scholarly journals Applying Behavioral Nudges in a Dietary Comparator for Surgical Trials: Developing the MediDiet

2021 ◽  
Author(s):  
Irene Y. Zhang ◽  
Daniel Norwitz ◽  
Adam Drewnowski ◽  
Nidhi Agrawal ◽  
David R. Flum ◽  
...  
Keyword(s):  
Pilot Study ◽  
Positive Affect ◽  
Mediterranean Diet ◽  
Dietary Intervention ◽  
Behavioral Science ◽  
Negative Emotions ◽  
Dietary Change ◽  
Validated Questionnaire ◽  
The Mediterranean ◽  
Dietary Feedback

Introduction: The Mediterranean diet is being studied as an alternative to surgery for common gastrointestinal conditions. However, dietary change can be challenging. "Nudges" - behavioral science strategies seeking to influence cognitive processes to promote good behaviors - may help. We conducted a pilot study evaluating the acceptability of the MediDiet, a behaviorally designed dietary intervention incorporating nudges and recommendations based on the Mediterranean Diet. Methods: We conducted a three-phase pilot study involving parallel randomized surveys of U.S. adults. After completing a validated questionnaire assessing dietary consistency with a Mediterranean diet, participants were randomized to feedback containing no nudge versus nudge: peer comparison; peer comparison + positive affect induction; or default. Participants then rated their positive and negative emotions, motivation for dietary change, and interest in recipes. Responses were analyzed using baseline covariate-adjusted regression. Results: Among 1,709 participants, 56% were men, 73% were White, and the mean age was 38. In response to dietary feedback, participants reported low negative emotions, high positive emotions, moderate motivation for dietary change and high interest in recipes. Nudges did not affect the extent of negative (p=0.104) or positive (p=0.34) emotions, motivation (p=0.139), or interest (p=0.86). In exploratory analyses, those with moderate and high consistency with the Mediterranean diet, with or without nudges, reported lower negative affect, greater positive affect, greater motivation, and greater interest in recipes, than the minimally consistent, no nudge group. Conclusion: Delivering dietary feedback based on the Mediterranean diet using behavioral nudges was acceptable among U.S. adults, rousing positive reactions without triggering negative ones. As early evidence, this pilot study provides the basis for testing nudge-based dietary guidance among individuals with symptomatic gallstones, diverticulitis, and other gastrointestinal diseases.

scholarly journals Neutrophil-to-Lymphocyte Ratio, Mediterranean Diet, and Bone Health in Coeliac Disease Patients: A Pilot Study

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Francesca Palmacci ◽  
Elisabetta Toti ◽  
Anna Raguzzini ◽  
Giovina Catasta ◽  
Paola Aiello ◽  
...  
Keyword(s):  
Pilot Study ◽  
Coeliac Disease ◽  
Mediterranean Diet ◽  
Neutrophil To Lymphocyte Ratio ◽  
Dietary Habit ◽  
Food Groups ◽  
Mineral Density ◽  
Lymphocyte Ratio ◽  
The Mediterranean ◽  
The Relationship

Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a bone loss index in postmenopausal women and as a marker of inflammation in coeliac patients. The aims of this work were to evaluate the effect of gluten-free diet (GFD) on NLR retrospectively and study the relationship between NLR and Mediterranean diet adherence and selected food groups (fruits, vegetables, red meat, potatoes, and unrefined and refined cereals). Adult individuals (n=50), who had been on a strict GFD by at least 6 months, were recruited. The degree of adherence to the Mediterranean diet was calculated with two different scores: the Mediterranean Diet Score (MDS-14), assessed through the validated 14-item questionnaire of the PREDIMED study, and the MEDScore (Score-55) proposed by Panagiotakos. The latter includes the consumption of unrefined cereals (UC). High percentages of osteopenia and osteoporosis were found within the recruited subjects, who furnished the reports of bone mineral density (BMD), in particular in postmenopausal (Post-M) women. Recent NLR was higher in subjects with osteoporosis compared to osteopenia and normal BMD. However, retrospective analysis showed both increase and decrease in NLR after GFD, with no significant differences between Marsh grade, anemia, and BMD status. Moreover, premenopausal previous pregnancy (Pre-MPP) and Post-M had higher NLR at diagnosis compared to Men and premenopausal (Pre-M), but higher differences were observed in recent NLR between Pre-MPP and Men only. Chocolate consumption was associated with lower recent NLR, whereas the latter was correlated with Score-55, but not with MDS-14. Moreover, refined cereal consumption was correlated with recent NLR. Although large prospective studies are needed in order to clarify the relationship between UC and NLR in coeliac patients, in this pilot study, we have investigated for the first time the relationship between NLR, dietary habit, and osteoporosis in coeliac disease.

Intensive dietary intervention promoting the Mediterranean diet in people with high cardiometabolic risk: a non-randomized study

2017 ◽  
Vol 55 (3) ◽  
pp. 219-226 ◽  
Author(s):  
M. Grimaldi ◽  
O. Ciano ◽  
M. Manzo ◽  
M. Rispoli ◽  
M. Guglielmi ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Cardiometabolic Risk ◽  
Dietary Intervention ◽  
Randomized Study ◽  
The Mediterranean

scholarly journals Effects of Mediterranean Diet or Low-Fat Diet on Blood Fatty Acids in Patients with Coronary Heart Disease. A Randomized Intervention Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2389
Author(s):  
Monica Gianna Giroli ◽  
José Pablo Werba ◽  
Patrizia Risé ◽  
Benedetta Porro ◽  
Angelo Sala ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mediterranean Diet ◽  
Intervention Study ◽  
Dietary Intervention ◽  
Favorable Effect ◽  
Low Fat ◽  
Total N ◽  
Low Fat Diet ◽  
The Mediterranean

The Mediterranean diet (MD) prevents cardiovascular disease by different putative mechanisms, including modifications in the blood fatty acid (FA) profile. Polytherapy for secondary cardiovascular prevention might mask the effect of MD on the FA profile. This study was aimed to assess whether MD, in comparison with a low-fat diet (LFD), favorably modifies the blood FA profile in patients with coronary heart disease (CHD) on polytherapy. One hundred and twenty patients with a recent history of coronary stenting, randomized to MD or to LFD, completed 3 months of this open-label dietary intervention study. Diet Mediterranean-ness was evaluated using the Mediterranean Diet Adherence Screener (MeDAS) score. Both diets significantly reduced saturated FA (p < 0.01). Putative favorable changes in total n-3 FA (p = 0.03) and eicosapentaenoic acid plus docosahexaenoic acid (EPA + DHA; p = 0.04) were significantly larger with MD than with LFD. At 3 months, in the whole cohort, the MeDAS score correlated inversely with palmitic acid (R = −0.21, p = 0.02), and with palmitoleic acid (R = −0.32, p = 0.007), and positively with total n-3 FA (R = 0.19, p = 0.03), EPA (R = 0.28, p = 0.002), and EPA + DHA (R = 0.21, p = 0.02). In CHD patients on polytherapy, both MD and LFD shift FA blood composition towards a healthier profile, with a more favorable effect of MD on omega−3 levels.

scholarly journals Adherence to Mediterranean Diet and Metabolic Syndrome in BRCA Mutation Carriers

2017 ◽  
Vol 17 (1) ◽  
pp. 153-160 ◽  
Author(s):  
Eleonora Bruno ◽  
Siranoush Manoukian ◽  
Elisabetta Venturelli ◽  
Andreina Oliverio ◽  
Francesca Rovera ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Mediterranean Diet ◽  
Dietary Intervention ◽  
Brca Mutation ◽  
Intervention Group ◽  
Control Group ◽  
Mutation Carriers ◽  
Brca Mutation Carriers ◽  
The Mediterranean

Background. Insulin resistance is associated with higher breast cancer (BC) penetrance in BRCA mutation carriers. Metabolic syndrome (MetS), an insulin resistance syndrome, can be reversed by adhering to the Mediterranean diet (MedDiet). In a dietary intervention trial on BRCA mutation carriers, we evaluated adherence to the MedDiet, and the association with the MetS, by analyzing data from the Mediterranean Diet Adherence Screener (MEDAS). Methods. BRCA mutation carriers, with or without BC, aged 18 to 70 years, were eligible for the trial. After the baseline examinations, women were randomized to a dietary intervention or to a control group. Both groups completed the MEDAS at baseline and at the end of the dietary intervention. Results. A total of 163 women completed the 6 months of dietary intervention. Compared with controls, the women in the intervention group significantly reduced their consumption of red meat ( P < .01) and commercial sweets ( P < .01) and their MEDAS score rose significantly (+1.3 vs +0.55, P = .02). The number of MetS parameters decreased with increasing points of adherence to the MEDAS score ( P = .01). In the intervention group, there was a significant association with the greater reduction of MetS. Conclusion. BRCA mutation carriers in the intervention group experienced greater improvement in their MedDiet and MetS parameters.

scholarly journals Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial

2021 ◽  
Author(s):  
Cesar I. Fernandez-Lazaro ◽  
Estefanía Toledo ◽  
Pilar Buil-Cosiales ◽  
Jordi Salas-Salvadó ◽  
Dolores Corella ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Longitudinal Analysis ◽  
Self Efficacy ◽  
Chronic Conditions ◽  
Dietary Intervention ◽  
Dietary Change ◽  
Multiple Chronic Conditions ◽  
Dietary Changes ◽  
Factors Associated ◽  
Baseline Factors

Abstract Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25–1.83; OR12-month: 1.66, 95% CI 1.37–2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07–2.46; OR12-month: 1.62, 95% CI 1.07–2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53–0.79; OR12-month: 0.76, 95% CI 0.62–0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64–0.99; OR12-month: 0.71, 95% CI 0.57–0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. Trial registration ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870.

scholarly journals Adherence to the Mediterranean diet in Cyprus and its relationship to multi-morbidity: an epidemiological study

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Kyprianidou ◽  
Demosthenes Panagiotakos ◽  
Antigoni Faka ◽  
Maria Kambanaros ◽  
Konstantinos C Makris ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mediterranean Diet ◽  
Adult Population ◽  
International Classification Of Diseases ◽  
Future Research ◽  
Beneficial Effects ◽  
Lower Tertile ◽  
Validated Questionnaire ◽  
Prevention Programmes ◽  
The Mediterranean

Abstract Objective: To examine the adherence to the Mediterranean diet in the adult general population of Cyprus and assess its relationship with multi-morbidity. Design: A representative sample of the adult population of Cyprus was selected in 2018–2019 using stratified sampling. Demographics, Mediterranean diet, smoking and physical activity, as well as the presence of chronic, clinical and mental conditions, were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, 10th Revision. Setting: The five government-controlled municipalities of the Republic of Cyprus. Participants: A total of 1140 Cypriot men and women over 18 years. Results: The average Mediterranean diet score was 15·5 ± 4·0 with males and residents of rural regions being more adherent to the Mediterranean diet compared with females and residents of urban regions (P < 0·05). Being in the higher tertile of adherence to the Mediterranean diet was associated with lower odds of multi-morbidity compared with the lower tertile, and this result was statistically significant even after adjusting for age, gender, smoking habits and physical activity (OR = 0·68, 95 % CI 0·46, 0·99). Conclusions: The study provides evidence of the adherence to the Mediterranean diet in Cypriot population and its association with multi-morbidity. Adherence to the Mediterranean diet was associated with lower risk of multi-morbidity. Future research would attempt to replicate such results that could add solid pieces of evidence towards meeting some criteria of causality and severity tests; hence, prevention programmes and practice guidelines in Cyprus and elsewhere should take into account those beneficial effects.

scholarly journals Multi-Morbidity and Mediterranean Diet in the Cypriot population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Kyprianidou ◽  
D Panagiotakos ◽  
M Kambanaros ◽  
K C Makris ◽  
C A Christophi
Keyword(s):  
Mediterranean Diet ◽  
Meat Products ◽  
Educational Status ◽  
International Classification Of Diseases ◽  
Beneficial Effects ◽  
Lower Tertile ◽  
Validated Questionnaire ◽  
Classification Of Diseases ◽  
Diet Pattern ◽  
The Mediterranean

Abstract Introduction Knowledge about factors associated with multi-morbidity in a given population has important implications for prevention, diagnosis, treatment, and prognosis strategies. Objectives To examine the association of Mediterranean diet with multi-morbidity in the adult general population of Cyprus. Methods A representative sample of n = 1142 Cypriots over 18 years old was recruited during 2018-2019. Multi-morbidity was assessed using a validated questionnaire and diseases were classified according to the International Classification of Diseases, 11th Revision (ICD-11). Mediterranean diet was evaluated using the MedDiet score tool which included the weekly consumption of non-refined cereals, fruit, vegetables, legumes, potatoes, fish, meat and meat products, poultry, full fat dairy products, as well as olive oil and alcohol intake. Results The average Mediterranean diet score was 15.5 ± 4.0 with males adhering more to the Mediterranean diet compared to females (p &lt; 0.001). Being in the higher tertile of adherence to the Mediterranean diet was associated with lower odds of multi-morbidity at α = 0.10, even after adjusting for age, gender, educational status, smoking habits, and physical activity (OR = 0.72, 95% CI: 0.49, 1.06, p = 0.09), compared to the lower tertile. Conclusions To the best to our knowledge, this is the first study which provides evidence of an association between Mediterranean diet and multi-morbidity. Adherence to Mediterranean diet was associated with lower risk of multi-morbidity. Future prevention programs and practice guidelines in Cyprus and elsewhere should take into account the beneficial effects of a Mediterranean diet on multi-morbidity. Key messages This study provides the first evidence of an association between Mediterranean diet and multi-morbidity. health benefits in terms of multiple chronic diseases in an individual can be gained from Mediterranean diet pattern.

Patient empowerment and the Mediterranean diet as a possible tool to tackle prediabetes associated with overweight or obesity: a pilot study

HORMONES ◽  
2019 ◽  
Vol 18 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Giovanna Muscogiuri ◽  
Luigi Barrea ◽  
Carolina Di Somma ◽  
Barbara Altieri ◽  
Martina Vecchiarini ◽  
...  
Keyword(s):  
Pilot Study ◽  
Mediterranean Diet ◽  
Patient Empowerment ◽  
The Mediterranean ◽  
Overweight Or Obesity

scholarly journals A Pilot Low-Inflammatory Dietary Intervention to Reduce Inflammation and Improve Quality of Life in Patients With Familial Adenomatous Polyposis: Protocol Description and Preliminary Results

2019 ◽  
Vol 18 ◽  
pp. 153473541984640 ◽  
Author(s):  
Patrizia Pasanisi ◽  
Manuela Gariboldi ◽  
Paolo Verderio ◽  
Stefano Signoroni ◽  
Andrea Mancini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Familial Adenomatous Polyposis ◽  
Mediterranean Diet ◽  
Dietary Intervention ◽  
Prophylactic Surgery ◽  
Adenomatous Polyposis ◽  
Dietary Recommendations ◽  
Preliminary Results ◽  
The Mediterranean

Patients with familial adenomatous polyposis (FAP) depend on a lifelong endoscopic surveillance programme and prophylactic surgery, and usually suffer nutritional problems. Intestinal inflammation has been linked to both FAP and colorectal cancer. Epidemiological studies show a relationship between diet and inflammation. Preventive dietary recommendations for FAP patients are so far lacking. We have designed a nonrandomized prospective pilot study on FAP patients to assess whether a low-inflammatory diet based on the Mediterranean diet principles and recipes, by interacting with the microbiota, reduces gastrointestinal markers of inflammation and improves quality of life. This report describes the scientific protocol of the study and reports the participants’ adherence to the proposed dietary recommendations. Thirty-four FAP patients older than 18 years, bearing the APC pathogenic variant, who underwent prophylactic total colectomy with ileo-rectal anastomosis were eligible into the study. During the 3-month dietary intervention, they reported improvements in their consumption of Mediterranean foods (vegetables, fruits, fish, and legumes), and a reduction in pro-inflammatory foods (red/processed meat and sweets); this led to a significant increase in their adherence to the Mediterranean diet. The improvement was accompanied by a decrease in the number of diarrhoeal discharges. These preliminary results are encouraging with regard to feasibility, dietary outcome measures, and safety.

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