Validation of the 14-item mediterranean diet adherence screener

BACKGROUND

The Mediterranean diet (MedDiet) is suggested as a healthy dietary pattern. 14-point Mediterranean Diet Adherence Screener (MEDAS) questionnaire is a valid and rapid tool to estimate the adherence to the Mediterranean diet. The aim of this study was to assess the validity of the 14-point Mediterranean Diet Adherence Screener in Turkish population.

METHODS

A total of 188 people (%58 females) participated in this study (31.7 ± 10.97 years). Turkish version of the MEDAS questionnaire was applied with 3-day food record, and mean total Mediterranean Diet (MedDiet) score and each of the MedDiet component scores was calculated from both 3-day food records and MEDAS tool. Intra-class correlation coefficient (ICC) was used to evaluate the total score agreement between the two dietary assessment methods, and each of the MedDiet components was estimated using Cohen's kappa. This project was a cross-sectional study.

RESULTS

There was good correlation between the food record total MEdDiet score and MEDAS-derived MedDiet score (r = 0.750, p < 0.001; ICC = 0.749, 95% CI 0.679-0.806, p < 0.001). Highest concordance was observed for olive oil for cooking (К = 0.763), sugar sweetened beverages (К = 0.666), sweets, pastries (К = 0.753), and sofrito (К = 0.796) while the lowest was for fish and seafood (К = 0.196). Re-test analysis showed a similar mean total MedDiet score for both administrations of MEDAS.

CONCLUSIONS

The MEDAS is a valid and reliable tool to assess adherence to the Mediterranean diet in Turkish population.

Recent Advances in Nanoencapsulation of Phytochemicals to Combat Obesity and Its Comorbidities

An increasing epidemic of obesity has become a serious public health concern primarily because it contributes to pathogenesis of many chronic diseases including type 2 diabetes, cardiovascular disease, hepatobiliary disease, obstructive sleep apnea, kidney disease, some types of cancer, among others. Consumption of a variety of phytochemicals has emerged as a promising potential for combating obesity and its comorbidities. However, the generally low aqueous solubility, stability, bioavailability, and target specificity of phytochemicals, along with their side-effects and toxicity seen when used at high doses, have restricted their clinical applications. As a solution, phytochemicals can be encapsulated into nanoparticles to increase their stability and solubility, enhance their bioavailability, protect them from premature degradation in the body, prolong their circulation time, and thus enhance their antiobesity activity. In this perspective, we summarize the problems and limitations of the prominent phytochemicals (epigallocatechin gallate, trans-resveratrol, curcumin, and quercetin), the major biocompatible and biodegradable nanoparticles, and the efficacy of nanoencapsulated forms of these phytochemicals in combating obesity and its comorbidities.

Body Composition Changes in Female APOE*3Leiden.CETP Transgenic Mice After 5-week Injection of Resveratrol-encapsulated Liposomes to Inguinal White Adipose Tissue (P21-041-19)

Objectives

Many cell culture and animal studies have demonstrated that Trans-resveratrol (R) has the potential to induce beige cell formation and activity. Although human studies indicate that R can maintain metabolic health, evidence is inconclusive regarding its browning effectiveness mainly due to its low aqueous solubility and high hepatic metabolism in humans. To combat the shortcomings of R, we have successfully synthesized biocompatible and biodegradable R-encapsulated liposomes (Rlipo). We will directly inject Rlipo into inguinal white adipose tissue (iWAT) in this project. The purpose of this study to evaluate the anti-obesity effects of resveratrol-encapsulated liposomes in female APOE*3Leiden.CETP transgenic mice, which have human-like lipoprotein metabolism.

Methods

Rlipo was prepared using R and soy phosphatidylcholine (soy-PC) dissolved in ethanol. After mixing and drying with nitrogen, deionized water was added followed by a sonication step. Ultrafiltration was used to remove any unencapsulated R. The void liposomes (Vlipo) were prepared using only soy-PC.

Female APOE*3Leiden.CETP mice (n = 40) were fed with a high fat diet (45% of calorie from fat) throughout the study. After 4 weeks of the high-fat diet administration, mice were randomly divided into 4 groups (n = 10) and received iWAT injections of Rlipo, Vlipo, free R and saline (control) once per week for 5 weeks. R concentration was 17.5 mg/kg body weight/week. Body weight and food intake were measured weekly. Body composition of mice was measured using an EchoMRITM every other week. Paired sample t-test and One-way ANOVA were used to analyze differences between means.

Results

After 5-weeks of treatment compared to baseline, fat percentage differences were 1.99 ± 0.93%, 1.85 ± 0.58%, 1.45 ± 0.67%, and 1.40 ± 0.68% in control, free R, Vlipo and Rlipo groups, respectively. Body weight and fat mass showed a similar trend of change. Although control group showed an increase in lean mass (0.25 ± 0.95 g), RLipo group showed a decrease (−0.14 ± 0.52 g). Food intake was similar among four groups.

Conclusions

Nanoencapsulation of R can enhance R's anti-obesity effects. However longer treatment time might be necessary to see more prominent results.

Funding Sources

NIH/NCCIH (Grant R15AT008733).

Energy expenditure and nutritional status of coal miners: A cross-sectional study

The objectives of this study were to assess the nutritional status, daily energy intake, and daily energy expenditure of coal miners in Turkey. A total of 135 healthy coal miners (aged 19-64 years) were evaluated. Heart rates were measured using Polar watches, and the total energy expenditure was calculated using physical activity level formula and Hiilloskorpi equation. The average body mass index of the participants was 25.7 ± 3.98 kg/m², and the average energy intake was 3,973.7 ± 420.85 kcal. According to Dietary Reference Intakes, the energy and nutrient intakes of the miners were adequate, except for the intake of vitamin D. The coal miners were found to be at moderate (43.0%), heavy (41.5%), and very heavy (13.3%) activity levels. Calculations of the energy expenditure at work were found to be 2,189.8 ± 376.19 to 2,788.8 ± 359.89 kcal per day. Further studies have to be conducted for developing national standards for each occupation.

Aortic cholesterol accumulation correlates with systemic inflammation but not hepatic and gonadal adipose tissue inflammation in low-density lipoprotein receptor null mice

Inflammation is a major contributor to the development of atherosclerotic plaque, yet the involvement of liver and visceral adipose tissue inflammatory status in atherosclerotic lesion development has yet to be fully elucidated. We hypothesized that an atherogenic diet would increase inflammatory response and lipid accumulation in the liver and gonadal adipose tissue (GAT) and would correlate with systemic inflammation and aortic lesion formation in low-density lipoprotein (LDL) receptor null (LDLr-/-) mice. For 32 weeks, LDLr-/- mice (n = 10/group) were fed either an atherogenic (high saturated fat and cholesterol) or control (low fat and cholesterol) diet. Hepatic and GAT lipid content and expression of inflammatory factors were measured using standard procedures. Compared with the control diet, the atherogenic diet significantly increased hepatic triglyceride and total cholesterol (TC), primarily esterified cholesterol, and GAT triglyceride content. These changes were accompanied by increased expression of acyl-CoA synthetase long-chain family member 5, CD36, ATP-binding cassette, subfamily A, member 1 and scavenger receptor B class 1, and they decreased the expression of cytochrome P450, family 7 and subfamily a, polypeptide 1 in GAT. Aortic TC content was positively associated with hepatic TC, triglyceride, and GAT triglyceride contents as well as plasma interleukin 6 and monocyte chemoattractant protein-1 concentrations. Although when compared with the control diet, the atherogenic diet increased hepatic tumor necrosis factor α production, they were not associated with aortic TC content. These data suggest that the LDLr-/- mice responded to the atherogenic diet by increasing lipid accumulation in the liver and GAT, which may have increased inflammatory response. Aortic TC content was positively associated with systemic inflammation but not hepatic and GAT inflammatory status.

Effects of bariatric surgery on adipokine-induced inflammation and insulin resistance

Over a third of the US population is obese and at high risk for developing type 2 diabetes, insulin resistance, and other metabolic disorders. Obesity is considered a chronic low-grade inflammatory condition that is primarily attributed to expansion and inflammation of adipose tissues. Indeed, adipocytes produce and secrete numerous proinflammatory and anti-inflammatory cytokines known as adipokines. When the balance of these adipokines is shifted toward higher production of proinflammatory factors, local inflammation within adipose tissues and subsequently systemic inflammation occur. These adipokines including leptin, visfatin, resistin, apelin, vaspin, and retinol binding protein-4 can regulate inflammatory responses and contribute to the pathogenesis of diabetes. These effects are mediated by key inflammatory signaling molecules including activated serine kinases such as c-Jun N-terminal kinase and serine kinases inhibitor κB kinase and insulin signaling molecules including insulin receptor substrates, protein kinase B (PKB, also known as Akt), and nuclear factor kappa B. Bariatric surgery can decrease body weight and improve insulin resistance in morbidly obese subjects. However, despite reports suggesting reduced inflammation and weight-independent effects of bariatric surgery on glucose metabolism, mechanisms behind such improvements are not yet well understood. This review article focuses on some of these novel adipokines and discusses their changes after bariatric surgery and their relationship to insulin resistance, fat mass, inflammation, and glucose homeostasis.