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Mediterranean Diet and Health—New Insights into an Old Story

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (15 September 2020) | Viewed by 19807

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Dr. Meropi Kontogianni

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Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 El. Venizelou St., 17671 Athens, Greece
Interests: clinical nutrition; dietary patterns; Mediterranean diet; lifestyle patterns; metabolic syndrome; insulin resistance; inflammation; nonalcoholic fatty liver disease; malnutrition; cachexia; sarcopenia
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Dear Colleagues,

Increased adherence to the Mediterranean diet has been associated with longevity, as well as with lower prevalence of several chronic diseases (such as cancer, cardiovascular disease, type 2 diabetes mellitus, metabolic syndrome and its components, neurodegenerative diseases, frailty) both in Mediterranean and non-Mediterranean populations. However, concerns and controversies still exist regarding several issues including the transferability of the Mediterranean diet beyond the Mediterranean region, the ability of the existing scoring systems to assess adherence to the Mediterranean diet, the sustainability dimensions of this dietary pattern within and outside the Mediterranean, as well as its synergistic effect with other dimensions of the lifestyle. Furthermore, the mechanisms through which adherence to the Medieterranean diet exerts its beneficial effects remain partially elucidated. This Special Issue welcomes original articles, as well as review articles and meta-analyses that will add information to the aforementioned topics as well as to other relevant ones.

Dr. Meropi Kontogianni
Guest Editor

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Keywords

Mediterranean diet
Lifestyle
Prevention
Treatment
Sustainability
Dietary assessment

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Published Papers (4 papers)

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35 pages, 1489 KiB

Open AccessArticle

Adherence to Mediterranean Diet and Maternal Lifestyle during Pregnancy: Island–Mainland Differentiation in the CRIBS Birth Cohort

by Dubravka Havaš Auguštin, Jelena Šarac, Mario Lovrić, Jelena Živković, Olga Malev, Nives Fuchs, Natalija Novokmet, Mirjana Turkalj and Saša Missoni

Nutrients 2020, 12(8), 2179; https://doi.org/10.3390/nu12082179 - 22 Jul 2020

Cited by 20 | Viewed by 4600

Abstract

Maternal nutrition and lifestyle in pregnancy are important modifiable factors for both maternal and offspring’s health. Although the Mediterranean diet has beneficial effects on health, recent studies have shown low adherence in Europe. This study aimed to assess the Mediterranean diet adherence in 266 pregnant women from Dalmatia, Croatia and to investigate their lifestyle habits and regional differences. Adherence to the Mediterranean diet was assessed through two Mediterranean diet scores. Differences in maternal characteristics (diet, education, income, parity, smoking, pre-pregnancy body mass index (BMI), physical activity, contraception) with regards to location and dietary habits were analyzed using the non-parametric Mann–Whitney U test. The machine learning approach was used to reveal other potential non-linear relationships. The results showed that adherence to the Mediterranean diet was low to moderate among the pregnant women in this study, with no significant mainland–island differences. The highest adherence was observed among wealthier women with generally healthier lifestyle choices. The most significant mainland–island differences were observed for lifestyle and socioeconomic factors (income, education, physical activity). The machine learning approach confirmed the findings of the conventional statistical method. We can conclude that adverse socioeconomic and lifestyle conditions were more pronounced in the island population, which, together with the observed non-Mediterranean dietary pattern, calls for more effective intervention strategies. Full article

(This article belongs to the Special Issue Mediterranean Diet and Health—New Insights into an Old Story)

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15 pages, 666 KiB

Open AccessArticle

Cardiometabolic Benefits of a Weight-Loss Mediterranean Diet/Lifestyle Intervention in Patients with Obstructive Sleep Apnea: The “MIMOSA” Randomized Clinical Trial

by Michael Georgoulis, Nikos Yiannakouris, Ioanna Kechribari, Kallirroi Lamprou, Eleni Perraki, Emmanouil Vagiakis and Meropi D Kontogianni

Nutrients 2020, 12(6), 1570; https://doi.org/10.3390/nu12061570 - 28 May 2020

Cited by 24 | Viewed by 5988

Abstract

Although continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA), its cardiometabolic benefits are questionable. Our aim was to explore whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care leads to greater cardiometabolic improvements compared with standard care alone. We randomly assigned 187 adult, overweight, polysomnography-diagnosed moderate-to-severe OSA patients to a standard care group (SCG, n = 65), a Mediterranean diet group (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All three groups were prescribed with CPAP. Additionally, the SCG only received brief written healthy lifestyle advice, while intervention arms were subjected to a six-month weight-loss behavioral intervention based on the Mediterranean diet. The MLG also received guidance for improving physical activity and sleep habits. Glucose metabolism indices, blood lipids, liver enzymes and blood pressure improved only in intervention arms, and were significantly lower compared to the SCG post-intervention (all p < 0.05). The age-, sex-, baseline- and CPAP use-adjusted relative risk (95% confidence interval) of metabolic syndrome was 0.58 (0.34–0.99) for the MDG and 0.30 (0.17–0.52) for the MLG compared to the SCG. The MLG additionally presented a lower relative risk of metabolic syndrome compared to the MDG (0.52 (0.30–0.89)). After further adjustment for body-weight change, a lower relative risk of metabolic syndrome was still evident for the MLG compared to the SCG. In conclusion, although standard care alone does not improve OSA patients’ cardiometabolic profile, its combination with a weight-loss Mediterranean diet/lifestyle intervention leads to significant cardiometabolic benefits. Full article

(This article belongs to the Special Issue Mediterranean Diet and Health—New Insights into an Old Story)

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12 pages, 1521 KiB

Open AccessArticle

Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

by Marta Gómez Sánchez, Leticia Gómez Sánchez, Maria C Patino-Alonso, Rosario Alonso-Domínguez, Natalia Sánchez-Aguadero, Cristina Lugones-Sánchez, Emiliano Rodríguez Sánchez, Luis García Ortiz and Manuel A Gómez-Marcos

Nutrients 2020, 12(4), 1025; https://doi.org/10.3390/nu12041025 - 8 Apr 2020

Cited by 18 | Viewed by 3806

Abstract

The objective of this study is to analyze the influence of adherence to the Mediterranean diet (MDA) and its components on early vascular aging (EVA) in a Spanish population sample free of cardiovascular disease and to analyze the differences by sex. Methods: We recruited 501 individuals aged 35–75 without cardiovascular disease by random sampling (55.90 ± 14.24 years, 49.70% men). EVA was defined in two steps: Step 1: subjects with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: subjects at the percentile of the combined Vascular Aging Index (VAI) were classified; ≥ p90 was considered EVA and < p90 was considered normal vascular aging (NVA), estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76 by age and sex. Carotid-femoral pulse wave velocity (cfPWV) was measured by SphigmoCor System^® and carotid intima-media thickness by Sonosite Micromax^® ultrasound and classified thus: values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA, with population percentiles analyzed. The principal result variable was assessed using the 14-item MEDAS questionnaire, developed and validated by the PREDIMED group, comprising 12 questions about the frequency of food consumption and two questions regarding the Spanish population’s typical eating habits. Results: MDA was observed by 25% (17% men and 34% women). EVA was present in 17% (29% men and 4% women). The adjusted logistic regression models showed that an increase in MDA decreases the probability of EVA in the global analysis (OR = 0.36; 95% CI: 0.16–0.82). In the analysis by sex, this association was only seen in men (OR = 0.33; 95% CI: 0.12–0.86), but not in women (OR = 0.31; 95% CI: 0.04–2.50). Conclusion: The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting EVA. In the analysis by sex, this association applies only to men. Full article

(This article belongs to the Special Issue Mediterranean Diet and Health—New Insights into an Old Story)

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13 pages, 960 KiB

Open AccessArticle

Spanish People with Type 2 Diabetes Show an Improved Adherence to the Mediterranean Diet

by Nuria Alcubierre, Minerva Granado-Casas, Jordi Real, Hèctor Perpiñán, Esther Rubinat, Mireia Falguera, Esmeralda Castelblanco, Josep Franch-Nadal and Didac Mauricio

Nutrients 2020, 12(2), 560; https://doi.org/10.3390/nu12020560 - 20 Feb 2020

Cited by 8 | Viewed by 4860

Abstract

The aim of this study was to assess the dietary pattern (i.e., Mediterranean Diet (MedDiet) and healthy eating) in people with type 2 diabetes (T2D) compared with those without diabetes. In addition, we explored clinical factors associated with the dietary pattern. This cross-sectional study was performed with a sample of 476 participants (238 with T2D and 238 participants without diabetes, matched for age and sex). The alternate Mediterranean Diet (aMED) score and the alternate Healthy Eating Index (aHEI) were calculated. Statistical analysis included comparison between groups and multivariable models. Participants with T2D showed higher aMED and aHEI scores (mean (SD): 4.3 (1.5) and 43.9 (6.5), respectively) in comparison with the control group (3.5 (1.8) and 39.4 (7.4), respectively; p < 0.001). In addition, a higher proportion of participants with T2D in higher tertiles of aMED (21.8%) and aHEI (39.9%) was observed compared with participants without diabetes (11.3% for the aMED, and 19.3% for the aHEI; p < 0.001). The adjusted multivariable analysis revealed that T2D (p < 0.001), increasing age (p = 0.006 and p = 0.030, respectively), and physical activity (p = 0.009) were positively associated with higher aMED and aHEI scores. Dyslipidemia and female gender were positively associated with aMED and aHEI (p = 0.031 and p < 0.001, respectively). The specific multivariable analysis for the group with T2D yielded a positive association of age (p < 0.001) and dyslipidemia (p = 0.021) with aMED. Regarding the aHEI, only female gender was positively related with this score in diabetes participants (p = 0.025). Participants with T2D showed a higher adherence to the MedDiet and a healthier eating pattern. Full article

(This article belongs to the Special Issue Mediterranean Diet and Health—New Insights into an Old Story)

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