AB0316 ADHERENCE TO THE MEDITERRANEAN DIET AND ITS ASSOCIATION WITH DISEASE ACTIVITY AND DAMAGE ACCRUAL IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Background:There is limited evidence regarding the impact of the Mediterranean Diet (Med Diet) on autoimmune diseases although it has been proposed that adherence to the Med Diet may decrease the risk of certain autoimmune diseases. However, the potential usefulness of the Med Diet as a high-quality dietary pattern for other autoimmune diseases such as SLE has not yet been investigated.Objectives:The aim of this study was to evaluate the potential association between the adherence to the Med Diet and disease activity, damage accrual and SLE-related clinical markers in a large cohort of women with SLE.Methods:In this cross-sectional study, we assessed Med Diet adherence through a 14-item questionnaire in 253 women with SLE (mean age 46.74 ± 12.70 years). The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to asses disease activity and disease-related damage, respectively. Levels of C-reactive protein (CRP; mg/dL), homocysteine (Hcy; mol/L), anti-double stranded DNA antibodies (anti-dsDNA) (IU/mL), complement C3 (mg/dL), and complement C4 (mg/dL) were determined.Results:The Med Diet adherence score was classified as follows: low adherence (≤ 5 points); medium adherence (6–9 points) and good adherence (≥ 10 points). Only 50.2% of the SLE women had good adherence to the Med Diet. The ANCOVA models showed significant differences between patients with good adherence to the Med Diet and those with medium and low adherence in SLEDAI (p ≤ 0.001) and SDI (p ≤ 0.001). Age, medical treatment (immunosuppressors, corticoids, or antimalarials), smoking status, and body mass index (BMI) were included as confounding factors. The odds ratio (OR) for having active SLE (SLEDAI ≥ 5) or the presence of damage (SDI ≥ 1) was lower among patients whose Med Diet score was higher (p ≤ 0.001).Conclusion:Adherence to the Med Diet influences disease activity and damage accrual in SLE women. Thus, these patients would benefit from nutritional counselling and education on modification, to help adapt their lifestyles towards the Med Diet pattern. This would help slow the progression of SLE and the damage it causes.References:[1]Sedaghat F, Jessri M, Behrooz M, Mirghotbi M, Rashidkhani B. Mediterranean diet adherence and risk of multiple sclerosis: a case-control study. Asia Pac J Clin Nutr. 2016;25(2):377–84.[2]orsyth C, Kouvari M, D’Cunha NM, Georgousopoulou EN, Panagiotakos DB, Mellor DD, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018 May 18;38(5):737–47.[3]Minihane AM, Vinoy S, Russell WR, Baka A, Roche HM, Tuohy KM, et al. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 2015 Oct 14;114(7):999–1012.Acknowledgements:This research was supported by the grant PI0523-2016 from “Consejería de igualdad, salud y políticas sociales” (Junta de Andalucía) and is part of the research group LyDIMED “Lupus y Dieta Mediterránea”.Disclosure of Interests:None declared

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Mediterranean diet in axial spondyloarthritis: an observational study in an Italian monocentric cohort

Arthritis Research & Therapy ◽

10.1186/s13075-021-02600-0 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Francesca Ometto ◽

Augusta Ortolan ◽

Davide Farber ◽

Mariagrazia Lorenzin ◽

Giulia Dellamaria ◽

...

Keyword(s):

Disease Activity ◽

Mediterranean Diet ◽

Axial Spondyloarthritis ◽

Complete Information ◽

Nutritional Advice ◽

Beneficial Impact ◽

Multivariable Regression ◽

The Mediterranean ◽

The Impact ◽

Optimal Adherence

Abstract Background Little evidence is available about the impact of diet on disease activity of axial spondyloarthritis (axSpA). This study evaluated the impact of a 6-month nutritional advice based on the Mediterranean diet on the disease activity of axSpA. Methods We prospectively collected the information of a group of axSpA patients who were offered nutritional advice for a 6-month period, who were compared to axSpA patients followed at the same center who were not on a specific diet. A nutritionist gave suggestions for dietary modification at baseline and thereafter every 2 months until month 6. Adherence to the Mediterranean diet was evaluated with the PREDIMED questionnaire ranging from 0 (no adherence) to 10 (optimal adherence); disease activity was evaluated with ASDAS-CRP. A multivariable regression analysis was conducted to identify independent predictors of PREDIMED and of ASDAS-CRP improvement (improvement ≥ 20% of each score). Results A total of 161 patients were included: 81 receiving nutritional advice and 80 controls; 47 in the nutritional group and 63 controls had complete information until month 6. Overall, 40 (36.4%) were females, the mean age was 51.7 ± 1.3 years, and 58 (52.7%) were affected with psoriasis. No relevant change of anthropometric or laboratory measures was observed in either group. Adherence to the Mediterranean diet was moderate (PREDIMED score 6.7 ± 1.8 at baseline; 7.6 ± 2.1 at month 6) and improved more in the nutritional group compared to controls (p = 0.020). Predictors of a PREDIMED improvement ≥ 20% were receiving nutritional advice (OR 4.53, 1.36–15.1, p = 0.014), age (per 10-year increase OR 1.05, 1.02–1.68, p = 0.007), and BMI (OR 0.77, 0.63–0.9, p = 0.006). An ASDAS-CRP improvement ≥ 20% was more frequent in the nutritional group compared to controls (p = 0.020). A PREDIMED improvement ≥ 20% was associated with a ASDAS-CRP improvement ≥ 20% (OR 6.75,1.8–25.3, p = 0.005). Psoriasis and disease duration were negatively but not significantly associated to the ASDAS-CRP improvement. Conclusions Improving adherence to the Mediterranean diet may have a beneficial impact on the activity of axSpA. Patients with a lower BMI and older patients are less prone to modify their diet towards the Mediterranean diet following nutritional advice. Patients with psoriasis may have a limited benefit from dietary improvement. Study registration Protocol No. 52723, Padova Hospital Medical Ethical Committee (October 11, 2010).

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Pilot Study on the Impact of the Mediterranean Diet and Intermittent Fasting

Case Medical Research ◽

10.31525/ct1-nct04185948 ◽

2019 ◽

Author(s):

Keyword(s):

Pilot Study ◽

Mediterranean Diet ◽

Intermittent Fasting ◽

The Mediterranean ◽

The Impact

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THU0389 OBESITY IS A STRONG PREDICTOR OF WORSE CLINICAL OUTCOMES AND TREATMENT RESPONSES TO BIOLOGICS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4445 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 429.2-429

Author(s):

L. Hu ◽

X. Ji ◽

F. Huang

Keyword(s):

Ankylosing Spondylitis ◽

Disease Activity ◽

Clinical Outcomes ◽

Normal Weight ◽

Low Grade ◽

Hla B27 ◽

Treatment Responses ◽

The Impact ◽

Overweight Or Obesity

Background:Obesity population are rising rapidly and have become a major health issue. Studies have shown that obesity is a low-grade inflammatory status characterized by increase in proinflammatory cytokines.Objectives:To examine the impact of overweight or obesity on disease activity and treatment responses to biologics in patients with ankylosing spondylitis (AS) in a real-world setting.Methods:Body mass index (BMI) is available in 1013 patients from the Chinese Ankylosing Spondylitis Imaging Cohort (CASPIC). Differences in clinical outcomes (such as BASDAI, ASDAS, BASFI, and ASAS HI) and treatment responses to biologics (ΔBASDAI and ΔASDAS) over 3, 6, 9, and 12 months are assessed between BMI categories (normal weight BMI <24 kg/m2; overweight BMI=24-28 kg/m2; obesity BMI ≥28 kg/m2) using Kruskal-Wallis test. The association between BMI and clinical characteristics and treatment responses to biologics was determined, and multivariate median regression analyses were conducted to adjust for confounders (such as age, gender, smoke, and HLA-B27).Results:Among 1013 patients with AS, overweight accounts for 33%, while obesity for 12.4%. There were significant differences between patients who were obese or overweight and those with a normal weight regarding clinical outcomes (BASDAI: 2.90/2.56 vs 2.21; ASDAS-CRP: 2.20/1.99 vs 1.81; BASFI: 2.13/1.69 vs 1.38; ASAS HI: 6.87/5.29 vs 5.12 and BASMI: 2.35/1.76 vs 1.62; all P<0.05). After adjusting for age, gender, smoke, and HLA-B27, obesity remained associated with higher disease activity (BASDAI: β=0.55, P=0.005; ASDAS-CRP: β=0.40, P<0.001), poorer functional capacity (BASFI: β=0.58, P=0.001), worse health index (ASAS HI: β=1.92, P<0.001) and metrology index (BASMI: β=0.71, P=0.013). For TNFi users, BMI was found to be negatively correlated with changes in disease activity (ΔBASDAI and ΔASDAS) in the multivariate regression model (all P<0.05), and overweight and obese patients showed an unsatisfactory reduction in disease activity during 3-month, 6-month, 9-month, and 12-month follow-up period, compared to normal weight patients (all P<0.05).Conclusion:Overweight or obesity impacts greatly on clinical outcomes and treatment responses to biologics in patients with ankylosing spondylitis, which argues strongly for obesity management to become central to prevention and treatment strategies in patients with AS.References:[1]Maachi M, Pieroni L, Bruckert E, et al. Systemic low-grade inflammation is related to both circulating and adipose tissue TNFalpha, leptin and IL-6 levels in obese women. Int J Obes Relat Metab Disord 2004;28:993–7.Figure 1.Changes of disease activity for TNFi users during 3-, 6-, 9- and 12-month follow-up according to BMI categories. a: vs. normal weight, P<0.05 in 3 months; b: vs. normal weight, P<0.05 in 6 months; c: vs. normal weight, P<0.05 in 9 months; d: vs. normal weight, P<0.05 in 12 months.Acknowledgments:We appreciate the contribution of the present or former members of the CASPIC study group.Disclosure of Interests:None declared

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Gender-Related Determinants of Adherence to the Mediterranean Diet in Adults with Ischemic Heart Disease

Nutrients ◽

10.3390/nu12030759 ◽

2020 ◽

Vol 12 (3) ◽

pp. 759

Author(s):

Valeria Raparelli ◽

Giulio Romiti ◽

Valeria Spugnardi ◽

Marco Borgi ◽

Roberto Cangemi ◽

...

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Mediterranean Diet ◽

Perceived Stress ◽

Smoking Habit ◽

Multivariable Analysis ◽

Ischemic Heart ◽

Related Factors ◽

Diet Adherence ◽

The Mediterranean

Background: The reasons behind low adherence to the Mediterranean diet (Med-diet) are still not entirely known. We aimed to evaluate the effect of biological (i.e., sex-related) and psycho-socio-cultural (i.e., gender-related) factors on Med-diet adherence. Methods: Baseline Med-diet adherence was measured using a self-administered questionnaire among adults with ischemic heart disease (IHD) from the EVA (Endocrine Vascular Disease Approach) study. A multivariable analysis was performed to estimate the effect of sex- and gender-related factors (i.e., identity, roles, relations, and institutionalized gender) on low adherence. Results: Among 366 participants (66 ± 11 years, 31% women), 81 (22%) adults with low adherence demonstrated higher rates of diabetes, no smoking habit, lower male BSRI (Bem Sex Role Inventory) (median (IQR) 4.8 (4.1 to 5.5) vs. 5.1 (4.5 to 5.6) and p = 0.048), and higher Perceived Stress Scale 10 items (PSS-10) (median (IQR) 19 (11 to 23) vs. 15 (11 to 20) and p = 0.07) scores than those with medium-high adherence. In the multivariable analysis, only active smoking (odds ratio, OR = 2.10, 95% confidence interval, CI 1.14 to 3.85 and p = 0.017), PPS-10 (OR = 1.04, 95% CI 1.00 to 1.08, and p = 0.038) and male BSRI scores (OR = 0.70, 95% CI 0.52 to 0.95, and p = 0.021) were independently associated with low adherence. Conclusions: Male personality traits and perceived stress (i.e., gender identity) were associated with low Med-diet adherence regardless of the sex, age, and comorbidities. Therefore, gender-sensitive interventions should be explored to improve adherence in IHD.

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Sex-Related Differences in the Effects of the Mediterranean Diet on Glucose and Insulin Homeostasis

Journal of Nutrition and Metabolism ◽

10.1155/2014/424130 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Alexandra Bédard ◽

Louise Corneau ◽

Benoît Lamarche ◽

Sylvie Dodin ◽

Simone Lemieux

Keyword(s):

Sex Differences ◽

Insulin Sensitivity ◽

Mediterranean Diet ◽

Sex Difference ◽

Premenopausal Women ◽

Nonesterified Fatty Acids ◽

Time Interaction ◽

Insulin Homeostasis ◽

The Mediterranean ◽

The Impact

Objective. To document sex differences in the impact of the Mediterranean diet (MedDiet) on glucose/insulin homeostasis and to verify whether these sex-related effects were associated with changes in nonesterified fatty acids (NEFA).Methods. All foods were provided to 38 men and 32 premenopausal women (24–53 y) during 4 weeks. Variables were measured during a 180 min OGTT before and after the MedDiet.Results. A sex-by-time interaction for plasma insulin iAUC was found (men: −17.8%,P=0.02; women: +9.4%,P=0.63;Pfor sex-by-time interaction = 0.005). A sex-by-time interaction was also observed for insulin sensitivity (Cederholm index,P=0.03), for which only men experienced improvements (men: +8.1%,P=0.047; women: −5.9%,P=0.94). No sex difference was observed for glucose and C-peptide responses. Trends toward a decrease in NEFA AUC (P=0.06) and an increase in NEFA suppression rate (P=0.06) were noted, with no sex difference. Changes in NEFA were not associated with change in insulin sensitivity.Conclusions. Results suggest that the more favorable changes in glucose/insulin homeostasis observed in men compared to women in response to the MedDiet are not explained by sex differences in NEFA response. This clinical trial is registered with clinicaltrials.govNCT01293344.

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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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An Italian Survey on Dietary Habits and Changes during the COVID-19 Lockdown

Nutrients ◽

10.3390/nu13041197 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1197

Author(s):

Luana Izzo ◽

Antonio Santonastaso ◽

Gaetano Cotticelli ◽

Alessandro Federico ◽

Severina Pacifico ◽

...

Keyword(s):

Mediterranean Diet ◽

Dietary Habits ◽

Lifestyle Changes ◽

World Health ◽

Italian Population ◽

Online Questionnaire ◽

Diet Adherence ◽

Mediterranean Diet Adherence ◽

The World ◽

The Impact

The World Health Organization has declared the coronavirus outbreak a Public Health Emergency of International Concern; the outbreak has led to lockdowns in several parts of the world, and sudden changes in people’s lifestyles. This study explores the impact of the first coronavirus disease 2019 (COVID-19) pandemic period on dietary habits, lifestyle changes, and adherence to the Mediterranean diet among the Italian population, through an online questionnaire, conducted from April to May 2020, involving 1519 participants. The 14-point Mediterranean Diet Adherence Screener (MEDAS) highlighted a medium Mediterranean diet adherence in 73.5% of responders, which principally included the younger population, aged 18–30 years (p < 0.05). In regards to changes in eating habits, 33.5% of responders declared an influence of the pandemic period on nutritional practice. A decrease in alcohol consumption was reported by 81% of responders, while an increase in frozen food consumption was reported by 81.3% of responders. In addition, 58.8% reported positive weight modification (40.8%, +1–3 kg); physical activity reduction was reported for 70.5% of responders. Our study contributes toward amplifying the investigation on the dietary habits and changes of the Italian population during the COVID-19 lockdown, although the pandemic is ongoing. Similar studies should be performed around the world to understand how the emergency has impacted people’s habits.

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Does adherence to the Mediterranean diet modify the impact of smoking on health?

Public Health ◽

10.1016/j.puhe.2009.02.001 ◽

2009 ◽

Vol 123 (6) ◽

pp. 459-460 ◽

Cited By ~ 6

Author(s):

C.I. Vardavas ◽

A. Papadaki ◽

W.H.M. Saris ◽

A.G. Kafatos

Keyword(s):

Mediterranean Diet ◽

The Mediterranean ◽

The Impact

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Effects of Olive Oil on Blood Pressure: Epidemiological, Clinical, and Mechanistic Evidence

Nutrients ◽

10.3390/nu12061548 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1548 ◽

Cited By ~ 2

Author(s):

Marika Massaro ◽

Egeria Scoditti ◽

Maria Annunziata Carluccio ◽

Nadia Calabriso ◽

Giuseppe Santarpino ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Olive Oil ◽

Mediterranean Diet ◽

Lifestyle Changes ◽

Antihypertensive Medications ◽

Hypertensive Patients ◽

High Oleic ◽

The Mediterranean ◽

The Impact

The increasing access to antihypertensive medications has improved longevity and quality of life in hypertensive patients. Nevertheless, hypertension still remains a major risk factor for stroke and myocardial infarction, suggesting the need to implement management of pre- and hypertensive patients. In addition to antihypertensive medications, lifestyle changes, including healthier dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet, have been shown to favorably affect blood pressure and are now recommended as integrative tools in hypertension management. An analysis of the effects of nutritional components of the Mediterranean diet(s) on blood pressure has therefore become mandatory. After a literature review of the impact of Mediterranean diet(s) on cardiovascular risk factors, we here analyze the effects of olive oil and its major components on blood pressure in healthy and cardiovascular disease individuals and examine underlying mechanisms of action. Both experimental and human studies agree in showing anti-hypertensive effects of olive oil. We conclude that due to its high oleic acid and antioxidant polyphenol content, the consumption of olive oil may be advised as the optimal fat choice in the management protocols for hypertension in both healthy and cardiovascular disease patients.

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From the Table to the Tumor: The Role of Mediterranean and Western Dietary Patterns in Shifting Microbial-Mediated Signaling to Impact Breast Cancer Risk

Nutrients ◽

10.3390/nu11112565 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2565 ◽

Cited By ~ 8

Author(s):

Tiffany M. Newman ◽

Mara Z. Vitolins ◽

Katherine L. Cook

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Mediterranean Diet ◽

Dietary Patterns ◽

Gut Microbiome ◽

Western Diet ◽

Diet Pattern ◽

The Mediterranean ◽

The Impact

Diet is a modifiable component of lifestyle that could influence breast cancer development. The Mediterranean dietary pattern is considered one of the healthiest of all dietary patterns. Adherence to the Mediterranean diet protects against diabetes, cardiovascular disease, and cancer. Reported consumption of a Mediterranean diet pattern was associated with lower breast cancer risk for women with all subtypes of breast cancer, and a Western diet pattern was associated with greater risk. In this review, we contrast the available epidemiological breast cancer data, comparing the impact of consuming a Mediterranean diet to the Western diet. Furthermore, we will review the preclinical data highlighting the anticancer molecular mechanism of Mediterranean diet consumption in both cancer prevention and therapeutic outcomes. Diet composition is a major constituent shaping the gut microbiome. Distinct patterns of gut microbiota composition are associated with the habitual consumption of animal fats, high-fiber diets, and vegetable-based diets. We will review the impact of Mediterranean diet on the gut microbiome and inflammation. Outside of the gut, we recently demonstrated that Mediterranean diet consumption led to distinct microbiota shifts in the mammary gland tissue, suggesting possible anticancer effects by diet on breast-specific microbiome. Taken together, these data support the anti-breast-cancer impact of Mediterranean diet consumption.

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