Lessons from Studies in Middle-Aged and Older Adults Living in Mediterranean Islands: The Role of Dietary Habits and Nutrition Services

Background. Islands in the Mediterranean basin share particular habits and traditions and greater life expectancy than other European regions. In this paper, particular interest has been given to the effect of the Mediterranean diet, as well as nutritional services on CVD risk, on Mediterranean islands. Methods. Published results from observational studies were retrieved from electronic databases (Pubmed and Scopus) and summarized. Results. Prevalence of CVD risk factors is increased. Adherence to the Mediterranean diet was moderate, even among the elderly participants. Furthermore, the presence of a dietician was associated with higher adherence to the Mediterranean dietary pattern and consequently lowers CVD risk. Conclusion. Adherence to the Mediterranean diet is reduced, while the prevalence of CVD risk factors is increasing at alarming rates. Public health nutrition policy has the opportunity to improve the health and quality of life of people living in isolated insular areas of the Mediterranean basin

The role of Mediterranean diet in the epidemiology of metabolic syndrome; converting epidemiology to clinical practice

Metabolic syndrome is a collection of associated conditions such as dyslipidemia, high blood pressure, impaired glucose tolerance and tendency to develop fat around the abdomen. It is now well known that individuals with the metabolic syndrome are at high risk for atherosclerosis and, especially, coronary heart disease. However, it has been suggested that people with the metabolic syndrome may benefit from aggressive lifestyle modification, through diet and exercise. In this review we summarize scientific evidence regarding the effect of Mediterranean diet on the development of metabolic syndrome

Diet, lifestyle factors and hypercholesterolemia in elderly men and women from Cyprus

BACKGROUND: We sought to investigate the single and combined effect of Mediterranean diet, being physically active, moderate alcohol use, and non-smoking on clinical status of 150 elderly people from Cyprus. METHODS: The study comprises individuals enrolled in surveys from Greece and Cyprus. This work includes 53 apparently men and 97 women, aged 65 to 100 years, from various areas of Cyprus. The cohort study was conducted between 2004 and 2005. A diet score that assesses the inherent characteristics of the Mediterranean diet was developed (range 0–55) and then a healthy index was calculated that evaluated four lifestyle habits (range 0 – 4), i.e. non-smoking, alcohol intake, physical activity and adherence to the Mediterranean diet (i.e. above the median of the score). RESULTS: 65% participants had hypercholesterolemia (total serum cholesterol > 200 mg/dl or use of lipid lowering agents). Moreover, 32% of the participants reported physically active, 5% reported smoking habits and 4% that they have stopped smoking during the past decade, while 8% reported alcohol drinking. A positive association was observed between prevalence of hypercholesterolemia and smoking habits (odds ratio = 4.3, p = 0.03), while an inverse association was observed between hypercholesterolemia, alcohol drinking (odds ratio = 0.3, p = 0.04) and adherence to a Mediterranean diet (odds ratio = 0.77, p = 0.02), controlled for age, sex, and other factors. CONCLUSION: Adherence to a Mediterranean diet and healthful lifestyle is associated with reduced odds of having hypercholesterolemia among elderly people

Adherence to the Mediterranean diet moderates the association of aminotransferases with the prevalence of the metabolic syndrome; the ATTICA study

<p>Abstract</p> <p>Background</p> <p>Elevated liver enzymes are markers of liver steatosis and metabolic syndrome. We aimed to investigate the association of Mediterranean diet on the relationship between aminotransferases (i.e., AST, ALT, gGT) and the metabolic syndrome.</p> <p>Methods</p> <p>The ATTICA study has randomly enrolled 1514 adult males (18–87 yrs) and 1528 females (18–89 yrs) from the greater area of Athens. Adherence to Mediterranean diet was assessed through the MedDietScore. According to NCEP III criteria, participants were classified into those with or without the metabolic syndrome.</p> <p>Results</p> <p>Women with metabolic syndrome had higher γGT (p = 0.02) and lower AST/ALT levels (p = 0.018) than those without, and men with metabolic had a lower AST/ALT ratio (p = 0.01) compared to those without metabolic syndrome. The AST/ALT ratio was also positively correlated with MedDietScore (rho = 0.17, <it>p </it>< 0.001), while higher MedDietScore was associated with lower likelihood of having the metabolic syndrome in a multi-adjusted analysis (OR = 0.34, 95% CI: 0.16–0.73). Stratified analysis by the level of adherence to the Mediterranean diet, revealed that only in subjects away or with moderate adherence to the Mediterranean diet, an increase in the AST/ALT ratio was associated with lower likelihood of having the metabolic syndrome (OR = 0.33, <it>p </it>< 0.05 and OR = 0.34, <it>p </it>< 0.09, respectively); however, when we focused in those with greater adherence to the Mediterranean diet, AST/ALT ratio was not associated with the presence of the syndrome (OR = 0.51, <it>p </it>= 0.55). These findings remained similar in both genders, and even when the quantity of alcohol drinking was taken into account.</p> <p>Conclusion</p> <p>Aminotransferases ratio constitutes a marker of the metabolic syndrome among healthy adults; however, this relationship is moderated when individuals are close to the Mediterranean dietary pattern.</p

Dietary meat fats and burden of cardiovascular disease risk factors, in the elderly: a report from the MEDIS study

Dietary fats have long been associated with human health, and especially cardiovascular disease (CVD). Some observational studies have shown that reduction in dietary fats, and particularly cholesterol is associated with lower cardiovascular risk; however, other prospective studies or randomized controlled trials of dietary fat reduction or modification have shown varying results on CVD morbidity and mortality. In this work we evaluated the relationships between dietary fats and a cluster of CVD risk factors (i.e., diabetes, obesity, hypercholesterolemia, hypertension), among elderly individuals without known CVD. In particular, dietary and clinical data from 1486 elderly (aged 65 to 100 years) men and women living in Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Syros, Naxos, Corfu and Zakynthos islands, and participated in the MEDIS study, were analysed. Data analysis revealed that 18.5% of males and 33.3% of females had three or four cardiovascular disease risk factors; the major source of fat was olive oil (mean intake for men and women 50.0 ± 19.3 g/day and 46.0 ± 16.8 g/day, p < 0.001). In addition it was observed that a 5% increase in energy adjusted fat intake from meat was associated with a 21% increase in the likelihood of having one additional CVD risk factor (95%CI 6%-39%); no significant associations were observed regarding the other types of fat consumed by the elderly participants. These findings may state a hypothesis that the consumption of fat only from meat or its products seems to increase the burden of CVD risk factors among CVD-free, elderly people

The Effect of Exclusive Olive Oil Consumption on Successful Aging: A Combined Analysis of the ATTICA and MEDIS Epidemiological Studies

The consumption of dietary fats, which occur naturally in various foods, poses important impacts on health. The aim of this study was to elucidate the association of exclusive use of olive oil for culinary purposes with successful aging in adults aged >50 years old and residing in Greece. Use of olive oil in food preparation and bio-clinical characteristics of the Greek participants enrolled in the ATTICA (n = 1128 adults from Athens metropolitan area) and the MEDiterranean Islands Study (MEDIS) (n = 2221 adults from various Greek islands and Mani) studies, were investigated in relation to successful aging (SA). Participants were divided into the following three categories: (a) no olive oil consumption; (b) combined consumption of olive oil and other dietary fats; and (c) exclusive olive oil consumption. The SA was measured using the previously validated successful aging index (SAI). After adjusting for age, sex, and smoking habits, combined consumption of olive oil and other fats (vs. no olive oil use) was not significantly associated with SAI levels (p = 0.114). However, exclusive olive oil intake (vs. no use of olive oil) was significantly associated with SAI (p = 0.001), particularly among those aged older than 70 years. Therefore, the exclusive consumption of olive oil, as opposed to either combined or no olive oil consumption, beneficially impacts successful aging, particularly among individuals over 70 years of age. Primary public health prevention strategies should seek to encourage the enhanced adoption of such dietary practices in order to promote healthy aging and longevity