Dairy consumption and cardiometabolic diseases: systematic review and updated meta-analyses of prospective cohort studies

Purpose of Review Dairy products contain both beneficial and harmful nutrients in relation to cardiometabolic diseases. Here, we provide the latest scientific evidence regarding the relationship between dairy products and cardiometabolic diseases by reviewing the literature and updating meta-analyses of observational studies. Recent Findings We updated our previous meta-analyses of cohort studies on type 2 diabetes, coronary heart disease (CHD), and stroke with nine studies and confirmed previous results. Total dairy and low-fat dairy (per 200 g/d) were inversely associated with a 3–4% lower risk of diabetes. Yogurt was non-linearly inversely associatedwith diabetes (RR = 0.86, 95%CI: 0.83–0.90 at 80 g/ d). Total dairy and milk were not associated with CHD (RR~1.0). An increment of 200 g of daily milk intake was associated with an 8% lower risk of stroke. Summary The latest scientific evidence confirmed neutral or beneficial associations between dairy products and risk of cardiometabolic diseases

Η θεμελίωση και η υφή των δικαιωμάτων σύμφωνα με τον Robert Nozick.

Η εργασία πραγματεύεται τη θεμελίωση και την υφή των δικαιωμάτων, όπως αυτά τα εισάγει ο Robert Nozick στο έργο του Anarchy, State and Utopia το οποίο εκδόθηκε το 1974. Το θέμα όμως είναι πιο ευρύ από ότι δηλώνει ο τίτλος γιατί ανάλογα την υφή και τον τρόπο με τον οποίο εισάγονται τα δικαιώματα σε μια θεωρία υπάρχουν βαθύτατα διαφορετικές κατευθύνσεις της ίδιας της θεωρίας αλλά και επί ζητημάτων στον υλικό κόσμο που καλείται να αντιμετωπίσει. Ο Nozick εισάγει με κεντρικό τρόπο τα δικαιώματα και η θεωρία του είναι μία rights based theory, δηλαδή μία θεωρία που θεμελιώνεται και βασίζεται στα δικαιώματα και στον κεντρικό τρόπο με τον οποίο εισάγονται. Η πρωτοκαθεδρία των δικαιωμάτων όπως αυτά εισάγονται από τον Nozick δεν αφήνει περιθώρια εισαγωγής μιας ωφελιμιστικής προσέγγισης, ούτε ενός ωφελιμισμού των δικαιωμάτων. Από την άλλη μεριά, ο απόλυτος τρόπος εισαγωγής των δικαιωμάτων ως πλευρικών περιορισμών καθώς και όσα δέχεται περί ιδιοκτησίας ο Nozick, οδηγούν στην υιοθέτηση λύσεων όπως το ελάχιστο κράτος και η απόρριψη κάθε έννοιας κρατικής μέριμνας για αναδιανεμητική δικαιοσύνη.The work deals with the foundation and texture of rights, such as these Robert Nozick in his work Anarchy, State and Utopia, published in 1974. But the issue is broader than the title suggests because depending on the texture and the way in which rights are introduced into a theory, there are profoundly different directions of the theory itself but also on issues in the material world that it is called to face.Nozick introduces rights in a central way and his theory is a rights based theory, that is, a theory that is founded and based on the rights and the central way in which they are introduced. The primacy of rights as introduced by Nozick leaves no room for the introduction of a utilitarian approach, nor of a utilitarianism of rights. On the other hand, the absolute way of introducing rights as lateral restrictions as well as what Nozick accepts about property, lead to the adoption of solutions such as the minimum state and the rejection of any notion of state care for redistributive justice

Mediterranean Diet and Cardiovascular Health: Teachings of the PREDIMED Study123

The PREDIMED (Prevención con Dieta Mediterránea) study was designed to assess the long-term effects of the Mediterranean diet (MeDiet) without any energy restriction on incident cardiovascular disease (CVD) as a multicenter, randomized, primary prevention trial in individuals at high risk. Participants were randomly assigned to 3 diet groups: 1) MeDiet supplemented with extra-virgin olive oil (EVOO); 2) MeDiet supplemented with nuts; and 3) control diet (advice on a low-fat diet). After 4.8 y, 288 major CVD events occurred in 7447 participants; crude hazard ratios were 0.70 (95% CI: 0.53, 0.91) for the MeDiet + EVOO and 0.70 (95% CI: 0.53, 0.94) for the MeDiet + nuts compared with the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 participants without diabetes were 0.60 (95% CI: 0.43, 0.85) and 0.82 (95% CI: 0.61, 1.10) compared with the control group. After 1-y follow-up, participants in the MeDiet + nuts group showed a significant 13.7% reduction in prevalence of metabolic syndrome compared with reductions of 6.7% and 2.0% in the MeDiet + EVOO and control groups, respectively. Analyses of intermediate markers of cardiovascular risk demonstrated beneficial effects of the MeDiets on blood pressure, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis, as well as on the expression of proatherogenic genes involved in vascular events and thrombosis. Nutritional genomics studies demonstrated interactions between a MeDiet and cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), apolipoprotein A2 (APOA2), cholesteryl ester transfer protein plasma (CETP), and transcription factor 7-like 2 (TCF7L2) gene polymorphisms. The PREDIMED study results demonstrate that a high-unsaturated fat and antioxidant-rich dietary pattern such as the MeDiet is a useful tool in the prevention of CVD

Intake estimation of total and individual flavan-3-ols, proanthocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Epidemiological studies suggest health-protective effects of flavan-3-ols and their derived compounds on chronic diseases. The present study aimed to estimate dietary flavan-3-ol, proanthocyanidin (PA) and theaflavin intakes, their food sources and potential determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration cohort. Dietary data were collected using a standardised 24 h dietary recall software administered to 36 037 subjects aged 35-74 years. Dietary data were linked with a flavanoid food composition database compiled from the latest US Department of Agriculture and Phenol-Explorer databases and expanded to include recipes, estimations and retention factors. Total flavan-3-ol intake was the highest in UK Health-conscious men (453·6 mg/d) and women of UK General population (377·6 mg/d), while the intake was the lowest in Greece (men: 160·5 mg/d; women: 124·8 mg/d). Monomer intake was the highest in UK General population (men: 213·5 mg/d; women: 178·6 mg/d) and the lowest in Greece (men: 26·6 mg/d in men; women: 20·7 mg/d). Theaflavin intake was the highest in UK General population (men: 29·3 mg/d; women: 25·3 mg/d) and close to zero in Greece and Spain. PA intake was the highest in Asturias (men: 455·2 mg/d) and San Sebastian (women: 253 mg/d), while being the lowest in Greece (men: 134·6 mg/d; women: 101·0 mg/d). Except for the UK, non-citrus fruits (apples/pears) were the highest contributors to the total flavan-3-ol intake. Tea was the main contributor of total flavan-3-ols in the UK. Flavan-3-ol, PA and theaflavin intakes were significantly different among all assessed groups. This study showed heterogeneity in flavan-3-ol, PA and theaflavin intake throughout the EPIC countries

Validation of self-reported incident cardiovascular disease events in the Greek EPIC cohort study

Background: the aim of the study is to investigate the validity of self-reported incident cardiovascular disease in the Greek EPIC cohort during follow up. Methods: cardiovascular disease was considered in 4 groups: Myocardial infarction (MI), Angina, Cerebrovascular disease, and other coronary heart disease (other CHD). Validation for all reported incident cardiovascular events was sought through medical records of hospitals around the country and local death registries. Results: in total, there had been 121 self reported incident cases of angina, 683 of MI, 622 of other CHD and 855 of cerebrovascular disease. Records were searched for 926 participants with reported cardiovascular disease (CVD), and from those, medical records for the 832 (90%) were obtained from the respective hospitals. Examination of the medical records that were obtained confirmed the self report in 72% of incident strokes, 65% of MIs, 55% of other CHD cases and 32% of angina. Conclusions: it appears that in our study self reported MI and stroke (or transient ischemic attacks) had a higher validity, compared to self reported angina and other CHD. Our results are comparable to those in other cohort studies

Οι νομικές μεταφυτεύσεις (legal transplants) : οφέλη και προβληματική.

Oι κοινωνίες, σε πολλές περιπτώσεις, όπου είχαμε συνάντηση πολιτισμών, ενίοτε υιοθετούσαν ξένες νομικές λύσεις για συγκεκριμένα προβλήματα. Με άλλα λόγια, στα προβλήματα που συναντούσαν οι κοινωνίες, σε πολλές περιπτώσεις, εφάρμοζαν δοκιμασμένες λύσεις από άλλεςκοινωνίες, μεταφυτεύοντας δίκαιο από τις τελευταίες. Mε τον όρο νομικές μεταφυτεύσεις, εννοούμε την εισαγωγή νομικών κανόνων από ένα ξένο νομικό σύστημα. Διαισθητικά αντιλαμβανόμαστε πως η μεταφορά των νομικών κανόνων από ένα νομικό σύστημα σε ένα άλλο νομικό σύστημα αποτελεί ένα περίπλοκο διάβημα με βαθιές εξωνομικές επιπτώσεις. Μεταξύ αυτών, οι πολιτιστικές επιπτώσεις είναι προφανείς. Έτσι, θα γίνει μια προσπάθεια να απαντηθούν στην παρούσα ερωτήματα, όπως: κατά πόσο οι νομικές μεταφυτεύσεις αλλοιώνουν τον πολιτισμό μιας κοινωνίας, μπορούν να εισάγονται χωρίς κάποιες προϋποθέσεις ή με κάποιο μηχανισμό, ποιοι οι κίνδυνοι και γιατί, εν τέλει, χρησιμοποιούνται.The societies, in many cases, where we had meeting of cultures, they sometimes adopted foreign legal solutions for specific problems. In other words, to the problems encountered by the societies, in many cases, they applied tried and tested solutions from other societies, transplanting law from the latter. By the term legal transplants, we mean the introduction of legal rules from a foreign legal system. We intuitively understand that the transfer of legal rules from one legal system to another legal system is a complex process with profound extra-legal implications. Among these, the cultural implications are obvious. Thus, an attempt will be made to answer the present questions, such as: to what extent legal transplants alter the culture of a society, can they be introduced without some conditions or with some mechanism, what are the risks and why, in the end, are they used

The role of a Mediterranean diet on the risk of oral and pharyngeal cancer.

BACKGROUND: The Mediterranean diet has a beneficial role on various neoplasms, but data are scanty on oral cavity and pharyngeal (OCP) cancer. METHODS: We analysed data from a case-control study carried out between 1997 and 2009 in Italy and Switzerland, including 768 incident, histologically confirmed OCP cancer cases and 2078 hospital controls. Adherence to the Mediterranean diet was measured using the Mediterranean Diet Score (MDS) based on the major characteristics of the Mediterranean diet, and two other scores, the Mediterranean Dietary Pattern Adherence Index (MDP) and the Mediterranean Adequacy Index (MAI). RESULTS: We estimated the odds ratios (ORs), and the corresponding 95% confidence intervals (CI), for increasing levels of the scores (i.e., increasing adherence) using multiple logistic regression models. We found a reduced risk of OCP cancer for increasing levels of the MDS, the ORs for subjects with six or more MDS components compared with two or less being 0.20 (95% CI 0.14-0.28, P-value for trend <0.0001). The ORs for the highest vs the lowest quintile were 0.20 (95% CI 0.14-0.28) for the MDP score (score 66.2 or more vs less than 57.9), and 0.48 (95% CI 0.33-0.69) for the MAI score (score value 2.1 or more vs value less 0.92), with significant trends of decreasing risk for both scores. The favourable effect of the Mediterranean diet was apparently stronger in younger subjects, in those with a higher level of education, and in ex-smokers, although it was observed in other strata as well. CONCLUSIONS: Our study provides strong evidence of a beneficial role of the Mediterranean diet on OCP cancer

Adherence to a Mediterranean-like dietary pattern in children from eight European countries : the IDEFICS study

BACKGROUND: Despite documented benefits of a Mediterranean-like dietary pattern, there is a lack of knowledge about how children from different European countries compare with each other in relation to the adherence to this pattern. In response to this need, we calculated the Mediterranean diet score (MDS) in 2-9-year-old children from the Identification and prevention of dietary-and lifestyle-induced health effects in children and infants (IDEFICS) eight-country study. SUBJECTS AND METHODS: Using 24 h dietary recall data obtained during the IDEFICS study (n = 7940), an MDS score was calculated based on the age- and sex-specific population median intakes of six food groups (vegetables and legumes, fruit and nuts, cereal grains and potatoes, meat products and dairy products) and the ratio of unsaturated to saturated fats. For fish and seafood, which was consumed by 10% of the population, one point was given to consumers. The percentages of children with high MDS levels (43) were calculated and stratified by sex, age and by having at least one migrant parent or both native parents. Demographic (sex and age) and socioeconomic characteristics (parental education and income) of children showing high (43) vs low (<= 3) MDS levels were examined. RESULTS: The highest prevalence of children with MDS 43 was found among the Italian pre-school boys (55.9%) and the lowest among the Spanish school-aged girls (26.0%). Higher adherence to a Mediterranean-like dietary pattern was not associated with living in a Mediterranean country or in a highly educated or high-income family, although with some exceptions. Differences in adherence between boys and girls or age groups varied between countries without any general pattern. CONCLUSIONS: With the exception of Italian pre-schoolers, similar adherence levels to a Mediterranean-like dietary pattern have been observed among European children

Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality – a systematic review and dose-response meta-analysis of prospective studies

Background: Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations. Methods: PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included. Results: For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90–0.94, I2 = 0%, n = 15] for coronary heart disease, 0.84 (95% CI: 0.76–0.92, I2 = 73%, n = 10) for stroke, 0.92 (95% CI: 0.90–0.95, I2 = 31%, n = 13) for cardiovascular disease, 0.97 (95% CI: 0.95–0.99, I2 = 49%, n = 12) for total cancer and 0.90 (95% CI: 0.87–0.93, I2 = 83%, n = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal. Conclusions: Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality

Estimation of the intake of anthocyanidins and their food sources in the European prospective investigation into cancer and nutrition (EPIC) study

Anthocyanidins are bioactive flavonoids with potential health-promoting effects. These may vary among single anthocyanidins considering differences in their bioavailability and some of the mechanisms involved. The aim of the present study was to estimate the dietary intake of anthocyanidins, their food sources and the lifestyle factors (sex, age, BMI, smoking status, educational level and physisical activity) involved among twenty-seven centres in ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthocyanidin intake and their food sources for 36 037 subjects, aged between 35 and 74 years, in twenty-seven redefined centres were obtained using standardised 24 h dietary recall software (EPIC-SOFT). An ad hoc food composition database on anthocyanidins (cyanidin, delphinidin, malvidin, pelargonidin, peonidin, petunidin) was compiled using data from the US Department of Agriculture and Phenol-Explorer databases and was expanded by adding recipes, estimated values and cooking factors. For men, the total anthocyanidin mean intake ranged from 19·83 (se 1·53) mg/d (Bilthoven, The Netherlands) to 64·88 (se 1·86) mg/d (Turin, Italy), whereas for women the range was 18·73 (se 2·80) mg/d (Granada, Spain) to 44·08 (se 2·45) mg/d (Turin, Italy). A clear south to north gradient intake was observed. Cyanidins and malvidins were the main anthocynidin contributors depending on the region and sex. Anthocyanidin intake was higher in non-obese older females, non-smokers, and increased with educational level and physical activity. The major food sources were fruits, wine, non-alcoholic beverages and some vegetables. The present study shows differences in both total and individual anthocyanidin intakes and various lifestyle factors throughout Europe, with some geographical variability in their food sources