Mediterranean diet and cardiodiabesity: a review

Cardiodiabesity has been used to define and describe the well-known relationship between type 2 Diabetes Mellitus (T2DM), obesity, the metabolic syndrome (MetS) and cardiovascular disease (CVD). The objective of this study was to perform a scientific literature review with a systematic search to examine all the cardiovascular risk factors combined and their relationship with adherence to the Mediterranean Diet (MedDiet) pattern as primary prevention against cardiodiabesity in a holistic approach. Research was conducted using the PubMed database including clinical trials, cross-sectional and prospective cohort studies. Thirty-seven studies were reviewed: fourteen related to obesity, ten to CVD, nine to MetS, and four to T2DM. Indeed 33 provided strong evidence on the association between adherence to a MedDiet and a reduced incidence of collective cardiodiabesity risk in epidemiological studies. This scientific evidence makes the MedDiet pattern very useful for preventive strategies directed at the general population and also highlights the need to consider all these diet-related risk factors and health outcomes together in daily primary care

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents

Acord transformatiu CRUE-CSICPurpose Weight Bias Internalization (WBI) is pervasive and potentially damaging for health. Little is known about WBI in youth. As negative efects of WBI have been observed when controlling for BMI, measures that allow WBI to be assessed across diferent weight categories are needed. The Modifed Weight Bias Internalization Scale (WBIS-M) is one of the most frequently used scales in this feld. Our purpose was to obtain a Spanish validated version of the WBIS-M for adolescents across diferent weight statuses. Methods The data were collected from 298 secondary students (mean age 14.31; 48.32% girls; 18.8% were overweight and 6.4% had obesity). Internal structure was examined by a cross-validation analysis, using both exploratory and confrmatory factor analyses in diferent subsamples. Results Item 1 showed a psychometric anomalous functioning and was deleted. The one-factor structure of the 10-item version was confrmed with adequate ft ([EFA (KMO =0.915, χ2(55)=1075.633, p<0.0001)]; [CFA (χ2 (35)=200.515; GFI=0.995; PGFI=0.992; NFI=0.991; SRMR=0.060)]). Internal consistency was high (훼 = 0.93; ω=0.93). Signifcant correlations with the same set of external variables assessed in the original version (anti-fat bias, self-esteem, mood, body dissatisfaction, drive for thinness, binge eating), all of them correlates of WBI in adolescents, were found. Girls and participants with obesity obtained higher scores. Conclusion The results provide support for the validity and reliability of our WBIS-M version for use with adolescents across weight categories in Spain. Level of evidence Level III, evidence obtained from well-designed cohort studies

Influence of the degree of adherence to the mediterranean diet and its components on cardiometabolic risk during pregnancy. The GESTAFIT project

The study was funded by the Regional Ministry of Health of the Junta de Andalucia (PI-0395-2016) and the University of Granada, Unit of Excellence on Exercise and Health (UCEES) . MFA was additionally funded by the Spanish Ministry of Education, Culture and Sports (Grant number FPU17/03715) . The funders of the study had no role in the design of the study, data collection, data analysis or data interpretation. This study is included in the thesis of MFA enrolled in the Doctoral Programme in Nutrition and Food Sciences of the University of Granada.Background and aims: Studies regarding dietary patterns and cardiometabolic risk markers during pregnancy are scarce. The aim of the present study was to analyse whether different degrees of adherence to the Mediterranean diet (MD) and the MD components were associated with cardiometabolic markers and a clustered cardiometabolic risk during pregnancy. Methods and results: This study comprised 119 pregnant women from the GEStation and FITness (GESTAFIT) project. Dietary habits were assessed with a food frequency questionnaire at the 16th and 34th gestational weeks (g.w.). The Mediterranean Diet Score was employed to assess MD adherence. The following cardiometabolic markers were assessed: pre-pregnancy body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C). A greater MD adherence was associated with a better cardiometabolic status in cross-sectional (16th g.w. and 34th g.w.) and prospective analyses (MD adherence at the 16th g.w. and cardiometabolic markers at the 34th g.w.; SBP, DBP and HDL-C; all, p < 0.05). Participants with the highest MD adherence (Tertile 3) had a lower clustered cardiometabolic risk than those with the lowest MD adherence (Tertile 1) at the 16th and 34th g.w. (both, p < 0.05). A higher intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts were associated with a lower cardiometabolic risk during pregnancy (all, p < 0.05). Conclusion: A higher MD adherence, a greater intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts showed a cardioprotective effect throughout gestation.Regional Ministry of Health of the Junta de Andalucia PI-0395-2016University of Granada, Unit of Excellence on Exercise and Health (UCEES)Spanish Ministry of Education, Culture and Sports FPU17/0371

Diet, exercise and dementia: The potential impact of a Mediterranean diet pattern and physical activity on cognitive health in a UK population

Diet and physical activity play key roles in maintaining health and preventing or delaying disease. The global prevalence of dementia, an umbrella term describing a set of symptoms which affect cognitive function, is set to rise dramatically by 2050, with current drug treatments inadequate. Diet and physical activity are modifiable factors in dementia, influencing both disease risk and pathophysiology. It has been known since the 1950s that a Mediterranean diet has positive health benefits. Over the past 25 years, a causal link has been shown between consumption of a Mediterranean diet and decreased risk of cardiovascular disease, particularly in Mediterranean countries. There have also been indications that a Mediterranean diet and increased physical activity can improve cognitive health and delay the onset of dementia. However, causative demonstrations of these effects, as well as the feasibility of implementing such lifestyle changes in a non‐Mediterranean population, are lacking. The new MedEx‐UK programme will attempt to address both these points

Mediterranean diet pyramid today. Science and cultural updates

Objective: To present the Mediterranean diet (MD) pyramid: a lifestyle for today. Design: A new graphic representation has been conceived as a simplified main frame to be adapted to the different nutritional and socio-economic contexts of the Mediterranean region. This review gathers updated recommendations considering the lifestyle, dietary, sociocultural, environmental and health challenges that the current Mediterranean populations are facing. Setting and Subjects: Mediterranean region and its populations. Results: Many innovations have arisen since previous graphical representations of the MD. First, the concept of composition of the ‘main meals’ is introduced to reinforce the plant-based core of the dietary pattern. Second, frugality and moderation is emphasised because of the major public health challenge of obesity. Third, qualitative cultural and lifestyle elements are taken into account, such as conviviality, culinary activities, physical activity and adequate rest, along with proportion and frequency recommendations of food consumption. These innovations are made without omitting other items associated with the production, selection, processing and consumption of foods, such as seasonality, biodiversity, and traditional, local and eco-friendly products. Conclusions: Adopting a healthy lifestyle and preserving cultural elements should be considered in order to acquire all the benefits from the MD and preserve this cultural heritage. Considering the acknowledgment of the MD as an Intangible Cultural Heritage of Humanity by UNESCO (2010), and taking into account its contribution to health and general well-being, we hope to contribute to a much better adherence to this healthy dietary pattern and its way of life with this new graphic representation.peer-reviewe

Portugal nutritional transition during the last 4 decades: 1974–2011

Objective: To examine trends in food availability for Portugal during the last 4 decades (1974–2011) and analyze such changes in accordance with the nutritional transition theory.Methods: Food balance sheets from Portugal from 1974 to 2011 were analyzed for potential trends by linear regression to study the availability of protein, fat, carbohydrate, ethanol, and total energy and the availability of the following food groups: (i) cereals and tubers; (ii) vegetables; (iii) fruit; (iv) milk; (v) meat, fish, and eggs; (vi) fat; (vii) pulses; (viii) alcoholic beverages; and (ix) sugar and sweeteners. A comparison regarding protein, fat, and carbohydrate availability and WHO recommendation was also performed.Results: The data suggest that in Portugal food availability and consumption have changed throughout the analyzed period. The national availability of most food groups increased considerably, which also resulted in an increase in daily energy. The consumption of cereals and tubers, pulses, and alcohol diminished during this time. Energy availability increased by 406 kcal/person/day, a result from an increase in protein and fat. Protein availability was in accordance with WHO recommendations during the 4 decades analyzed, whereas carbohydrate have always been below the recommended level and fat has been above the recommended level since the second decade (1984).Conclusion: Portugal has crossed into a nutritional transition over the last 4 decades, revealing characteristics of a pattern of degenerative diseases. The country may experience a new nutritional transition that would involve positive changes of behavior, as observed in other developed countries, driven by community multisectorial strategies.info:eu-repo/semantics/publishedVersio

An energy- and nutrient-corrected functional unit to compare LCAs of diets

Dietary choices, a main driver of food production, play a significant role within the climate change arena. Consequently, there is a growing trend on publishing research assessing the environmental impacts of diets and dietary shifts, mainly following the life cycle assessment (LCA) methodology. However, several methodological issues still bring a challenge, especially in the definition of the function and the quantification of the functional unit (FU). The FU is the reference unit of an LCA study, and it is the basis for allowing comparison among different systems. This short communication defines the function of diets as the supply of the daily required amount of calories and nutrients, and it proposes a novel FU that accounts for the energy intake and the nutritional quality of the diet. In order to compare the performance of the proposed FU to the most commonly ones used for diet LCAs (mass-based and isocaloric), dietary scenarios within the Spanish context are assessed. On the one hand, using a mass-based FU, greenhouse gas (GHG) emissions are underestimated, since the nutrition properties of food are not considered, and, on the other hand, the isocaloric substitution does not allow comparison among diets with different levels of energy intake. In contrast, the proposed caloric- and nutrient-corrected FU allows to compare diets that differ in energy and nutritional quality in a fairer way. Finally, it is recommended to use this FU for future diet LCAs.This study is part of the Ceres-Procon Project: Food production and consumption strategies for climate change mitigation (CTM2016-76176-C2-1-R) (AEI/FEDER, UE), financed by the Spanish Ministry of Economy and Competitiveness, which aims to determine strategies to improve the sustainability of current food production and consumption

Updating the mediterranean diet pyramid towards sustainability: focus on environmental concerns

Background: Nowadays the food production, supply and consumption chain represent a major cause of ecological pressure on the natural environment, and diet links worldwide human health with environmental sustainability. Food policy, dietary guidelines and food security strategies need to evolve from the limited historical approach, mainly focused on nutrients and health, to a new one considering the environmental, socio-economic and cultural impact—and thus the sustainability—of diets. Objective: To present an updated version of the Mediterranean Diet Pyramid (MDP) to reflect multiple environmental concerns. Methods: We performed a revision and restructuring of the MDP to incorporate more recent findings on the sustainability and environmental impact of the Mediterranean Diet pattern, as well as its associations with nutrition and health. For each level of the MDP we provided a third dimension featuring the corresponding environmental aspects related to it. Conclusions: The new environmental dimension of the MDP enhances food intake recommendations addressing both health and environmental issues. Compared to the previous 2011 version, it emphasizes more strongly a lower consumption of red meat and bovine dairy products, and a higher consumption of legumes and locally grown eco-friendly plant foods as much as possible

Long-term effects of an exercise and Mediterranean diet intervention in the vascular function of an older, healthy population

Background - Preserving endothelial function and microvascular integrity is suggested to reduce cardiovascular disease risk. It was recently shown that the age-dependent decline in endothelial and microvascular integrity may be reversed when combining exercise with Mediterranean diet (MD) in an 8-week intervention. The present study investigates whether the risk-reduction improvement in microcirculatory and cardiorespiratory functions are sustained in this age-group after a 1-year follow-up. Design and methods - Twenty sedentary healthy participants (age, 55 ± 4 years) from the original study underwent cardiopulmonary exercise tolerance test and were assessed for their upper- and lower-limb vascular endothelial cutaneous vascular conductance (CVC) using laser Doppler fluximetry (LDF) with endothelium-dependent [ACh (acetylcholine chloride)] and endothelium-independent [SNP (sodium nitroprusside)] vasodilation, 1 year after completing the intervention. Results - Both MD and exercise groups appeared to have an improved microvascular responses, in comparison to baseline as far as ACh is concerned. Exploring the interactions between the time point and the original group, however, revealed a stronger improvement in the MD group in comparison to the exercise group, for ACh (p = 0.04, d = 0.41). In the upper body, the time point and group interaction for ACh, indicated a better improvement for MD, without however statistical significance (p = 0.07, d = 0.24). Additionally, cardiorespiratory improvement in ventilatory threshold was maintained, 1 year after (12.2 ± 3.0 vs. 13.2 ± 3.2 ml ∙ kg− 1 ∙ min− 1, p Conclusions - The original improvements from an 8-week exercise and MD intervention were still evident, particularly in the microcirculatory and cardiorespiratory assessments, 1 year after the initial study. This suggests that a brief intervention combining MD with exercise in this high-risk group promises long-term health benefits.</p