Plasma Lipids in Hypercholesterolemic South Korean Patients. Nutrients 2021; 13:nu13103393. [PMID: 34684393 PMCID: PMC8539389 DOI: 10.3390/nu13103393] [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: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/02/2023] Open
Abstract
The objective of this randomized cross-over trial was to evaluate the short term effects of a calorie-restricted Korean style Mediterranean diet (KMD) versus a calorie-restricted conventional diet on lipid profile and other metabolic parameters in hypercholesterolemic patients. Ninety-two patients with hypercholesterolemia were randomly assigned to two groups and switched to the other group following a 4-week intervention after a 2-week washout period. While participants during KMD intervention period received home delivery of two meals daily except for weekends, those during the control group were advised to consume a conventional diet. Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) significantly decreased in KMD group even after adjusting for age, sex, total energy intake changes, alcohol consumption, smoking status, and physical activity changes (all p < 0.05). Anthropometric parameters, white blood cell (WBC), fasting glucose, fasting insulin, HOMA-IR, and fatty liver index (FLI) also significantly decreased after KMD intervention (all p < 0.05). In addition, WBC, fasting glucose, total cholesterol, LDL-C and FLI were significantly decreased even after adjusting for weight reduction changes. Calorie-restricted KMD not only helps to treat dyslipidemia by improving the lipid parameters but also has beneficial effects on reducing cardiovascular risk by improving chronic inflammation, insulin resistance, and fatty liver.
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Affiliation(s)
- Da-Hye Son
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul 03722, Korea; (D.-H.S.); (Y.-J.K.)
| | - Yu-Jin Kwon
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul 03722, Korea; (D.-H.S.); (Y.-J.K.)
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, College of Medicine, Yonsei University, Seoul 03722, Korea;
| | - Hyung-Mi Kim
- Department of Food and Nutrition, Dongduck Women’s University, Seoul 02748, Korea;
| | - Ji-Won Lee
- Department of Family Medicine, College of Medicine, Yonsei University, Seoul 03722, Korea; (D.-H.S.); (Y.-J.K.)
- Correspondence: ; Tel.: +82-10-2949-5645
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12
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Mediterranean diet scoring systems: understanding the evolution and applications for Mediterranean and non-Mediterranean countries. Br J Nutr 2021; 128:1371-1392. [PMID: 34289917 DOI: 10.1017/s0007114521002476] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Mediterranean diet (MedD) is a flexible dietary pattern which has such variability that has led to inconsistencies in definitions and assessment. The purpose of this narrative review is to evaluate scoring systems in a cultural and geographic context, from Mediterranean and non-Mediterranean countries, for comparison and application. The early MedD scoring systems (i.e. Trichopoulou's MedD Scale (T-MDS) and alternative MedD Scale (aMed)) are widely applied throughout the world but use population-specific median cut-offs which limit interpretation and cross-study comparisons. The T-MDS and aMed also do not account for non-traditional MedD foods which are consumed in greater quantities than when the scoring systems were developed. Scoring systems developed after the MedD pyramid publication in 2011 have generally used these recommendations as a basis for food group intake cut-offs, incorporating more foods/food groups as negative components, and some have included dietary and lifestyle behaviours. The different approaches to MedD assessment have created much variability in the foods/food group components included in scoring systems. Assessments that include dietary and lifestyle behaviours may reflect the nutrition transition occurring in Mediterranean countries and better guide clinical intervention approaches. While the new scoring systems are theorised to better capture MedD adherence and behaviours, comparisons are sparse in the literature and none exists outside of Europe. Consensus on food and dietary behaviours to include as well as the methodology for assigning points in MedD scoring systems is needed to advance our understanding of MedD and health relationships to promote public health messaging and clinical application.
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13
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Schröder H, Zomeño MD, Martínez-González MA, Salas-Salvadó J, Corella D, Vioque J, Romaguera D, Martínez JA, Tinahones FJ, Miranda JL, Estruch R, Bueno-Cavanillas A, Alonso Gómez AM, Tur JA, Warnberg J, Serra-Majem L, Martín V, Vázquez C, Lapetra J, Pintó X, Vidal J, Daimiel L, Gaforio JJ, Matía-Martín P, Ros E, Lassale C, Ruiz-Canela M, Babio N, Sorlí JV, García-Arellano A, Díaz-López A, Fitó M, Castañer O. Validity of the energy-restricted Mediterranean Diet Adherence Screener. Clin Nutr 2021; 40:4971-4979. [PMID: 34364236 DOI: 10.1016/j.clnu.2021.06.030] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/11/2021] [Accepted: 06/27/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Short dietary assessment tools can be useful to estimate food intake and diet quality in large-scale epidemiological studies with time constraints. OBJECTIVE To determine the concurrent validity of the 17-item energy-restricted Mediterranean Adherence Screener (er-MEDAS) used in the PREDIMED (PREvención con DIeta MEDiterránea)-Plus trial and to analyse its capacity to detect 1-year changes in diet and cardiometabolic risk factors. METHODS Validation study nested in the PREDIMED-Plus (n = 6760, 55-75 years). Dietary data were collected by the 17-item er-MEDAS and a 143-item validated semiquantitative food frequency questionnaire (FFQ) at baseline and after 1-year intervention. Cardiometabolic risk markers were measured at both time points. A Mediterranean diet (MedDiet) score was derived from both instruments. Concurrent validity was evaluated by Pearson and intra-class correlation coefficients (ICC) and Bland and Altman limits of agreement. Construct validity was evaluated by assessing 1-year changes in FFQ-reported dietary intake and cardiometabolic profile changes in relation to changes in er-MEDAS. RESULTS A moderate to good correlation between the MedDiet score calculated by both measurement instruments was found: r = 0.61 and ICC = 0.60 (both p < 0.001). Agreement of each of the er-MEDAS items ranged from 55.4% to 85.0% with a moderate mean concordance (kappa = 0.41). Between baseline and 1-year follow-up, energy intake measured by the FFQ decreased by 242 kcal, while Mediterranean food consumption increased in participants with the highest increase in the er-MEDAS MedDiet score. An increase in the er-MEDAS MedDiet score ratings was associated with a decrease in BMI, waist circumference, triglycerides, fasting glucose, diastolic blood pressure, and triglycerides/HDL-cholesterol ratio (p < 0.001 for all), and with an increase in HDL-cholesterol (p = 0.006). CONCLUSION The er-MEDAS shows a modest to good concurrent validity compared with FFQ data. It shows acceptable construct validity, as a greater er-MEDAS score was associated with more favourable dietary and cardiometabolic profiles over time. TRIAL REGISTRY ISRCTN89898870; registration date, 24 July 2014. https://www.isrctn.com/ISRCTN89898870.
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Affiliation(s)
- Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Maria Dolors Zomeño
- Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain; Programa de Doctorado en Alimentación y Nutrición, Facultad de Farmacia, Universidad de Barcelona, Barcelona, Spain
| | - Miguel Angel Martínez-González
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, IISPV, Hospital Universitari de Sant Joan de Reus, 43201, Reus, Spain
| | - Dolores Corella
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Miguel Hernández University, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Cardiometabolic Nutrition Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Francisco J Tinahones
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Virgen de La Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - José López Miranda
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada
| | - Angel M Alonso Gómez
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Julia Warnberg
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institute for Biomedical Research, University of Las Palmas de Gran Canarias, 35016, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, Madrid, Spain
| | - José Lapetra
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut D'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - José Juan Gaforio
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Health Sciences, Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaen, Jaen, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Camille Lassale
- Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Miguel Ruiz-Canela
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Nancy Babio
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, IISPV, Hospital Universitari de Sant Joan de Reus, 43201, Reus, Spain
| | - José V Sorlí
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ana García-Arellano
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Emergency Department, Complejo Hospitalario de Navarra, Servicio Navarro de Salud-Osaunbidea, Spain
| | - Andrés Díaz-López
- CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Serra Hunter Fellow, Universitat Rovira I Virgili, Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain; CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain; CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Saavedra Y, Mena V, Priken K. Effect of the Mediterranean diet on histological indicators and imaging tests in non-alcoholic fatty liver disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 45:350-360. [PMID: 34157365 DOI: 10.1016/j.gastrohep.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 02/09/2023]
Abstract
AIM To analyze the scientific evidence regarding to the effect of the Mediterranean diet on the imaging tests and biopsy characteristics in subjects with non-alcoholic fatty liver disease (NAFLD). METHODS A bibliographic search was carried out in this narrative review in Pubmed and Web of Science databases, considering studies published between 2011 and 2020, in English or Spanish, randomized clinical trials and observational studies in patients with a diagnosis of NAFLD, in subjects over 18years of age of both sexes. RESULTS In the observational studies found, an inverse association between adherence to a Mediterranean diet and liver damage stands out, while in the intervention studies with measurement of liver biopsy a 4.4% reduction in intrahepatic lipids and with magnetic resonance a reduction between 4.2 and 10.2% was found. In experimental studies with ultrasound measurement, the proportion of people with moderate (6-16%) and severe (25%) degree decreased and the studies with transient elastography showed a decrease in liver stiffness between 0.5 and 2.1kPa. CONCLUSIONS The Mediterranean diet contributes to the treatment of NAFLD, which is manifested in the liver and histological imaging tests characteristics.
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Affiliation(s)
- Yeily Saavedra
- Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - Valentina Mena
- Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - Kathleen Priken
- Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile.
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15
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Lee S, You H, Lee M, Kim D, Jung S, Park Y, Hyun S. Different Reactions in Each Enterotype Depending on the Intake of Probiotic Yogurt Powder. Microorganisms 2021; 9:1277. [PMID: 34208176 PMCID: PMC8230767 DOI: 10.3390/microorganisms9061277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
Probiotics can be used as a nutritional strategy to improve gut homeostasis. We aimed to evaluate the intestinal microbiota profile of 18 subjects after ingestion of probiotic yogurt powder (PYP) based on enterotype. The subjects were classified into three enterotypes according to their microbial community: Bacteroides (n = 9, type B), Prevotella (n = 3, type P), and Ruminococcus (n = 6, type R). We performed controlled termination in a transient series that included a control period of three weeks before probiotic intake, PYP intake for three weeks, and a three-week washout period. Fecal microbiota composition was analyzed by sequencing the V3-V4 super variable region of 16S rRNA. Based on the Bristol stool shape scale, abnormal stool shape improved with PYP intake, and bowel movements were activated. The abundance of Faecalibacterium, Eggerthella, and Leuconostoc, which ferment and metabolize glucose, showed a strong correlation with type B Bacteroides, and glucose metabolism improvement was observed in all type B subjects. Alkaline phosphatase was significantly improved only in type B. In addition, the abundance of type B Bacteroides showed a negative correlation with that of Lactobacillus. The abundance of Streptococcus, Agathobacter, and Christensenella, which are involved in lipid metabolism, showed a strong correlation with that of type P Prevotella, and triglyceride metabolism improvement was observed in all type P subjects. The gut microbiota showed only short-term changes after PYP intake and showed resilience by returning to its original state when PYP intake was interrupted. In summary, the different responses to PYP intake may result from the different enterotypes and associated strains; therefore, the probiotic composition should be adjusted based on the individual enterotype.
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Affiliation(s)
- Songhee Lee
- Department of Biomedical Laboratory Science, Graduate School, Eulji University, Dongil-ro 712, Uijeongbu-si 11759, Korea;
| | - Heesang You
- Department of Senior Healthcare, Graduate School, Eulji University, Dongil-ro 712, Uijeongbu-si 11759, Korea;
| | - Minho Lee
- Department of Food Science and Service, College of Bio-Convergence, Eulji University, Sansung daero 553, Seongnam-si 13135, Korea;
| | - Doojin Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Eulji University, Sansung daero 553, Seongnam-si 13135, Korea;
| | - Sunghee Jung
- Department of Internal Medicine, College of Medicine, Eulji University, Dunsan-seo 95, Daejeon-si 35233, Korea;
| | - Youngsook Park
- Department of Gastroenterology, Nowon Eulji University Hospital, Eulji University School of Medicine, Hangeul Biseok-ro 68, Seoul 01830, Korea;
| | - Sunghee Hyun
- Department of Biomedical Laboratory Science, Graduate School, Eulji University, Dongil-ro 712, Uijeongbu-si 11759, Korea;
- Department of Senior Healthcare, Graduate School, Eulji University, Dongil-ro 712, Uijeongbu-si 11759, Korea;
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16
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Bakaloudi DR, Chrysoula L, Kotzakioulafi E, Theodoridis X, Chourdakis M. Impact of the Level of Adherence to Mediterranean Diet on the Parameters of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2021; 13:1514. [PMID: 33946280 PMCID: PMC8146502 DOI: 10.3390/nu13051514] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
High adherence to the Mediterranean diet (MD) has been associated with a lower prevalence of Metabolic Syndrome (MetS). The present study aimed to investigate the impact of MD adherence on parameters of MetS. A systematic literature search was performed in PubMed, Cochrane Central Registry of Clinical Trials (CENTRAL), Scopus, EMBASE, Web of Science and Google Scholar databases. Observational studies that recorded adherence to MD and components/measures of the MetS, such as waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG), high-density lipoprotein (HDL) cholesterol and triglycerides (TG), were included in this study. A total of 58 studies were included in our study. WC and TG were significantly lower in the high adherence MD group (SMD: -0.20, (95%CI: -0.40, -0.01), SMD: -0.27 (95%CI: -0.27, -0.11), respectively), while HDL cholesterol was significantly higher in the same group (SMD: -0.28 (95%CI: 0.07, 0.50). There was no difference in FBG and SBP among the two groups (SMD: -0.21 (95%CI: -0.54, 0.12) & SMD: -0.15 (95%CI: -0.38, 0.07), respectively). MD may have a positive impact on all parameters of MetS. However, further research is needed in this field.
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Affiliation(s)
| | | | | | | | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.R.B.); (L.C.); (E.K.); (X.T.)
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17
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Marendić M, Polić N, Matek H, Oršulić L, Polašek O, Kolčić I. Mediterranean diet assessment challenges: Validation of the Croatian Version of the 14-item Mediterranean Diet Serving Score (MDSS) Questionnaire. PLoS One 2021; 16:e0247269. [PMID: 33647026 PMCID: PMC7920370 DOI: 10.1371/journal.pone.0247269] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
Mediterranean diet (MD) is among the most commonly investigated diets and recognized as one of the healthiest dietary patterns. Due to its complexity, geographical and cultural variations, it also represents a challenge for quantification. The aim of this cross-sectional study was to assess reliability and validity of the Croatian version of the 14-item Mediterranean Diet Serving Score (MDSS), using the Mediterranean Diet Adherence Screener (MEDAS) as the referent test. We included the exploratory sample of 360 medical students, and a confirmatory sample of 299 health studies students from the University of Split, Croatia. Test-retest reliability and validity of the MDSS were tested using intra-class correlation coefficients (ICC), while Cohen's kappa statistic was used to test correct classification of subjects into MD adherent/non-adherent category. A very good reliability was shown for the overall MDSS score (ICC = 0.881 [95% CI 0.843-0.909]), and a moderate reliability for the binary adherence (κ = 0.584). Concurrent validity of the MDSS was also better when expressed as a total score (ICC = 0.544 [0.439-0.629]) as opposed to the adherence (κ = 0.223), with similar result in the confirmatory sample (ICC = 0.510 [0.384-0.610]; κ = 0.216). Disappointingly, only 13.6% of medical students were adherent to the MD according to MDSS, and 19.7% according to the MEDAS questionnaire. Nevertheless, MDSS score was positively correlated with age (ρ = 0.179: P = 0.003), self-assessed health perception (ρ = 0.123; P = 0.047), and mental well-being (ρ = 0.139: P = 0.022). MDSS questionnaire is a short, reliable and reasonably valid instrument, and thus useful for assessing the MD adherence, with better results when used as a numeric score, even in the population with low MD adherence.
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Affiliation(s)
- Mario Marendić
- University Department of Health Studies, University of Split, Split, Croatia
- University Postgraduate Doctoral Study Program Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia
| | - Nikolina Polić
- Institute of Emergency Medicine of Split-Dalmatia County, Split, Croatia
| | | | | | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, Split, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, Split, Croatia
- * E-mail:
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Fontalba-Romero MI, López-Enriquez S, Lago-Sampedro A, Garcia-Escobar E, Pastori RL, Domínguez-Bendala J, Alvarez-Cubela S, Valdés S, Rojo-Martinez G, García-Fuentes E, Labajos-Manzanares MT, García-Serrano S. Association between the Mediterranean Diet and Metabolic Syndrome with Serum Levels of miRNA in Morbid Obesity. Nutrients 2021; 13:nu13020436. [PMID: 33572759 PMCID: PMC7911421 DOI: 10.3390/nu13020436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The Mediterranean diet (MD) could be involved in the regulation of different miRNAs related to metabolic syndrome (MS). Methods: We analyzed the serum level of mir-let7a-5p, mir-21, mir-590, mir-107 and mir-192 in patients with morbid obesity and its association with the MD and MS. Results: There is an association between the adherence to MD and higher serum levels of mir-590. Mir-590 was lower in those patients who consumed >2 commercial pastries/week. Mir-let7a was lower in those who consumed ≥1 sweetened drinks, in those who consumed ≥3 pieces of fruit/day and in those who consumed less red than white meat. A lower mir-590 and mir-let7a, and a higher mir-192 level, were found in patients who met the high-density lipoprotein cholesterol (HDL) criterion of MS. A higher mir-192 was found in those patients who met the triglyceride criterion of MS and in those with type 2 diabetes (T2DM). Conclusions: There is an association between specific serum levels of miRNAs and the amount and kind of food intake related to MD. Mir-590 was positively associated with a healthy metabolic profile and type of diet, while mir-192 was positively associated with a worse metabolic profile. These associations could be suggestive of a possible modulation of these miRNAs by food.
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Affiliation(s)
- María I. Fontalba-Romero
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario, 29010 Málaga, Spain; (M.I.F.-R.); (A.L.-S.); (E.G.-E.); (S.V.); (S.G.-S.)
| | - Soledad López-Enriquez
- Departamento de Bioquímica Médica, Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, 41009 Sevilla, Spain;
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
| | - Ana Lago-Sampedro
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario, 29010 Málaga, Spain; (M.I.F.-R.); (A.L.-S.); (E.G.-E.); (S.V.); (S.G.-S.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
| | - Eva Garcia-Escobar
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario, 29010 Málaga, Spain; (M.I.F.-R.); (A.L.-S.); (E.G.-E.); (S.V.); (S.G.-S.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), 29009 Málaga, Spain
| | - Ricardo L. Pastori
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.L.P.); (J.D.-B.); (S.A.-C.)
| | - Juan Domínguez-Bendala
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.L.P.); (J.D.-B.); (S.A.-C.)
| | - Silvia Alvarez-Cubela
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.L.P.); (J.D.-B.); (S.A.-C.)
| | - Sergio Valdés
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario, 29010 Málaga, Spain; (M.I.F.-R.); (A.L.-S.); (E.G.-E.); (S.V.); (S.G.-S.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), 29009 Málaga, Spain
| | - Gemma Rojo-Martinez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario, 29010 Málaga, Spain; (M.I.F.-R.); (A.L.-S.); (E.G.-E.); (S.V.); (S.G.-S.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), 29009 Málaga, Spain
- Correspondence: (G.R.-M); (E.G.-F.)
| | - Eduardo García-Fuentes
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
- Correspondence: (G.R.-M); (E.G.-F.)
| | | | - Sara García-Serrano
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario, 29010 Málaga, Spain; (M.I.F.-R.); (A.L.-S.); (E.G.-E.); (S.V.); (S.G.-S.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain
- CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), 29009 Málaga, Spain
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Andrade V, Jorge R, García-Conesa MT, Philippou E, Massaro M, Chervenkov M, Ivanova T, Maksimova V, Smilkov K, Ackova DG, Miloseva L, Ruskovska T, Deligiannidou GE, Kontogiorgis CA, Pinto P. Mediterranean Diet Adherence and Subjective Well-Being in a Sample of Portuguese Adults. Nutrients 2020; 12:E3837. [PMID: 33339084 PMCID: PMC7765516 DOI: 10.3390/nu12123837] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022] Open
Abstract
The Mediterranean diet (MD) and other lifestyle characteristics have been associated with well-being, a broad multiparameter concept that includes individual's subjective assessment of their own well-being (SWB). Some studies have suggested that diet influences SWB, thus, this work aimed to add novel information on the association of MD and SWB in a sample of Portuguese adults. Data on sociodemographic, economic, lifestyle, diet, and SWB were collected through a self-filled online questionnaire. MD adherence was assessed by the Mediterranean Diet Adherence Screener (MEDAS) score ]. Results showed a moderate adherence to the MD in 490 Portuguese adults (mean MEDAS of 7.4 ± 2.1). A higher MD adherence was found to be significantly positively associated with women, employed individuals, a higher number of meals per day, and those with frequent contact with nature (p-value < 0.0025, using Bonferroni adjustment). As a novelty, this study divided the participants into low SWB, medium SWB, and medium to high SWB profiles (3.9 ± 1.0; 6.2 ± 1.0; 8.2 ± 1.3, respectively; p-value < 0.05), which reported significantly increasing MEDAS scores (6.5 ± 2.1; 7.3 ± 2.1; 7.8 ± 1.9; respectively, p-value < 0.05).
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Affiliation(s)
- Vanda Andrade
- Polytechnic Institute of Santarém, School of Agriculture, 2001-904 Santarém, Portugal; (V.A.); (R.J.)
| | - Rui Jorge
- Polytechnic Institute of Santarém, School of Agriculture, 2001-904 Santarém, Portugal; (V.A.); (R.J.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - María-Teresa García-Conesa
- Research Group on Quality, Safety and Bioactivity of Plant Foods, Campus de Espinardo, Centro de Edafologia y Biologia Aplicada del Segura-Consejo Superior de Investigaciones Científicas (CEBAS-CSIC), P.O. Box 164, 30100 Murcia, Spain;
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus;
- Department of Nutritional Sciences, King’s College London, London SE1 9NH, UK
| | - Marika Massaro
- National Research Council (CNR), Institute of Clinical Physiology, 73100 Lecce, Italy;
| | - Mihail Chervenkov
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria;
- Faculty of Veterinary Medicine, University of Forestry, 1797 Sofia, Bulgaria;
| | - Teodora Ivanova
- Faculty of Veterinary Medicine, University of Forestry, 1797 Sofia, Bulgaria;
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Viktorija Maksimova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, Republic of North Macedonia; (V.M.); (K.S.); (D.G.A); (L.M.); (T.R.)
| | - Katarina Smilkov
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, Republic of North Macedonia; (V.M.); (K.S.); (D.G.A); (L.M.); (T.R.)
| | - Darinka Gjorgieva Ackova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, Republic of North Macedonia; (V.M.); (K.S.); (D.G.A); (L.M.); (T.R.)
| | - Lence Miloseva
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, Republic of North Macedonia; (V.M.); (K.S.); (D.G.A); (L.M.); (T.R.)
| | - Tatjana Ruskovska
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, Republic of North Macedonia; (V.M.); (K.S.); (D.G.A); (L.M.); (T.R.)
| | - Georgia Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, 68100 Dragana, Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, 68100 Dragana, Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Paula Pinto
- Polytechnic Institute of Santarém, School of Agriculture, 2001-904 Santarém, Portugal; (V.A.); (R.J.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Research Unit of Polytechnic Institute of Santarém, 2001-904 Santarém, Portugal
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20
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Exploring the Validity of the 14-Item Mediterranean Diet Adherence Screener (MEDAS): A Cross-National Study in Seven European Countries around the Mediterranean Region. Nutrients 2020; 12:nu12102960. [PMID: 32992649 PMCID: PMC7601687 DOI: 10.3390/nu12102960] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022] Open
Abstract
This study provides comprehensive validation of the 14-item Mediterranean Diet Adherence Screener (14-MEDAS) in an adult population from Greece (GR), Portugal (PT), Italy (IT), Spain (SP), Cyprus (CY), Republic of North Macedonia (NMK), and Bulgaria (BG). A moderate association between the 14-MEDAS and the reference food diary was estimated for the entire population (Pearson r = 0.573, p-value < 0.001; Intraclass Correlation Coefficient (ICC) = 0.692, p-value < 0.001) with the strongest correlation found in GR, followed by PT, IT, SP, and CY. These results were supported by kappa statistics in GR, PT, IT, and SP with ≥50% of food items exhibiting a fair or better agreement. Bland-Altman analyses showed an overestimation of the 14-MEDAS score in the whole population (0.79 ± 1.81, 95%Confidence Interval (CI) 0.61, 0.96), but this value was variable across countries, with GR, NMK, and BG exhibiting the lowest bias. Taking all analyses together, the validation achieved slightly better results in the Mediterranean countries but a definitive validation ranking order was not evident. Considering growing evidence of the shift from Mediterranean Diet (MD) adherence and of the importance of culture in making food choices it is crucial that we further improve validation protocols with specific applications to compare MD adherence across countries.
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