Higher adherence to the Mediterranean Diet is associated with weight loss maintenance: the MedWeight study

AbstractIntroductionAdherence to the Mediterranean dietary pattern has been associated with numerous health benefits in non-communicable diseases, including obesity management. However, the associations of the Mediterranean Diet with weight loss maintenance remain to be evaluated.MethodsWe analyzed data from 500 participants (61% women) of the MedWeight study. Eligible volunteers were men and women 18–65 years old, reporting an intentional weight loss of at least 10%, starting from a BMI ≥ 25 kg/m2. Based on their current weight, participants were characterized as maintainers (current weight ≤ 90% of maximum weight), or regainers (current weight > 95% of maximum weight). Socio-demographics, lifestyle measurements and weight history were recorded. Dietary intake was assessed by 2 telephone 24-hour recalls. Adherence to the Mediterranean Diet was assessed with the MedDietScore (range 0–55, greater scores showing higher adherence). Physical activity levels were assessed with the International Physical Activity Questionnaire-short form. Results are expressed as means ± SD, frequencies (%) or Odds Ratio [OR; 95%Confidence Interval].ResultsCompared to regainers (31%), maintainers were younger (31.4 ± 10.0 vs. 36.6 ± 10.8 years, p < 0.001), had lower BMI (25.7 ± 4.3 vs. 31.4 ± 5.1 kg/m2, p < 0.001), and had greater initial body weight loss (25.5 ± 8.6% vs. 18.4 ± 6.9%, p < 0.001). Sex and years of formal education were not significantly different between maintainers and regainers (p > 0.05). Being in the highest MedDietScore quintile (vs. the lowest) was associated with 91% higher odds of being a maintainer [crude OR = 1.91; 1.05–3.45]. This association remained significant after adjusting for sex, age, physical activity level (METŸminutes/week) and energy intake (kcal/day) [adjusted OR = 2.01; 1.05–3.83].DiscussionHigher adherence to the Mediterranean Diet was independently associated with 2-fold increased likelihood of weight loss maintenance. Our results highlight the favorable effects of a prudent dietary pattern in long-term obesity management, as well as novel targets for diet planning during weight loss maintenance.

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Exploring the relationship between the Mediterranean diet and weight loss maintenance: the MedWeight study

British Journal Of Nutrition ◽

10.1017/s0007114520001798 ◽

2020 ◽

Vol 124 (8) ◽

pp. 874-880 ◽

Cited By ~ 3

Author(s):

Dimitrios Poulimeneas ◽

Costas A. Anastasiou ◽

Inês Santos ◽

James O. Hill ◽

Demosthenes B. Panagiotakos ◽

...

Keyword(s):

Weight Loss ◽

Mediterranean Diet ◽

Linear Trend ◽

Weight Loss Maintenance ◽

Food Group ◽

Maximum Weight ◽

Intentional Weight Loss ◽

Mediterranean Populations ◽

The Mediterranean ◽

The Relationship

AbstractWeight loss maintenance is crucial for obesity management, yet optimal dietary patterns for this period are not established. We aimed to explore the relationship between adherence to the Mediterranean diet and weight loss maintenance. Sample includes 565 adults (62 % women) of the MedWeight study. Eligible volunteers were those reporting intentional weight loss of ≥10 %, starting from a BMI ≥ 25 kg/m2, over 12 months prior to enrolment. Based on current weight, participants were characterised as maintainers (≤90 % maximum weight) or regainers (>95 % maximum weight). Socio-demographics and weight history were recorded. Dietary intake was assessed by two non-consecutive 24-h recalls within 10 d and analysed in energy, macronutrient and food group intakes. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Score (MedDietScore) (range 0–55, greater scores showing higher adherence). Protein intake was higher in maintainers than in regainers (P < 0·001). When MedDietScore quartiles were considered, a linear trend for weight loss maintenance was revealed (P < 0·05). After adjustment for basic demographic characteristics, being in the third or fourth quartile of the MedDietScore (v. first) was associated with 2·30 (95 % CI 1·29, 4·09) and 1·88 (95 % CI 1·10, 3·22) increased odds of maintenance. Regarding individual MedDietScore components, only fruit intake is associated with increased odds for maintenance (1·03 (95 % CI 1·01, 1·06)). The leave-one-out approach revealed that at least six MedDietScore components were essential for the observed relationship. Higher adherence to the Mediterranean diet was associated with 2-fold increased likelihood of weight loss maintenance. Future studies should replicate these findings in non-Mediterranean populations as well.

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Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study

Nutrients ◽

10.3390/nu12072114 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2114 ◽

Cited By ~ 1

Author(s):

Cristina Bouzas ◽

Maria del Mar Bibiloni ◽

Alicia Julibert ◽

Miguel Ruiz-Canela ◽

Jordi Salas-Salvadó ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Body Weight ◽

Mediterranean Diet ◽

Longitudinal Research ◽

Adult Population ◽

Body Weight Loss ◽

Health Study ◽

Mediterranean Population ◽

The Mediterranean

Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m2 (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1: <10%, n = 1495; Q2: 10–15%, n = 1804; Q3: <15–20%, n = 1470; Q4: ≥20%, n = 1589). Diet was assessed using a validated food frequency questionnaire and a 17-item Mediterranean diet questionnaire. Physical activity was assessed by the validated Minnesota-REGICOR and the validated Spanish version of the Nurses’ Health Study questionnaire. Results. Participants reporting higher percentages of desired weight loss (Q3 and Q4) were younger, had higher real and perceived BMI and were more likely to have abdominal obesity. Desired weight loss correlated inversely to physical activity (Q1: 2106 MET min/week; Q4: 1585 MET min/week. p < 0.001) and adherence to Mediterranean diet (Q1: 8.7; Q4: 8.3. p < 0.001). Conclusions. In older Mediterranean individuals with weight excess, desired weight loss was inversely associated with Mediterranean lifestyle adherence. Deeply rooted aspects of the MedDiet remained similar across groups. Longitudinal research is advised to be able to establish causality.

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Gut microbiome characteristics at the crossroads of metabolic health and lifestyle patterns in an adult population

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004322 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Evdokia K. Mitsou ◽

M. Pilar Francino ◽

Maria Yannakoulia ◽

Smaragdi Antonopoulou ◽

Adamantini Kyriacou

Keyword(s):

Physical Activity ◽

Gut Microbiota ◽

Mediterranean Diet ◽

Dietary Patterns ◽

Gut Microbiome ◽

Dietary Pattern ◽

Adult Population ◽

Metabolic Health ◽

Activity Level ◽

Obesity Status

AbstractIntroductionCumulative findings have recently highlighted the role of gut microbiota as a novel environmental factor in the fight against obesity and related comorbidities. We aimed to investigate (1) the gut microbiome characteristics of a Greek adult population in terms of adiposity prevalence and (2) to further elucidate the potential effect of physical activity level and adherence to a-priori (Mediterranean Diet) and a-posteriori dietary patterns in gut microbiota profiling after accounting for sex, age and obesity status.Materials and MethodsAdult participants (n = 125) underwent clinical, anthropometric, dietary, physical activity and lifestyle evaluation. Obesity status [normal-weight (NW), overweight (OW), obesity (OB)] was defined based on body weight and height measurements, Body Mass Index calculation and the World Health Organization criteria. Levels of physical activity (low/medium/high) were estimated according to International Physical Activity Questionnaire (IPAQ) scoring. Dietary intake was evaluated through a food frequency questionnaire. Adherence to the Mediterranean diet was based on the MedDietScore and Principal Component Analysis (PCA) was applied for dietary patterns analysis. Gut microbial community characteristics (diversity, richness and proportions at phylum level) were calculated based on 16S rRNA gene sequencing.ResultsA total of 122 subjects (58 females; mean age 42.4 ± 13.1 years) completed the study. OB was characterized by lower proportions of Verrucomicrobia compared to NW state (p = 0.034 for univariate), unidentified bacteria (p = 0.014) and the Archaea Euryarchaeota (p = 0.003) compared to OW status, and the phylum Candidatus Saccharibacteria compared to NW (p = 0.027) and OW (p = 0.039) after sex and age adjustments. Regarding lifestyle parameters, our data proposed no significant effect of total physical activity levels on gut microbiome; notably, a ‘fruit and vegetables’ dietary pattern and adherence to Mediterranean diet were both characterized by lower microbial diversity and proportions of Actinobacteria but higher proportions of Cyanobacteria/Chloroplast and Lentisphaerae, respectively. Furthermore, a Western-type dietary pattern (high in full fat dairy products, potatoes, refined cereals, red meat, snacks and junkfood) was characterized by lower gut microbial richness (Chao1 index), whereas a healthy dietary pattern (high in low fat dairy and wholegrain cereals and low in snack and junk food) was characterized by higher proportion of Firmicutes.DiscussionOur data proposed variable connections of metabolic health and dietary patterns with features of gut microbiota; design of gut microbiome studies is advisable to account for host- and lifestyle-related potential confounders.

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Weight Status, Adherence to the Mediterranean Diet, Physical Activity Level, and Sleep Behavior of Italian Junior High School Adolescents

Nutrients ◽

10.3390/nu12020478 ◽

2020 ◽

Vol 12 (2) ◽

pp. 478 ◽

Cited By ~ 3

Author(s):

Alice Rosi ◽

Francesca Giopp ◽

Giulia Milioli ◽

Gabriele Melegari ◽

Matteo Goldoni ◽

...

Keyword(s):

Physical Activity ◽

Sleep Quality ◽

Mediterranean Diet ◽

Sleep Duration ◽

Physical Activity Level ◽

Vigorous Physical Activity ◽

Activity Level ◽

Sleep Habits ◽

Achievement Data ◽

The Mediterranean

Inadequate diet, physical activity, and sleep-related behaviors are potential risk factors for overweight and obese, therefore we investigated the relations between body mass index (BMI) and behavioral factors in a sample of Italian adolescents. Four hundred nine Italian secondary school students (46% females, 12.5 ± 0.6 y.o.) were enrolled in this cross-sectional study. Anthropometric measures, adherence to the Mediterranean Diet (KIDMED), physical activity level (PAQ-C), sleep duration, daytime sleepiness (PDSS), sleep quality, and school achievement data were collected through an online questionnaire. The percentage of overweight adolescents was slightly lower (14%) compared to the regional and the national figures. Approximately 88% of the sample reported a medium/high adherence to the Mediterranean Diet and 77% a moderate/vigorous physical activity level. The average sleep duration was in line with the international sleep recommendation for adolescents and 82% had a medium/high sleep quality. No differences were found between genders except for BMI (lower in females). Unexpectedly, no differences were found among the BMI groups (normal weight vs. overweight vs. obese) for lifestyle variables; in contrast, Mediterranean Diet adherence was associated with sleep habits. Further investigation is required to better explore the associations among behavioral variables involved in adolescents’ healthy development.

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Relationship between volition, physical activity and weight loss maintenance: Study rationale, design, methods and baseline characteristics

Scandinavian Journal of Public Health ◽

10.1177/1403494816682378 ◽

2016 ◽

Vol 45 (3) ◽

pp. 299-304 ◽

Cited By ~ 1

Author(s):

Sune Dandanell ◽

Anne-Marie Elbe ◽

Gertrud Pfister ◽

Peter Elsborg ◽

Jørn W Helge

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Oxygen Uptake ◽

Maximal Oxygen Uptake ◽

Physical Activity Level ◽

Mixed Model ◽

Linear Mixed Model ◽

Weight Loss Maintenance ◽

Activity Level

Aims: To investigate the relationship between volition, physical activity and weight loss maintenance. Methods: We recruited 84 sedentary (maximal oxygen uptake: 25 ± 5 ml/min), overweight and obese (Body mass index (BMI) 38 ± 7 m/h2, fat 44 ± 7 %) women ( n = 55) and men ( n = 29) for an interdisciplinary prospective study with follow-up. The change in lifestyle and weight loss is promoted via a 3-month intensive lifestyle intervention at a private health school. The intervention consists of supervised training (1–3 hours/day), a healthy hypo-caloric diet (−500 to −700 kCal/day) and education in healthy lifestyle in classes/groups. The participants’ body weight and composition (Dual Energy X-ray absorptiometry), volitional skills (questionnaire), physical activity level (heart rate accelerometer/questionnaire) and maximal oxygen uptake (indirect calorimetry) are to be monitored before, after, and 3 and 12 months after the intervention. Results: At the 12-month follow-up, three different groups will be established: Clinical weight loss maintenance (> 10% weight loss from baseline), moderate weight loss maintenance (1–10% weight loss) and no weight loss (or weight regain). A linear mixed model analysis will be used to compare levels of volitional skills, physical activity and maximal oxygen uptake over time, between the three groups. Correlational analyses will be used to investigate possible associations between volition, maximal oxygen uptake, physical activity level and weight loss maintenance. Conclusions: If specific volitional skills are identified as predictors of adherence to physical activity and success in clinical weight loss maintenance, these can be trained in future intensive lifestyle interventions in order to optimize the success rate.

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Physical Activity Level, Mediterranean Diet Adherence, and Emotional Intelligence as a Function of Family Functioning in Elementary School Students

Children ◽

10.3390/children8010006 ◽

2020 ◽

Vol 8 (1) ◽

pp. 6

Author(s):

Eduardo Melguizo-Ibáñez ◽

Virginia Viciana-Garófano ◽

Félix Zurita-Ortega ◽

José Luis Ubago-Jiménez ◽

Gabriel González-Valero

Keyword(s):

Physical Activity ◽

Emotional Intelligence ◽

Mediterranean Diet ◽

Activity Level ◽

Activity Engagement ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

Emotional Clarity ◽

The Mediterranean ◽

Family Functionality

(1) Background: Family is considered as one of the most important elements for the transmission of healthy habits that improve the lives of students. For this reason, the present study aims to describe the degree of family functionality, emotional intelligence, Mediterranean diet adherence, and extra-curricular physical activity engagement. A further aim is to perform a correlational analysis between these variables. (2) Methods: To this end, an ad hoc questionnaire was used, alongside the APGAR, KIDMED, and Trait Meta Mood Scale (TMMS-24). (3) Results: Finally, the data suggest that a high percentage of students need to improve their diet. Further, students reporting severe family dysfunction showed worse outcomes. Thus, levels of emotional clarity were lower when family functionality was poor. Poor diet quality was also associated with lower emotional attention, with Mediterranean diet adherence being positively related to emotional clarity and repair, as well as normal family functionality. (4) Conclusions: Boys showed higher levels of adherence to the Mediterranean diet adherence, while girls reported higher family functionality. Thus, compliance with the minimum recommendations for physical activity engagement was associated with adequate adherence to the Mediterranean diet. The importance of diet for obtaining an optimal physical condition, adequate emotional state, and family functionality is highlighted.

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Physical Activity and Adherence to the Mediterranean Diet among Spanish Employees in a Health-Promotion Program before and during the COVID-19 Pandemic: The Sanitas-Healthy Cities Challenge

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052735 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2735

Author(s):

Evelia Franco ◽

Jesús Urosa ◽

Rubén Barakat ◽

Ignacio Refoyo

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Mediterranean Diet ◽

Short Form ◽

Health Promotion Program ◽

Noncommunicable Diseases ◽

Healthy Cities ◽

Sedentary Behaviors ◽

Promotion Program ◽

The Mediterranean

Physical activity and a healthy diet are key factors for avoiding major noncommunicable diseases. The aim of the present study was to analyze how physical activity (PA) and adherence to the Mediterranean diet among employees participating in the Healthy Cities program have been affected during confinement due to the COVID-19 pandemic. The sample was composed of 297 employees from 40 leading companies based in Spain, who participated in the 5th edition of the Sanitas “Healthy Cities” challenge. The participants (148 women and 149 men), aged between 24 and 63 years old (M = 42.76; SD = 7.79) completed the short form of the International Physical Activity Questionnaire (IPAQ) and the PREDIMED (Prevención con Dieta Mediterránea) questionnaire to measure adherence to the Mediterranean diet before and during the pandemic. Pearson χ2 tests revealed that workers were more likely to show sedentary behaviors during the pandemic than before (83.5% vs. 66.7%). Additionally, they were more likely to reach high levels of PA (51.2% vs. 64%), and Wilcoxon tests revealed that energy expenditure measured in Metabolic Equivalent of Task (MET) was higher during the pandemic (4199.03 METs) than before (3735.32 METs), due to an increase in moderate PA. Lastly, a higher adherence to a Mediterranean diet during the pandemic (76.4%) than before (54.5%) was reported. The findings of this investigation suggest a positive effect of working from home for employees involved in a health-promotion program, and highlight the relevance of this kind of action among this population.

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Mediterranean Diet: The Need for Cross-Disciplinary Perspectives

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115687 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5687

Author(s):

F. Xavier Medina

Keyword(s):

Mediterranean Diet ◽

Dietary Pattern ◽

The Past ◽

Sustainable Diet ◽

The Mediterranean ◽

Past Half

The notion of the Mediterranean diet has progressively evolved over the past half a century, from a healthy (coronary) dietary pattern to a model of sustainable diet [...]

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Influence of Physical Activity on Bone Mineral Content and Density in Overweight and Obese Children with Low Adherence to the Mediterranean Dietary Pattern

Nutrients ◽

10.3390/nu10081075 ◽

2018 ◽

Vol 10 (8) ◽

pp. 1075 ◽

Cited By ~ 3

Author(s):

Victoria Muñoz-Hernandez ◽

Lide Arenaza ◽

Luis Gracia-Marco ◽

Maria Medrano ◽

Elisa Merchan Ramirez ◽

...

Keyword(s):

Physical Activity ◽

Bone Mineral Content ◽

Bone Mineral ◽

Dietary Pattern ◽

Mineral Content ◽

Overweight And Obesity ◽

Moderate Intensity ◽

Obese Children ◽

Mediterranean Dietary Pattern ◽

The Mediterranean

The objective of the present cross-sectional study was to examine the associations of physical activity and the adherence to the Mediterranean dietary pattern (MDP) with bone mineral content (BMC) and density (BMD) in children with overweight and obesity. A total of 177 (n = 80 girls) children with overweight and obesity aged 8 to 12 years old participated in the study. Both BMC and BMD were assessed by Dual-Energy X-ray absorptiometry. Dietary patterns were assessed by the KIDMED questionnaire and two 24-hour recalls. Physical activity was assessed by accelerometers for 7 consecutive days (24 hours/day). Low adherence to the MDP was observed in 82.4% of participants. Higher physical activity levels (of at least moderate intensity) and lower sedentary time were significantly associated with BMC and BMD in children with low adherence to the MDP (all p < 0.05). No associations were observed between physical activity and BMC and BMD in children with high adherence to the MDP. In conclusion, engaging in moderate to vigorous physical activity and reducing the time spent in sedentary behavior might be particularly beneficial for improving bone health in overweight or obese children with poor adherence to the Mediterranean dietary pattern.

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Self-Perceived Physical Activity and Adherence to the Mediterranean Diet in Healthy Adolescents during COVID-19: Findings from the DIMENU Pilot Study

Healthcare ◽

10.3390/healthcare9060622 ◽

2021 ◽

Vol 9 (6) ◽

pp. 622

Author(s):

Angelo Galluccio ◽

Giovanna Caparello ◽

Ennio Avolio ◽

Emanuele Manes ◽

Simona Ferraro ◽

...

Keyword(s):

Physical Activity ◽

Mediterranean Diet ◽

Eating Habits ◽

Wellness Programs ◽

Health Impact ◽

The Self ◽

Global Pandemic ◽

Mediterranean Diet Adherence ◽

The Mediterranean ◽

The Impact

The global pandemic coronavirus disease (COVID-19) resulted in restrictions which forced adolescents to stay at home and influenced their food habits and lifestyles with potential negative health impact. This study aims to investigate the self-reported physical activity (PA) and eating habits related to the consumption of Mediterranean foods in a sample of adolescents during the COVID-19 lockdown enrolled into the DIMENU study. A web survey was launched for 91 adolescents (aged 15–17 years) to assess their adherence to the Mediterranean Diet using the KIDMED test and lifestyle habits using a questionnaire designed following recommendations by Italian National Institute of Health (ISS score). Our results indicate that most of the sample declared no changes in eating habits and PA without sex differences. After dividing the sample into active and sedentary groups based on the self-perceived PA, we found that KIDMED and ISS scores were significantly higher (p = 0.0028 and p = 0.0001, respectively) in active adolescents. Moreover, KIDMED was positively correlated with ISS only in active adolescents (r = 0.311, p = 0.0185). In conclusion, our data underline the impact of the PA on the Mediterranean diet adherence in adolescents during the lockdown, suggesting the usefulness of promoting wellness programs directed towards inactive individuals to increase their awareness on the importance of healthy lifestyles.

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