The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change:A Follow-Up Study in the General Population of Southern Croatia

The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18–98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0–24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007–2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (−8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p < 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (−35.1%), fish (−23.4%), white meat (−11.6%), cereals (−10.9%), and dairy products (−9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake

Searching for carbonylome biomarkers of aging – development and validation of the proteomic method for quantification of carbonylated protein in human plasma

Aim To develop a method for measuring protein carbonylation in human plasma and serum samples, which was previously implied in numerous age-related phenotypes. Methods Protein expression and carbonylation were analyzed in plasma samples obtained from 12 healthy human individuals by using a novel method that combines affinity-based albumin and immunoglobulin G removal, and aminooxy dyeing in one- or two-dimensional gels. In addition, carbonylome profile of plasma and serum was compared. Coefficients of variation and intra-class correlation coefficients were used in statistical analysis. Results Following a step-wise laboratory development and optimization process, we measured the protein expression and carbonylation for 813 proteins from the plasma. The analysis of repeated measurements suggested excellent coefficients of variation, which rarely exceeded 10%. The average value of intra-class correlation based on absolute agreement (ICC) for protein expression was 0.97 ± 0.02, while for carbonylation it was 0.73 ± 0.24. The removal of the most extreme protein outlier in carbonylation assessment increased the average ICC to 0.87 ± 0.04. Low protein spot volume substantially reduced repeatability. Serum carbonylation estimates were similar to those from plasma, with the ICC in the range of 0.86-0.89. Conclusion We developed a reliable method for the measurement of human plasma protein carbonylation, which can be used for the assessment of carbonylome biomarkers of aging

Odrednice, trendovi i zdravstveni ishodi povezani s mediteranskom prehranom u populaciji Dalmacije, Hrvatska

One of the foremost public health challenges today and on the global level are noncommunicable disease, arising mostly due to an unhealthy lifestyle. Especially high burden represents an unhealthy diet. The Mediterranean diet is one of the most commonly investigated nutritional pattern with a large body of evidence showing that adherence to it can sustain and preserve human health, with numerous health benefits already being recorded. The most prominent characteristics of the MD are the use of olive oil as the primary fat source, an abundance of vegetables, fruits, nuts, and whole grains daily, moderate red wine and legumes consumption, while animal products are more of a relish, and the priority is given to fish and white meat over red and processed meat. The research aims of this thesis are to assess the compliance with the Mediterranean dietary pattern and its constituting components, to estimate the temporal trend in adherence to the Mediterranean diet and the contribution of several socio-economic factors in the changing pattern of both the Mediterranean diet and body mass index in a follow-up study, and to investigate the association between nut consumption and various cardiovascular risk factors in the population of Dalmatia in Southern Croatia. The results of this study revealed a rather unsatisfactory situation in Southern Croatia in terms of Mediterranean diet consumption. A wide range of adherence to MDSS components was present (from as low as 4.6% for nuts, and up to 91.7% adherence for cereals), with a rather low prevalence of adherence to the Mediterranean diet in the entire sample (28.5%), especially among younger individuals (14.0%). Better compliance with the overall Mediterranean diet, as well as for the majority of the MDSS components was recorded among the oldest group of subjects, especially women. We failed to find any association between subjective material status and adherence to the Mediterranean diet, whereas objective material status presented as the most prominent socio-economic indicator for the overall adherence to the Mediterranean diet, but also several food groups. Subjects included in the follow-up had higher adherence to the Mediterranean diet at baseline (36.6%), with a borderline insignificant decline at the end of the follow-up period (33.5%). The multivariate model revealed that female gender, older age at baseline, the highest level of education, and a moderate level of physical activity were positively associated, while the MDSS at baseline was negatively associated with the MDSS change during the follow-up. On the other hand, BMI had increased on average by 6.5% in subjects available for follow-up. BMI change during follow-up was positively associated with the female gender, and negatively with initial BMI, initial adherence to the MD, and change in adherence to the MD, as found in the regression analysis. Nut consumption in this study was associated with reduced odds for decreased HDL cholesterol and reduced odds for increased fibrinogen, while total cholesterol and LDL cholesterol did not reach the significance level (when overall P value was observed) and triglycerides did not exhibit any association with nut intake within this study. The study also revealed the association between nut consumption and indices of central obesity (defined by the waist-to-height and waist-to-hip ratios), while at the same time there was no association with direct measures, namely waist circumference or BMI. We found no such association between nut intake and the presence of the diagnosis of hypertension, diabetes or gout, but we did find some indication of the association between monthly nut intake and lower odds for metabolic syndrome presence. Interestingly, we found that subjects who did not comply with a Mediterranean diet had lower odds for the presence of diabetes and elevated HbA1c, but higher odds for obesity. Overall, the importance of a healthy lifestyle and healthy dietary habits came to the frontline of attention due to the COVID-19 pandemic. The insights from these studies should be used to inform the necessary and targeted public health interventions aimed at increasing the MD uptake to ensure beneficial outcomes at the individual and the population level. This is relevant from the perspective of population health and delivery of adequate health care, as well as from the perspective of economic, social, and cultural development, and preservation of cultural heritage for generations to come.Jedan od najvećih javnozdravstvenih izazova danas na globalnoj razini su nezarazne bolesti, koje uglavnom nastaju zbog nezdravog načina života. Posebno veliko opterećenje predstavlja nezdrava prehrana. Mediteranska prehrana jedan je od najčešće istraživanih prehrambenih obrazaca s velikim brojem dokaza koji pokazuju da njezino pridržavanje može održati i očuvati ljudsko zdravlje, uz brojne zabilježene zdravstvene prednosti. Najistaknutije karakteristike mediteranske prehrane su korištenje maslinovog ulja kao primarnog izvora masti, svakodnevno obilje povrća, voća, orašastih plodova i cjelovitih žitarica, umjerena konzumacija crnog vina i mahunarki, dok su životinjski proizvodi više užitak a u odnosu na crveno i prerađeno meso prednost ima riba i bijelo meso. Ciljevi istraživanja ovog doktorskog rada su procijeniti usklađenost s mediteranskim načinom prehrane i njegovim sastavnim komponentama, procijeniti vremenski trend pridržavanja mediteranske prehrane i doprinos nekoliko socio-ekonomskih čimbenika u promjeni obrasca mediteranske prehrane i indeksa tjelesne mase u ponovljenoj studiji, kao i istražiti povezanost između konzumacije orašastih plodova i različitih kardiovaskularnih čimbenika rizika u populaciji Dalmacije u južnoj Hrvatskoj. Rezultati ovog istraživanja pokazali su prilično nezadovoljavajuću situaciju u južnoj Hrvatskoj u pogledu pridržavanja mediteranskoj prehrani. Prisutan je širok raspon pridržavanja pojedinim komponentama MDSS-a (od čak 4,6% za orašaste plodove, do 91,7% pridržavanja za žitarice), s prilično niskom prevalencijom pridržavanja mediteranskoj prehrani u cijelom uzorku (28,5%), osobito među mlađim osobama (14,0%). Bolja usklađenost s cjelokupnom mediteranskom prehranom, kao i za većinu komponenti MDSS-a zabilježena je kod najstarije skupine ispitanika, posebice žena. Nismo uspjeli pronaći povezanost između subjektivnog materijalnog statusa i pridržavanja mediteranske prehrane, dok je objektivni materijalni status predstavljen kao najistaknutiji socio-ekonomski pokazatelj za cjelokupno pridržavanje mediteranske prehrane, ali i nekoliko skupina namirnica. Ispitanici uključeni u praćenje imali su veću privrženost mediteranskoj prehrani na početku (36,6%), s graničnim neznatnim padom na kraju razdoblja praćenja (33,5%). Multivarijatni model je otkrio da su ženski spol, starija dob na početku, najviša razina obrazovanja i umjerena razina tjelesne aktivnosti bili pozitivno povezani, dok je MDSS na početku bio negativno povezan s promjenom MDSS-a tijekom praćenja. S druge strane, indeks tjelesne mase se u prosjeku povećao za 6,5% kod ispitanika dostupnih za praćenje. Promjena BMI tijekom praćenja bila je pozitivno povezana sa ženskim spolom, a negativno s početnim BMI-om, početnim pridržavanjem mediteranskoj prehrani i promjenom pridržavanja mediteranskoj prehrani, kao što je pronađeno u regresijskoj analizi. Konzumacija orašastih plodova u ovoj studiji bila je povezana sa smanjenim izgledima za smanjenje HDL kolesterola i smanjenim izgledima za povećanje fibrinogena, dok ukupni kolesterol i LDL kolesterol nisu dosegli razinu značajnosti (kada je promatrana ukupna P vrijednost), a trigliceridi nisu pokazali nikakvu povezanost s unosom orašastih plodova unutar ove studije. Studija je također otkrila povezanost između konzumacije orašastih plodova i indeksa središnje pretilosti (definiranih omjerima struka prema visini, te struka i boka), dok u isto vrijeme nije bilo povezanosti s izravnim mjerama, odnosno opsegom struka ili indeksom tjelesne mase. Nismo pronašli takvu povezanost između unosa orašastih plodova i prisutnosti dijagnoze hipertenzije, dijabetesa ili gihta, ali smo pronašli neke naznake povezanosti između mjesečnog unosa orašastih plodova i nižih izgleda za prisutnost metaboličkog sindroma. Zanimljiv je rezultat da ispitanici koji se nisu pridržavali mediteranske prehrane imaju manje šanse za prisutnost dijabetesa i povišen HbA1c, ali veće šanse za pretilost. Općenito, važnost zdravog načina života i zdravih prehrambenih navika došla je u prvi plan pozornosti zbog pandemije COVID-19. Uvidi iz ovih studija trebali bi se koristiti za informiranje o potrebnim i ciljanim javno-zdravstvenim intervencijama usmjerenim na povećanje prihvaćanja mediteranske prehrane kako bi se osigurali korisni ishodi na razini pojedinca i populacije. To je relevantno iz perspektive zdravlja stanovništva i pružanja adekvatne zdravstvene skrbi, kao i iz perspektive gospodarskog, društvenog i kulturnog razvoja, te očuvanja kulturne baštine za generacije koje dolaze

Odrednice, trendovi i zdravstveni ishodi povezani s mediteranskom prehranom u populaciji Dalmacije, Hrvatska

One of the foremost public health challenges today and on the global level are noncommunicable disease, arising mostly due to an unhealthy lifestyle. Especially high burden represents an unhealthy diet. The Mediterranean diet is one of the most commonly investigated nutritional pattern with a large body of evidence showing that adherence to it can sustain and preserve human health, with numerous health benefits already being recorded. The most prominent characteristics of the MD are the use of olive oil as the primary fat source, an abundance of vegetables, fruits, nuts, and whole grains daily, moderate red wine and legumes consumption, while animal products are more of a relish, and the priority is given to fish and white meat over red and processed meat. The research aims of this thesis are to assess the compliance with the Mediterranean dietary pattern and its constituting components, to estimate the temporal trend in adherence to the Mediterranean diet and the contribution of several socio-economic factors in the changing pattern of both the Mediterranean diet and body mass index in a follow-up study, and to investigate the association between nut consumption and various cardiovascular risk factors in the population of Dalmatia in Southern Croatia. The results of this study revealed a rather unsatisfactory situation in Southern Croatia in terms of Mediterranean diet consumption. A wide range of adherence to MDSS components was present (from as low as 4.6% for nuts, and up to 91.7% adherence for cereals), with a rather low prevalence of adherence to the Mediterranean diet in the entire sample (28.5%), especially among younger individuals (14.0%). Better compliance with the overall Mediterranean diet, as well as for the majority of the MDSS components was recorded among the oldest group of subjects, especially women. We failed to find any association between subjective material status and adherence to the Mediterranean diet, whereas objective material status presented as the most prominent socio-economic indicator for the overall adherence to the Mediterranean diet, but also several food groups. Subjects included in the follow-up had higher adherence to the Mediterranean diet at baseline (36.6%), with a borderline insignificant decline at the end of the follow-up period (33.5%). The multivariate model revealed that female gender, older age at baseline, the highest level of education, and a moderate level of physical activity were positively associated, while the MDSS at baseline was negatively associated with the MDSS change during the follow-up. On the other hand, BMI had increased on average by 6.5% in subjects available for follow-up. BMI change during follow-up was positively associated with the female gender, and negatively with initial BMI, initial adherence to the MD, and change in adherence to the MD, as found in the regression analysis. Nut consumption in this study was associated with reduced odds for decreased HDL cholesterol and reduced odds for increased fibrinogen, while total cholesterol and LDL cholesterol did not reach the significance level (when overall P value was observed) and triglycerides did not exhibit any association with nut intake within this study. The study also revealed the association between nut consumption and indices of central obesity (defined by the waist-to-height and waist-to-hip ratios), while at the same time there was no association with direct measures, namely waist circumference or BMI. We found no such association between nut intake and the presence of the diagnosis of hypertension, diabetes or gout, but we did find some indication of the association between monthly nut intake and lower odds for metabolic syndrome presence. Interestingly, we found that subjects who did not comply with a Mediterranean diet had lower odds for the presence of diabetes and elevated HbA1c, but higher odds for obesity. Overall, the importance of a healthy lifestyle and healthy dietary habits came to the frontline of attention due to the COVID-19 pandemic. The insights from these studies should be used to inform the necessary and targeted public health interventions aimed at increasing the MD uptake to ensure beneficial outcomes at the individual and the population level. This is relevant from the perspective of population health and delivery of adequate health care, as well as from the perspective of economic, social, and cultural development, and preservation of cultural heritage for generations to come.Jedan od najvećih javnozdravstvenih izazova danas na globalnoj razini su nezarazne bolesti, koje uglavnom nastaju zbog nezdravog načina života. Posebno veliko opterećenje predstavlja nezdrava prehrana. Mediteranska prehrana jedan je od najčešće istraživanih prehrambenih obrazaca s velikim brojem dokaza koji pokazuju da njezino pridržavanje može održati i očuvati ljudsko zdravlje, uz brojne zabilježene zdravstvene prednosti. Najistaknutije karakteristike mediteranske prehrane su korištenje maslinovog ulja kao primarnog izvora masti, svakodnevno obilje povrća, voća, orašastih plodova i cjelovitih žitarica, umjerena konzumacija crnog vina i mahunarki, dok su životinjski proizvodi više užitak a u odnosu na crveno i prerađeno meso prednost ima riba i bijelo meso. Ciljevi istraživanja ovog doktorskog rada su procijeniti usklađenost s mediteranskim načinom prehrane i njegovim sastavnim komponentama, procijeniti vremenski trend pridržavanja mediteranske prehrane i doprinos nekoliko socio-ekonomskih čimbenika u promjeni obrasca mediteranske prehrane i indeksa tjelesne mase u ponovljenoj studiji, kao i istražiti povezanost između konzumacije orašastih plodova i različitih kardiovaskularnih čimbenika rizika u populaciji Dalmacije u južnoj Hrvatskoj. Rezultati ovog istraživanja pokazali su prilično nezadovoljavajuću situaciju u južnoj Hrvatskoj u pogledu pridržavanja mediteranskoj prehrani. Prisutan je širok raspon pridržavanja pojedinim komponentama MDSS-a (od čak 4,6% za orašaste plodove, do 91,7% pridržavanja za žitarice), s prilično niskom prevalencijom pridržavanja mediteranskoj prehrani u cijelom uzorku (28,5%), osobito među mlađim osobama (14,0%). Bolja usklađenost s cjelokupnom mediteranskom prehranom, kao i za većinu komponenti MDSS-a zabilježena je kod najstarije skupine ispitanika, posebice žena. Nismo uspjeli pronaći povezanost između subjektivnog materijalnog statusa i pridržavanja mediteranske prehrane, dok je objektivni materijalni status predstavljen kao najistaknutiji socio-ekonomski pokazatelj za cjelokupno pridržavanje mediteranske prehrane, ali i nekoliko skupina namirnica. Ispitanici uključeni u praćenje imali su veću privrženost mediteranskoj prehrani na početku (36,6%), s graničnim neznatnim padom na kraju razdoblja praćenja (33,5%). Multivarijatni model je otkrio da su ženski spol, starija dob na početku, najviša razina obrazovanja i umjerena razina tjelesne aktivnosti bili pozitivno povezani, dok je MDSS na početku bio negativno povezan s promjenom MDSS-a tijekom praćenja. S druge strane, indeks tjelesne mase se u prosjeku povećao za 6,5% kod ispitanika dostupnih za praćenje. Promjena BMI tijekom praćenja bila je pozitivno povezana sa ženskim spolom, a negativno s početnim BMI-om, početnim pridržavanjem mediteranskoj prehrani i promjenom pridržavanja mediteranskoj prehrani, kao što je pronađeno u regresijskoj analizi. Konzumacija orašastih plodova u ovoj studiji bila je povezana sa smanjenim izgledima za smanjenje HDL kolesterola i smanjenim izgledima za povećanje fibrinogena, dok ukupni kolesterol i LDL kolesterol nisu dosegli razinu značajnosti (kada je promatrana ukupna P vrijednost), a trigliceridi nisu pokazali nikakvu povezanost s unosom orašastih plodova unutar ove studije. Studija je također otkrila povezanost između konzumacije orašastih plodova i indeksa središnje pretilosti (definiranih omjerima struka prema visini, te struka i boka), dok u isto vrijeme nije bilo povezanosti s izravnim mjerama, odnosno opsegom struka ili indeksom tjelesne mase. Nismo pronašli takvu povezanost između unosa orašastih plodova i prisutnosti dijagnoze hipertenzije, dijabetesa ili gihta, ali smo pronašli neke naznake povezanosti između mjesečnog unosa orašastih plodova i nižih izgleda za prisutnost metaboličkog sindroma. Zanimljiv je rezultat da ispitanici koji se nisu pridržavali mediteranske prehrane imaju manje šanse za prisutnost dijabetesa i povišen HbA1c, ali veće šanse za pretilost. Općenito, važnost zdravog načina života i zdravih prehrambenih navika došla je u prvi plan pozornosti zbog pandemije COVID-19. Uvidi iz ovih studija trebali bi se koristiti za informiranje o potrebnim i ciljanim javno-zdravstvenim intervencijama usmjerenim na povećanje prihvaćanja mediteranske prehrane kako bi se osigurali korisni ishodi na razini pojedinca i populacije. To je relevantno iz perspektive zdravlja stanovništva i pružanja adekvatne zdravstvene skrbi, kao i iz perspektive gospodarskog, društvenog i kulturnog razvoja, te očuvanja kulturne baštine za generacije koje dolaze

Odrednice, trendovi i zdravstveni ishodi povezani s mediteranskom prehranom u populaciji Dalmacije, Hrvatska

One of the foremost public health challenges today and on the global level are noncommunicable disease, arising mostly due to an unhealthy lifestyle. Especially high burden represents an unhealthy diet. The Mediterranean diet is one of the most commonly investigated nutritional pattern with a large body of evidence showing that adherence to it can sustain and preserve human health, with numerous health benefits already being recorded. The most prominent characteristics of the MD are the use of olive oil as the primary fat source, an abundance of vegetables, fruits, nuts, and whole grains daily, moderate red wine and legumes consumption, while animal products are more of a relish, and the priority is given to fish and white meat over red and processed meat. The research aims of this thesis are to assess the compliance with the Mediterranean dietary pattern and its constituting components, to estimate the temporal trend in adherence to the Mediterranean diet and the contribution of several socio-economic factors in the changing pattern of both the Mediterranean diet and body mass index in a follow-up study, and to investigate the association between nut consumption and various cardiovascular risk factors in the population of Dalmatia in Southern Croatia. The results of this study revealed a rather unsatisfactory situation in Southern Croatia in terms of Mediterranean diet consumption. A wide range of adherence to MDSS components was present (from as low as 4.6% for nuts, and up to 91.7% adherence for cereals), with a rather low prevalence of adherence to the Mediterranean diet in the entire sample (28.5%), especially among younger individuals (14.0%). Better compliance with the overall Mediterranean diet, as well as for the majority of the MDSS components was recorded among the oldest group of subjects, especially women. We failed to find any association between subjective material status and adherence to the Mediterranean diet, whereas objective material status presented as the most prominent socio-economic indicator for the overall adherence to the Mediterranean diet, but also several food groups. Subjects included in the follow-up had higher adherence to the Mediterranean diet at baseline (36.6%), with a borderline insignificant decline at the end of the follow-up period (33.5%). The multivariate model revealed that female gender, older age at baseline, the highest level of education, and a moderate level of physical activity were positively associated, while the MDSS at baseline was negatively associated with the MDSS change during the follow-up. On the other hand, BMI had increased on average by 6.5% in subjects available for follow-up. BMI change during follow-up was positively associated with the female gender, and negatively with initial BMI, initial adherence to the MD, and change in adherence to the MD, as found in the regression analysis. Nut consumption in this study was associated with reduced odds for decreased HDL cholesterol and reduced odds for increased fibrinogen, while total cholesterol and LDL cholesterol did not reach the significance level (when overall P value was observed) and triglycerides did not exhibit any association with nut intake within this study. The study also revealed the association between nut consumption and indices of central obesity (defined by the waist-to-height and waist-to-hip ratios), while at the same time there was no association with direct measures, namely waist circumference or BMI. We found no such association between nut intake and the presence of the diagnosis of hypertension, diabetes or gout, but we did find some indication of the association between monthly nut intake and lower odds for metabolic syndrome presence. Interestingly, we found that subjects who did not comply with a Mediterranean diet had lower odds for the presence of diabetes and elevated HbA1c, but higher odds for obesity. Overall, the importance of a healthy lifestyle and healthy dietary habits came to the frontline of attention due to the COVID-19 pandemic. The insights from these studies should be used to inform the necessary and targeted public health interventions aimed at increasing the MD uptake to ensure beneficial outcomes at the individual and the population level. This is relevant from the perspective of population health and delivery of adequate health care, as well as from the perspective of economic, social, and cultural development, and preservation of cultural heritage for generations to come.Jedan od najvećih javnozdravstvenih izazova danas na globalnoj razini su nezarazne bolesti, koje uglavnom nastaju zbog nezdravog načina života. Posebno veliko opterećenje predstavlja nezdrava prehrana. Mediteranska prehrana jedan je od najčešće istraživanih prehrambenih obrazaca s velikim brojem dokaza koji pokazuju da njezino pridržavanje može održati i očuvati ljudsko zdravlje, uz brojne zabilježene zdravstvene prednosti. Najistaknutije karakteristike mediteranske prehrane su korištenje maslinovog ulja kao primarnog izvora masti, svakodnevno obilje povrća, voća, orašastih plodova i cjelovitih žitarica, umjerena konzumacija crnog vina i mahunarki, dok su životinjski proizvodi više užitak a u odnosu na crveno i prerađeno meso prednost ima riba i bijelo meso. Ciljevi istraživanja ovog doktorskog rada su procijeniti usklađenost s mediteranskim načinom prehrane i njegovim sastavnim komponentama, procijeniti vremenski trend pridržavanja mediteranske prehrane i doprinos nekoliko socio-ekonomskih čimbenika u promjeni obrasca mediteranske prehrane i indeksa tjelesne mase u ponovljenoj studiji, kao i istražiti povezanost između konzumacije orašastih plodova i različitih kardiovaskularnih čimbenika rizika u populaciji Dalmacije u južnoj Hrvatskoj. Rezultati ovog istraživanja pokazali su prilično nezadovoljavajuću situaciju u južnoj Hrvatskoj u pogledu pridržavanja mediteranskoj prehrani. Prisutan je širok raspon pridržavanja pojedinim komponentama MDSS-a (od čak 4,6% za orašaste plodove, do 91,7% pridržavanja za žitarice), s prilično niskom prevalencijom pridržavanja mediteranskoj prehrani u cijelom uzorku (28,5%), osobito među mlađim osobama (14,0%). Bolja usklađenost s cjelokupnom mediteranskom prehranom, kao i za većinu komponenti MDSS-a zabilježena je kod najstarije skupine ispitanika, posebice žena. Nismo uspjeli pronaći povezanost između subjektivnog materijalnog statusa i pridržavanja mediteranske prehrane, dok je objektivni materijalni status predstavljen kao najistaknutiji socio-ekonomski pokazatelj za cjelokupno pridržavanje mediteranske prehrane, ali i nekoliko skupina namirnica. Ispitanici uključeni u praćenje imali su veću privrženost mediteranskoj prehrani na početku (36,6%), s graničnim neznatnim padom na kraju razdoblja praćenja (33,5%). Multivarijatni model je otkrio da su ženski spol, starija dob na početku, najviša razina obrazovanja i umjerena razina tjelesne aktivnosti bili pozitivno povezani, dok je MDSS na početku bio negativno povezan s promjenom MDSS-a tijekom praćenja. S druge strane, indeks tjelesne mase se u prosjeku povećao za 6,5% kod ispitanika dostupnih za praćenje. Promjena BMI tijekom praćenja bila je pozitivno povezana sa ženskim spolom, a negativno s početnim BMI-om, početnim pridržavanjem mediteranskoj prehrani i promjenom pridržavanja mediteranskoj prehrani, kao što je pronađeno u regresijskoj analizi. Konzumacija orašastih plodova u ovoj studiji bila je povezana sa smanjenim izgledima za smanjenje HDL kolesterola i smanjenim izgledima za povećanje fibrinogena, dok ukupni kolesterol i LDL kolesterol nisu dosegli razinu značajnosti (kada je promatrana ukupna P vrijednost), a trigliceridi nisu pokazali nikakvu povezanost s unosom orašastih plodova unutar ove studije. Studija je također otkrila povezanost između konzumacije orašastih plodova i indeksa središnje pretilosti (definiranih omjerima struka prema visini, te struka i boka), dok u isto vrijeme nije bilo povezanosti s izravnim mjerama, odnosno opsegom struka ili indeksom tjelesne mase. Nismo pronašli takvu povezanost između unosa orašastih plodova i prisutnosti dijagnoze hipertenzije, dijabetesa ili gihta, ali smo pronašli neke naznake povezanosti između mjesečnog unosa orašastih plodova i nižih izgleda za prisutnost metaboličkog sindroma. Zanimljiv je rezultat da ispitanici koji se nisu pridržavali mediteranske prehrane imaju manje šanse za prisutnost dijabetesa i povišen HbA1c, ali veće šanse za pretilost. Općenito, važnost zdravog načina života i zdravih prehrambenih navika došla je u prvi plan pozornosti zbog pandemije COVID-19. Uvidi iz ovih studija trebali bi se koristiti za informiranje o potrebnim i ciljanim javno-zdravstvenim intervencijama usmjerenim na povećanje prihvaćanja mediteranske prehrane kako bi se osigurali korisni ishodi na razini pojedinca i populacije. To je relevantno iz perspektive zdravlja stanovništva i pružanja adekvatne zdravstvene skrbi, kao i iz perspektive gospodarskog, društvenog i kulturnog razvoja, te očuvanja kulturne baštine za generacije koje dolaze

The Role of Socioeconomic Status in Adherence to the Mediterranean Diet and Body Mass Index Change: A Follow-Up Study in the General Population of Southern Croatia

The Mediterranean diet (MD) is one of the most healthful dietary patterns, beneficial for humans and the environment. However, the MD has recently exhibited a declining trend, especially in younger and less affluent people. This study investigated the association between socioeconomic indicators and adherence to the MD in 4671 adult subjects from Dalmatia, Croatia (age range 18–98 years; 61.9% were women). Additionally, in the follow-up we examined the change in adherence to the MD and in BMI (subsample, N = 1342; 62.5% were women; mean follow-up time of 5.8 years). The adherence to the MD was based on the Mediterranean Diet Serving Score (range 0–24 points, cut-off value ≥ 14 points), with a prevalence in the overall sample of 28.5%. Higher odds of adherence to the MD were recorded in women, older subjects, and those with higher level of objective material status, while it was less likely in the period after economic crisis of 2007–2008. Additionally, we detected no change in adherence to the MD in the follow-up subsample (−8.5%, p = 0.056), but there was an increase in BMI (+6.5%, p &lt; 0.001). We recorded an increase in adherence for nuts (+127.5%), sweets (+112.6%), red meat (+56.4%), and wine (+50.0%), unlike the reduction in adherence for vegetables (−35.1%), fish (−23.4%), white meat (−11.6%), cereals (−10.9%), and dairy products (−9.6%). Similar results were obtained across all quartiles of objective material status. Over time, the absolute change in the MD score was positively associated with female gender, age, higher education, and moderate physical activity, but it was negatively associated with adherence to the MD at baseline. BMI change was positively associated with female gender, and negatively with initial BMI, initial adherence to the MD, and MD change. Our findings point towards a less than ideal adherence to the MD in the general population of southern Croatia, and identify important characteristics associated with adherence change over time, informing necessary interventions aimed at increasing MD uptake

Genome-Wide Meta-Analysis Identifies Multiple Novel Rare Variants to Predict Common Human Infectious Diseases Risk

Infectious diseases still threaten global human health, and host genetic factors have been indicated as determining risk factors for observed variations in disease susceptibility, severity, and outcome. We performed a genome-wide meta-analysis on 4624 subjects from the 10,001 Dalmatians cohort, with 14 infection-related traits. Despite a rather small number of cases in some instances, we detected 29 infection-related genetic associations, mostly belonging to rare variants. Notably, the list included the genes CD28, INPP5D, ITPKB, MACROD2, and RSF1, all of which have known roles in the immune response. Expanding our knowledge on rare variants could contribute to the development of genetic panels that could assist in predicting an individual’s life-long susceptibility to major infectious diseases. In addition, longitudinal biobanks are an interesting source of information for identifying the host genetic variants involved in infectious disease susceptibility and severity. Since infectious diseases continue to act as a selective pressure on our genomes, there is a constant need for a large consortium of biobanks with access to genetic and environmental data to further elucidate the complex mechanisms behind host–pathogen interactions and infectious disease susceptibility

Does Each Menstrual Cycle Elicit a Distinct Effect on Olfactory and Gustatory Perception?

The obesity pandemic has brought forth a scientific interest in food intake and sensory perception interactions. Olfactory perception and gustatory perception are very complex and under the influence of many factors, including the menstrual cycle. This study aims to clarify conflicting findings on the influence of the menstrual cycle on olfactory and gustatory perception. Women were assessed during four consecutive phases of one complete cycle (mid-follicular, ovulatory, mid-luteal, and late luteal phases (N = 21)), in contrast to women measured across the same phases belonging to two menstrual cycles (N = 29). Additional control groups were men (N = 17), postmenopausal women (N = 14), oral contraceptive users (N = 10), and women with an anovulatory cycle (N = 8). Olfactory threshold, odor discrimination, and identification were tested using the “Sniffin Sticks“ test kit. Suprathreshold intensity and hedonic ratings for sweet, salty, sour, and bitter solutions were assessed. One-way ANOVA and ANOVA for repeated measurements was applied in the analysis, along with linear and trigonometric data fitting and linear mixed models. Linear increases in olfactory discrimination, identification, and overall olfactory performance were observed only in women followed across a complete menstrual cycle. Compared to other groups, these women displayed a cyclic pattern characterized by a predilection for sweet solution; reduced distaste for salty and sour solutions; and increased intensity perception of salty, sour, and bitter solutions towards the end of the cycle. These results suggest that a distinct hormonal milieu of a complete menstrual cycle may be affecting both olfactory and gustatory perception