scholarly journals Adherence to the Mediterranean diet assessed by a novel dietary biomarker score and mortality in older adults: the InCHIANTI cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicole Hidalgo-Liberona ◽  
Tomás Meroño ◽  
Raul Zamora-Ros ◽  
Montserrat Rabassa ◽  
Richard Semba ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Mediterranean Diet ◽  
Cancer Mortality ◽  
Food Groups ◽  
Mediterranean Diet Score ◽  
Dietary Biomarkers ◽  
The Mediterranean ◽  
Diet Score

Abstract Background Dietary biomarkers may complement dietary intake assessment made by dietary questionnaires. We developed an a-posteriori dietary biomarkers score based on Mediterranean diet food groups and evaluated its association with mortality. Methods 642 participants (56% female), aged ≥65 years, with complete data on dietary biomarkers were followed during 20 years in the InCHIANTI cohort study (Tuscany, Italy). The main outcomes were all-cause, cardiovascular, and cancer mortality. Dietary biomarkers were selected from literature and from correlation analyses with dietary intakes of Mediterranean diet food groups in the study. The baseline levels of the following dietary biomarkers were chosen: urinary total polyphenols and resveratrol metabolites, and plasma carotenoids, selenium, vitamin B12, linolenic, eicosapentaenoic and docosahexaenoic acids, and the mono-unsaturated/saturated fatty acid ratio. Associations of the Mediterranean diet score using dietary biomarkers and a validated food frequency questionnaire (FFQ) (as tertiles) with mortality were assessed through Cox regression. Results During the 20-year follow-up [median (Q1–Q3), 14 (8–18) years], and 435 deaths occurred (139 from cardiovascular diseases and 89 from cancer-related causes). In the fully adjusted models, the dietary biomarker-Mediterranean diet score was inversely associated with all-cause (HRT3vs.T1 0.72; 95%CI 0.56–0.91) and cardiovascular (HRT3vs.T1 0.60; 95%CI 0.38–0.93), but not with cancer mortality. Associations between the FFQ-Mediterranean diet score and mortality were not statistically significant. Conclusions A greater adherence at baseline to a Mediterranean diet assessed by a dietary biomarker score was associated with a lower risk of mortality in older adults during a 20-year follow-up. The measurement of dietary biomarkers may contribute to guide individualized dietary counseling to older people. Trial registration NCT01331512

scholarly journals Mediterranean diet in pregnancy is protective for wheeze and atopy in childhood

Thorax ◽  
2008 ◽  
Vol 63 (6) ◽  
pp. 507-513 ◽  
Author(s):  
L Chatzi ◽  
M Torrent ◽  
I Romieu ◽  
R Garcia-Esteban ◽  
C Ferrer ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Mediterranean Diet ◽  
Statistical Significance ◽  
A Priori ◽  
Food Groups ◽  
Mediterranean Diet Score ◽  
High Level ◽  
The Impact ◽  
Diet Score

Introduction:Dietary intake of specific nutrients or food groups during pregnancy could play a role in the risk of asthma and atopy in offspring, but specific dietary patterns have not been implicated. The authors evaluated the impact of maternal (during pregnancy) and child adherence to a Mediterranean diet on asthma and atopy in childhood.Methods:Women presenting for antenatal care at all general practices in Menorca, a Mediterranean island in Spain, over a 12 month period starting in mid-1997 were recruited. 460 children were included in the analysis after 6.5 years of follow-up. Maternal dietary intake during pregnancy and children’s dietary intake at age 6.5 years were assessed by food frequency questionnaires, and adherence to a Mediterranean diet was evaluated by a priori defined scores. During follow-up, parents completed questionnaires on the child’s respiratory and allergic symptoms. Children underwent skin prick tests with six common aeroallergens.Results:The prevalence rates of persistent wheeze, atopic wheeze and atopy at age 6.5 years were 13.2%, 5.8% and 17.0%, respectively. One-third (36.1%) of mothers had a low quality Mediterranean diet during pregnancy according to the Mediterranean Diet Score, while the rest had a high score. A high Mediterranean Diet Score during pregnancy (at two levels, using “low” score as the reference) was found to be protective for persistent wheeze (OR 0.22; 95% CI 0.08 to 0.58), atopic wheeze (OR 0.30; 95% CI 0.10 to 0.90) and atopy (OR 0.55; 95% CI 0.31 to 0.97) at age 6.5 years after adjusting for potential confounders. Childhood adherence to a Mediterranean diet was negatively associated with persistent wheeze and atopy although the associations did not reach statistical significance.Conclusion:These results support a protective effect of a high level of adherence to a Mediterranean diet during pregnancy against asthma-like symptoms and atopy in childhood.

scholarly journals Adequacy of Critical Nutrients Affecting the Quality of the Spanish Diet in the ANIBES Study

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2328 ◽  
Author(s):  
Josune Olza ◽  
Emilio Martínez de Victoria ◽  
Javier Aranceta-Bartrina ◽  
Marcela González-Gross ◽  
Rosa M. Ortega ◽  
...  
Keyword(s):  
Older Adults ◽  
Mediterranean Diet ◽  
Diet Quality ◽  
Balance Study ◽  
Mediterranean Diet Score ◽  
Scientific Authority ◽  
The Mediterranean ◽  
Critical Nutrients ◽  
Diet Score

Diet is one of the key modifiable behaviors that can help to control and prevent non-communicable chronic diseases. Therefore, it is important to evaluate the overall diet composition of the population through non-invasive and independent indexes or scores as diet quality indexes (DQIs). The primary aim of the present work was to estimate the adequacy of the intake of critical nutrients in the Spanish “Anthropometry, Intake, and Energy Balance Study” (ANIBES) (n = 2285; 9–75 years), considering, as a reference, the European Food Scientific Authority (EFSA) values for nutrients for the European Union. We also assessed the quality of the diet for adults and older adults using four internationally accepted DQIs, namely the Healthy Diet Indicator (HDI), the Mediterranean Diet Score (MDS), the Mediterranean Diet Score-modified (MDS-mod), and the Mediterranean-Diet Quality Index (MED-DQI), as well as the ANIBES-DQI, stratified by education and income. The ANIBES-DQI was based on compliance with EFSA and Food and Agriculture Organization recommendations for a selected group of nutrients (i.e., total fat, saturated fatty acids (SFAs), simple sugars, fiber, calcium, vitamin C, and vitamin A), with a total range of 0–7. Misreporting was assessed according to the EFSA protocol, which allowed us to assess the DQIs for both the general population and plausible reporters. The majority of the Spanish population had high intakes of SFAs and sugars and low intakes of fiber, folate, and vitamins A and C. In addition, about half of the population had low DQI scores and exhibited low adherence to the Mediterranean diet pattern. Overall, older adults (>65–75 years) showed better DQIs than adults (18–64 years), without major differences between men and women. Moreover, primary education and low income were associated with low MDS and ANIBES-DQI scores. For the ANIBES-DQI, the percentage of the population with low scores was higher in the whole population (69.5%) compared with the plausible energy reporters (49.0%), whereas for medium and high scores the percentages were higher in plausible reporters (41.2% vs. 26.2% and 9.8% vs. 4.3%, respectively). In conclusion, the present study adds support to marked changes in the Mediterranean pattern in Spain, and low education and income levels seem to be associated with a low-quality diet. Additionally, the misreported evaluation in the ANIBES population suggests that this analysis should be routinely included in nutrition surveys to give more precise and accurate data related to nutrient intake and diet quality.

scholarly journals Prospective association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040959
Author(s):  
Saman Khalatbari-Soltani ◽  
Pedro Marques-Vidal ◽  
Fumiaki Imamura ◽  
Nita G. Forouhi
Keyword(s):  
Cohort Study ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Mediterranean Diet ◽  
Population Level ◽  
Inverse Association ◽  
Alcoholic Fatty Liver ◽  
The Mediterranean ◽  
Prospective Association

ObjectiveThe Mediterranean diet has been promoted as a healthy dietary pattern, but whether the Mediterranean diet may help to prevent hepatic steatosis is not clear. This study aimed to evaluate the prospective association between adherence to the Mediterranean diet and risk of hepatic steatosis.DesignPopulation-based prospective cohort study.SettingThe Swiss CoLaus Study.ParticipantsWe evaluated 2288 adults (65.4% women, aged 55.8±10.0 years) without hepatic steatosis at first follow-up in 2009–2012. Adherence to the Mediterranean diet was scaled as the Mediterranean diet score (MDS) based on the Mediterranean diet pyramid ascertained with responses to Food Frequency Questionnaires.Outcome measuresNew onset of hepatic steatosis was ascertained by two indices separately: the Fatty Liver Index (FLI, ≥60 points) and the non-alcoholic fatty liver disease (NAFLD) score (≥−0.640 points). Prospective associations between adherence to the Mediterranean diet and risk of hepatic steatosis were quantified using Poisson regression.ResultsDuring a mean 5.3 years of follow-up, hepatic steatosis was ascertained in 153 (6.7%) participants by FLI criteria and in 208 (9.1%) by NAFLD score. After multivariable adjustment, higher adherence to MDS was associated with lower risk of hepatic steatosis based on FLI: risk ratio 0.84 (95% CI 0.73 to 0.96) per 1 SD of MDS; 0.85 (0.73 to 0.99) adjusted for BMI; and 0.85 (0.71 to 1.02) adjusted for both BMI and waist circumference. When using NAFLD score, no significant association was found between MDS and risk of hepatic steatosis (0.95 (0.83 to 1.09)).ConclusionA potential role of the Mediterranean diet in the prevention of hepatic steatosis is suggested by the inverse association observed between adherence to the Mediterranean diet and incidence of hepatic steatosis based on the FLI. The inconsistency of this association when hepatic steatosis was assessed by NAFLD score points to the need for accurate population-level assessment of fatty liver and its physiological markers.

scholarly journals The Mediterranean Diet Score and Mortality Are Inversely Associated in Adults Living in the Subarctic Region

2012 ◽  
Vol 142 (8) ◽  
pp. 1547-1553 ◽  
Author(s):  
Gianluca Tognon ◽  
Lena Maria Nilsson ◽  
Lauren Lissner ◽  
Ingegerd Johansson ◽  
Göran Hallmans ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Subarctic Region ◽  
Mediterranean Diet Score ◽  
The Mediterranean ◽  
Diet Score

scholarly journals Sex Differences in the Effects of Repeated Taste Exposure to the Mediterranean Diet: A 6-month Follow-up Study

2016 ◽  
Vol 77 (3) ◽  
pp. 125-132 ◽  
Author(s):  
Alexandra Bédard ◽  
Louise Corneau ◽  
Sylvie Dodin ◽  
Simone Lemieux
Keyword(s):  
Body Weight ◽  
Sex Differences ◽  
Weight Management ◽  
Mediterranean Diet ◽  
Food Groups ◽  
Post Intervention ◽  
Time Interaction ◽  
The Mediterranean ◽  
Taste Exposure

Purpose: To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations and tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. Methods: Thirty-eight males and 32 premenopausal females (all aged 24–53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations and tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. Results: Compared with baseline, the Mediterranean score (MedScore) increased at the end of the 6-month follow-up (time effect P = 0.003), with no sex difference (sex-by-time interaction P = 0.97). With regard to MedScore components, sex differences were observed with males reporting changes in more dietary food groups than females. Although the intervention was not focused on body weight management, compared with baseline, BMI decreased during the intervention in both males and females; however, only females maintained the lower BMI 6 months after the intervention. Conclusions: Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both sexes and helps in the management of body weight, especially in females.

Abstract 13: Adherence to Various Dietary Patterns and Risk of Recurrent Coronary Heart Disease and Mortality in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
James M Shikany ◽  
Monika M Safford ◽  
Joanna Bryan ◽  
PK Newby ◽  
Joshua S Richman ◽  
...  
Keyword(s):  
Racial Differences ◽  
Mediterranean Diet ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Mediterranean Diet Score ◽  
The Mediterranean ◽  
Diet Score

Background: We have shown that the Southern dietary pattern, characterized by added fats, fried foods, organ and processed meats, and sugar-sweetened beverages, is associated with a greater risk of incident CHD in REGARDS, a national, population-based, longitudinal cohort. We sought to determine if the Southern pattern, other dietary patterns, and the Mediterranean diet score were associated with CHD events and mortality in REGARDS participants who previously reported CHD. Methods: REGARDS enrolled white and black adults aged ≥45 years between 2003-2007. Data were analyzed from 3,562 participants with CHD at baseline. Participants completed an FFQ at baseline, from which 5 dietary patterns were derived through factor analysis (Table). The Mediterranean diet score was calculated for each participant. Expert-adjudicated CHD events included myocardial infarction and CHD death. Cox proportional hazards regression was used to model the association of the dietary patterns and score with CHD events and death, adjusting for sociodemographics, lifestyle factors, energy intake, anthropometrics, and medical conditions. Results: Over 7 years of follow-up, there were 581 recurrent CHD events and 1,098 deaths. In fully-adjusted analyses, the highest quartile of adherence to the alcohol/salads pattern and highest group of the Mediterranean diet score were associated with lower risk of recurrent CHD compared to the lowest quartile/group (HR: 0.76; 95% CI: 0.59 – 0.98, HR: 0.78; 95% CI: 0.62 – 0.98, respectively). The highest quartile of adherence to the Southern pattern was associated with higher mortality (HR: 1.57; 95% CI: 1.28 – 1.91), while the highest group of the Mediterranean diet score was associated with lower mortality (HR: 0.80; 95% CI: 0.68 – 0.95). Conclusions: While the Southern dietary pattern was not related to risk of recurrent CHD, it was associated with higher mortality in REGARDS participants with existing CHD. Greater adherence to a Mediterranean diet was associated with lower risk of recurrent CHD and mortality.

scholarly journals Healthy dietary patterns from food diaries and FFQ are not associated with colorectal cancer risk: results from the UKWCS

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Petra Jones ◽  
Janet Cade ◽  
Charlotte Evans ◽  
Neil Hancock ◽  
Darren Greenwood
Keyword(s):  
Colorectal Cancer ◽  
Cancer Risk ◽  
Mediterranean Diet ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Colorectal Cancer Risk ◽  
Mediterranean Diet Score ◽  
Bland Altman Method ◽  
The Mediterranean ◽  
Diet Score

AbstractDietary pattern analyses have most commonly used food frequency questionnaire (FFQ) data for large population studies, whilst food diaries (FD) tend to be used with smaller datasets and followed up for shorter terms, restricting the possibility of a direct comparison. Studies comparing dietary patterns derived from two different assessment methods, in relation to diet and disease are limited. The aims of this study are to assess the agreement between dietary patterns derived from FFQ and FDs and to compare the associations between the Mediterranean dietary pattern and the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) dietary pattern in relation to colorectal cancer incidence.The study population included 2276 healthy middle-aged women – participants of the UK Women's Cohort Study. Energy and nutrient intakes, derived from 4-day FDs and from a 217-item FFQ were compared. A 10 and an 8-component score indicating adherence to the Mediterranean diet and to the 2007 WCRF/AICR cancer prevention recommendations respectively were generated. Agreement was assessed by weighted Kappa statistics and the Bland-Altman method. Cox regression was used to estimate hazard ratios (HRs) for colorectal cancer risk for both the FD and the FFQ patterns, for each score separately.The Bland-Altman method showed that the FFQ gave a higher energy intake compared to the FD with a bias of -525 kcal (95% CI -556, -493) between the two methods. Agreement was slight for the Mediterranean diet score (Κ = 0.15; 95% CI: 0.14, 0.16) and fair for the WCRF/AICR score (Κ = 0.38; 95% CI: 0.37, 0.39). A total of 173 incident cases of colorectal cancer were documented. In the multi-variable adjusted models, the estimates for an association with colorectal cancer were weak: HR = 0.94 (95% CI: 0.83 to 1.06) for a 1-unit increment in the Mediterranean diet score using FD and HR = 1.01 (95% CI: 0.83 to 1.24) for a 1-unit increment in the WCRF/AICR score using FD. For scores derived from the FFQ, estimates were inverse, but weak (HR = 0.80 (95% CI: 0.90 to 1.00) for a 1-unit increment in the Mediterranean diet score using FFQ and HR = 0.84 (95% CI: 0.67 to 1.05) for a 1-unit increment in the WCRF/AICR score using FFQ.There is insufficient evidence of an association of colorectal cancer risk with the Mediterranean dietary pattern or with the WCRF/AICR cancer prevention recommendations, irrespective of the dietary assessment method in this sample. Further studies with larger sample sizes, using FD for diet assessment are warranted.

scholarly journals Mediterranean diet score and incidence of IHD: a global comparative study

2019 ◽  
Vol 22 (8) ◽  
pp. 1444-1450 ◽  
Author(s):  
Ayako Sezaki ◽  
Tomoko Imai ◽  
Keiko Miyamoto ◽  
Fumiya Kawase ◽  
Hiroshi Shimokata
Keyword(s):  
Comparative Study ◽  
Linear Model ◽  
Mediterranean Diet ◽  
General Linear Model ◽  
General Linear ◽  
Mediterranean Diet Score ◽  
Per Capita ◽  
The Mediterranean ◽  
International Comparative ◽  
Diet Score

AbstractObjectiveThe aim of the present study was to clarify the global relationship between Mediterranean diet score (MDS) and the incidence of IHD by country using international statistics.DesignThe incidence of IHD by country was derived from the Global Burden of Disease (GBD) database. Average supplies of food (g/d per capita) and energy (kcal/d per capita) by country, excluding loss between production and household, were obtained from the FAOSTAT database. MDS was evaluated based on the total score of nine food items that characterize the Mediterranean diet. The association between MDS and the incidence of IHD was examined in countries with a population of 1 million or greater using a general linear model controlled for socio-economic and lifestyle variables.SettingPopulation data from global international databases.ParticipantsOne hundred and thirty-two countries with a population of over 1 million.ResultsMDS was inversely correlated with obesity rate, ageing rate, years of education and IHD incidence; however, no associations were found with gross domestic product, life expectancy, smoking rate, energy supply or health expenditure. In the general linear model of IHD incidence by MDS controlled for socio-economic and lifestyle variables, the β of the MDS was –26·4 (se 8·6; P<0·01).ConclusionsThe results of this global international comparative study confirmed that the Mediterranean diet is inversely associated with the incidence of IHD.

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