The Mediterranean diet as a nutrition education, health promotion and disease prevention tool

AbstractObjectiveWhile epidemiological research on the protective role of the Mediterranean diet (MD) is highly publicised, little is known about MD education interventions. This exploratory study aimed to provide insight into methodology and effectiveness of the MD as a nutrition education and health promotion tool.Design and settingTwo searches were conducted within PubMed using the terms ‘Mediterranean diet’ and ‘Education’ or ‘Intervention’. Abstracts yielded were screened for distinct studies in which participants were instructed on the application of MD principles in their diet. Four studies met this criterion. These were further analysed for sample/target population, and intervention design, duration, tools, evaluative measures/tests and outcomes.ResultsInterventions targeted both healthy and at-risk populations and lasted between 12 weeks to 1 year, including follow-up. They used individual counselling, tailored computer-based counselling, group education, internet-based education, cookery classes and printed materials. Outcomes were measured using food diaries, FFQ, questionnaires on psychosocial factors and on usage of the educational tools, as well as anthropometrics and biomarkers. Interventions showed statistically significant increases in participants’ intake of vegetables, legumes, nuts, fruit, whole grains, seeds, olive oil and dietary PUFA and MUFA, and statistically significant decreases in total cholesterol, ox-LDL-cholesterol, total:HDL-cholesterol ratio, insulin resistance, BMI, body weight and waist circumference.ConclusionsMD education interventions may be cost-effective strategies for helping to protect against and treat a variety of health problems in different populations. Details of such interventions need to be publicised internationally. This introductory review could help inform the design of future targeted MD nutrition education.

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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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The Mediterranean Eating in Scotland Experience project: evaluation of an Internet-based intervention promoting the Mediterranean diet

British Journal Of Nutrition ◽

10.1079/bjn20051476 ◽

2005 ◽

Vol 94 (2) ◽

pp. 290-298 ◽

Cited By ~ 39

Author(s):

Angeliki Papadaki ◽

Jane A. Scott

Keyword(s):

Nutrition Education ◽

Mediterranean Diet ◽

Intervention Group ◽

Saturated Fat ◽

Hdl Cholesterol ◽

Control Group ◽

Monounsaturated Fat ◽

Feedback Intervention ◽

Intention To Treat ◽

The Mediterranean

A 6-month intervention study with a quasi-experimental design was conducted to evaluate the effectiveness of an Internet-based, stepwise, tailored-feedback intervention promoting four key components of the Mediterranean diet. Fifty-three (intervention group) and nineteen (control group) healthy females were recruited from the Universities of Glasgow and Glasgow Caledonian, Scotland, respectively. Participants in the intervention group received tailored dietary and psychosocial feedback and Internet nutrition education over a 6-month period, while participants in the control group were provided with minimal dietary feedback and general healthy-eating brochures. Internet education was provided via an innovative Mediterranean Eating Website. Dietary changes were assessed with 7 d estimated food diaries at baseline and 6 months, and data were analysed to calculate the Mediterranean Diet Score, a composite score based on the consumption of eight components of the traditional Mediterranean diet. The ‘intention-to-treat’ analyses showed that, at 6 months, participants in the intervention group had significantly increased their intake of vegetables, fruits and legumes, as well as the MUFA:saturated fatty acid ratio in their diet, and had significantly increased plasma HDL-cholesterol levels and a reduced ratio of total:HDL-cholesterol. Participants in the control group increased their intake of legumes but showed no other favourable significant changes compared with baseline. This Internet-based, tailored-feedback intervention promoting components of the Mediterranean diet holds promise in encouraging a greater consumption of plant foods, as well as increasing monounsaturated fat and decreasing saturated fat in the Scottish diet; it also shows that the Mediterranean diet can be adopted by healthy individuals in northern European countries.

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The Mediterranean Diet: Socio-cultural Relevance for contemporary Health Promotion

The Open Public Health Journal ◽

10.2174/1874944520150601e001 ◽

2015 ◽

Vol 8 (1) ◽

Author(s):

Surinder Phull

Keyword(s):

Health Promotion ◽

Mediterranean Diet ◽

Cultural Relevance ◽

The Mediterranean

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The role of Mediterranean diet in the course of subjective cognitive decline in the elderly population of Greece: results from a prospective cohort study

British Journal Of Nutrition ◽

10.1017/s0007114521005109 ◽

2021 ◽

pp. 1-29

Author(s):

George S. Vlachos ◽

Mary Yannakoulia ◽

Costas A. Anastasiou ◽

Mary H. Kosmidis ◽

Efthimios Dardiotis ◽

...

Keyword(s):

Cognitive Decline ◽

Mediterranean Diet ◽

The Elderly ◽

Protective Role ◽

Subjective Cognitive Decline ◽

Preventive Strategy ◽

Food Groups ◽

Medical Disorders ◽

The Mediterranean

Abstract Very few data are available regarding the association of adherence to the Mediterranean Diet (MeDi) with Subjective Cognitive Decline (SCD) evolution over time. A cohort of 939 cognitively normal individuals reporting self-experienced, persistent cognitive decline not attributed to neurological, psychiatric or medical disorders from the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD study) was followed-up for a mean period of 3.10 years. We defined our SCD score as the number of reported SCD domains (memory, language, visuoperceptual and executive), ranging from 0 to 4. Dietary intake at baseline was assessed through a food frequency questionnaire; adherence to the MeDi pattern was evaluated through the Mediterranean Diet Score (MDS) that ranged from 0 to 55, with higher values indicating greater adherence to the MeDi. The mean SCD score in our cohort increased by 0.20 cognitive domains during follow-up. After adjustment for multiple potential confounders, we showed that an MDS higher by 10 points was associated with a 7% reduction in the progression of SCD within one year. In terms of food groups, every additional vegetable serving consumption per day was associated with a 2.3% reduction in SCD progression per year. Our results provide support to the notion that MeDi may have a protective role against the whole continuum of cognitive decline, starting at the first subjective complaints. This finding may strengthen the role of the MeDi as a population-wide, cost-effective preventive strategy targeting the modifiable risk factors for cognitive decline.

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Effect of COVID-19 Lockdown on Adherence to the Mediterranean Diet Among Participants in a Health-Promotion Program

10.1007/978-3-030-88163-4_39 ◽

2021 ◽

pp. 463-471

Author(s):

Evelia Franco ◽

Rubén Barakat

Keyword(s):

Health Promotion ◽

Mediterranean Diet ◽

Health Promotion Program ◽

Promotion Program ◽

The Mediterranean

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Chronotype and Adherence to the Mediterranean Diet in Obesity: Results from the Opera Prevention Project

Nutrients ◽

10.3390/nu12051354 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1354

Author(s):

Giovanna Muscogiuri ◽

Luigi Barrea ◽

Sara Aprano ◽

Lydia Framondi ◽

Rossana Di Matteo ◽

...

Keyword(s):

Nutrition Education ◽

Mediterranean Diet ◽

Eating Habits ◽

Common Finding ◽

Middle Aged ◽

Unhealthy Lifestyle ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Prevention Project ◽

The Mediterranean

Chronotype is the attitude of a subject in determining individual circadian preference in behavioral and biological rhythm relative to the external light–dark cycle. Obesity and unhealthy eating habits have been associated with evening chronotype. The Mediterranean diet (MD) is a healthy nutritional pattern that has been reported to be associated with better health and quality of sleep. Thus, the aim of the study was to investigate the association of chronotype categories with adherence to the MD in a population of middle-aged Italian adults. This cross-sectional study included 172 middle-aged adults (71.5% females; 51.8 ± 15.7 years) that were consecutively enrolled in a campaign to prevent obesity called the OPERA (obesity, programs of nutrition, education, research and assessment of the best treatment) Prevention Project that was held in Naples on 11–13 October 2019. Anthropometric parameters, adherence to the MD and chronotype were studied. Chronotype was classified as morning in 58.1% of subjects, evening in 12.8% and intermediate in 28.1%. Our results demonstrated that individuals with evening chronotype, when compared to intermediate (p < 0.001) and morning chronotype (p < 0.001), were more prone to follow unhealthy lifestyle, performing less regular activity and being more frequently smokers. In addition, they showed the lowest adherence to the MD compared to morning (p < 0.001) and intermediate chronotypes (p < 0.001). The lower the chronotype score, the higher body mass index (BMI) values in the whole population (r = −0.158; p = 0.038), thus suggesting that evening chronotype was a common finding in subjects with obesity. In addition, positive correlations of chronotype score with age (r = 0.159; p = 0.037) and PREDIMED score (r = 0.656; p < 0.001) were found. The adherence to the MD, more than the intake of the single food items, was found to predict morning and evening chronotypes. In conclusion, evening chronotype was associated with unhealthy lifestyle and low adherence to the MD. Chronotype score was inversely associated to BMI and positively associated to age and adherence to the MD. Thus, the assessment of chronotype should be taken into account in the management of obesity and in the development of nutritional strategies.

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The Mediterranean diet and its protective role against cancer

European Journal of Cancer Prevention ◽

10.1097/01.cej.0000130009.53407.a3 ◽

2004 ◽

Vol 13 (3) ◽

pp. 155-157 ◽

Cited By ~ 4

Author(s):

A. Giacosa

Keyword(s):

Mediterranean Diet ◽

Protective Role ◽

The Mediterranean

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Perspectives of Environmental Health Promotion and the Mediterranean Diet: A Thematic Narrative Synthesis

Journal of Hunger & Environmental Nutrition ◽

10.1080/19320248.2020.1777242 ◽

2020 ◽

pp. 1-23 ◽

Cited By ~ 1

Author(s):

Laura Coats ◽

Basil H. Aboul-Enein ◽

Elizabeth Dodge ◽

Nada Benajiba ◽

Joanna Kruk ◽

...

Keyword(s):

Health Promotion ◽

Environmental Health ◽

Mediterranean Diet ◽

Narrative Synthesis ◽

The Mediterranean

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Sleep Quality in Obesity: Does Adherence to the Mediterranean Diet Matter?

Nutrients ◽

10.3390/nu12051364 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1364 ◽

Cited By ~ 6

Author(s):

Giovanna Muscogiuri ◽

Luigi Barrea ◽

Sara Aprano ◽

Lydia Framondi ◽

Rossana Di Matteo ◽

...

Keyword(s):

Sleep Quality ◽

Nutrition Education ◽

Mediterranean Diet ◽

Sleep Disturbances ◽

Poor Sleep ◽

Middle Aged ◽

Roc Curve Analysis ◽

Anthropometric Parameters ◽

Cross Sectional ◽

The Mediterranean

Obesity and unhealthy eating habits have been associated with sleep disturbances (SD). The Mediterranean diet (MD) is a healthy nutritional pattern that has been reported to be associated with better health and sleep quality. Thus, the aim of the study was to investigate whether adherence to the MD is associated with sleep quality in a population of middle-aged Italian adults. This cross-sectional study included 172 middle-aged adults (71.5% females; 51.8 ± 15.7 years) that were consecutively enrolled in a campaign to prevent obesity called the OPERA (Obesity, Programs of Nutrition, Education, Research and Assessment of the best treatment) prevention project that was held in Naples on 11–13 October 2019. Anthropometric parameters, adherence to the MD and sleep quality were studied. Overall, 50.6% of the subjects were good sleepers (the Pittsburgh Sleep Quality Index (PSQI) < 5) while 49.4% were poor sleepers (PSQI ≥ 5). Our results demonstrated that good sleepers, when compared to poor sleepers (p < 0.001) had significantly higher adherence to the MD as assessed by PREDIMED (Prevención con Dieta Mediterránea) score, lower BMI (body mass index) and waist circumference (WC). The higher PSQI, the higher the BMI (p < 0.001) and WC values (p < 0.001), thus suggesting that poor sleep was more common in subjects with obesity. In addition, a negative correlation between PSQI and the PREDIMED score (p < 0.001) was found. to the intake of the cluster of foods enclosed in the MD, rather than the intake of the single food, predicted PSQI. By performing a receiver operator characteristic (ROC) curve analysis, we determined a cut-off value at a PREDIMED score < 9 as the threshold for screening poor sleepers. In conclusion, good sleepers had lower BMI and WC and higher adherence to the MD than poor sleepers. PSQI was positively associated to BMI and WC while it was negatively associated to adherence to the MD. The consumption of the MD dietary pattern rather than the intake of a single nutrient has a beneficial effect on sleep quality. Hence, the assessment of sleep should be taken into account in the management of obesity and promoting adherence to the MD could be a tool to improve SD.

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