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Xing NN, Ren F, Yang H. Effects of ketogenic diet on weight loss parameters among obese or overweight patients with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trails. Food Nutr Res 2024; 68:9835. [PMID: 38571924 PMCID: PMC10989237 DOI: 10.29219/fnr.v68.9835] [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: 07/25/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 04/05/2024] Open
Abstract
Aim To evaluate how effective a low carbohydrate ketogenic diet (KD) is for changing key physical measurements such as weight, waist circumference (WC), body mass index (BMI), and fat mass (FM) in women with polycystic ovary syndrome (PCOS) who were obese or overweight. Methods Several online databases, including PubMed, Scopus, EMBASE, Cochrane Library, and Web of Science (WOS), were searched systematically to find relevant randomized controlled trials (RCTs) up until June 2023. The Q-test and I2 statistics were used to assess the level of heterogeneity among the included studies. The data were then combined using either a fixed or random effects model and presented as a weighted mean difference (WMD) along with a 95% confidence interval (CI). Results Of the 682 citations, 11 RCTs were included. The pooled results showed a significant decrease in the WMD of weight levels [WMD = -9.13 kg; 95% CI, -11.88, -6.39, P < 0.001; I2 = 87.23%] following KD. Moreover, KD significantly reduced BMI levels [WMD = -2.93 kg/m2; 95% CI, -3.65, -2.21, P < 0.001; I2 = 78.81%] compared to the controls. Patients with PCOS received KD demonstrated significant decrease in WC [WMD = -7.62 cm; 95% CI, -10.73, -4.50, P < 0.001; I2 = 89.17%] and FM [WMD = -5.32 kg; 95% CI, -7.29, -3.36, P < 0.001; I2 = 83.97%]. Conclusion KD was associated with lower weight loss (WL) parameters, including weight, BMI, WC, and FM, in obese or overweight women with PCOS, highlighting the significance of physicians and nurses in taking care of the nutritional needs of overweight/obese patients with PCOS.
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Affiliation(s)
- Nan-nan Xing
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang Ren
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hui Yang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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Filgueiras MDS, Pessoa MC, Bressan J, do Carmo AS, Fogal Vegi AS, de Albuquerque FM, de Novaes JF. Obesogenic neighborhood environment is associated with body fat and low-grade inflammation in Brazilian children: could the mother's BMI be a mediating factor? Public Health Nutr 2023; 27:e14. [PMID: 38031476 PMCID: PMC10830377 DOI: 10.1017/s1368980023002628] [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: 01/10/2023] [Revised: 11/13/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To evaluate the direct and indirect associations of obesogenic and leptogenic neighborhood environments with body fat, and pro- and anti-inflammatory adipokines in Brazilian children. DESIGN Cross-sectional study. The body fat distribution was assessed using dual-energy X-ray absorptiometry (DXA). Concentrations of leptin and adiponectin were measured. Four hundred meters (0·25 miles) road network buffer was the neighborhood unit used to assess the environmental characteristics around households. Obesogenic and leptogenic environments were the latent variables obtained from the observed characteristics. The mother's BMI, ultra-processed food consumption, and physical activity before and after school, were tested as mediating variables. A hybrid model of structural equations was used to test the direct and indirect associations of obesogenic and leptogenic environments with body fat, leptin and adiponectin concentrations. SETTING Urban area of Viçosa, Minas Gerais, Brazil. PARTICIPANTS Children aged 8- and 9-years (n 367). RESULTS Obesogenic environment was directly associated with the mother's BMI (β: 0·24, P = 0·02) and the child's body fat (β: 0·19, P = 0·02). The mother's BMI and body fat mediated the association of the obesogenic environment with leptin concentrations (β: 0·05, P = 0·02). CONCLUSIONS Obesogenic neighborhood environment was directly associated with body fat and mother's BMI, and indirectly associated with leptin concentrations in Brazilian children, mediated by the mother's BMI and body fat.
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Affiliation(s)
- Mariana De Santis Filgueiras
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa, Minas Gerais36570-900, Brazil
| | - Milene Cristine Pessoa
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena 190, Santa Efigênia, Belo Horizonte, Minas Gerais30130-100, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa, Minas Gerais36570-900, Brazil
| | - Ariene Silva do Carmo
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena 190, Santa Efigênia, Belo Horizonte, Minas Gerais30130-100, Brazil
| | - Aline Siqueira Fogal Vegi
- Nutrition School, Universidade Federal de Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, Ouro Preto, Minas Gerais35400-000, Brazil
| | - Fernanda Martins de Albuquerque
- Nutrition Institute, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, 12th floor, Maracanã, Rio de Janeiro20550-900, Brazil
| | - Juliana Farias de Novaes
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa, Minas Gerais36570-900, Brazil
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Su Y, Wu KC, Chien SY, Naik A, Zaslavsky O. A Mobile Intervention Designed Specifically for Older Adults With Frailty to Support Healthy Eating: Pilot Randomized Controlled Trial. JMIR Form Res 2023; 7:e50870. [PMID: 37966877 PMCID: PMC10687683 DOI: 10.2196/50870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/10/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Frailty, a common geriatric syndrome, predisposes older adults to functional decline. No medications can alter frailty's trajectory, but nutritional interventions may aid in supporting independence. OBJECTIVE This paper presents a pilot randomized controlled trial to investigate the feasibility and efficacy of a mobile health intervention, "Olitor," designed to enhance adherence to the Mediterranean diet among older adults with frailty, requiring no external assistance. METHODS The study sample consisted of 15 participants aged 66-77 (mean 70.5, SD 3.96) years randomized into intervention (n=8; 8 females; mean 72.4, SD 4.8 years) and control groups (n=7; 6 females, 1 male; mean 70.0, SD 3.9 years). The intervention involved a patient-facing mobile app called "Olitor" and a secure web-based administrative dashboard. Participants were instructed to use the app at least weekly for 3 months, which provided feedback on their food choices, personalized recipe recommendations, and an in-app messaging feature. Using Mann-Whitney tests to compare change scores and Hedges g statistics to estimate effect sizes, the primary efficacy outcomes were adherence to the Mediterranean diet score and insulin resistance measures. Secondary outcomes included retention as a measure of feasibility, engagement level and user app quality ratings for acceptability, and additional metrics to evaluate efficacy. Models were adjusted for multiple comparisons. RESULTS The findings demonstrated a significant improvement in the Mediterranean diet adherence score in the intervention group compared to the control (W=50.5; adjusted P=.04) with median change scores of 2 (IQR 2-4.25) and 0 (IQR -0.50 to 0.50), respectively. There was a small and insignificant reduction in homeostasis model assessment of insulin resistance measure (W=23; adjusted P=.85). Additionally, there were significant increases in legume intake (W=54; adjusted P<.01). The intervention's effect size was large for several outcomes, such as Mediterranean diet adherence (Hedges g=1.58; 95% CI 0.34-2.67) and vegetable intake (Hedges g=1.14; 95% CI 0.08-2.21). The retention rate was 100%. The app's overall quality rating was favorable with an average interaction time of 12 minutes weekly. CONCLUSIONS This pilot study revealed the potential of the mobile intervention "Olitor" in promoting healthier eating habits among older adults with frailty. It demonstrated high retention rates, significant improvement in adherence to the Mediterranean diet, and increased intake of recommended foods. Insulin resistance showed a minor nonsignificant improvement. Several secondary outcomes, such as lower extremity function and Mediterranean diet knowledge, had a large effect size. Although the app's behavior change features were similar to those of previous digital interventions, the distinctive focus on theory-informed mechanistic measures involved in behavioral change, such as self-regulation, self-efficacy, and expected negative outcomes, may have enhanced its potential. Further investigations in a more diverse and representative population, focusing on individuals with impaired insulin sensitivity, are warranted to validate these preliminary findings. TRIAL REGISTRATION ClinicalTrials.gov NCT05236712; https://clinicaltrials.gov/study/NCT05236712.
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Affiliation(s)
- Yan Su
- College of Nursing & Health Sciences, University of Massachusetts Dartmouth, Darmouth, MA, United States
| | - Kuan-Ching Wu
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Shao-Yun Chien
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Aishwarya Naik
- Human Centered Design and Engeneering, University of Washington, Seattle, WA, United States
| | - Oleg Zaslavsky
- School of Nursing, University of Washington, Seattle, WA, United States
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Bagheri M, Nouri M, Homayounfar R, Akhlaghi M. Association between adherence to the Mediterranean diet with cardiometabolic risk factors: a cross-sectional study on PERSIAN cohort study in Fasa. Sci Rep 2023; 13:14870. [PMID: 37684269 PMCID: PMC10491824 DOI: 10.1038/s41598-023-41935-3] [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: 01/08/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023] Open
Abstract
The relationship between Mediterranean diet and obesity-related markers is a matter of debate. We investigated the association between adherence to the Mediterranean diet and anthropometric indices, body composition, and cardiometabolic risk factors in Iranian population. The cross-sectional study was performed on data of 3386 participants from Fasa PERSIAN cohort study. The Mediterranean diet score (MDS) was calculated based on consumption of 11 food groups (unrefined cereals, potatoes, fruits, vegetables, legumes, fish, red meat, poultry, dairy, olive oil, and alcoholic beverages). The association between MDS and cardiometabolic risk factors was examined by linear regression analysis. MDS was inversely associated with waist circumference (β = - 1.11; P = 0.033), waist-to-hip ratio (β = - 0.007; P = 0.011), waist-to-height ratio (β = - 0.009; P = 0.015), fasting glucose (β = - 3.59; P = 0.001), and HDL-cholesterol (β = - 0.96; P = 0.031) in unadjusted model. After adjusting for energy intake, the associations of MDS with markers of abdominal obesity and HDL-cholesterol disappeared. In fully adjusted model, MDS showed inverse relationships with waist-to-hip ratio (β = - 0.005; P = 0.037) and fasting glucose (β = - 2.71; P = 0.013). In conclusion, MDS showed an inverse relationship with fasting glucose and waist-to-hip ratio. Since energy intake increased along with increasing MDS, adherence to the Mediterranean diet may associate with lower abdominal obesity and better glycemic control if an energy-controlled Mediterranean diet is used.
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Affiliation(s)
- Milad Bagheri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, Shiraz, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, Shiraz, Iran
- Students' Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Homayounfar
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, Shiraz, Iran.
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Chen W, Ding S, Tu J, Xiao G, Chen K, Zhang Y, Huang R, Liao Y. Association between the insulin resistance marker TyG index and subsequent adverse long-term cardiovascular events in young and middle-aged US adults based on obesity status. Lipids Health Dis 2023; 22:65. [PMID: 37202751 DOI: 10.1186/s12944-023-01834-y] [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: 03/10/2023] [Accepted: 05/11/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND A lthough the triglyceride-glucose (TyG) index has been shown to closely correlate with cardiometabolic outcomes and predict cardiovascular events in many groups, it remains unclear whether obese status in young and middle-aged adults is associated with long-term unfavorable cardiovascular events. This warrants further investigation. METHODS This retrospective cohort study analyzed data from the National Health and Nutrition Examination Survey spanning the years 1999-2018, with follow-up for mortality status until December 31, 2019. To categorize participants based on the TyG level, the optimal critical value was determined through restricted cubic spline function analysis, dividing them into high and low TyG groups. The study assessed the relationship between TyG and cardiovascular events and all-cause mortality in young and middle-aged adults stratified by obesity status. Kaplan‒Meier and Cox proportional risk models were used to analyze the data. RESULTS During a follow-up period of 123 months, a high TyG index increased the risk of cardiovascular events by 63% (P = 0.040) and the risk of all-cause mortality by 32% (P = 0.010) in individuals after adjusting for all covariates. High TyG was shown to be linked to cardiovascular events in obese people (Model 3: HR = 2.42, 95% CI = 1.13-5.12, P = 0.020); however, there was no significant difference in TyG groups for nonobese adults in Model 3 (P = 0.08). CONCLUSIONS TyG was independently associated with harmful long-term cardiovascular events in young and middle-aged US populations, with a stronger association observed in those who were obese.
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Affiliation(s)
- Weihua Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Shan Ding
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, China
| | - Jiabin Tu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Guitao Xiao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Kaihong Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Yanbin Zhang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China
| | - Rongchong Huang
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100053, China.
| | - Ying Liao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000, China.
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Khadem A, Shiraseb F, Mirzababaei A, Noori S, Mirzaei K. Association of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolically unhealthy overweight/obesity phenotypes among Iranian women: a cross sectional study. BMC Endocr Disord 2023; 23:84. [PMID: 37076804 PMCID: PMC10114364 DOI: 10.1186/s12902-023-01333-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Paradoxes have been found in obesity, including individuals with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO), and diet may be one of the reasons for the creation of these metabolic phenotypes. Hence, the purpose of the present study was to investigate the association of the Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet with metabolically unhealthy overweight/obesity (MUHOW/O) phenotypes. METHODS In this cross-sectional study, 229 overweight and obese women (body mass index (BMI) ≥ 25 kg/m2) aged 18-48 years were examined. Anthropometric measures and biochemical parameters were collected from all participants. The body composition of each participant was assessed using a bioelectrical impedance analyzer (BIA). The MIND diet score was determined based on 15 components using a valid and reliable food frequency questionnaire (FFQ) containing 147 items. Karelis criteria was used to determine metabolically healthy/unhealthy phenotype (MH/MUH). RESULTS Among the participants, 72.5% of individuals were identified as MUH and 27.5% as MH, with a mean ± standard deviation (SD) age of 36.16 (8.33) years. The results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was no significant association observed between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.01, 95% CI: 0.86-4.17, P-value = 0.10), T3 (OR: 1.89, 95% CI: 0.86-4.17, P-value = 0.11) of MIND score, and only the odds of MUH relative to MH with a marginal significant decreasing trend was observed from the second to the third tertile (1.89 vs. 2.01) (P - trend = 0.06). Also, after additional adjustment for marital status, the nonsignificant association between overweight/obesity phenotypes with tertile 2 (T2) (OR: 2.13, 95% CI: 0.89-5.10, P-value = 0.08), T3 (OR: 1.87, 95% CI: 0.83-4.23, P-value = 0.12) of MIND score remained, and the odds of MUH relative to MH with a significant decreasing trend was observed with increasing tertiles (P-trend = 0.04). CONCLUSIONS In conclusion, no significant associations were found between adherence to MIND diet with MUH, and only a significant downward trend in the odds of MUH was observed with increasing tertiles. We suggest further studies in this field.
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Affiliation(s)
- Alireza Khadem
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Salihefendic D. Eating and Lifestyle Habits in Underweight Patients with Insulin Resistance. Mater Sociomed 2023; 35:18-22. [PMID: 37095873 PMCID: PMC10122527 DOI: 10.5455/msm.2023.35.18-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/02/2023] [Indexed: 04/26/2023] Open
Abstract
Background In recent years, there has been a significant increase in the prevalence of insulin resistance (IR) which has become a global health problem. Obesity is the typical clinical presentation of IR. The connection between underweight and IR is less known. Objective The study aimed to investigate the characteristics of eating habits in underweight and obese patients with IR. After the obtained results, propose suitable dietary instructions specific to 2 subject groups. The task was to determine the difference in the nutritional status of underweight and obese patients with proven IR. The questionnaire was designed to collect data on diet and eating habits. Methods The research included 60 subjects of both sexes between the ages of 20 and 60. Inclusion criteria for entering the study were: proven obesity (BMI ≥ 30), underweight (BMI≤18,5) and confirmed IR by assessment of the homeostatic model for insulin resistance (HOMA IR-2). BMI, waist-to-hip ratio (WHR), and visceral fat area (VFA) were calculated using the bioelectrical impedance. Data on dietary habits was collected using a questionnaire that included general patient data, physical activity, lifestyle and eating habits. Descriptive statistical methods were used to process and analyse the obtained data. Results The average BMI in obese subjects was 34.32 kg/m2, and in underweight subjects, 17.26 kg/m2. There are statistically significant differences between BMI, WHR and VFA. The mean value of HOMA-IR in the obese patients was 2.87 and in the underweight, 2.45. Underweight subjects have a statistically significant (p<0.05) tendency to lose weight, consume milk and milk products, prefer lean meat, and drink more alcohol. Obese subjects are significantly (p<0.05) less physically active, more prone to insomnia, tend to gain weight, enjoy food, consume fewer fruits and vegetables and more carbohydrate food, do not follow clinical nutritional guidelines, and mostly eat in a social setting. Both groups rarely practiced mindful eating. Consumption of highly processed food and sweets is common in both groups. Conclusion There are statistically significant differences in the dietary and lifestyle habits of underweight and obese patients diagnosed with IR. It is necessary to educate healthcare workers and the general population about the importance of nutrition for preventing IR, regardless of body weight.
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Haghighatdoost F, Mohammadifard N, Zakeri P, Najafian J, Sadeghi M, Roohafza H, Sarrafzadegan N. Differences in all-cause mortality risk associated with animal and plant dietary protein sources consumption. Sci Rep 2023; 13:3396. [PMID: 36854962 PMCID: PMC9974986 DOI: 10.1038/s41598-023-30455-9] [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: 07/17/2022] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
The relationship between protein intake and mortality is still controversial. We prospectively examined the associations of dietary protein sources with all-cause mortality risk in the Isfahan cohort study (ICS). A total of 5431 participants, aged ≥ 35 years, were enrolled in the ICS, in 2001 and followed through 2013. The frequency of protein intakes from different sources was estimated through a validated food frequency questionnaire at baseline. Any new case of death was recorded over the follow-up duration. Hazard ratio (HR)s and 95% confidence interval (CI)s were estimated through Cox proportional hazards regression models. During a median follow-up of 11.3 years, 483 deaths were documented. Higher intakes of plant proteins (HR = 0.64, 95% CI 0.46, 0.91) and animal proteins (HR = 1.52, 95% CI 1.13, 2.05) were associated with a decreased and increased risk of mortality, respectively. Additional adjustment for some mediators did not considerably affect the associations for animal protein (HR = 1.55, 95% CI 1.15, 2.09), whereas led to a tendency towards lower risk for plant protein in the top quintile compared with the bottom one (HR = 0.67, 95% CI 0.48, 0.95; P trend = 0.06). Among specific major sources, higher intakes of nuts and fish were associated with a 27% (95% CI 0.58, 0.93) and 21% (95% CI 0.62, 1.01) lower risk of mortality, respectively. The inverse association between plant protein and mortality risk might be mediated by some metabolic disorders. However, our results suggest an independent positive association for animal protein and all-cause mortality.
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Affiliation(s)
- Fahimeh Haghighatdoost
- grid.411036.10000 0001 1498 685XInterventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Parisa Zakeri
- grid.411036.10000 0001 1498 685XHypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jamshid Najafian
- grid.411036.10000 0001 1498 685XHypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- grid.411036.10000 0001 1498 685XCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- grid.411036.10000 0001 1498 685XHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- grid.411036.10000 0001 1498 685XIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran ,grid.17091.3e0000 0001 2288 9830School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Yiannakou I, Singer MR, Moore LL. Indices of Mediterranean diet adherence and breast cancer risk in a community-based cohort. Front Nutr 2023; 10:1148075. [PMID: 37025613 PMCID: PMC10070722 DOI: 10.3389/fnut.2023.1148075] [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: 01/20/2023] [Accepted: 02/27/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction A Mediterranean-style dietary pattern is believed to have cancer-protective effects. We compared the prospective associations between adherence to four established Mediterranean diet indices and breast cancer risk (including total, postmenopausal, and hormone receptor positive cases) in women in the Framingham Offspring Study. Methods The four indices used two different approaches to measuring adherence to a Mediterranean diet: (a) scores based on the population-specific median intakes of Mediterranean diet-related foods in a given population (i.e., alternate Mediterranean Diet (aMED) index and Mediterranean Diet Score (MDS) index), and (b) scores based on compliance with recommended intakes of relevant foods from the Mediterranean diet pyramid [i.e., Mediterranean Diet (MeDiet) index and Mediterranean Style Dietary Pattern (MSDP) index]. Dietary data were derived from semiquantitative food frequency questionnaires collected in 1991-95. Participants included 1579 women aged ≤ 30 years who were free of prevalent cancer. Women were followed through 2014, and Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for various confounders. Results During a median follow-up of approximately 18 years, 87 breast cancer cases were documented. Women in the highest (vs. lowest) score category of the pyramid-based scores (i.e., MeDiet or MSDP) had approximately 45% statistically significantly lower breast cancer risks. These effects were even stronger for any hormone receptor positive cases using the MeDiet index (highest vs. lowest score categories: HR = 0.45, 95% CI: 0.22-0.90). Neither of the median intake-based scores (i.e., aMED, MDS) was associated with breast cancer risk. Discussion Our results suggest that the methodology and the composition of Mediterranean diet indices influence their ability to assess conformity to this specific diet pattern and predict breast cancer risk.
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Affiliation(s)
- Ioanna Yiannakou
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- Graduate Medical Sciences/Doctoral Program in Biomedical Sciences, Nutrition and Metabolism, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Martha R. Singer
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Lynn L. Moore
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- *Correspondence: Lynn L. Moore
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Zańko A, Siewko K, Krętowski AJ, Milewski R. Lifestyle, Insulin Resistance and Semen Quality as Co-Dependent Factors of Male Infertility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010732. [PMID: 36613051 PMCID: PMC9819053 DOI: 10.3390/ijerph20010732] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 05/11/2023]
Abstract
Infertility is a problem that affects millions of couples around the world. It is known as a disease of couples, not individuals, which makes diagnosis difficult and treatment unclear. Male infertility can have many causes, from mechanical ones to abnormal spermatogenesis or spermiogenesis. Semen quality is determined by a number of factors, including those dependent on men themselves, with the number of infertile men growing every year. These include, e.g., diet, physical activity, sleep quality, stress, among many others. As these factors co-exist with insulin resistance, which is a disease closely related to lifestyle, it has been singled out in the study due to its role in affecting semen quality. In order to examine connections between lifestyle, insulin resistance, and semen quality, a review of literature published from 1989 to 2020 in the following databases PubMed/Medline, EMBASE (Elsevier), Scopus, Web of Science, and Google Scholar was performed. Hence, semen quality, environment, and insulin resistance are interrelated, thus it is difficult to indicate which aspect is the cause and which is the effect in a particular relationship and the nature of possible correlations. Since the influence of lifestyle on semen quality has been extensively studied, it is recommended that more thorough research be done on the relationship between insulin resistance and semen quality, comparing the semen quality of men with and without insulin resistance.
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Affiliation(s)
- Adrianna Zańko
- Doctoral School, Medical University of Białystok, 15-089 Białystok, Poland
| | - Katarzyna Siewko
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
| | - Adam Jacek Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Białystok, 15-295 Białystok, Poland
- Correspondence:
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11
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Sadowska-Krępa E, Gdańska A, Přidalová M, Rozpara M, Grabara M. The effect of calorie restriction on the anthropometric parameters, HOMA-IR index, and lipid profile of female office workers with overweight and obesity: a preliminary study. Int J Occup Med Environ Health 2022; 35:693-706. [PMID: 35880994 PMCID: PMC10464818 DOI: 10.13075/ijomeh.1896.01963] [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: 12/26/2021] [Accepted: 06/13/2022] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVES This study evaluates the effect of a 3-month calorie restriction (CR) without snacking on the anthropometric parameters, Homeostatic Model Assesment of Insulin Resistance (HOMA-IR), and lipid profiles of female office workers with overweight or obesity, whose physical activity was limited during the COVID-19 pandemic lockdown. MATERIAL AND METHODS Forty-eight women aged 20-38 years (28.9±5.24) with low physical activity levels were divided into a non-snacking (NS) group (N = 21) and a snacking (S) group (N = 27) prior to the dietary intervention. Their daily energy intake during the intervention was lowered by 30% compared with the baseline level, and the proportion of polyunsaturated fatty acids and fiber in their diet was increased (to >30 g/day). The proportion of saturated fatty acids and simple carbohydrates was also reduced. The study participants were assessed at the baseline and post-intervention for anthropometric variables (body weight, body fat percentage BMI, waist circumference, hip circumference, waist-to-hip ratio) and the concentrations of insulin, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Moreover, the values for HOMA-IR, the atherogenic index of plasma (AIP), and the ratios of TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C were calculated. RESULTS All anthropometric parameter values obtained post-intervention were lower than the baseline in both groups. The serum insulin concentration and HOMA-IR decreased respectively by an average of 6% and 25% in the NS group and 37% and 45% in the S group. The lipid profiles of all participants improved significantly, with the LDL-C concentration showing a more promising trend in the S group (decrease by 27%) than in the NS group (17%). CONCLUSIONS The study showed that CR improved the anthropometric parameters, HOMA-IR index, and lipid profiles of all participants. Int J Occup Med Environ Health. 2022;35(6):693-706.
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Affiliation(s)
- Ewa Sadowska-Krępa
- Jerzy Kukuczka Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| | - Agnieszka Gdańska
- Jerzy Kukuczka Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| | - Miroslava Přidalová
- Palacký University, Department of Natural Sciences in Kinanthropology, Olomouc, Czech Republic
| | - Michał Rozpara
- Jerzy Kukuczka Academy of Physical Education, Institute of Sport Sciences, Katowice, Poland
| | - Małgorzata Grabara
- Palacký University, Department of Natural Sciences in Kinanthropology, Olomouc, Czech Republic
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12
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Zhu L, Kim EJ, González E, Fraser MA, Zhu S, Rubio-Torio N, Ma GX, Yeh MC, Tan Y. Reducing Liver Cancer Risk through Dietary Change: Positive Results from a Community-Based Educational Initiative in Three Racial/Ethnic Groups. Nutrients 2022; 14:4878. [PMID: 36432564 PMCID: PMC9698707 DOI: 10.3390/nu14224878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Dietary behaviors and alcohol consumption have been linked to liver disease and liver cancer. So far, most of the liver cancer awareness campaigns and behavioral interventions have focused on preventive behaviors such as screening and vaccination uptake, while few incorporated dietary aspects of liver cancer prevention. We implemented a community-based education initiative for liver cancer prevention among the African, Asian, and Hispanic populations within the Greater Philadelphia and metropolitan New York City areas. Data from the baseline and the 6-month follow-up surveys were used for the assessment of changes in dietary behaviors and alcohol consumption among participants. In total, we recruited 578 participants through community-/faith-based organizations to participate in the educational workshops. The study sample included 344 participants who completed both baseline and follow-up survey. The Hispanic subgroup was the only one that saw an overall significant change in dietary behaviors, with the Mediterranean dietary score increasing significantly from 30.000 at baseline survey to 31.187 at 6-month follow-up assessment (p < 0.05), indicating a trend towards healthier dietary habit. In the African Americans participants, the consumption scores of fruits and poultry increased significantly, while vegetables and red meats decreased. In Asian Americans, the consumption of non-refined cereals, red meats, and dairy products decreased. Alcohol consumption decreased significantly among Hispanics while it did not change significantly among the other two communities. This community-based educational initiative generated different impacts in the three populations, further highlighting the needs for more targeted, culturally tailored efforts in health promotion among these underprivileged communities.
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Affiliation(s)
- Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Ellen Jaeseon Kim
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Evelyn González
- Office of Community Outreach, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA 19111, USA
| | | | - Steven Zhu
- Pennsylvania United Chinese Coalition, Philadelphia, PA 19107, USA
| | | | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
- Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Ming-Chin Yeh
- Nutrition Program, Hunter College, City University of New York, New York, NY 10017, USA
| | - Yin Tan
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
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13
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Bartels ECM, den Braver NR, Borgonjen-van den Berg KJ, Rutters F, van der Heijden A, Beulens JWJ. Adherence to the Dutch healthy diet index and change in glycemic control and cardiometabolic markers in people with type 2 diabetes. Eur J Nutr 2022; 61:2761-2773. [PMID: 35284962 PMCID: PMC9279194 DOI: 10.1007/s00394-022-02847-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
Purpose To investigate whether adherence to the Dutch Healthy Diet index 2015 (DHD15-index) is associated with change in glycemic control and cardio-metabolic markers over two-year follow-up in people with type 2 diabetes (T2D). Methods This prospective cohort study included 1202 individuals with T2D (mean age 68.7 ± 9.0 years; 62.5% male; mean HbA1c 53.8 ± 11.7 mmol/mol) from the Diabetes Care System cohort. Baseline dietary intake was assessed using a validated food frequency questionnaire, and adherence to the DHD15-index was estimated (range 0–130). HbA1c, fasting glucose, blood lipids (HDL and LDL cholesterol, cholesterol ratio), blood pressure, estimated glomerular filtration rate (eGFR), and BMI were measured at baseline, and after one- and two-year follow-up. Linear mixed model analyses were conducted to examine the associations between adherence to the DHD15-index and glycemic control and the cardio-metabolic outcomes, adjusting for energy intake, sociodemographic and lifestyle characteristics, and medication. Results Highest adherence (T3) to the DHD15-index was not associated with change in HbA1c, compared to lowest adherence (T1) [βT3vsT1: 0.62 mmol/mol (− 0.94; 2.19), Ptrend = 0.44]. There was a non-linear association with fasting glucose, where moderate adherence (T2) was associated with a decrease in fasting glucose [βT2vsT1: − 0.29 mmol/L (− 0.55; − 0.03), Ptrend = 0.30]. Higher adherence to the DHD15-index was associated with a decrease in BMI [β10point: − 0.41 kg/m2 (− 0.60; − 0.21), Ptrend < 0.001], but not with blood lipids, blood pressure or kidney function. Conclusion In this well-controlled population of people with T2D, adherence to the DHD15-index was associated with a decrease in BMI, but not with change in glycemic control or other cardio-metabolic parameters. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02847-6.
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Affiliation(s)
- Ehlana Catharina Maria Bartels
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Nicolette Roelina den Braver
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Karin Johanna Borgonjen-van den Berg
- Department of Agrotechnology and Food Sciences, Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Amber van der Heijden
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joline Wilhelma Johanna Beulens
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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14
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Lai KZH, Semnani-Azad Z, Retnakaran R, Harris SB, Hanley AJ. Changes in adiposity mediate the associations of diet quality with insulin sensitivity and beta-cell function. Nutr Metab Cardiovasc Dis 2021; 31:3054-3063. [PMID: 34518089 DOI: 10.1016/j.numecd.2021.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS To examine the mediating role of adiposity on the associations of diet quality with longitudinal changes in insulin sensitivity and beta-cell function. METHODS AND RESULTS Adults at-risk for type 2 diabetes (T2D) in the PROMISE cohort had 4 assessments over 9 years (n = 442). Alternate Healthy Eating Index (AHEI) scores were used to assess diet quality. Generalized Estimating Equations (GEE) evaluated the associations between the AHEI and longitudinal changes in insulin sensitivity (HOMA2-%S and ISI) and beta-cell function (IGI/HOMA-IR and ISSI-2). The proportion of the mediating effect of waist circumference changes was estimated using the difference method. In the primary longitudinal analysis, AHEI was positively associated with insulin sensitivity and beta-cell function over time (% difference per standard deviation increase of AHEI for HOMA2-%S (β = 11.0, 95%CI 5.43-17.0), ISI (β = 10.4, 95%CI 4.35-16.8), IGI/HOMA-IR (β = 7.12, 95%CI 0.98-13.6) and ISSI-2 (β = 4.38, 95%CI 1.05-7.80), all p < 0.05). There was no significant association between AHEI and dysglycemia incidence (OR = 0.95, 95%CI 0.77-1.17). Adjustments for longitudinal changes in waist circumference substantially attenuated all associations of AHEI with insulin sensitivity and beta-cell function. Mediation analysis indicated that waist circumference mediated 73%, 70%, 83% and 81% of the association between AHEI and HOMA2-%S, ISI, IGI/HOMA-IR, and ISSI-2, respectively (all p < 0.01). CONCLUSION In a Canadian population at-risk for T2D, AHEI score was positively associated with changes in insulin sensitivity and beta-cell function. These associations were substantially mediated by waist circumference, suggesting that changes in adiposity may represent an important pathway linking diet quality with risk phenotypes for T2D.
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Affiliation(s)
- Kira Zhi Hua Lai
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Zhila Semnani-Azad
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Ravi Retnakaran
- Division of Endocrinology and Metabolism, University of Toronto, Toronto, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
| | - Stewart B Harris
- Department of Family Medicine, Western University, London, Canada.
| | - Anthony J Hanley
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Endocrinology and Metabolism, University of Toronto, Toronto, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
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15
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Park YMM, Shivappa N, Petimar J, Hodgson ME, Nichols HB, Steck SE, Hébert JR, Sandler DP. Dietary inflammatory potential, oxidative balance score, and risk of breast cancer: Findings from the Sister Study. Int J Cancer 2021; 149:615-626. [PMID: 33783833 PMCID: PMC8256885 DOI: 10.1002/ijc.33581] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 12/16/2022]
Abstract
Diet, inflammation, and oxidative stress may be important in breast carcinogenesis, but evidence on the role of the inflammatory and prooxidative potential of dietary patterns is limited. Energy adjusted-Dietary Inflammatory Index (E-DII™) and dietary oxidative balance score (D-OBS) were calculated for 43 563 Sister Study cohort participants who completed a Block 1998 food frequency questionnaire at enrollment in 2003-2009 and satisfied eligibility criteria. D-OBS was validated using measured F2 -isoprostanes and metabolites. High E-DII score and low D-OBS represent a more proinflammatory and prooxidant diet, respectively, and associations of quartiles of each index with breast cancer (BC) risk were estimated using multivariable Cox proportional hazards regression. There were 2619 BCs diagnosed at least 1 year after enrollment (mean follow-up 8.4 years). There was no overall association between E-DII and BC risk, whereas there was a suggestive inverse association for the highest vs lowest quartile of D-OBS (HR 0.92 [95% CI, 0.81-1.03]). The highest quartile of E-DII was associated with risk of triple-negative BC (HR 1.53 [95% CI, 0.99-2.35]). When the two indices were combined, a proinflammatory/prooxidant diet (highest tertile of E-DII and lowest tertile of D-OBS) was associated with increased risk for all BC (HR 1.13 [95% CI, 1.00-1.27]) and for triple-negative BC (1.72 [95% CI, 1.10-2.70]), compared to an antiinflammatory/antioxidant diet (lowest tertile of E-DII and highest tertile of D-OBS). Diets with increased inflammatory potential and reduced oxidative balance were positively associated with overall and triple-negative BC.
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Affiliation(s)
- Yong-Moon Mark Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations, LLC, Columbia, South Carolina, USA
| | - Joshua Petimar
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Susan E Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Connecting Health Innovations, LLC, Columbia, South Carolina, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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Shannon OM, Ashor AW, Scialo F, Saretzki G, Martin-Ruiz C, Lara J, Matu J, Griffiths A, Robinson N, Lillà L, Stevenson E, Stephan BCM, Minihane AM, Siervo M, Mathers JC. Mediterranean diet and the hallmarks of ageing. Eur J Clin Nutr 2021; 75:1176-1192. [PMID: 33514872 DOI: 10.1038/s41430-020-00841-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/09/2020] [Accepted: 12/07/2020] [Indexed: 12/21/2022]
Abstract
Ageing is a multifactorial process associated with reduced function and increased risk of morbidity and mortality. Recently, nine cellular and molecular hallmarks of ageing have been identified, which characterise the ageing process, and collectively, may be key determinants of the ageing trajectory. These include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion and altered intercellular communication. Healthier dietary patterns reduce the risk of age-related diseases and increase longevity and may influence positively one or more of these hallmarks. The Mediterranean dietary pattern (MedDiet) is a plant-based eating pattern that was typical of countries such as Greece, Spain, and Italy pre-globalisation of the food system and which is associated with better health during ageing. Here we review the potential effects of a MedDiet on each of the nine hallmarks of ageing, and provide evidence that the MedDiet as a whole, or individual elements of this dietary pattern, may influence each hallmark positively-effects which may contribute to the beneficial effects of this dietary pattern on age-related disease risk and longevity. We also highlight potential avenues for future research.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne,, NE2 4HH, UK
| | - Ammar W Ashor
- Department of Pharmacology, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq
| | - Filippo Scialo
- Biosciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne,, NE4 5PL, UK
- Dipartimento di Scienze Mediche Traslazionali, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Saretzki
- Biosciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne,, NE4 5PL, UK
| | - Carmen Martin-Ruiz
- Bioscience Institute, Bioscreening Core Facility, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne,, NE4 5PL, UK
| | - Jose Lara
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne,, NE1 8ST, UK
| | - Jamie Matu
- School of Clinical Applied Sciences, Leeds Beckett University, Leeds,, LS1 3HE, UK
| | - Alex Griffiths
- Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds,, LS163QS, UK
| | - Natassia Robinson
- Biosciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne,, NE4 5PL, UK
| | - Lionetti Lillà
- Department of Chemistry and Biology, University of Salerno, via Giovanni Paolo II, 132, 84084, Fisciano, SA, Italy
| | - Emma Stevenson
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne,, NE2 4HH, UK
| | - Blossom C M Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
| | - Anne Marie Minihane
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia (UEA), Norwich, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham,, NG7 2UH, UK.
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne,, NE2 4HH, UK
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Zhang S, Bian H, Qiu S, Cai B, Jin K, Zheng X, Li J, Tu X, Ai J, Yang L, Wei Q. Associations between the dietary inflammatory index and urinary incontinence among women younger than 65 years. Sci Rep 2021; 11:9340. [PMID: 33927304 PMCID: PMC8084978 DOI: 10.1038/s41598-021-88833-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/12/2021] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to evaluate the association between dietary inflammatory index (DII) and urinary incontinence (UI) among a representative sample of the US women. We performed a cross-sectional analysis of women younger than 65 years using the 1999 to 2016 NHANES (National Health and Nutrition Examination Survey) populations. DII were calculated based on baseline dietary intake using 24-h dietary recalls. UI was determined and categorized by self-reported questions. Multivariable logistic regression models were used to assess the association between DII and UI. Stratified linear regression models were applied to test for interaction in prespecified subgroup of interest. A total of 13,441 women age between 20 and 65 years were included in the final analysis. Of these participants 3230 (24.03%) complained of urgency UI, 5276 (39.25%) complained of stress UI and 2028 (15.09%) complained of mixed UI. On multivariate analysis, analysis with DII categorized as quartiles revealed significantly increase odds of urgency UI in the most pro-inflammatory quartile compared to the most anti-inflammatory quartile (OR 1.24, 95% CI 1.07–1.44, P = 0.004 for trend) in full adjustment model. Similar results were observed in SUI (OR 1.14, 95% CI 1.00–1.30, P = 0.021 for trend) and MUI (OR 1.20, 95% CI 1.02−1.43, P = 0.022 for trend). More pro-inflammatory diets, as presented by higher DII scores are associated with an increased likelihood of UI in American women younger than 65 years. Further studies are needed to explore the possible physiological mechanism and evaluate the potential therapeutic implications.
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Affiliation(s)
- Shiyu Zhang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Haiyang Bian
- Institute of Reproductive and Child Health and Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Shi Qiu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.,Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Boyu Cai
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Kun Jin
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xiaonan Zheng
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Jiakun Li
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xiang Tu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Jianzhong Ai
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lu Yang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Qiang Wei
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.
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18
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Jayanama K, Theou O, Godin J, Cahill L, Shivappa N, Hébert JR, Wirth MD, Park YM, Fung TT, Rockwood K. Relationship between diet quality scores and the risk of frailty and mortality in adults across a wide age spectrum. BMC Med 2021; 19:64. [PMID: 33722232 PMCID: PMC7962372 DOI: 10.1186/s12916-021-01918-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/19/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Beyond intakes of total energy and individual nutrient, eating patterns may influence health, and thereby the risk of adverse outcomes. How different diet measures relate to frailty-a general measure of increased vulnerability to unfavorable health outcomes-and mortality risk, and how this might vary across the life course, is not known. We investigated the associations of five dietary indices (Nutrition Index (NI), the energy-density Dietary Inflammatory Index (E-DII™), Healthy Eating Index-2015 (HEI-2015), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH)) with frailty and mortality. METHODS We included 15,249 participants aged ≥ 20 years from the 2007-2012 cohorts of the National Health and Nutrition Examination Survey (NHANES). The NI combined 31 nutrition-related deficits. The E-DII is a literature-derived dietary index associated with inflammation. The HEI-2015 assesses adherence to the Dietary Guidelines of Americans. The MDS represents adherence to the traditional Mediterranean diet. DASH combines macronutrients and micronutrients to prevent hypertension. Frailty was evaluated using a 36-item frailty index. Mortality status was ascertained up to December 31, 2015. RESULTS Participants' mean age was 47.2 ± 16.7 years and 51.7% were women. After adjusting for age, sex, race, educational level, marital and employment status, smoking, BMI, and study cohort, higher NI and E-DII scores and lower HEI-2015, MDS, and DASH scores were individually significantly associated with frailty. All dietary scores were significantly associated with 8-year mortality risk after adjusting for basic covariates and frailty: NI (hazard ratio per 0.1 point, 1.15, 95%CI 1.10-1.21), E-DII (per 1 point, 1.05, 1.01-1.08), HEI-2015 (per 10 points, 0.93, 0.89-0.97), MDS (per 1 point, 0.94, 0.90-0.97), and DASH (per 1 point, 0.96, 0.93-0.99). The associations of E-DII, HEI-2015, and MDS scores with 8-year mortality risk persisted after additionally adjusting for NI. CONCLUSIONS NI, E-DII, HEI-2015, MDS, and DASH scores are associated with frailty and 8-year mortality risk in adults across all ages. Nevertheless, their mechanisms and sensitivity to predict health outcomes may differ. Nutrition scores have the potential to include measures of both consumption and laboratory and physical measures of exposure.
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Affiliation(s)
- Kulapong Jayanama
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand.,Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Olga Theou
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada.,School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Judith Godin
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Leah Cahill
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Michael D Wirth
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA.,College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Yong-Moon Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Simmons University, Boston, MA, USA
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia, Canada. .,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
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19
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Cárdenas-Fuentes G, Lassale C, Martínez-González J MÁ, Grau M, Salas-Salvadó J, Corella D, Serra-Majem L, Warnberg J, Konieczna J, Estruch R, Pintó X, Martínez JA, Vázquez C, Vidal J, Tur JA, Díaz-López A, Lancova H, Fito M, Schröder H. Anthropometric variables as mediators of the association of changes in diet and physical activity with inflammatory profile. J Gerontol A Biol Sci Med Sci 2021; 76:2021-2029. [PMID: 33693782 DOI: 10.1093/gerona/glab072] [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: 07/13/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mechanisms underlying the associations of high levels of physical activity (PA) and adherence to the Mediterranean Diet (MedDiet) with a better inflammatory profile remain unclear. Our objective was to assess the mediating role of changes in body mass index (BMI) and waist circumference (WC), as markers of body fat in the association of changes in PA and adherence to the MedDiet, with changes in the inflammatory profile. METHODS This study included 489 adults, aged 55 to 75 years, from the PREDIMED-Plus multi-centre lifestyle intervention trial. An inflammatory score was calculated, based on 8 blood biomarkers: high-sensitivity C-reactive protein, interleukin 6, interleukin 8, interleukin 18, monocyte chemo-attractant protein-1, C-peptide, leptin, and regulated on activation, normal T-cell expressed and secreted chemokine (RANTES). Biomarkers, levels of PA, score of MedDiet adherence, BMI and WC were measured at baseline and at one-year follow-up. Linear regression models were fitted according to the Baron and Kenny framework for mediation analysis. RESULTS Changes in BMI and WC mediated the association of both changes in PA and changes in the MedDiet adherence with the inflammatory score. BMI mediated 26% of the association of changes in total PA with the inflammatory profile, and 27% of the association of changes in the MedDiet, while WC mediated 13% and 12% of these associations, respectively. CONCLUSION In older adults at high cardiovascular risk, increasing PA levels and adherence to a MedDiet during 1 year were associated with a lower inflammatory score, which was partly mediated by a reduction in body fat.
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Affiliation(s)
- Gabriela Cárdenas-Fuentes
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Camille Lassale
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Miguel Ángel Martínez-González J
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 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, MA, USA
| | - María Grau
- Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Human Nutrition Unit, Reus, Spain.,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Lluis Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Julia Warnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Nursing, School of Health Sciences, University of Málaga-Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jadwiga Konieczna
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Ramón Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Precision Nutrition Program on Cardiometabolic Health IMDEA CEI UAM+CSIC Madrid Spain
| | - Clotilde Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz. Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, Madrid, 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
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 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
| | - Andrés Díaz-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Human Nutrition Unit, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Hana Lancova
- Servicio Navarro de Salud (Osasunbidea), Pamplona, Spain.,CAP Angles de Institut d'Assistència Sanitària, Departament de Salut, Generalitat de Catalunya, Girona, Spain
| | - Montserrat Fito
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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20
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Haghighatdoost F, Feizi A, Esmaillzadeh A, Keshteli AH, Roohafza H, Afshar H, Adibi P. The MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) and Mediterranean Diets are differently associated with psychosomatic complaints profile in adults: Results from SEPAHAN Cross-sectional study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: In spite of an obvious association between diet and mental health, there is only few report regarding the association between diet and psychosomatic complaints. OBJECTIVE: To investigate the association of the Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet with psychosomatic complaints profile in comparison with the Mediterranean diet (aMED). METHODS: In this cross-sectional study on 2818 Isfahanian adults, a validated dish-based food frequency questionnaire was used to assess dietary intakes. Psychosomatic complaints profile was evaluated through a self-administered Persian validated questionnaire by using exploratory factor analysis. RESULTS: After controlling for potential confounders, individuals in the highest quintile of the MIND diet had lower risk for experiencing psychological (odds ratio (OR) = 0.60, 95% confidence interval (CI): 0.42, 0.86; P trend < 0.0001), and pharyngeal-respiratory (OR = 0.57, 95% CI: 0.41, 0.79; P = 0.002). The association for neuro-skeletal complaints was marginally significant (OR = 0.66, 95% CI: 0.43, 1.03; P = 0.093). The aMED diet tended to lower gastrointestinal complaints (OR = 0.68, 95% CI: 0.46, 1.01; P = 0.062). CONCLUSION: The MIND diet was inversely associated with different psychosomatic complaints risk, but no evidence of such an association for the MED diet was observed.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Biostatistics and Epidemiology Department, School of Health and Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan, Iran
- Cardiac rehabilitation research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac rehabilitation research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center and Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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Shang Y, Zhou H, Hu M, Feng H. Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2020; 105:5867491. [PMID: 32621748 DOI: 10.1210/clinem/dgaa425] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/03/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The effect of diet on insulin resistance (IR) in polycystic ovary syndrome (PCOS) is controversial. Thus, we conducted this systematic review and meta-analysis to evaluate whether diet could reduce IR in women with PCOS while providing optimal and precise nutrition advice for clinical practice. DESIGN The search was conducted in 8 databases through June 30, 2019. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A random-effects model was adopted to calculate the overall effects. RESULTS A total of 19 trials (1193 participants) were included. The analysis showed that diet was significantly related to improvements in IR and body composition (eg, homeostasis model assessment of insulin resistance, fasting insulin, fasting plasma glucose, body mass index [BMI], weight, and waist circumference) in PCOS patients. The Dietary Approaches to Stop Hypertension diet and calorie-restricted diets might be the optimal choices for reducing IR and improving body composition, respectively, in the PCOS population. Additionally, the effects were associated with the course of treatment. The longer the duration, the greater the improvement was. Compared with metformin, diet was also advantageous for weight loss (including BMI and weight) and had the same effects on insulin regulation. CONCLUSION Overall, our findings suggest that diet is an effective, acceptable and safe intervention for relieving IR, and professional dietary advice should be offered to all PCOS patients.
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Affiliation(s)
- Yujie Shang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Huifang Zhou
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Minghui Hu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Hua Feng
- Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Vocational College of Medicine, Yancheng, China
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22
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O'Connor LE, Kim JE, Clark CM, Zhu W, Campbell WW. Effects of Total Red Meat Intake on Glycemic Control and Inflammatory Biomarkers: A Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2020; 12:115-127. [PMID: 32910818 PMCID: PMC7850054 DOI: 10.1093/advances/nmaa096] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/16/2020] [Accepted: 07/21/2020] [Indexed: 01/24/2023] Open
Abstract
Our objective was to conduct a systematic review and meta-analysis to assess the effects of total red meat (TRM) intake on glycemic control and inflammatory biomarkers using randomized controlled trials of individuals free from cardiometabolic disease. We hypothesized that higher TRM intake would negatively influence glycemic control and inflammation based on positive correlations between TRM and diabetes. We found 24 eligible articles (median duration, 8 weeks) from 1172 articles searched in PubMed, Cochrane, and CINAHL up to August 2019 that included 1) diet periods differing in TRM; 2) participants aged ≥19 years; 3) included either men or women who were not pregnant/lactating; 4) no diagnosed cardiometabolic disease; and 5) data on fasting glucose, insulin, HOMA-IR, glycated hemoglobin (HbA1c), C-reactive protein (CRP), or cytokines. We used 1) a repeated-measures ANOVA to assess pre to post diet period changes; 2) random-effects meta-analyses to compare pre to post changes between diet periods with ≥ vs. <0.5 servings (35g)/day of TRM; and 3) meta-regressions for dose-response relationships. We grouped diet periods to explore heterogeneity sources, including risk of bias, using the National Heart, Lung, and Blood Institute's Quality Assessment of Controlled Interventions Studies. Glucose, insulin, and HOMA-IR values decreased, while HbA1c and CRP values did not change during TRM or alternative diet periods. There was no difference in change values between diet periods with ≥ vs. <0.5 servings/day of TRM [weighted mean differences (95% CIs): glucose, 0.040 mmol/L (-0.049, 0.129); insulin, -0.710 pmol/L (-6.582, 5.162); HOMA-IR, 0.110 (-0.072, 0.293); CRP, 2.424 nmol/L (-1.460, 6.309)] and no dose response relationships (P > 0.2). Risk of bias (85% of studies were fair to good) did not influence results. Total red meat consumption, for up to 16 weeks, does not affect changes in biomarkers of glycemic control or inflammation for adults free of, but at risk for, cardiometabolic disease. This trial was registered at PROSPERO as 2018 CRD42018096031.
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Affiliation(s)
- Lauren E O'Connor
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA,Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Jung Eun Kim
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA,Department of Food Science and Technology, National University of Singapore, Singapore
| | - Caroline M Clark
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Wenbin Zhu
- Department of Statistics, Purdue University, West Lafayette, IN, USA
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23
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NHANES 2011-2014 Reveals Cognition of US Older Adults may Benefit from Better Adaptation to the Mediterranean Diet. Nutrients 2020; 12:nu12071929. [PMID: 32610616 PMCID: PMC7399952 DOI: 10.3390/nu12071929] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 01/19/2023] Open
Abstract
Although the Mediterranean diet (MedD) has gained interest for potential Alzheimer’s disease (AD) prevention, it is unknown how well US older adults follow a MedD. We used two National Health and Nutrition Examination Survey (NHANES) cycles (2011–2014) to conduct our primary aim of reporting population estimates of MedD adherence among older adults (60+ years) in the US (n = 3068). The mean MedD adherence score for US older adults was 5.3 ± 2.1 (maximum possible = 18), indicating that older adults in the US do not adhere to a MedD. There were various differences in MedD scores across demographic characteristics. We also assessed the cross-sectional relationship between MedD adherence and cognitive performance using survey-weighted ordinary least squares regression and binary logistic regression models adjusted for 11 covariates. Compared to the lowest MedD adherence tertile, the highest tertile had a lower odds ratio of low cognitive performance on three of five cognitive measures (p < 0.05 for each). Sensitivity analyses within participants without subjective memory complaints over the past year revealed similar results on the same three cognitive measures. We conclude that MedD interventions are a departure from usual dietary intake of older adults in the US and are a reasonable approach for AD prevention trials.
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24
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López-Moreno A, Suárez A, Avanzi C, Monteoliva-Sánchez M, Aguilera M. Probiotic Strains and Intervention Total Doses for Modulating Obesity-Related Microbiota Dysbiosis: A Systematic Review and Meta-analysis. Nutrients 2020; 12:E1921. [PMID: 32610476 PMCID: PMC7400323 DOI: 10.3390/nu12071921] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a growing health threat worldwide. Administration of probiotics in obesity has also parallelly increased but without any protocolization. We conducted a systematic review exploring the administration pattern of probiotic strains and effective doses for obesity-related disorders according to their capacity of positively modulating key biomarkers and microbiota dysbiosis. Manuscripts targeting probiotic strains and doses administered for obesity-related disorders in clinical studies were sought. MEDLINE, Scopus, Web of Science, and Cochrane Library databases were searched using keywords during the last fifteen years up to April 2020. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. From 549 interventional reports identified, we filtered 171 eligible studies, from which 24 full-text assays were used for calculating intervention total doses (ITD) of specific species and strains administered. Nine of these reports were excluded in the second-step because no specific data on gut microbiota modulation was found. Six clinical trials (CT) and 9 animal clinical studies were retained for analysis of complete outcome prioritized (body mass index (BMI), adiposity parameters, glucose, and plasma lipid biomarkers, and gut hormones). Lactobacillus spp. administered were double compared to Bifidobacterium spp.; Lactobacillus as single or multispecies formulations whereas most Bifidobacteria only through multispecies supplementations. Differential factors were estimated from obese populations' vs. obesity-induced animals: ITD ratio of 2 × 106 CFU and patterns of administrations of 11.3 weeks to 5.5 weeks, respectively. Estimation of overall probiotics impact from selected CT was performed through a random-effects model to pool effect sizes. Comparisons showed a positive association between the probiotics group vs. placebo on the reduction of BMI, total cholesterol, leptin, and adiponectin. Moreover, negative estimation appeared for glucose (FPG) and CRP. While clinical trials including data for positive modulatory microbiota capacities suggested that high doses of common single and multispecies of Lactobacillus and Bifidobacterium ameliorated key obesity-related parameters, the major limitation was the high variability between studies and lack of standardized protocols. Efforts in solving this problem and searching for next-generation probiotics for obesity-related diseases would highly improve the rational use of probiotics.
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Affiliation(s)
- Ana López-Moreno
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
| | - Antonio Suárez
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
| | - Camila Avanzi
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
| | - Mercedes Monteoliva-Sánchez
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
| | - Margarita Aguilera
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
- IBS: Instituto de Investigación Biosanitaria ibs., 18012 Granada, Spain
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25
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Ehrampoush E, Nazari N, Homayounfar R, Ghaemi A, Osati S, Tahamtan S, Hashempur MH, Bahmanyar M. Association between dietary patterns with insulin resistance in an Iranian population. Clin Nutr ESPEN 2020; 36:45-52. [PMID: 32220368 DOI: 10.1016/j.clnesp.2020.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/02/2019] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
Abstract
AIM To assess the association between dietary patterns no single food or group, and risk of insulin resistance (Fasting blood sugar (FBS), Fasting insulin, 2h-glucose, 2h-insulin and HOMA-IR). METHODS In a cross-sectional, population-based study in Tehran, Iran, 2016-2017. Adults (n = 1500, 38% men) mean age 43.72 ± 14.9 years. Dietary intake was collected by semi-quantitative food frequency questionnaire and insulin resistance was evaluated by Fasting blood sugar (FBS), Fasting insulin, 2h glucose, 2h insulin and HOMA-IR. Associations were assessed by using correlation and multivariable linear regression. RESULTS After controlling of the confounding factor or possible underlying such as gender, age, menopausal, BMI, physical activity and the amount of daily energy intake, unhealthy dietary pattern had a positive relationship with all indexes of insulin resistance except 2h glucose and HOMA-IR, healthy dietary pattern had negative and significant relationship with indexes of insulin resistance but apart from 2h glucose. CONCLUSIONS It can be figured out that receiving diet rich in healthy foods might reduce the risk of creating insulin resistance.
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Affiliation(s)
- Elham Ehrampoush
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; Health Policy Research Center, Institute of Health, Shiraz University of Medical Science, Shiraz, Iran
| | - Nahid Nazari
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran; Health Policy Research Center, Institute of Health, Shiraz University of Medical Science, Shiraz, Iran; National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Alireza Ghaemi
- Department of Nutrition, Health Sciences Research Center, Addiction Institute, Faculty of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Osati
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Tahamtan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Maryam Bahmanyar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
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Jones JPH, Abdullah MMH, Wood D, Jones PJH. Economic modeling for improved prediction of saving estimates in healthcare costs from consumption of healthy foods: the Mediterranean-style diet case study. Food Nutr Res 2019; 63:3418. [PMID: 31565041 PMCID: PMC6756079 DOI: 10.29219/fnr.v63.3418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/16/2019] [Accepted: 08/16/2019] [Indexed: 01/14/2023] Open
Abstract
Background By design, existing scenario-based nutrition economics studies on the financial benefits of healthy dietary behaviors generally report uncertainty in inputs and wide ranges of outcome estimates. Objectives This modeling exercise aimed to establish precision in prediction of the potential healthcare cost savings that would follow a reduction in the incidence of cardiovascular disease (CVD) consistent with an increase in adherence to a Mediterranean-style diet (MedDiet). Design Using a Monte Carlo simulation model on a cost-of-illness analysis assessing MedDiet adherence, CVD incidence reduction, and healthcare cost savings in the United States and Canada, short- and long-term cost savings that are likely to accrue to the American and Canadian healthcare systems were estimated using 20 and 80% increases in MedDiet adherence scenarios. Results Increasing percentage of population adhering to a MedDiet by 20% beyond the current adherence level produced annual savings in CVD-related costs of US$8.2 billion (95% confidence interval [CI], $7.5-$8.8 billion) in the United States and Can$0.32 billion (95% CI, $0.29-$0.34 billion) in Canada. An 80% increase in adherence resulted in savings equal to US$31 billion (95% CI, $28.6-$33.3 billion) and Can$1.2 billion (95% CI, $1.11-$1.30 billion) in each respective country. Conclusion Computational techniques with stochastic parameter inputs, such as the Monte Carlo simulation, could be an effective way of incorporating variability of modeling parameters in nutrition economics studies for improved precision in estimating the monetary value of healthy eating habits.
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Affiliation(s)
| | | | | | - Peter J H Jones
- Nutritional Fundamentals for Health, Vaudreuil-Dorion, QC, Canada
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Adherencia a la dieta mediterránea en pacientes diabéticos con mal control. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2019; 31:210-217. [DOI: 10.1016/j.arteri.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/27/2019] [Accepted: 03/25/2019] [Indexed: 01/22/2023]
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Factors Associated to Arterial Stiffness in Patients With Symptomatic Peripheral Artery Disease. Ann Vasc Surg 2019; 61:78-82. [PMID: 31352085 DOI: 10.1016/j.avsg.2019.04.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 04/21/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND The aim of this study was to identify the clinical factors associated with arterial stiffness in patients with symptomatic peripheral artery disease. METHODS In this cross-sectional study, 181 patients (67% men; mean aged 66 ± 9 years) were recruited and had their central arterial stiffness assessed by carotid-femoral pulse wave velocity (cf-PWV). Clinical characteristics are sociodemographic data, body mass index, comorbid conditions, and walking capacity. RESULTS Multiple linear regression analysis showed that age (b = 0.182, P = 0.032), body mass index (b = 0.254, P = 0.002), and mean blood pressure (b = 0.249, P = 0.021) were positively associated with cf-PWV. CONCLUSIONS Our results showed that the aging, elevated body mass index, and higher blood pressure are clinical factors associated with increased arterial stiffness in patients with peripheral artery disease.
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EL-Ashmawy HM, Ahmed AM. Association of serum Sestrin-2 level with insulin resistance, metabolic syndrome, and diabetic nephropathy in patients with type 2 diabetes. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_85_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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The inflammatory potential of diet in determining cancer risk; A prospective investigation of two dietary pattern scores. PLoS One 2019; 14:e0214551. [PMID: 30978193 PMCID: PMC6461253 DOI: 10.1371/journal.pone.0214551] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/15/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose Inflammation-related mechanisms may contribute to the link between diet and cancer. We sought to investigate the inflammatory impact of diet on cancer risk using the Dietary inflammatory index (DII) and an adapted Mediterranean diet score (MDS). Methods This population-based, prospective cohort study used self-reported dietary data from the Västerbotten Intervention Programme, including 100,881 participants, of whom 35,393 had repeated measures. Associations between dietary patterns and cancer risk were evaluated using Cox proportional hazards regression. We also used restricted cubic splines to test for potential non-linear associations. Results A total of 9,250 incident cancer cases were diagnosed during a median follow-up of 15 years. The two dietary patterns were moderately correlated to each other and had similar associations with cancer risk, predominantly lung cancer in men (DII per tertile decrease: Hazard ratio (HR) 0.81 (0.66–0.99), MDS per tertile increase: HR 0.86 (0.72–1.03)), and gastric cancer in men (DII: 0.73 (0.53–0.99), MDS: 0.73 (0.56–0.96)). Associations were, in general, found to be linear. We found no longitudinal association between 10-year change in diet and cancer risk. Conclusion We confirm small, but consistent and statistically significant associations between a more anti-inflammatory or healthier diet and reduced risk of cancer, including a lower risk of lung and gastric cancer in men. The dietary indexes produced similar associations with respect to the risk of cancer.
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Lohman MC, Resciniti NV, Wirth MD, Shivappa N, Hébert JR. Obesity, Dietary inflammation, and Frailty among Older Adults: Evidence from the National Health and Nutrition Examination Survey. J Nutr Gerontol Geriatr 2019; 38:18-32. [PMID: 30849025 DOI: 10.1080/21551197.2018.1552226] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Knowledge related to the relationship between obesity and frailty is limited. This study aimed to investigate associations between obesity, dietary inflammation, and frailty among older adults. Study data came from National Health and Nutrition Examination Survey (2007-2014) examinations of adults age ≥60 years (n = 7182). Dietary inflammatory potential was determined using the Dietary Inflammatory Index (DII®) derived from 24-h dietary recall. We analyzed independent and joint associations of obesity and DII with frailty to evaluate interaction. Multivariable logistic regression revealed that both obesity (Odds Ratio [OR] = 2.24, 95% CI: 1.68, 2.99) and moderately pro-inflammatory DII (OR = 1.68, 95% CI: 1.10, 2.58) were independently associated with greater frailty prevalence. A negative multiplicative interaction between obesity and highest pro-inflammatory diet also was found (adjusted odds in non-obese and obese were 2.07 and 2.37, respectively; p = 0.046). Results indicate the importance of considering obesity and dietary inflammatory potential when screening for frailty or developing treatments.
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Affiliation(s)
- Matthew C Lohman
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA
| | - Nicholas V Resciniti
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA
| | - Michael D Wirth
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,b Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , USA.,c College of Nursing , University of South Carolina , Columbia , SC , USA.,d Connecting Health Innovations, LLC , Columbia , SC , USA
| | - Nitin Shivappa
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,b Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , USA.,d Connecting Health Innovations, LLC , Columbia , SC , USA
| | - James R Hébert
- a Department of Epidemiology and Biostatistics, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,b Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , USA.,d Connecting Health Innovations, LLC , Columbia , SC , USA
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McEvoy CT, Hoang T, Sidney S, Steffen LM, Jacobs DR, Shikany JM, Wilkins JT, Yaffe K. Dietary patterns during adulthood and cognitive performance in midlife: The CARDIA study. Neurology 2019; 92:e1589-e1599. [PMID: 30842290 DOI: 10.1212/wnl.0000000000007243] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate whether dietary patterns (Mediterranean diet [MedDiet], Dietary Approaches to Stop Hypertension [DASH], and A Priori Diet Quality Score [APDQS]) during adulthood are associated with midlife cognitive performance. METHODS We studied 2,621 Coronary Artery Risk Development in Young Adults (CARDIA) participants; 45% were black, 57% were female, and mean age was 25 ± 3.5 years at baseline (year 0). Mean diet scores were calculated from diet history at baseline, year 7, and year 20 (mean age 25, 32, and 45 years, respectively). Cognitive function was assessed at years 25 and 30 (mean age 50 and 55 years, respectively). Linear models were used to examine association between tertiles of diet score and change in composite cognitive function and cognitive z scores (verbal memory [Rey Auditory Verbal Learning Test], processing speed [Digit Symbol Substitution Test], and executive function [Stroop Interference test]) and the Montreal Cognitive Assessment (MoCA) at year 30. RESULTS DASH was not associated with change in cognitive performance. Higher MedDiet and APDQS scores were associated with less decline in cognitive function (MedDiet: low -0.04, middle 0.03, high 0.03, p = 0.03; APDQS: low -0.04, middle -0.00, high 0.06, p < 0.01) and Stroop Interference (MedDiet: low 0.09, middle -0.06, high -0.03; APDQS: low 0.10, middle 0.01, high -0.09, both p < 0.01). Odds ratios (95% confidence interval) for poor global cognitive function (≥1 SD below mean MoCA score) comparing extreme tertiles of diet scores were 0.54 (0.39-0.74) for MedDiet, 0.48 (0.33-0.69) for APDQS, and 0.89 (0.68-1.17) for DASH. CONCLUSION Greater adherence to MedDiet and APDQS dietary patterns during adulthood was associated with better midlife cognitive performance. Additional studies are needed to define the combination of foods and nutrients for optimal brain health across the life course.
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Affiliation(s)
- Claire T McEvoy
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA.
| | - Tina Hoang
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
| | - Stephen Sidney
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
| | - Lyn M Steffen
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
| | - David R Jacobs
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
| | - James M Shikany
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
| | - John T Wilkins
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
| | - Kristine Yaffe
- From the Centre for Public Health (C.T.M.), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Northern Ireland, UK; Global Brain Health Institute (C.T.M., K.Y.), Department of Neurology (K.Y.), and Department of Epidemiology and Biostatistics (K.Y.), University of California, San Francisco; Trinity College Dublin (C.T.M.), Ireland; Northern California Institute for Research and Education (T.H.), San Francisco; Division of Research (S.S.), Kaiser Permanente Northern California, Oakland; Division of Epidemiology and Community Health (L.M.S., D.R.J.), School of Public Health, University of Minnesota, Minneapolis; Division of Preventive Medicine (J.M.S.), School of Medicine, University of Alabama at Birmingham; Department of Preventive Medicine and Medicine (Cardiology) (J.T.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; and San Francisco Veterans Affairs Medical Center (K.Y.), CA
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Božina T, Lovrić J, Šimičević L, Merkler A, Božina M, Jelaković B, Sertić J. Can the choice of diet undermine the potential genetic risk of AT1R 1166A>C gene polymorphism? Gene 2018; 679:291-296. [PMID: 30205174 DOI: 10.1016/j.gene.2018.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/10/2018] [Accepted: 09/03/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Angiotensin II type 1 receptor (AT1R) gene 1166A>C polymorphism is strongly associated with the incidence of cardiovascular diseases and predicts the development of metabolic syndrome (MetS). There is little information about the gene-diet interactions associated with MetS. This investigation examined the interaction between dietary patterns and AT1R polymorphism in relation to development risk of MetS. METHODS A prospective, non-interventional, case-control study included 265 MetS patients and 262 healthy controls in an adult population from Croatia. Collected data included clinical variables, type of diet (Mediterranean, continental and mixed), biochemical tests and AT1R genotyping. AT1R 1166A>C genotyping was performed by PCR restriction fragment length polymorphism methods. To examine gene-diet interactions, a total predictive model was built using a hierarchical backward elimination approach. RESULTS Participants on Continental-diet were nearly 20 times more likely to have MetS than those on Mediterranean or mixed diet (OR = 19.96; 95% CI 10.44-38.18). In multivariate prediction, control subjects with AT1R 1166AC or CC genotype had a higher risk for high triglycerides compared to the AA genotype carriers. 1166AC or CC genotype carriers more often chose Mediterranean or mixed-diet versus 1166AA genotype carriers whose choice often was continental diet. CONCLUSIONS Our results are the first to suggest the possibility that the choice of diet can undermine the potential genetic risk of the AT1R polymorphism as polymorphism carriers may spontaneously choose the Mediterranean-diet.
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Affiliation(s)
- T Božina
- School of Medicine, Department of Medical Chemistry, Biochemistry and Clinical Chemistry, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia.
| | - J Lovrić
- School of Medicine, Department of Medical Chemistry, Biochemistry and Clinical Chemistry, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
| | - L Šimičević
- University Hospital Centre Zagreb, Department of Laboratory Diagnostics, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - A Merkler
- University Hospital Centre Zagreb, Department of Laboratory Diagnostics, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - M Božina
- Belupo, I. Savica 36, P.P. 62, 10000 Zagreb, Croatia
| | - B Jelaković
- University Hospital Centre Zagreb, Division of Nephrology and Arterial Hypertension, Department of Internal Medicine, School of Medicine, University of Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - J Sertić
- School of Medicine, Department of Medical Chemistry, Biochemistry and Clinical Chemistry, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia; University Hospital Centre Zagreb, Department of Laboratory Diagnostics, Kišpatićeva 12, 10000 Zagreb, Croatia
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Ahmad S, Moorthy MV, Demler OV, Hu FB, Ridker PM, Chasman DI, Mora S. Assessment of Risk Factors and Biomarkers Associated With Risk of Cardiovascular Disease Among Women Consuming a Mediterranean Diet. JAMA Netw Open 2018; 1:e185708. [PMID: 30646282 PMCID: PMC6324327 DOI: 10.1001/jamanetworkopen.2018.5708] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
IMPORTANCE Higher Mediterranean diet (MED) intake has been associated with lower risk of cardiovascular disease (CVD), but limited data are available about the underlying molecular mechanisms of this inverse disease association in human populations. OBJECTIVE To better characterize the relative contribution of traditional and novel factors to the MED-related risk reduction in CVD events in a US population. DESIGN, SETTING, AND PARTICIPANTS Using a prospective cohort design, baseline MED intake was assessed in 25 994 initially healthy US women in the Women's Health Study who were followed up to 12 years. Potential mediating effects of a panel of 40 biomarkers were evaluated, including lipids, lipoproteins, apolipoproteins, inflammation, glucose metabolism and insulin resistance, branched-chain amino acids, small-molecule metabolites, and clinical factors. Baseline study information and samples were collected between April 30, 1993, and January 24, 1996. Analyses were conducted between August 1, 2017, and October 30, 2018. EXPOSURES Intake of MED is a 9-category measure of adherence to a Mediterranean dietary pattern. Participants were categorized into 3 levels based on their adherence to the MED. MAIN OUTCOMES AND MEASURES Incident CVD confirmed through medical records and the proportion of CVD risk reduction explained by mediators. RESULTS Among 25 994 women (mean [SD] age, 54.7 [7.1] years), those with low, middle, and upper MED intakes composed 39.0%, 36.2%, and 24.8% of the study population and experienced 428 (4.2%), 356 (3.8%), and 246 (3.8%) incident CVD events, respectively. Compared with the reference group who had low MED intake, CVD risk reductions were observed for the middle and upper groups, with respective HRs of 0.77 (95% CI, 0.67-0.90) and 0.72 (95% CI, 0.61-0.86) (P for trend < .001). The largest mediators of the CVD risk reduction of MED intake were biomarkers of inflammation (accounting for 29.2% of the MED-CVD association), glucose metabolism and insulin resistance (27.9%), and body mass index (27.3%), followed by blood pressure (26.6%), traditional lipids (26.0%), high-density lipoprotein measures (24.0%) or very low-density lipoprotein measures (20.8%), with lesser contributions from low-density lipoproteins (13.0%), branched-chain amino acids (13.6%), apolipoproteins (6.5%), or other small-molecule metabolites (5.8%). CONCLUSIONS AND RELEVANCE In this study, higher MED intake was associated with approximately one-fourth relative risk reduction in CVD events, which could be explained in part by known risk factors, both traditional and novel.
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Affiliation(s)
- Shafqat Ahmad
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Preventive Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - M. Vinayaga Moorthy
- Preventive Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Olga V. Demler
- Preventive Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Paul M Ridker
- Preventive Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel I. Chasman
- Preventive Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Samia Mora
- Preventive Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Lipid Metabolomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Diets along with interval training regimes improves inflammatory & anti-inflammatory condition in obesity with type 2 diabetes subjects. J Diabetes Metab Disord 2018; 17:253-267. [PMID: 30918861 DOI: 10.1007/s40200-018-0368-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/01/2018] [Indexed: 12/11/2022]
Abstract
Background Different physical activities and diets change the regulation of inflammations in both type 2 diabetes (T2D) patients and obese individuals, but the effect of both (Physical activity and diet) on pro/anti-inflammations has remained unknown. We investigated pro/anti-inflammations control, cardiovascular function, and total physiological parameters before and after 24 weeks of low volume high intensity interval training (HIIT) on a cycle ergometer along with four dietary regimes in obesity with T2D patients. Methods 33 non-active obesity T2D patients (BMI ≥ 30) midges (47 yrs. ± 5) were volunteered to participate and randomly divided into three experimental(n = 11) [(1) LCD = low Carbohydrate Diet, (2) LFD = Low Fat Diet and (3) HFD = High Fat Diet)] and one control (n = 9) [ND = normal diet] groups. The whole groups performed underwent 8-week dietary regimes and then performed 3 days/weeks (3 set 10 × 60 s) HIIT on a cycle ergometer for 12 weeks, which followed by a 4-week diet period again. Also, prior to and after 8 weeks diet-12 weeks High Intensity Interval Training (HIIT) and 4 weeks diet 2-h oral glucose tolerance test (OGTT), resting blood pressure, incremental maximal oxygen uptake (VO2peak) cycle ergometer test and blood sample was collected from the subjects in order to measure pro/anti-inflammatory cytokines (IL-6, TNF-α, leptin, resistin, adiponectin, and FGF21). Results After 24 weeks of intervention, the results indicated that the highest improvement in the percentage of changes in glucose happened in LCD (-34.76), insulin in ND (+16.43), cholesterol in LCD (-33.35), LDL in LFD (-9.14), HDL in LCD (+41.81), TG in LCD (-40.71), weight in LCD (-12.49) and HOMA-IR in HFD (-6.82). The results also indicated that after 24 weeks of HIIT and diet interventions, highest benefit percentage change IL-6, resistin and leptin occurred in LCD (-32.10, -28.29 and - 53.92, respectively), TNF-α, FGF21 and adiponectin in LFD (-48.06, +55.30 and + 42.32, respectively). However, these changes were observed in other groups. Conclusions These results demonstrated that HIIT along with low carbohydrate regimes improves overall cardiovascular parameters and reduce pro-inflammatory markers and increase anti-inflammatory markers in type 2 diabetic patients. Additionally, as with HIIT along with low carbohydrate, HIIT coupled with low fat would improve inflammation markers, though these effects were less significant. These findings suggest that HIIT along with low carbohydrate is a beneficial exercise and dietary strategy in T2D patients.
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Short-Term Effects of Healthy Eating Pattern Cycling on Cardiovascular Disease Risk Factors: Pooled Results from Two Randomized Controlled Trials. Nutrients 2018; 10:nu10111725. [PMID: 30423846 PMCID: PMC6266045 DOI: 10.3390/nu10111725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 02/07/2023] Open
Abstract
Adherence to healthy eating patterns (HEPs) is often short-lived and can lead to repetitive attempts of adopting—but not maintaining—HEPs. We assessed effects of adopting, abandoning, and readopting HEPs (HEP cycling) on cardiovascular disease risk factors (CVD-RF). We hypothesized that HEP cycling would improve, worsen, and again improve CVD-RF. Data were retrospectively pooled for secondary analyses from two randomized, crossover, controlled feeding trials (n = 60, 52 ± 2 years, 30.6 ± 0.6 kg/m2) which included two 5–6 week HEP interventions (Dietary Approaches to Stop Hypertension-style or Mediterranean-style) separated by a four-week unrestricted eating period. Ambulatory and fasting blood pressures (BP), fasting serum lipids, lipoproteins, glucose, and insulin were measured before and during the last week of HEP interventions. Fasting systolic BP and total cholesterol decreased (−6 ± 1 mm Hg and −19 ± 3 mg/dL, respectively, p < 0.05), returned to baseline, then decreased again (−5 ± 1 mm Hg and −13 ± 3 mg/dL, respectively, p < 0.05) when adopting, abandoning, and readopting a HEP; magnitude of changes did not differ. Ambulatory and fasting diastolic BP and high-density lipoprotein cholesterol concentrations followed similar patterns; glucose and insulin remained unchanged. Low-density lipoprotein cholesterol concentrations decreased with initial adoption but not readoption (−13 ± 3 and −6 ± 3, respectively, interaction p = 0.020). Healthcare professionals should encourage individuals to consistently consume a HEP for cardiovascular health but also encourage them to try again if a first attempt is unsuccessful or short-lived.
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Mazidi M, Katsiki N, Kengne AP, Mikhailidis DP, Banach M. Adiposity mediates the association between whole grain consumption, glucose homeostasis and insulin resistance: findings from the US NHANES. Lipids Health Dis 2018; 17:219. [PMID: 30223829 PMCID: PMC6142682 DOI: 10.1186/s12944-018-0805-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/26/2018] [Indexed: 12/14/2022] Open
Abstract
Background Growing evidence suggests an inverse association between whole grain (WG) consumption and insulin resistance (IR) or inflammation. However, it is still unclear whether adiposity plays a role in this relationship. We investigated whether the associations between WG intake with IR, glucose homeostasis and inflammation are mediated by adiposity in US adults. Methods The 2005–2010 National Health and Nutrition Examination Surveys participants were included. WG intake was assessed and markers of IR and glucose homeostasis, inflammation, general and central adiposity. Analysis of co-variance and mediation analysis were applied, while accounting for survey design. Results Overall 16,621 participants were included in this analysis (mean age = 47.1 years, 48.3% men). After adjustment for age, gender, and race, mean C-reactive protein (CRP), apolipoprotein B (apo-B), fasting blood glucose (FBG), insulin, homeostatic model assessment of IR (HOMA-IR) and β cell function (HOMA-β), hemoglobin A1c (HbA1c), and 2 h glucose after an oral glucose tolerance test decreased with increasing quarters of WG (all p < 0.001). Body mass index (BMI) had significant mediation effects on the associations between WG intake and CRP, apo-B, fasting glucose, insulin, HOMA-IR, HOMA-B, HbA1c, triglyceride to high density lipoprotein-cholesterol (TG:HDL-C) ratio and triglyceride-glucose (TyG) index (all p < 0.05) after adjustment for age, gender, race/ethnicity, educational status, smoking and level of physical activity. Both waist circumference (WC) and anthropometrically predicted visceral adipose tissue (apVAT) mediated the association between WG intakes with CRP, FBG, HbA1c, TG:HDL-C ratio and TyG index, i.e. WC and apVAT had indirect effect (all p < 0.05). Conclusion Our findings provide insights into the favourable impact of WG consumption on IR and inflammation, which may be affected by both central and visceral adiposity, i.e. the link between WG with IR and inflammation is more mediated in overweight/obese compared with lean individuals.
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Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology,Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, 100101, People's Republic of China.
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.,Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.,Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents. CHILDREN-BASEL 2018; 5:children5040054. [PMID: 29690631 PMCID: PMC5920400 DOI: 10.3390/children5040054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/12/2018] [Accepted: 04/17/2018] [Indexed: 11/24/2022]
Abstract
It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME) core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR) curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents (N = 203), and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.
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Park YMM, Choi MK, Lee SS, Shivappa N, Han K, Steck SE, Hébert JR, Merchant AT, Sandler DP. Dietary inflammatory potential and risk of mortality in metabolically healthy and unhealthy phenotypes among overweight and obese adults. Clin Nutr 2018; 38:682-688. [PMID: 29705061 DOI: 10.1016/j.clnu.2018.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 03/20/2018] [Accepted: 04/02/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS This study was designed to investigate the association between the dietary inflammatory index (DII®) scores, metabolic phenotypes, and risk of mortality risk in overweight/obese individuals from a representative sample of the U.S. POPULATION METHODS Data from 3733 overweight/obese adults (BMI ≥ 25 kg/m2) aged 20-90 years from the National Health and Nutrition Examination Survey III, 1988-1994 were analyzed; these participants were followed for mortality through December 31, 2011. DII scores were computed based on baseline dietary intake using 24-h dietary recalls. Metabolically unhealthy status was defined as having 2 or more of these metabolic abnormalities: high glucose, insulin resistance, elevated blood pressure, triglycerides, C-reactive protein levels, or low high-density lipoprotein-cholesterol values. RESULTS In metabolically unhealthy overweight/obese (MUO) individuals, DII score was associated with increased risk of all-cause mortality (HRTertile 3 vs Tertile 1 1.44; 95% CI 1.11-1.86 Ptrend = 0.008; HR1SD increase 1.08; 95% CI 0.99-1.18). Additionally, a stronger association with cardiovascular mortality was observed (HRT3 vs T1 3.29; 95% CI 2.01-5.37 Ptrend < 0.001; HR1SD increase 1.40; 95% CI 1.18-1.66), after adjusting for potential confounders. Furthermore, when analyses were restricted to obese individuals (BMI ≥ 30 kg/m2), the association was more pronounced, especially for cardiovascular mortality (HRT3 vs T1 5.55; 95% CI 2.11-14.57 Ptrend = 0.006; HR1SD increase 1.74; 95% CI 1.21-2.50). No association was observed between DII score and risk of mortality in individuals with metabolically healthy overweight/obese (MHO) phenotype, or for cancer mortality in either MHO or MUO phenotype. CONCLUSIONS A pro-inflammatory diet appears to increase risk of all-cause and cardiovascular mortality in the MUO phenotype, but not among the MHO phenotype.
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Affiliation(s)
- Yong-Moon Mark Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States
| | - Moon Kyung Choi
- Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA, United States
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Connecting Health Innovations, LLC, Columbia, SC, United States
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Susan E Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Connecting Health Innovations, LLC, Columbia, SC, United States
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States
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Kim H, Caulfield LE, Rebholz CM. Healthy Plant-Based Diets Are Associated with Lower Risk of All-Cause Mortality in US Adults. J Nutr 2018; 148:624-631. [PMID: 29659968 PMCID: PMC6669955 DOI: 10.1093/jn/nxy019] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/18/2018] [Indexed: 12/11/2022] Open
Abstract
Background Plant-based diets, often referred to as vegetarian diets, are associated with health benefits. However, the association with mortality is less clear. Objective We investigated associations between plant-based diet indexes and all-cause and cardiovascular disease mortality in a nationally representative sample of US adults. Methods Analyses were based on 11,879 participants (20-80 y of age) from NHANES III (1988-1994) linked to data on all-cause and cardiovascular disease mortality through 2011. We constructed an overall plant-based diet index (PDI), which assigns positive scores for plant foods and negative scores for animal foods, on the basis of a food-frequency questionnaire administered at baseline. We also constructed a healthful PDI (hPDI), in which only healthy plant foods received positive scores, and a less-healthful (unhealthy) PDI (uPDI), in which only less-healthful plant foods received positive scores. Cox proportional hazards models were used to estimate the association between plant-based diet consumption in 1988-1994 and subsequent mortality. We tested for effect modification by sex. Results In the overall sample, PDI and uPDI were not associated with all-cause or cardiovascular disease mortality after controlling for demographic characteristics, socioeconomic factors, and health behaviors. However, among those with an hPDI score above the median, a 10-unit increase in hPDI was associated with a 5% lower risk in all-cause mortality in the overall study population (HR: 0.95; 95% CI: 0.91, 0.98) and among women (HR: 0.94; 95% CI: 0.88, 0.99), but not among men (HR: 0.95; 95% CI: 0.90, 1.01). There was no effect modification by sex (P-interaction > 0.10). Conclusions A nonlinear association between hPDI and all-cause mortality was observed. Healthy plant-based diet scores above the median were associated with a lower risk of all-cause mortality in US adults. Future research exploring the impact of quality of plant-based diets on long-term health outcomes is necessary.
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Affiliation(s)
- Hyunju Kim
- Center for Human Nutrition, Department of International Health
| | | | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Address correspondence to CMR (e-mail: )
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Mazidi M, Kengne AP, Katsiki N, Mikhailidis DP, Banach M. Lipid accumulation product and triglycerides/glucose index are useful predictors of insulin resistance. J Diabetes Complications 2018; 32:266-270. [PMID: 29395839 DOI: 10.1016/j.jdiacomp.2017.10.007] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/02/2017] [Accepted: 10/15/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To investigate the association of triglycerides/glucose index (TyG index), anthropometrically predicted visceral adipose tissue (apVAT), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglycerides (TG):high density lipoprotein-cholesterol (HDL-C) ratio with insulin resistance (IR) in adult Americans. METHODS This study was based on data from three NHANES cycles (2005 to 2010). The TyG index was calculated as ln [TG×fasting glucose/2]. VAI was calculated using gender-specific formulas: men [waist circumference (WC)/39.68+(1.88×body mass index (BMI)]×(TG/1.03)×(1.31/HDL-C); women: [WC/36.58+(1.89×BMI)]×(TG/0.81)×(1.52/HDL-C). LAP index was calculated as [WC-65]×[TG] in men, and [WC-58]×[TG] in women. Correlation and regression analyses accounted for the complex sampling of database. RESULTS A total of 18,318 subjects was included in this analysis [mean age 47.6Years]; 48.7% (n=8918) men]. The homeostatic model assessment of insulin resistance (HOMA-IR) had a significant positive correlation with the TyG index (r=0.502), LAP (r=0.551), apVAT (r=0.454), TG:HDL-C ratio (r=0.441) and VAI (r=451) (p<0.001 for all comparisons). Bland-Altman plots showed no systematic errors. The optimal cut-off to predict HOMA-diagnosed IR was 0.473 (sensitivity=74.5% and specificity=72.7%) for LAP, 0.478 (75.9%, 71.9%) for TyG, 0.391 (70.4%, 67.1%) for VAI, 0.392 (77.1% and 62.0%) for TG:HDL-C ratio and 0.381 (63.8%, 74.8%) for apVAT. CONCLUSIONS The LAP index is a simple, cheap and accurate although not perfect, surrogate marker of HOMA-diagnosed IR among adult Americans. Moreover, it has higher predictability than other screening tools which traditionally applied. Among the markers, apVAT had the highest specificity and the TG:HDL-C ratio had the highest sensitivity.
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Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China; Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China.
| | - Andre-Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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Zaragoza-Martí A, Cabañero-Martínez MJ, Hurtado-Sánchez JA, Laguna-Pérez A, Ferrer-Cascales R. Evaluation of Mediterranean diet adherence scores: a systematic review. BMJ Open 2018; 8:e019033. [PMID: 29478018 PMCID: PMC5855302 DOI: 10.1136/bmjopen-2017-019033] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/23/2017] [Accepted: 01/04/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of this review was to evaluate the conceptual suitability, applicability and psychometric properties of scores used internationally to measure adherence to the Mediterranean diet (MD). DESIGN This was a systematic review to identify original articles that examined some aspects of the conceptual suitability, applicability or psychometric properties of the MD adherence score. Electronic searches were carried out on the international databases MEDLINE, Scopus, Web of Science and EMBASE (from January 1980 to 31 December 2015). ELIGIBILITY CRITERIA FOR SELECTING STUDIES The study included original articles that examined some aspects of the conceptual suitability, applicability or psychometric properties of the MD adherence score. The studies where MD adherence scores were administered but did not bring forward any evidence about their performance related to conceptual suitability, applicability or psychometric properties were excluded. DATA EXTRACTION Information relating to the scales was extracted in accordance with the quality criteria defined by the Scientific Advisory Committee of the Medical Outcomes Trust for measurement of health results and the quality criteria recommended by Terwee: (1) conceptual, (2) applicability and (3) psychometric properties. Three authors independently extracted information from eligible studies. RESULTS Twenty-seven studies were identified as meeting the inclusion criteria, yielding 28 MD adherence scores. The results showed that evidence is scarce and that very few scores fulfilled the applicability parameters and psychometric quality. The scores developed by Panagiotakos et al, Buckland et al and Sotos-Prieto et al showed the highest levels of evidence. CONCLUSIONS Scores measuring adherence to MD are useful tools for identifying the dietary patterns of a given population. However, further information is required regarding existing scores. In addition, new instruments with greater conceptual and methodological rigour should be developed and evaluated for their psychometric properties.
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Affiliation(s)
- A Zaragoza-Martí
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - M J Cabañero-Martínez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - J A Hurtado-Sánchez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - A Laguna-Pérez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - R Ferrer-Cascales
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain
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Sureda A, Bibiloni MDM, Julibert A, Bouzas C, Argelich E, Llompart I, Pons A, Tur JA. Adherence to the Mediterranean Diet and Inflammatory Markers. Nutrients 2018; 10:E62. [PMID: 29320413 PMCID: PMC5793290 DOI: 10.3390/nu10010062] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 12/22/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023] Open
Abstract
The aim was to assess inflammatory markers among adults and adolescents in relation to the adherence to the Mediterranean diet. A random sample (219 males and 379 females) of the Balearic Islands population (12-65 years) was anthropometrically measured and provided a blood sample to determine biomarkers of inflammation. Dietary habits were assessed and the adherence to the Mediterranean dietary pattern calculated. The prevalence of metabolic syndrome increased with age in both sexes. The adherence to the Mediterranean diet in adolescent males was 51.3% and 45.7% in adults, whereas in females 53.1% and 44.3%, respectively. In males, higher adherence to the Mediterranean diet was associated with higher levels of adiponectin and lower levels of leptin, tumor necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1 (PAI-1) and high-sensitivity C-reactive protein (hs-CRP) in adults, but not in young subjects. In females, higher adherence was associated with lower levels of leptin in the young group, PAI-1 in adults and hs-CRP in both groups. With increasing age in both sexes, metabolic syndrome increases, but the adherence to the Mediterranean diet decreases. Low adherence to the Mediterranean dietary pattern (MDP) is directly associated with a worse profile of plasmatic inflammation markers.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Maria del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Alicia Julibert
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Cristina Bouzas
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
| | - Emma Argelich
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
| | - Isabel Llompart
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain; (A.S.); (M.d.M.B.); (A.J.); (C.B.); (E.A.); (I.L.); (A.P.)
- CIBER Fisiopatología de la Obesidad la Nutrición (CIBEROBN)-Instituto de Salud Carlos III, E-07122 Palma de Mallorca, Spain
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Joyce T, Chirino YI, Natalia MT, Jose PC. Renal damage in the metabolic syndrome (MetSx): Disorders implicated. Eur J Pharmacol 2018; 818:554-568. [DOI: 10.1016/j.ejphar.2017.11.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 02/08/2023]
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Recio-Rodriguez JI, Gómez-Marcos MA, Agudo-Conde C, Ramirez I, Gonzalez-Viejo N, Gomez-Arranz A, Salcedo-Aguilar F, Rodriguez-Sanchez E, Alonso-Domínguez R, Sánchez-Aguadero N, Gonzalez-Sanchez J, Garcia-Ortiz L. EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol. Medicine (Baltimore) 2018; 97:e9633. [PMID: 29480874 PMCID: PMC5943855 DOI: 10.1097/md.0000000000009633] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. METHODS Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40 kg/m), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. DISCUSSION There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. ETHICS AND DISSEMINATION The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614.
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Affiliation(s)
- José I. Recio-Rodriguez
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
- Department of Nursing and Physiotherapy
| | - Manuel A. Gómez-Marcos
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
- Department of Medicine, University of Salamanca
| | - Cristina Agudo-Conde
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
| | - Ignasi Ramirez
- Centro de Salud Sta Ponça de Palma de Mallorca, Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
| | | | | | | | - Emiliano Rodriguez-Sanchez
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
| | - Rosario Alonso-Domínguez
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
| | - Natalia Sánchez-Aguadero
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
| | - Jesus Gonzalez-Sanchez
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
- Department of Nursing, University of Extremadura
| | - Luis Garcia-Ortiz
- Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Spanish Network for Preventive Activities and Health Promotion (REDIAPP)
- Department of Biomedical and Diagnostic Sciences, University of Salamanca,Spain
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Baratta F, Pastori D, Polimeni L, Bucci T, Ceci F, Calabrese C, Ernesti I, Pannitteri G, Violi F, Angelico F, Del Ben M. Adherence to Mediterranean Diet and Non-Alcoholic Fatty Liver Disease: Effect on Insulin Resistance. Am J Gastroenterol 2017; 112:1832-1839. [PMID: 29063908 DOI: 10.1038/ajg.2017.371] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/10/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The prevalence of cardiometabolic disorders, including non-alcoholic fatty liver disease (NAFLD), is increasing in western countries, because of changes in lifestyle and dietary habits. Mediterranean Diet (Med-Diet) is effective for cardiovascular prevention, but its relationship with NAFLD has been scarcely investigated. METHODS We included 584 consecutive outpatients presenting with one or more cardiovascular risk factor such as type 2 diabetes mellitus (T2DM), arterial hypertension, overweight/obesity, and dyslipidemia. Liver steatosis was assessed using ultrasonography. Med-Diet adherence was investigated by a validated semiquantitative nine-item dietary questionnaire; patients were divided into low, intermediate, and high adherence. Insulin resistance was defined by the 75th percentile of homeostasis model of insulin resistance (HOMA-IR; ≥3.8). RESULTS The mean age was 56.2±12.4 years and 38.2% were women. Liver steatosis was present in 82.7%, and its prevalence decreased from low to high adherence group (96.5% vs. 71.4%, P<0.001). In a multiple logistic regression analysis, hypertriglyceridemia (odds ratio (OR): 2.913; P=0.002), log (ALT) (OR: 6.186; P<0.001), Med-Diet adherence (intermediate vs. low OR: 0.115; P=0.041, high vs. low OR: 0.093; P=0.030), T2DM (OR: 3.940; P=0.003), and high waist circumference (OR: 3.012; P<0.001) were associated with NAFLD. Among single foods, low meat intake (OR: 0.178; P<0.001) was inversely significantly associated with NAFLD. In 334 non-diabetic NAFLD patients, age (OR: 1.035, P=0.025), high waist circumference (OR: 7.855, P<0.001), hypertriglyceridemia (OR: 2.152, P=0.011), and Log (ALT) (OR: 2.549, P=0.002) were directly associated with HOMA-IR, whereas Med-Diet score was inversely associated (OR: 0.801, P=0.018). CONCLUSIONS We found an inverse relationship between Med-Diet and NAFLD prevalence. Among NAFLD patients, good adherence to Med-Diet was associated with lower insulin resistance. Our findings suggest that Med-Diet may be a beneficial nutritional approach in NAFLD patients.
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Affiliation(s)
- Francesco Baratta
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.,Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences-Sapienza University of Rome, Rome, Italy
| | - Daniele Pastori
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.,Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences-Sapienza University of Rome, Rome, Italy
| | - Licia Polimeni
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Tommaso Bucci
- Department of Medical Specialties, Salerno University of Medicine, Salerno, Italy
| | - Fabrizio Ceci
- Department of Cellular Biotechnologies and Hematology, "La Sapienza" University, Policlinico Umberto I Hospital, Rome, Italy
| | - Cinzia Calabrese
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Ilaria Ernesti
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Nutrition, Sapienza University, Rome, Italy
| | - Gaetano Pannitteri
- Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Violi
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Francesco Angelico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Maria Del Ben
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
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47
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Strasser B. Immune-mediated inflammation as a driver of obesity and comorbid conditions. Obesity (Silver Spring) 2017; 25:987-988. [PMID: 28544797 DOI: 10.1002/oby.21872] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/06/2017] [Accepted: 04/09/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Barbara Strasser
- Division of Medical Biochemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
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