scholarly journals Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3925
Author(s):  
Luigi Barrea ◽  
Giovanna Muscogiuri ◽  
Gabriella Pugliese ◽  
Giulia de Alteriis ◽  
Annamaria Colao ◽  
...  
Keyword(s):  
Body Composition ◽  
Mediterranean Diet ◽  
Metabolic Profile ◽  
Low Grade ◽  
Inflammatory Status ◽  
Metabolically Healthy ◽  
The Mediterranean ◽  
Hs Crp ◽  
Metabolic Indices ◽  
Lower Adherence

Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m2 and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (p < 0.001), testosterone (p < 0.001), and insulin (p < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (p < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (p < 0.001) in spite of the same total energy intake (p = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, p < 0.001), more severe hyperandrogenism and cardio-metabolic indices (p < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, p < 0.001), and smaller PhAs (OR = 0.04, p < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (p < 0.001), followed by VAI (p < 0.001), and FLI (p = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (p < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.

scholarly journals The mediterranean diet: Healthy and sustainable dietary pattern in the time of Sars-Cov-2

2021 ◽  
pp. 1-17
Author(s):  
Carmela Bagnato ◽  
Carmela Perfetto ◽  
Flora Labanca ◽  
Lorenza Caregaro Negrin
Keyword(s):  
Mediterranean Diet ◽  
Dietary Pattern ◽  
Severe Disease ◽  
Fatal Outcome ◽  
Large Body ◽  
Healthy Plant ◽  
Low Grade ◽  
Mediterranean Dietary Pattern ◽  
Inflammatory Status ◽  
The Mediterranean

COVID-19, first reported in Wuhan, China in December 2019 quickly spread worldwide leading to serious health, social and economic consequences. A crucial role in the pathogenesis of severe disease has been attributed to the inflammatory status, that in more severe cases may evolve in an overproduction of pro-inflammatory cytokines (“cytokine storm)” and fatal outcome. Non-communicable diseases, nutritional disorders and advanced age, conditions associated with a low-grade systemic inflammation and immune function alterations, have been identified as major risks for severe COVID-19. General recommendations for fighting COVID-19 highlighted the paramount importance of adopting a healthy plant-based dietary pattern and healthy lifestyle. The Mediterranean dietary pattern is considered as one of the healthiest dietary patterns, and its benefits are supported by a large body of evidence. Furthermore, it is considered as a sustainable lifestyle model. The aim of this research was to update the multiple benefits of the Mediterranean dietary pattern on physical and mental health, focusing on the effects that it may have in combating COVID-19. The potential effects and mechanisms of action of the main bioactive components of Mediterranean diet were also analyzed. Considering its effects in modulating inflammation and oxidative stress and supporting the immune system, the Mediterranean dietary pattern may be considered the most promising dietary approach to combat COVID-19.

scholarly journals Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS)

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2278 ◽  
Author(s):  
Luigi Barrea ◽  
Angela Arnone ◽  
Giuseppe Annunziata ◽  
Giovanna Muscogiuri ◽  
Daniela Laudisio ◽  
...  
Keyword(s):  
Body Composition ◽  
Dietary Pattern ◽  
Polycystic Ovary ◽  
Fat Free Mass ◽  
Clinical Severity ◽  
Control Group ◽  
Low Grade ◽  
Testosterone Levels ◽  
Inflammatory Status ◽  
The Mediterranean

Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder and is characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Obesity, low-grade chronic inflammatory status, and insulin-resistance (IR) often coexist in PCOS. The Mediterranean diet (MD) is an anti-inflammatory dietary pattern, which is rich in complex carbohydrates and fiber, and high in monounsaturated fat. There is a close association among obesity, low-grade chronic inflammation, IR, and hormonal derangements in PCOS. The main aim of the present study was to evaluate the adherence to MD, the dietary intake, and the body composition and their association with PCOS clinical severity in a cohort of treatment-naïve women with PCOS when compared with a control group of healthy women matched for age and body mass index (BMI). In this case-controlled, cross-sectional study, we enrolled 112 patients with PCOS and 112 controls. PREvención con DIetaMEDiterránea (PREDIMED) and seven-day food records were used to evaluate the degree of adherence to the MD and dietary pattern, respectively. Body composition was evaluated by bioelectrical impedance analysis (BIA) phase-sensitive system. Testosterone levels and Ferriman-Gallwey score assessed the clinical severity of PCOS. C-reactive protein (CRP) levels were determined with a nephelometric assay with CardioPhase high sensitivity. PCOS women showed higher testosterone levels, Ferriman-Gallwey score, fasting insulin and glucose levels, and Homeostatic Model Assessment (HoMA)-IR when compared with the control group (p < 0.001). In addition, we found that the PCOS women consumed less extra-virgin olive oil, legumes, fish/seafood, and nuts compared with control group. Despite no differences in energy intake between the two groups, the PCOS women consumed a lower quantity of complex carbohydrate, fiber, monounsaturated fatty acids (MUFA), and n-3 polyunsaturated fatty acid (PUFA), and higher quantity of simple carbohydrate, total fat, saturated fatty acid (SFA), PUFA and n-6 PUFA than the control group. The PCOS women have an adverse body composition when compared with controls, with the lowest values of phase angle (PhA) and fat-free mass (p < 0.001). Additionally, after adjusting for BMI and total energy intake, testosterone levels showed significant negative correlations with PREDIMED score (p < 0.001) and consumption of protein (p = 0.005), complex carbohydrate (p < 0.001), fiber (p < 0.001), MUFA (p < 0.001), n-3 PUFA (p = 0.001), and positive associations with CRP levels, simple carbohydrate, SFA, n-6 PUFA (p < 0.001, respectively), and PUFA (p = 0.002). The cut-off for PREDIMED score ≤ 6 (p < 0.001, area under the curve (AUC) 0.848, standard error 0.036, 95% confidence interval (CI) 0.768 to 0.909) could serve as a threshold for significantly increased risk of high value of testosterone levels. In conclusion, a novel direct association between the adherence to MD and the clinical severity of the disease was reported in women with PCOS. This association could support a therapeutic role of foods and nutrients of the Mediterranean dietary pattern in the PCOS pathogenesis likely involving their inflammatory status, IR, and hyperandrogenemia. In addition, we reported a different body composition that is characterized by lower PhA and fat-free mass than controls. These data suggested a role of PhA as a useful marker of the clinical severity of this syndrome and provided strong evidence regarding the strategic relevance of the nutritional assessment in the management of women with PCOS.

scholarly journals Association of the Chronotype Score with Circulating Trimethylamine N-Oxide (TMAO) Concentrations

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1671
Author(s):  
Luigi Barrea ◽  
Giovanna Muscogiuri ◽  
Gabriella Pugliese ◽  
Chiara Graziadio ◽  
Maria Maisto ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Metabolic Profile ◽  
Cardiometabolic Risk ◽  
Linear Regression Analysis ◽  
Biological Rhythms ◽  
Unhealthy Lifestyle ◽  
Gut Dysbiosis ◽  
Study Population ◽  
The Mediterranean ◽  
The Individual

Individual differences in the chronotype, an attitude that best expresses the individual circadian preference in behavioral and biological rhythms, have been associated with cardiometabolic risk and gut dysbiosis. Up to now, there are no studies evaluating the association between chronotypes and circulating TMAO concentrations, a predictor of cardiometabolic risk and a useful marker of gut dysbiosis. In this study population (147 females and 100 males), subjects with the morning chronotype had the lowest BMI and waist circumference (p < 0.001), and a better metabolic profile compared to the other chronotypes. In addition, the morning chronotype had the highest adherence to the Mediterranean diet (p < 0.001) and the lowest circulating TMAO concentrations (p < 0.001). After adjusting for BMI and adherence to the Mediterranean diet, the correlation between circulating TMAO concentrations and chronotype score was still kept (r = −0.627, p < 0.001). Using a linear regression analysis, higher chronotype scores were mostly associated with lower circulating TMAO concentrations (β = −0.479, t = −12.08, and p < 0.001). Using a restricted cubic spline analysis, we found that a chronotype score ≥59 (p < 0.001, R2 = −0.824) demonstrated a more significant inverse linear relationship with circulating TMAO concentrations compared with knots <59 (neither chronotype) and <41 (evening chronotype). The current study reported the first evidence that higher circulating TMAO concentrations were associated with the evening chronotype that, in turn, is usually linked to an unhealthy lifestyle mostly characterized by low adherence to the MD.

scholarly journals Social Jet Lag Associates Negatively with the Adherence to the Mediterranean Diet and Body Mass Index among Young Adults

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1756 ◽  
Author(s):  
Zerón-Rugerio ◽  
Cambras ◽  
Izquierdo-Pulido
Keyword(s):  
Body Mass Index ◽  
Young Adults ◽  
Mediterranean Diet ◽  
Body Mass ◽  
Jet Lag ◽  
Sleep Habits ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
The Mediterranean ◽  
Lower Adherence

Obesity and unhealthy eating habits have been associated with irregular sleep–wake patterns during the week, also known as social jet lag. The Mediterranean diet is a healthy pattern related with a better health and sleep quality. However, potential associations with social jet lag remain unexplored. The aim of this study was to examine whether higher social jet lag is linked to lower adherence to the Mediterranean diet and whether it is associated with BMI (Body Mass Index). This cross-sectional study included 534 young adults (18–25 years). Anthropometric parameters, adherence to the Mediterranean diet, chronotype and social jet lag were studied. Our results revealed that individuals with greater social jet lag showed lower adherence to the Mediterranean diet and had a higher BMI. Among the habits that characterized the Mediterranean dietary pattern, we observed that higher social jet lag was significantly associated with a lower intake of fruits and vegetables, as well as skipping breakfast. Hence, the promotion of regular sleep habits together with healthy dietary patterns should be considered for obesity prevention, especially among young adults.

scholarly journals The Relationship Between Adherence to the Mediterranean Diet and Body Composition in Nutrition and Dietetic Students

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Servet Madencioğlu ◽  
Sevinç Yücecan
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Waist Circumference ◽  
Mediterranean Diet ◽  
Near East ◽  
Female Students ◽  
Significant Difference ◽  
The Mediterranean ◽  
Nutrition And Dietetics ◽  
The Relationship

AbstractIntroductionThe determination of level of adherence to the Mediterranean diet (MD) in young adults has been investigated in countries situated near the Mediterranean region generally. The main purpose of this study were to determine differences in body composition by gender and level of adherence to the MD and to determine the relationship between body composition and level of adherence to the MD in Nutrition and Dietetics students at Near East University in Cyprus.Materials and MethodsThe study was conducted on 126 Nutrition and Dietetics students, aged 18 to 32 years. MDS was calculated, and then classified into three groups: good (36–55 points), moderate (21–35 points), and poor (0–20 points). Body composition was assessed using bioelectrical impedance (BIA). Anthropometrical measurements; height (H), body weight (BW), waist circumference (WC) and hip circumference (HC) were assessed according to standardized procedures and physical activity (PA) was assessed by using International Physical Activity Questionnaire (IPAQ-short form). The study protocol was approved by the Ethics Committee at Near East University.ResultsAccording to study results 31.0% of students were found out to low adherence, while 69.0% of students had moderate adherence to the MD. There is no student had high adherence to the MD. There was no significant difference (p = 0.877) between the male and female students in terms of adherence to Mediterranean diet. The findings indicate that the eating habits of the Nutrition and Dietetics students, even those studying nutrition, are in need of improvement. The results show that 78.6% of students were normal and 21.4% of students were overweight and obese. Male students’ BW (p = 0.000), WC (p = 0.000) and HC (p = 0.015) were higher than females’, while female students’ fat mass (FM) (p = 0.000) was higher than males’. However, there is no significant difference between BW (p = 0.724), FM (p = 0.896), BMI (p = 0.691), WC (p = 0.632) and HC (p = 0.982) neither low adherence nor moderate adherence to the MD. Most of students minimal active according to IPAQ scores (41.2%) and there is no significant difference IPAQ score and adherence to the MD (p = 0.923).DiscussionOne of the healthiest diets worldwide is the traditional MD. Several studies have shown, that higher adherence to the MD is inversely related with BMI, waist circumference (WC) and waist-to-height ratio (WHR). Little is known of how adherence to the MD is related to body composition, especially in university students. Further large-scale studies are required to clarify the relationship between adherence to the MD and body composition

scholarly journals Role of Nutrition and Adherence to the Mediterranean Diet in the Multidisciplinary Approach of Hidradenitis Suppurativa: Evaluation of Nutritional Status and Its Association with Severity of Disease

Nutrients ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 57 ◽  
Author(s):  
Luigi Barrea ◽  
Gabriella Fabbrocini ◽  
Giuseppe Annunziata ◽  
Giovanna Muscogiuri ◽  
Marianna Donnarumma ◽  
...  
Keyword(s):  
Body Composition ◽  
Mediterranean Diet ◽  
Energy Intake ◽  
Hidradenitis Suppurativa ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Clinical Severity ◽  
Cross Sectional ◽  
Lower Phase ◽  
The Mediterranean

Hidradenitis suppurativa (HS) is a chronic, inflammatory and debilitating skin disorder. The exacerbating factors of HS include nutrition and adiposity. We aimed to investigate the relationships between body composition and the adherence to the Mediterranean diet (MD) with the severity of HS in a sample of naive-treatment patients with HS. In this case–controlled, cross-sectional study, we enrolled 41 HS patients and 41 control subjects. Body composition was evaluated by a bioelectrical impedance analysis (BIA) phase-sensitive system. PREvención con DIeta MEDiterránea (PREDIMED) and the 7-day food records were used to evaluate the degree of adherence to the MD and dietary pattern, respectively. The clinical severity was assessed by using the Sartorius HS score. HS patients had a worse body composition, in particular lower phase angle (PhA) (p < 0.001), and a lower adherence to the MD than controls, in spite of no differences in energy intake between the two groups. The receiver operator characteristic (ROC) analysis showing a value of PhA of ≤ 5.7 and a PREDIMED score of ≤ 5.0 identified HS patients with the highest clinical severity of the disease. After adjusting for sex, age, body mass index (BMI), and total energy intake, the HS Sartorius score maintained negative correlations with PhA (p < 0.001), PREDIMED score, and n-3 polyunsaturated fatty acids (p = 0.005). The results of the multivariate analysis showed PhA and PREDIMED score were the major determinants of HS Sartorius score, explaining 82.0% and 30.4% of its variability, respectively (p < 0.001). Novel associations were demonstrated between PhA and the degree of adherence to the MD with the HS severity. PhA and PREDIMED score might represent possible markers of severity of HS in a clinical setting.

scholarly journals Anti-inflammatory dietary intervention improved metabolic profile and body composition of obese adults

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Gordana Kenđel Jovanović ◽  
Sandra Pavičić Žeželj ◽  
Sanja Klobučar Majanović ◽  
Ines Mrakovčić Šutić ◽  
Greta Krešić
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Body Weight ◽  
Intervention Study ◽  
Dietary Intervention ◽  
Homa Index ◽  
Obese Patients ◽  
Inflammatory Status ◽  
Anti Inflammatory ◽  
Hs Crp

AbstractIt has become evident that chronic low-grade inflammation associated with excess adipose tissue plays an important role in the etiology of insulin resistance and other obesity related metabolic disturbances. Weight loss intervention focusing on anti-inflammatory dietary modification might help to attenuate and eventually reverse these disturbances. In this random case-control nutrition intervention study we hypothesized that obese patients will improve their inflammatory and metabolic status together with body composition following anti-inflammatory diet during 24 weeks. Body composition parameters of 42 obese patients, who completed the study, were determined by bioelectrical impedance analysis (Seca®, mBCA 515 Medical Body Composition Analyzer). Their inflammatory status was assessed with high-sensitivity C-reactive protein (hs-CRP), and insulin resistance with HOMA index. The inflammatory potential of their diet was assessed by the Dietary Inflammatory Index (DII®), based on 37 food parameters which derived from 123-item food frequency questionnaire. A positive DII® designates a diet with pro-inflammatory potential, while negative DII® designates a diet with anti-inflammatory potential. Data and z-scores were analyzed with Statistica v13.3 (StatSoft Inc., Tulsa, USA) for baseline and study end parameters differences. Obtained results have shown that, at the end of study, the patients significantly reduced their body weight (-3.3 %, p < 0.001), BMI (-3.2 %, p < 0.001), waist circumference (-1.9 %, p < 0.001), total (-3.3 %, p < 0.001) and visceral body fat (-10.4 %, p < 0.001), total (-3.1 %, p < 0.001) and extracellular water (-2.9 %, p < 0.001). The patients also significantly reduced hs-CRP (-37.7 %, p = 0.0025). Although we observed noteworthy -10.7 % reduction of HOMA index, this finding did not reach statistical significance (p = 0.862). The inflammatory potential of patients’ diet changed significantly from -0.45 to -1.73 on average (p < 0.001). With presented dietary intervention study it could be concluded that the change of the diet toward more anti-inflammatory milieu had significant influence on body weight, total and visceral body fat reduction. Consequently, those changes could have been involved in observed significant improvement of their inflammatory status. However, mild reduction of insulin resistance and rather small study group pointed out the need for further studies with more comprehensive dietary intervention.

Non-Transferrin-Bound Iron, Iron Load and Hypoxia May Induce Low-Grade Inflammation in Patients with Thalassemia Intermedia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4072-4072
Author(s):  
Antonios Kattamis ◽  
Emmanuel Kanavakis ◽  
Vassilios Ladis ◽  
Christos Kattamis ◽  
Ioannis Papassotiriou
Keyword(s):  
Clinical Chemistry ◽  
Graphite Furnace ◽  
Heme Iron ◽  
Tissue Hypoxia ◽  
Low Grade ◽  
Thalassemia Intermedia ◽  
Transfusion Therapy ◽  
Inflammatory Status ◽  
Hs Crp ◽  
Low Grade Inflammation

Abstract Abstract 4072 Poster Board III-1007 Background Inflammation is known to play an important role in the pathogenesis of thalassemia. Serum levels of pro-inflammatory cytokines such as IL-6 and TNF-a are known to be elevated in thalassemic patients, suggestive a low-grade inflammatory status. These levels are comparable to the ones observed in patients with diabetes, obesity and atherosclerosis. Altered redox status has also been shown in thalassemic erythrocytes. Reactive oxygen species (ROS) are generated in increased amounts after the precipitation of excess unmatched globin chains, the deposition of non-heme iron and hemichromes and the induced inflammation. In this study we assessed the levels and possible causes of inflammatory status in patients with thalassemia intermedia (TI). Patients and Methods Thirty-five patients with TI, 13 men and 22 women, aged 8-63 years were included in the study. None of the patients had received any transfusion therapy for at least 6 months prior of sampling, while 25/35 patients had been splenectomized. We measured the hematologic and biochemical parameters, including Hb, HbF ferritin and soluble transferrin receptors (sTfR) with standard methodology. Serum concentrations of non-transferrin bound iron (NTBI) were estimated using graphite furnace atomic absorption spectrometry. Determination of high-sensitivity CRP (hs-CRP or cardiophase-CRP) was performed using the Siemens Advia 1800 Clinical Chemistry System. Furthermore, we obtained P50 values from oxygen equilibrium curves (OEC) drawn in fresh whole blood. Oxygen delivery and release parameters were calculated using the “Siggaard–Andersen's Oxygen Status Algorithm”. Results hs-CRP levels were elevated 2.12±0.55 mg/L compared to lean control values 1.2±0.19 mg/L (p<0.008). Most of the patients (60 %) showed evidence of low-grade inflammation based on the hs-CRP levels. NTBI levels were significantly elevated (2.4±2.2micromol/L), with only 10/30 patients having levels <0.5micromol/L, which is proposed as normal limit. As accepted P50 values were indicative of relative tissue hypoxia (all patients demonstrate increase oxygen affinity). All of the patients showed evidence of increased eryhtropoeitic activity, as indicate by the elevated sTfR levels ranged from 4.0 to 22.9mg/L (3- to 19-fold increase of erythroid marrow activity). The main results of the evaluated correlations showed that: a) hs-CRP levels correlated positively with NTBI concentrations (r=0.741, p<0.0001), b) hs-CRP levels correlated positively with ferritin levels (r=0.522, p=0.004) and c) hs-CRP levels correlated negatively with P50 values (r=-0.409, p=0.03), while no correlation was found between hs-CRP levels and the degree of ineffective erythropoiesis expressed as sTfR concentrations (p> 0.223). Conclusions These findings demonstrate that patients with TI have a chronic low-grade inflammation. Similar inflammatory status has been also shown in patients with atherosclerosis, diabetes and obesity. The level of inflammation correlated with indexes of iron homoestasis, alteration of which is commonly observed in patients with TI. Thus, it seems plausible that the oxidative effects of NTBI and increased iron burden result in chronic inflammation in these patients. The observed negative correlation of inflammation and P50 is of interest, as it indicates possible involvement of tissue hypoxia in inflammation processes. Disclosures: Kattamis: Novartis: Consultancy, Honoraria, Speakers Bureau.

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