Impact of the traditional Mediterranean diet on the Framingham risk score and the metabolic syndrome according to sex

Background: The traditional Mediterranean diet (MedDiet) has been recognized as a food pattern with beneficial effects on cardiovascular health. However, even if sex-related differences in the cardiovascular response to diet have been previously highlighted, the existence of such differences in the impact of the MedDiet on the global cardiovascular risk has not been yet investigated. This study examined sex differences in the global cardiovascular impact of a 4-week isoenergetic controlled MedDiet using the Framingham risk score and the National Cholesterol Education Program (NCEP) metabolic syndrome criteria. Methods: This study included 38 men and 32 premenopausal women (24–53 years) who had slightly elevated low-density lipoprotein cholesterol (LDL-C) concentrations (between 3.4 and 4.9¿mmol/L) or total cholesterol-to-high-density lipoprotein cholesterol (HDL-C) ratios =5.0. Cardiovascular risk factors were measured before and after the controlled MedDiet. Results: A time effect (P=0.04) was found for the Framingham risk score, with both men and women showing a nonsignificant decrease in response to the MedDiet. No time effect was found for the prevalence of the metabolic syndrome and the number of metabolic syndrome criteria that were met by participants (P>0.05). However, a time effect was noted for the continuous metabolic syndrome score (P=0.008), with nonsignificant decreases in both men and women. No sex-by-time interaction was noted for any of variables studied (P>0.05). Conclusions: Results from this study suggest that the global cardiovascular impact of the MedDiet, as assessed by the Framingham risk score and metabolic syndrome criteria, is not significantly different in men than in premenopausal women in isoenergetic conditions

Gender differences in dietary intakes : what is the contribution of motivational variables ?

Background : Differences between men and women with respect to dietary intakes and eating behaviours have been reported and could be explained by gender differences in motivational variables associated with the regulation of food intake. The main objectives of the present study were to identify gender differences in dietary intakes, eating behaviours and motivational variables and to determine how motivational variables were associated with dietary intakes and eating behaviours in men and women. Methods : Sixty-four men and 59 premenopausal women were included in the present study and presented cardiovascular risk factors. The Regulation of Eating Behaviours scale was completed to assess motivational variables. A validated food frequency questionnaire was administered to evaluate dietary intakes and subjects completed the Three-Factor Eating questionnaire to assess eating behaviours. Results : Men had higher energy intake, energy density and percentage of energy from lipids and lower percentage of energy from carbohydrates than women (P = 0.04). Men also had a lower emotional susceptibility to disinhibition than women (P = 0.0001). Women reported a higher score for eating-related self-determined motivation [i.e. eating-related self-determination index (SDI)] than men (P = 0.002). The most notable gender difference in the pattern of associations was that eating-related SDI was negatively associated with energy density (r = -0.30; P = 0.02), only in women. Conclusions : Women had a better dietary profile and higher eating-related SDI than men. However, gender differences in dietary variables might be explained by a potential gender-specific pattern of association of eating-related SDI with dietary intakes and eating behaviours

Gender differences in the effects of repeated taste exposure to the Mediterranean diet : a 6-month follow-up study

Objectif. Déterminer si une intervention basée principalement sur l'exposition au régime méditerranéen, accompagnée de recommandations et d'outils pour encourager une alimentation saine, mène à des effets différents en ce qui concerne l'adhésion au régime alimentaire et la gestion du poids six mois après l'intervention chez des femmes et des hommes canadiens. Méthodes. Trente-huit hommes et 32 femmes préménopausées (tous âgés de 24 à 53 ans) ont été exposés au même régime méditerranéen expérimental pendant 4 semaines au cours desquelles la nourriture leur était fournie. Les participants ont aussi reçu des recommandations et des outils pour les aider à adhérer à un régime alimentaire sain, sans autre contact jusqu'à la visite de suivi 6 mois plus tard. Résultats. En comparaison au début de l'étude, le score méditerranéen a augmenté à la fin du suivi de 6 mois (effet temps P = 0,003) sans différence entre les sexes (interaction entre le sexe et le temps P = 0,97). Concernant les composantes du score méditerranéen, on a observé des différences entre les sexes, les hommes déclarant des changements dans plus de groupes alimentaires que les femmes. Bien que l'intervention n'était pas axée sur la gestion du poids, en comparaison au début, l'IMC des participants a diminué au cours de l'intervention tant chez les hommes que chez les femmes. Cependant, seules les femmes ont maintenu un IMC plus bas 6 mois après l'intervention. Conclusions. L'exposition de courte durée au régime méditerranéen favorise l'adhésion à ce modèle alimentaire chez les deux sexes et aide à la gestion du poids, particulièrement chez les femmes.Purpose: To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations/tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. Methods: Thirty-eight men and 32 premenopausal women (24-53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations/tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. Results: Compared to baseline, the Mediterranean score (MedScore) had increased at the end of the 6-month follow-up (time effect P=0.003), with no gender difference (gender-by-time interaction P=0.97). Although our intervention was not focused on body weight management, compared to baseline, BMI decreased during the intervention in both men and women (respectively P<0.0001 and P=0.03); however, only the female participants of this study managed to maintain the lower BMI, six months after the intervention (P=0.03 for women; gender-by-time interaction P=0.04). Conclusions: Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both genders and helps in the management of body weight, especially in women

Development and validation of the perceived food environment questionnaire in a french-canadian population

Objective: The present study aimed to develop and validate a questionnaire assessing perceived food environment in a French-Canadian population. Design: A questionnaire, the Perceived Food Environment Questionnaire, was developed assessing perceived accessibility to healthy (nine items) and unhealthy foods (three items). A pre-test sample was recruited for a pilot testing of the questionnaire. For the validation study, another sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on the items to assess the number of factors (subscales). Cronbach’s a was used to measure internal consistency reliability. Test–retest reliability was assessed with Pearson correlations. Setting: Online survey. Results: Men and women from the Québec City area (n 31 in the pre-test sample; n 150 in the validation study sample). The pilot testing did not lead to any change in the questionnaire. The exploratory factor analysis revealed a two-subscale structure. The first subscale is composed of six items assessing accessibility to healthy foods and the second includes three items related to accessibility to unhealthy foods. Three items were removed from the questionnaire due to low loading on the two subscales. The subscales demonstrated adequate internal consistency (Cronbach’s a=0·77 for healthy foods and 0·62 for unhealthy foods) and test–retest reliability (r=0·59 and 0·60, respectively; both P<0·0001). Conclusions: The Perceived Food Environment Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. Further validation is recommended if the questionnaire is to be used in other populations

Sex differences in the impact of the Mediterranean diet on LDL particle size distribution and oxidation

Sex differences have been previously highlighted in the cardioprotective effects of the Mediterranean diet (MedDiet). The objective of this study was to investigate whether sex differences also exist with regard to LDL particle size distribution and oxidation. Participants were 37 men and 32 premenopausal women (24–53 years) with slightly elevated LDL-C concentrations (3.4–4.9 mmol/L) or total cholesterol/HDL-C =5.0. Variables were measured before and after a four-week isoenergetic MedDiet. Sex differences were found in response to the MedDiet for the proportion of medium LDL (255–260 Å) (p for sex-by-time interaction = 0.01) and small, dense LDL (sdLDL; <255 Å) (trend; p for sex-by-time interaction = 0.06), men experiencing an increase in the proportion of medium LDL with a concomitant reduction in the proportion of sdLDL, while an opposite trend was observed in women. A sex difference was also noted for estimated cholesterol concentrations among sdLDL (p for sex-by-time interaction = 0.03), with only men experiencing a reduction in response to the MedDiet. The MedDiet marginally reduced oxidized LDL (oxLDL) concentrations (p = 0.07), with no sex difference. Results suggest that short-termconsumption of the MedDiet leads to a favorable redistribution of LDL subclasses from smaller to larger LDL only in men. These results highlight the importance of considering sex issues in cardiovascular benefits of the MedDie

Sex differences in the impact of the Mediterranean diet on cardiovascular risk profile

The traditional Mediterranean diet (MedDiet) is now widely recommended in the prevention of CVD. However, it is not known whether the MedDiet has the same beneficial cardiovascular effects in women and in men. The objective of the present study was to investigate sex-related differences with regard to changes in cardiometabolic variables in response to a 4-week isoenergetic MedDiet. Participants were thirty-eight men and thirty-two premenopausal women aged between 25 and 50 years who had slightly elevated LDL-cholesterol (LDL-C) concentrations (3·4–4·9 mmol/l) or total cholesterol:HDL-cholesterol ratio = 5·0. A 4-week run-in period preceded the MedDiet in order to control the inter- and intra-individual variability. Cardiometabolic variables were measured before and after the MedDiet. Total cholesterol, LDL-C, apoB and apoA-1 plasma concentrations as well as diastolic blood pressure decreased (P < 0·05) in both men and women (respectively, 10, 10, 10, 6 and 5 % for men and 6, 7, 9, 4 and 4 % for women). ApoA-2 concentrations and insulin concentrations 2 h after the oral administration of 75 g of glucose demonstrated sex × time interactions (respectively, P = 0·05 and P = 0·03) and only men experienced a decrease for these variables (respectively, 8 and 25 %). In conclusion, consuming a MedDiet led to significant changes in plasma lipid profile in both men and women, while only men had significant improvements in insulin homeostasis. These results support the importance of investigating sex-related differences in response to diet in order to perhaps further individualise dietary guidelines in the prevention of CVD and type 2 diabetes

Sex differences in the impact of the Mediterranean diet on systemic inflammation

Background: Some intervention trials have reported a reduction in systemic inflammation with the Mediterranean diet (MedDiet) while others have observed no effect. Despite the fact that sex differences have been highlighted in the inflammatory regulation, it is still not known whether MedDiet exerts similar effects on systemic inflammation in men and women. The aim of this study was therefore to investigate sex differences in the effects of the MedDiet on high-sensitivity C-reactive protein (hs-CRP). Findings: Participants were 35 men and 27 premenopausal women (24–53 years) presenting a slightly deteriorated lipid profile. All foods were provided to participants during a 4-week isocaloric MedDiet. At baseline, women had higher hs-CRP concentrations than men (P¿=¿0.03). No sex difference was observed in hs-CRP response to the MedDiet (P for sex-by-time interaction¿=¿0.36), with both men and women experiencing no change (respectively P¿=¿0.62 and P¿>¿0.99). When subgroups were formed according to hs-CRP concentration before the MedDiet phase, men with elevated baseline values (=2 mg/l) experienced a reduction in hs-CRP over time with the MedDiet (-26.5 %) while an increase was observed in men with lower baseline values (+96.6 %; P for group-by-time interaction¿=¿0.02). This pattern of change was not observed in women. Conclusions: Results from this controlled feeding study suggest that men and women have similar effects from the MedDiet on systemic inflammation. The individual’s overall inflammatory status seems to influence these effects, but only in men

Impact of a health-at-every-size intervention on changes in dietary intakes and eating patterns in premenopausal overweight women : results of a randomized trial

Background & aims : Previous studies have shown improvements in eating behaviors following a Health-At-Every-Size approach (HAES). However, to our knowledge, no study has yet investigated how a HAES intervention could influence dietary intakes and eating patterns in overweight women. Therefore, objectives of this study were to determine changes in dietary intakes and eating patterns in premenopausal overweight women in response to a HAES intervention compared to a social support intervention and a control group, and then to determine whether changes in eating behaviors were associated with changes in dietary intakes and eating patterns in response to the HAES intervention

Effect of the Mediterranean diet on lipid and lipoprotein profile : is it influenced by the family history of dyslipidemia?

Background: A large inter-individual variability in the lipid-lipoprotein response to Mediterranean diet (MedDiet) has been highlighted in clinical studies. This variability may be attributed to multiple factors, including inherited genetic susceptibilities to dyslipidemia. The aim of the present study was to examine whether family history of dyslipidemia influences the lipid-lipoprotein response to the MedDiet. Design and Methods: We recruited 36 individuals with a positive family history of dyslipidemia (i.e. having at least one firstdegree relative with a diagnosis of dyslipidemia) and 28 individuals with a negative family history of dyslipidemia, aged between 24-53 years, who had slightly elevated LDL-C concentrations (3.4-4.9 mmol/l) or total cholesterol to HDL-&UDWLR Variables related to the lipid-lipoprotein profile were measured before and after a 4-week isocaloric MedDiet during which all foods and drinks were provided to participants. Results: A group by time interaction was noted for plasma total cholesterol concentrations (P=0.03), subjects with a negative family history of dyslipidemia having greater decreases than those with a positive family history of dyslipidemia (respectively -11.3% vs. -5.1%). Decreases in LDL-C, HDLC, total cholesterol to HDL-C ratio, LDL-C to HDL-C ratio, apolipoprotein (apo) B, apo A- 1, apo A-2 and apo B to apo A-1 ratio were also noted, with no difference between groups (P for group by time interaction ). No change was observed for triglyceride (TG) concentrations and TG to HDL-C ratio. Conclusions: Results highlight that inherited susceptibilities to dyslipidemia may explain at least in part the heterogeneity in the cholesterol-lowering effects of the MedDiet. (A

Effects of the traditional Mediterranean diet on adiponectin and leptin concentrations in men and premenopausal women : do sex differences exist?

Background/Objectives: Most of the interventional studies have investigated the impact of the diet on adiponectin and leptin concentrations only in men or in women. Consequently, it is still unknown whether the consumption of a healthy diet influences in a sex-specific manner these adipocytokines. We examined sex differences in the effects of the Mediterranean diet (MedDiet) on adiponectin and leptin concentrations, and determined whether changes in these adipocytokines are associated with changes in cardiovascular risk factors in both sexes. Subjects/Methods: Participants were 38 men and 32 premenopausal women (24–53 years) with slightly elevated low-density lipoprotein cholestrol concentrations (3.4–4.9¿mmol/l) or total cholesterol/high-density lipoprotein cholestrol (HDL-C)greater than or equal to5.0. Adiponectin, leptin and cardiovascular risk factors were measured before and after a 4-week fully controlled isoenergetic MedDiet. Results: Adiponectin concentration decreased in response to the MedDiet, but this decrease reached statistical significance only in men (P<0.001 for men and P=0.260 for women; sex-by-time interaction, P=0.072). Adjustments for body weight or waist circumference did not change results obtained. Changes in adiponectin were positively associated with concomitant variations in HDL-C in men (r=0.52, P=0.003) and with variations in apolipoprotein A-1 and insulin sensitivity as calculated by both the homeostasis model assessment index for insulin sensitivity and Cederholm indices in women (respectively, r=0.44, P=0.021; r=0.79, P<0.001 and r=0.47, P=0.020). The MedDiet had no impact on leptin and the leptin-to-adiponectin ratio in both sexes. Conclusions: Results suggest a sex difference in adiponectin response to the short-term consumption of the MedDiet, with only men experiencing a decrease. Also sex-specific patterns of associations between changes in adiponectin concentration and changes in cardiovascular risk factors were observed