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Mattavelli E, Olmastroni E, Casula M, Grigore L, Pellegatta F, Baragetti A, Magni P, Catapano AL. Adherence to Mediterranean Diet: A Population-Based Longitudinal Cohort Study. Nutrients 2023; 15:nu15081844. [PMID: 37111063 PMCID: PMC10145158 DOI: 10.3390/nu15081844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Adherence to the Mediterranean diet (MedDiet) is recommended for cardiovascular disease prevention. However, recent epidemiological studies report a shift toward lower adherence to MedDiet. We have conducted a prospective cohort study to evaluate changes in individual determinants of MedDiet adherence over time. Clinical information and MedDiet adherence score (MEDAS) were collected in 711 subjects (mean age 68 ± 10 years; 42% males), enrolled in the PLIC study (Progression of Intimal Atherosclerotic Lesions in Carotid arteries), during two visits conducted, on average, 4.5 years apart. MEDAS score worsening and improvements (absolute change, ΔMEDAS) and the variation in the proportion of subjects reporting to meet each MEDAS criteria were assessed. Overall, 34% of the subjects improved their MedDiet adherence (ΔMEDAS: +1.87 ± 1.13), by consuming more olive oil, legumes and fish and use of dishes seasoned with sofrito and 48% subjects worsened their MedDiet adherence (ΔMEDAS: -2.02 ± 1.14) by consuming less fruit, legumes, fish and nuts, with higher rates of worsening in women and subjects aged 50-65 years. Subjects who improved the score were more obese, had higher plasma glucose levels, and metabolic syndrome at the basal visit. In summary, we report an overall decrease in MedDiet adherence, evaluated during a timeframe heavily affected by the COVID-19 pandemic, underlining the need for better dietary interventions.
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Affiliation(s)
- Elisa Mattavelli
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- MultiMedica IRCCS, Sesto S. Giovanni, 20099 Milan, Italy
| | - Elena Olmastroni
- MultiMedica IRCCS, Sesto S. Giovanni, 20099 Milan, Italy
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Manuela Casula
- MultiMedica IRCCS, Sesto S. Giovanni, 20099 Milan, Italy
- Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | | | | | - Andrea Baragetti
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- MultiMedica IRCCS, Sesto S. Giovanni, 20099 Milan, Italy
| | - Paolo Magni
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
- MultiMedica IRCCS, Sesto S. Giovanni, 20099 Milan, Italy
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Stratakis N, Siskos AP, Papadopoulou E, Nguyen AN, Zhao Y, Margetaki K, Lau CHE, Coen M, Maitre L, Fernández-Barrés S, Agier L, Andrusaityte S, Basagaña X, Brantsaeter AL, Casas M, Fossati S, Grazuleviciene R, Heude B, McEachan RRC, Meltzer HM, Millett C, Rauber F, Robinson O, Roumeliotaki T, Borras E, Sabidó E, Urquiza J, Vafeiadi M, Vineis P, Voortman T, Wright J, Conti DV, Vrijheid M, Keun HC, Chatzi L. Urinary metabolic biomarkers of diet quality in European children are associated with metabolic health. eLife 2022; 11:e71332. [PMID: 35076016 PMCID: PMC8789316 DOI: 10.7554/elife.71332] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/02/2022] [Indexed: 11/13/2022] Open
Abstract
Urinary metabolic profiling is a promising powerful tool to reflect dietary intake and can help understand metabolic alterations in response to diet quality. Here, we used 1H NMR spectroscopy in a multicountry study in European children (1147 children from 6 different cohorts) and identified a common panel of 4 urinary metabolites (hippurate, N-methylnicotinic acid, urea, and sucrose) that was predictive of Mediterranean diet adherence (KIDMED) and ultra-processed food consumption and also had higher capacity in discriminating children's diet quality than that of established sociodemographic determinants. Further, we showed that the identified metabolite panel also reflected the associations of these diet quality indicators with C-peptide, a stable and accurate marker of insulin resistance and future risk of metabolic disease. This methodology enables objective assessment of dietary patterns in European child populations, complementary to traditional questionary methods, and can be used in future studies to evaluate diet quality. Moreover, this knowledge can provide mechanistic evidence of common biological pathways that characterize healthy and unhealthy dietary patterns, and diet-related molecular alterations that could associate to metabolic disease.
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Affiliation(s)
- Nikos Stratakis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern CaliforniaLos AngelesUnited States
| | - Alexandros P Siskos
- Cancer Metabolism & Systems Toxicology Group, Division of Cancer, Department of Surgery & Cancer and Division of Systems Medicine, Department of Metabolism, Digestion & Reproduction, Imperial College London, Hammersmith Hospital CampusLondonUnited Kingdom
| | | | - Anh N Nguyen
- Department of Epidemiology, Erasmus University Medical CenterRotterdamNetherlands
| | - Yinqi Zhao
- Department of Preventive Medicine, Keck School of Medicine, University of Southern CaliforniaLos AngelesUnited States
| | - Katerina Margetaki
- Department of Preventive Medicine, Keck School of Medicine, University of Southern CaliforniaLos AngelesUnited States
| | - Chung-Ho E Lau
- Cancer Metabolism & Systems Toxicology Group, Division of Cancer, Department of Surgery & Cancer and Division of Systems Medicine, Department of Metabolism, Digestion & Reproduction, Imperial College London, Hammersmith Hospital CampusLondonUnited Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College LondonLondonUnited Kingdom
| | - Muireann Coen
- Cancer Metabolism & Systems Toxicology Group, Division of Cancer, Department of Surgery & Cancer and Division of Systems Medicine, Department of Metabolism, Digestion & Reproduction, Imperial College London, Hammersmith Hospital CampusLondonUnited Kingdom
- Oncology Safety, Clinical Pharmacology and Safety Sciences, R&D, AstraZenecaCambridgeUnited Kingdom
| | - Lea Maitre
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | - Silvia Fernández-Barrés
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | - Lydiane Agier
- Inserm, CNRS, University Grenoble Alpes, Team of environmental epidemiology applied to reproduction and respiratory health, IABGrenobleFrance
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus UniversityKaunasLithuania
| | - Xavier Basagaña
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | | | - Maribel Casas
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | - Serena Fossati
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | | | - Barbara Heude
- Centre for Research in Epidemiology and Statistics, Université de Paris, Inserm, InraParisFrance
| | - Rosemary RC McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradfordUnited Kingdom
| | | | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial CollegeLondonUnited Kingdom
- Department of Preventive Medicine, School of Medicine, University of São PauloSão PauloBrazil
| | - Fernanda Rauber
- Public Health Policy Evaluation Unit, School of Public Health, Imperial CollegeLondonUnited Kingdom
- Department of Preventive Medicine, School of Medicine, University of São PauloSão PauloBrazil
- Center for Epidemiological Research in Nutrition and Health, University of São PauloSão PauloBrazil
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College LondonLondonUnited Kingdom
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of CreteHeraklionGreece
| | - Eva Borras
- ISGlobalBarcelonaSpain
- Centre for Genomic Regulation, The Barcelona Institute of Science and TechnologyBarcelonaSpain
| | - Eduard Sabidó
- ISGlobalBarcelonaSpain
- Centre for Genomic Regulation, The Barcelona Institute of Science and TechnologyBarcelonaSpain
| | - Jose Urquiza
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of CreteHeraklionGreece
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College LondonLondonUnited Kingdom
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical CenterRotterdamNetherlands
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation TrustBradfordUnited Kingdom
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern CaliforniaLos AngelesUnited States
| | - Martine Vrijheid
- ISGlobalBarcelonaSpain
- Universitat Pompeu FabraBarcelonaSpain
- CIBER Epidemiologia y Salud PúblicaMadridSpain
| | - Hector C Keun
- Cancer Metabolism & Systems Toxicology Group, Division of Cancer, Department of Surgery & Cancer and Division of Systems Medicine, Department of Metabolism, Digestion & Reproduction, Imperial College London, Hammersmith Hospital CampusLondonUnited Kingdom
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern CaliforniaLos AngelesUnited States
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