Adherence to Mediterranean Diet and Cognitive Abilities in the Greek Cohort of Epirus Health Study

The Mediterranean diet is commonly proposed as a major modifiable protective factor that may delay cognitive impairment in the elderly. The aim of the study was to investigate the cross-sectional association of adherence to the Mediterranean diet with cognitive abilities in a younger Greek population. A total of 1201 healthy adults aged 21–77 years (mean: 47.8) from the Epirus Health Study cohort were included in the analysis. Adherence to the Mediterranean diet was measured using the 14-point Mediterranean Diet Adherence Screener (MEDAS) and cognition was measured using the Trail Making Test, the Verbal Fluency test and the Logical Memory test. Statistical analysis was performed using multiple linear regression models adjusted for age, sex, education, body mass index, smoking status, alcohol consumption and physical activity. Overall, no association was found between the MEDAS score and cognitive tests, which could be explained by the young mean age and high level of education of the participants. Future studies should target young and middle-aged individuals to gain further understanding of the association between Mediterranean diet and cognition in this age group.

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Design and development of an instrument to measure overall lifestyle habits for epidemiological research: the Mediterranean Lifestyle (MEDLIFE) index

Public Health Nutrition ◽

10.1017/s1368980014001360 ◽

2014 ◽

Vol 18 (6) ◽

pp. 959-967 ◽

Cited By ~ 26

Author(s):

Mercedes Sotos-Prieto ◽

Belén Moreno-Franco ◽

Jose M Ordovás ◽

Montse León ◽

Jose A Casasnovas ◽

...

Keyword(s):

Physical Activity ◽

Social Interaction ◽

Mediterranean Diet ◽

Dietary Habits ◽

Healthy Eating Index ◽

Health Study ◽

Study Cohort ◽

Linear Regression Models ◽

Lifestyle Habits ◽

The Mediterranean

AbstractObjectiveTo design and develop a questionnaire that can account for an individual’s adherence to a Mediterranean lifestyle including the assessment of diet and physical activity patterns, as well as social interaction.DesignThe Mediterranean Lifestyle (MEDLIFE) index was created based on the current Spanish Mediterranean food guide pyramid. MEDLIFE is a twenty-eight-item derived index consisting of questions about food consumption (fifteen items), traditional Mediterranean dietary habits (seven items) and physical activity, rest and social interaction habits (six items). Linear regression models and Spearman rank correlation were fitted to assess content validity and internal consistency.SettingA subset of participants in the Aragon Workers’ Health Study cohort (Zaragoza, Spain) provided the data for development of MEDLIFE.SubjectsParticipants (n 988) of the Aragon Workers’ Health Study cohort in Spain.ResultsMean MEDLIFE score was 11·3 (sd 2·6; range: 0–28), and the quintile distribution of MEDLIFE score showed a significant association with each of the individual items as well as with specific nutrients and lifestyle indicators (intra-validity). We also quantified MEDLIFE correspondence with previously reported diet quality indices and found significant correlations (ρ range: 0·44–0·53; P<0·001) for the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and Mediterranean Diet Adherence Screener.ConclusionsMEDLIFE is the first index to include an overall assessment of lifestyle habits. It is expected to be a more holistic tool to measure adherence to the Mediterranean lifestyle in epidemiological studies.

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Social capital, tolerance of diversity and adherence to Mediterranean diet: the Rhea Mother–Child Cohort in Crete, Greece

Public Health Nutrition ◽

10.1017/s136898001400144x ◽

2014 ◽

Vol 18 (7) ◽

pp. 1300-1307 ◽

Cited By ~ 9

Author(s):

George Kritsotakis ◽

Leda Chatzi ◽

Maria Vassilaki ◽

Vaggelis Georgiou ◽

Manolis Kogevinas ◽

...

Keyword(s):

Social Capital ◽

Mediterranean Diet ◽

A Priori ◽

Linear Regression Models ◽

Cross Sectional ◽

Mediterranean Diet Adherence ◽

Similar Dose ◽

The Mediterranean ◽

Study Participants ◽

Sectional Analysis

AbstractObjectiveTo estimate the associations of individual maternal social capital and social capital dimensions (Participation in the Community, Feelings of Safety, Value of Life and Social Agency, Tolerance of Diversity) with adherence to the Mediterranean diet during pregnancy.DesignThis is a cross-sectional analysis of data from a prospective mother–child cohort (Rhea Study). Participants completed a social capital questionnaire and an FFQ in mid-pregnancy. Mediterranean diet adherence was evaluated through an a priori score ranging from 0 to 8 (minimal–maximal adherence). Maternal social capital scores were categorized into three groups: the upper 10 % was the high social capital group, the middle 80 % was the medium and the lowest 10 % was the low social capital group. Multivariable log-binomial and linear regression models adjusted for confounders were performed.SettingHeraklion, Crete, Greece.SubjectsA total of 377 women with singleton pregnancies.ResultsHigh maternal Total Social Capital was associated with an increase of almost 1 point in Mediterranean diet score (highest v. lowest group: β coefficient=0·95, 95 % CI 0·23, 1·68), after adjustment for confounders. Similar dose–response effects were noted for the scale Tolerance of Diversity (highest v. lowest group: adjusted β coefficient=1·08, 95 % CI 0·39, 1·77).ConclusionsIndividual social capital and tolerance of diversity are associated with adherence to the Mediterranean diet in pregnancy. Women with higher social capital may exhibit a higher sense of obligation to themselves and to others that may lead to proactive nutrition-related activities. Less tolerant women may not provide the opportunity to new healthier, but unfamiliar, nutritional recommendations to become part of their regular diet.

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Homocysteine Levels Show Significant Differences among Mediterranean Dietary Quality Index Variables Compared to Folate and Vitamin B12 Status in Women

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000237 ◽

2015 ◽

Vol 85 (3-4) ◽

pp. 202-210 ◽

Cited By ~ 4

Author(s):

Ivona Višekruna ◽

Ivana Rumbak ◽

Ivana Rumora Samarin ◽

Irena Keser ◽

Jasmina Ranilović

Keyword(s):

Mediterranean Diet ◽

Diet Quality ◽

Quality Index ◽

Fruits And Vegetables ◽

Reproductive Age ◽

Dietary Quality ◽

Vitamin B ◽

Cross Sectional ◽

Poor Diet ◽

The Mediterranean

Abstract. Results of epidemiologic studies and clinical trials have shown that subjects following the Mediterranean diet had lower inflammatory markers such as homocysteine (Hcy). Therefore, the aim of this cross-sectional study was to assess female diet quality with the Mediterranean diet quality index (MDQI) and to determine the correlation between MDQI, homocysteine, folate and vitamin B12 levels in the blood. The study participants were 237 apparently healthy women (96 of reproductive age and 141 postmenopausal) between 25 and 93 years. For each participant, 24-hour dietary recalls for 3 days were collected, MDQI was calculated, and plasma Hcy, serum and erythrocyte folate and vitamin B12 levels were analysed. Total MDQI ranged from 8 to 10 points, which represented a medium-poor diet for the subjects. The strength of correlation using biomarkers, regardless of group type, age, gender and other measured parameters, was ranked from best (0.11) to worst (0.52) for olive oil, fish, fruits and vegetables, grains, and meat, in this order. Hcy levels showed the best response among all markers across all groups and food types. Our study shows significant differences between variables of the MDQI and Hcy levels compared to levels of folate and vitamin B12 in participants with medium-poor diet quality, as evaluated according to MDQI scores.

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Relationship Among Adherence to The Mediterranean Diet and Anthropometric and Metabolic Parameters in Subjects with Obesity

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320999201111161220 ◽

2020 ◽

Vol 20 ◽

Author(s):

Luisa Lampignano ◽

Roberta Zupo ◽

Rossella Donghia ◽

Vito Guerra ◽

Fabio Castellana ◽

...

Keyword(s):

Mediterranean Diet ◽

Hdl Cholesterol ◽

Fat Distribution ◽

Serum Levels ◽

Overweight And Obesity ◽

Height Ratio ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Waist To Height Ratio ◽

The Mediterranean

Background: There is moderate-to-high evidence that the Mediterranean diet prevents increases in body weight and waist circumference in non-obese individuals but less is known about its effects in subjects with overweight and obesity. The present study was focused on exploring the cross-sectional association among the adherence to Mediterranean diet and the most commonly used variables of metabolic and cardiovascular risk factors in a cohort of overweight subjects from a typical Mediterranean region, Apulia, in Southern Italy. Methods:: The study was performed in a cohort of 1214 individuals, all with overweight or obesity but no other clinical condition. We investigated the association among adherence to Mediterranean diet, assessed with the PREDIMED score, and anthropometric parameters [namely body mass index (BMI), WC, waist to height ratio (WHtR) and neck circumference (NC)], fasting serum levels of glucose, insulin, uric acid and lipids (triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol), and blood pressure and insulin resistance, measured by HOMA-IR. Results:: The waist to height ratio was negatively associated to a PREDIMED score ≥7 (p<0.04), whereas HDL cholesterol was positively associated to a PREDIMED score ≥7 (p<0.04) Conclusion: This study suggests that body fat distribution and HDL-cholesterol are the parameters most strongly influenced by MedDiet in Apulian subjects.

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Mediterranean Diet and Healthy Eating in Subjects with Prediabetes from the Mollerussa Prospective Observational Cohort Study

Nutrients ◽

10.3390/nu13010252 ◽

2021 ◽

Vol 13 (1) ◽

pp. 252

Author(s):

Mireia Falguera ◽

Esmeralda Castelblanco ◽

Marina Idalia Rojo-López ◽

Maria Belén Vilanova ◽

Jordi Real ◽

...

Keyword(s):

Glucose Tolerance ◽

Mediterranean Diet ◽

Healthy Eating ◽

Dietary Patterns ◽

Normal Glucose Tolerance ◽

Healthy Eating Index ◽

Study Cohort ◽

Cross Sectional ◽

Normal Glucose ◽

Multivariable Analyses

We aimed to assess differences in dietary patterns (i.e., Mediterranean diet and healthy eating indexes) between participants with prediabetes and those with normal glucose tolerance. Secondarily, we analyzed factors related to prediabetes and dietary patterns. This was a cross-sectional study design. From a sample of 594 participants recruited in the Mollerussa study cohort, a total of 535 participants (216 with prediabetes and 319 with normal glucose tolerance) were included. The alternate Mediterranean Diet score (aMED) and the alternate Healthy Eating Index (aHEI) were calculated. Bivariable and multivariable analyses were performed. There was no difference in the mean aMED and aHEI scores between groups (3.2 (1.8) in the normoglycemic group and 3.4 (1.8) in the prediabetes group, p = 0.164 for the aMED and 38.6 (7.3) in the normoglycemic group and 38.7 (6.7) in the prediabetes group, p = 0.877 for the aHEI, respectively). Nevertheless, women had a higher mean of aMED and aHEI scores in the prediabetes group (3.7 (1.9), p = 0.001 and 40.5 (6.9), p < 0.001, respectively); moreover, they had a higher mean of aHEI in the group with normoglycemia (39.8 (6.6); p = 0.001). No differences were observed in daily food intake between both study groups; consistent with this finding, we did not find major differences in nutrient intake between groups. In the multivariable analyses, the aMED and aHEI were not associated with prediabetes (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.75–1.87; p = 0.460 and OR: 1.32, 95% CI: 0.83–2.10; p = 0.246, respectively); however, age (OR: 1.04, 95% CI: 1.02–1.05; p < 0.001), dyslipidemia (OR: 2.02, 95% CI: 1.27–3.22; p = 0.003) and body mass index (BMI) (OR: 1.09, 95% CI: 1.05–1.14; p < 0.001) were positively associated with prediabetes. Physical activity was associated with a lower frequency of prediabetes (OR: 0.48, 95% CI: 0.31–0.72; p = 0.001). In conclusion, subjects with prediabetes did not show a different dietary pattern compared with a normal glucose tolerance group. However, further research is needed on this issue.

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High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries

Nutrients ◽

10.3390/nu13030995 ◽

2021 ◽

Vol 13 (3) ◽

pp. 995

Author(s):

Israa M. Shatwan ◽

Eiman A. Alhinai ◽

Balqees Alawadhi ◽

Shelini Surendran ◽

Najlaa M. Aljefree ◽

...

Keyword(s):

Mediterranean Diet ◽

Total Sample ◽

Cross Sectional Study ◽

Inverse Association ◽

Protective Effects ◽

Hip Circumference ◽

Cross Sectional ◽

Gulf Countries ◽

The Mean ◽

The Mediterranean

The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20–55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.

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Adhering to a Mediterranean diet in a Mediterranean country: an excess cost for families?

British Journal Of Nutrition ◽

10.1017/s0007114521002518 ◽

2021 ◽

pp. 1-24

Author(s):

Ricardo Alves ◽

Carla Lopes ◽

Sara Rodrigues ◽

Julian Perelman

Keyword(s):

Mediterranean Diet ◽

Food Group ◽

Food Prices ◽

Mediterranean Country ◽

Linear Regression Models ◽

Middle Income ◽

Diet Cost ◽

The Mediterranean ◽

The Cost ◽

Activity Survey

Abstract Background: Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. Methods: We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Results: Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Conclusions: Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population’s diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.

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Association between Depression, Lifestyles, Sleep Quality, and Sense of Coherence in a Population with Cardiovascular Risk

Nutrients ◽

10.3390/nu13020585 ◽

2021 ◽

Vol 13 (2) ◽

pp. 585

Author(s):

Aina Riera-Sampol ◽

Miquel Bennasar-Veny ◽

Pedro Tauler ◽

Mar Nafría ◽

Miquel Colom ◽

...

Keyword(s):

Cardiovascular Risk ◽

Sleep Quality ◽

Mediterranean Diet ◽

Sense Of Coherence ◽

Cross Sectional Study ◽

Poor Sleep ◽

Protective Effects ◽

Cross Sectional ◽

Health Related ◽

The Mediterranean

People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35–75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels.

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Health and nutrition literacy in adults: Links with lifestyle factors and obesity

Mediterranean Journal of Nutrition and Metabolism ◽

10.3233/mnm-200471 ◽

2020 ◽

Vol 13 (4) ◽

pp. 361-370

Author(s):

Maria Michou ◽

Demosthenes B. Panagiotakos ◽

Christos Lionis ◽

Vassiliki Costarelli

Keyword(s):

Physical Activity ◽

Alcohol Consumption ◽

Linear Regression ◽

Smoking Status ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Linear Regression Models ◽

Chi Square ◽

Cross Sectional

BACKGROUND: Low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. OBJECTIVES: The aim of this study was to investigate certain lifestyle factors and obesity, in relation to HL and NL. METHODS: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The sample consisted of 1281 individuals, aged ≥18 years. HL, NL sociodemographic characteristics and lifestyle factors (physical activity, smoking status, alcohol consumption,) were assessed. Mann-Whitney U, the Kruskall Wallis, Pearson chi-square tests and multiple linear regression models were used. RESULTS: Linear regression analysis has shown that smoking, alcohol consumption and physical activity, were associated with HL levels (–1.573 points for ex-smokers in comparison to smokers, p = 0.035, –1.349 points for alcohol consumers in comparison to non-consumers, p = 0.006 and 1.544 points for physically active individuals to non-active, p = 0.001). With respect to NL levels, it was also not associated with any of these factors. Obesity was not associated with HL and NL levels. CONCLUSIONS: Certain lifestyle factors, including physical activity, are predicting factors of HL levels, in Greek adults. The results contribute to the understanding of the relationship between lifestyle factors and HL and should be taken into account when HL policies are designed.

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