Search Results (214)

In the original randomised Dietary Intervention to Stop Coronary Atherosclerosis (DISCO-CT) trial, a 12-month Dietary Approaches to Stop Hypertension (DASH) project led by dietitians improved cardiovascular and metabolic risk factors and reduced platelet chemokine levels in patients with coronary artery disease (CAD). It is unclear whether these benefits are sustained. Objective: To determine whether the metabolic, inflammatory, and clinical benefits achieved during the DISCO-CT trial are sustained six years after the structured intervention ended. Methods: Ninety-seven adults with non-obstructive CAD confirmed in coronary computed tomography angiography were randomly assigned to receive optimal medical therapy (control group, n = 41) or the same therapy combined with intensive DASH counselling (DASH group, n = 43). After 301 ± 22 weeks, 84 individuals (87%) who had given consent underwent reassessment of body composition, meal frequency assessment, and biochemical testing (lipids, hs-CRP, CXCL4, RANTES and homocysteine). Major adverse cardiovascular events (MACE) were assessed. Results: During the intervention, the DASH group lost an average of 3.6 ± 4.2 kg and reduced their total body fat by an average of 4.2 ± 4.8 kg, compared to an average loss of 1.1 ± 2.9 kg and a reduction in total body fat of 0.3 ± 4.1 kg in the control group (both p < 0.01). Six years later, most of the lost body weight and fat tissue had been regained, and there was a sharp increase in visceral fat area in both groups (p < 0.0001). CXCL4 decreased by 4.3 ± 3.0 ng/mL during the intervention and remained lower than baseline values; in contrast, in the control group, it initially increased and then decreased (p < 0.001 between groups). LDL cholesterol and hs-CRP levels returned to baseline in both groups but remained below baseline in the DASH group. There was one case of MACE in the DASH group, compared with four cases (including one fatal myocardial infarction) in the control group (p = 0.575). Overall adherence to the DASH project increased by 26 points during counselling and then decreased by only four points, remaining higher than in the control group. Conclusions: A one-year DASH project supported by a physician and dietitian resulted in long-term suppression of the proatherogenic chemokine CXCL4 and fewer MACE over six years, despite a decline in adherence and loss of most anthropometric and lipid benefits. It appears that sustained systemic reinforcement of behaviours is necessary to maintain the benefits of lifestyle intervention in CAD. Full article

Understanding the components of the diet, food groups, and nutritional strategies that help prevent MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) is essential for identifying dietary behaviors that can stop the progression of this condition, which currently affects over one-quarter of the global population. This review highlights the importance of including antioxidant nutrients in the diet, such as vitamins C and E, CoQ10, and polyphenolic compounds. It also emphasizes substances that support lipid metabolism, including choline, alpha-lipoic acid, and berberine. Among food groups, it is crucial to choose those that help prevent metabolic disturbances. Among carbohydrate-rich foods, vegetables, fruits, and high-fiber products are recommended. For protein sources, eggs, fish, and white meat are preferred. Among fat sources, plant oils and fatty fish are advised due to their content of omega-3 and omega-6 fatty acids. Various dietary strategies aimed at preventing MASLD should include elements of the Mediterranean diet or be personalized to provide anti-inflammatory compounds and substances that inhibit fat accumulation in liver cells. Other recommended dietary models include the DASH diet, the flexitarian diet, intermittent fasting, and diets that limit fructose and simple sugars. Additionally, supplementing the diet with spirulina or chlorella, berberine, probiotics, or omega-3 fatty acids, as well as drinking several cups of coffee per day, may be beneficial. Full article

Background: The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) was a 3-year, multicenter, randomized controlled trial to test the effects of the MIND diet on cognitive decline in 604 individuals at risk for Alzheimer’s dementia. Here, we describe the genotyping, imputation, and quality control (QC) procedures for the genetic data of trial participants. Methods: DNA was extracted from either whole blood or serum, and genotyping was performed using the Infinium Global Diversity Array. Established sample and SNP QC procedures were applied to the genotyping data, followed by imputation using the 1000 Genomes Phase 3 v5 reference panel. Results: Significant study-site, specimen type, and batch effects were observed. A total of 494 individuals of inferred European ancestry and 58 individuals of inferred African ancestry were included in the final imputed dataset. Evaluation of the imputed APOE genotype against gold-standard sequencing data showed high concordance (98.2%). We replicated several known genetic associations identified from previous genome-wide association studies, including SNPs previously linked to adiponectin (rs16861209, p = 1.5 × 10⁻⁵), alpha-linolenic acid (rs174547, p = 1.3 × 10⁻⁷), and alpha-tocopherol (rs964184, p = 0.003). Conclusions: This dataset represents the first genetic resource derived from a dietary intervention trial focused on cognitive outcomes. It enables investigation of genetic contributions to variability in cognitive response to the MIND diet and supports integrative analyses with other omics data types to elucidate the biological mechanisms underlying cognitive decline. These efforts may ultimately inform precision nutrition strategies to promote cognitive health. Full article

The rising prevalence of elderly obesity in developed countries poses a public health challenge, since body composition changes during aging are associated with higher risks of chronic diseases. We cross-sectionally explored the relationship between diet, physical activity, and sex-specific differences in body composition among 378 elderly previously enrolled in the Florence European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Information on dietary habits and lifestyle was collected through validated questionnaires. Adherence to the Italian Mediterranean Index (IMI), Dietary Approaches to Stop Hypertension (DASH), and Greek Modified Mediterranean Diet (GMMD) a priori dietary patterns was calculated. Anthropometric measures were taken by trained personnel, and body composition parameters were estimated via bioelectrical impedance. In age- and energy-intake-adjusted regression models, adherence to the DASH and IMI patterns was associated with healthier body composition among women, while no significant relationship emerged among men. Fitness activities and total recreational physical activity revealed positive associations with healthier body composition (lower % fat mass, higher % muscle mass, and reduced waist circumference) in both sexes. These findings highlight the synergistic effect of diet and physical activity on body composition in the elderly and underscore the need for sex-specific interventions for promoting healthy aging. Full article

The Dietary Approaches to Stop Hypertension (DASH) diet, characterized by high consumption of fruits, vegetables, whole grains, low-fat dairy products, and limited intake of saturated fats, cholesterol, and refined sugars, has been suggested to reduce the risk of preeclampsia. This narrative review aimed to summarize and synthesize the evidence regarding the role of the DASH diet in preeclampsia prevention. PubMed/MEDLINE, Embase, Google Scholar, ScienceDirect, Scopus, and Web of Science databases were searched to identify relevant studies. Multiple observational and intervention studies examining DASH diet adherence and preeclampsia outcomes were included. Higher adherence to the DASH diet was associated with an approximately 35–45% reduced risk of preeclampsia in observational studies. Intervention trials in high-risk populations demonstrated improved blood pressure control and potential reductions in preeclampsia incidence. The DASH diet appears to exert protective effects through multiple mechanisms, including improved blood pressure regulation, enhanced antioxidant defense, reduced inflammation, and improved endothelial function. The heterogeneity in study designs, DASH diet assessment methods, and intervention protocols limited the strength of conclusions. Evidence for the effects of greater adherence to the DASH diet on preeclampsia prevention is promising but requires confirmation through larger randomized controlled trials. Future research should focus on standardized DASH diet assessment methods, optimal timing and duration of dietary intervention, and exploration of potential synergies with other preventive strategies. Full article

Child and adolescent obesity represents a growing public health crisis, with profound implications for physical and mental well-being. Despite the well-established benefits of physical activity, over 80% of adolescents fail to meet the World Health Organization’s (WHO) recommendations for daily exercise. This manuscript explores gym-based strength training as a tailored intervention for obese youth who often struggle with aerobic activities. This paper critically examines medical eligibility, safety protocols, and injury risks while also detailing personalized training regimens that prioritize neuromuscular adaptation, functional strength, and long-term engagement. Additionally, it integrates evidence-based dietary strategies and supplementation practices appropriate for this age group, highlighting the role of the Mediterranean diet, DASH, and the cautious use of supplementation, particularly probiotics and protein, while discouraging performance-enhancing substances in youth. Emphasis is placed on interdisciplinary approaches, combining exercise, nutrition, and medical oversight to support holistic treatment. This study identifies gaps in the current literature and provides practical recommendations for designing safe, effective, and sustainable gym-based interventions for children with obesity, encouraging further research to validate these protocols in clinical settings. A comprehensive search was conducted across multiple databases, including PubMed/MEDLINE, the Cochrane Library, Science Direct, and EBSCO, focusing on English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies. The websites of prominent scientific organizations such as WHO, APP, and AIS were also reviewed. The selection of articles was a collaborative effort among all authors. Full article

Metabolic syndrome (MetS) is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, and chronic inflammation, significantly increasing the risk of cardiovascular disease and type 2 diabetes. Effective management of MetS is critical, with exercise being a key intervention. This review analyzed the effects of different exercise intensities—low, moderate, and high-intensity interval training (HIIT)—on metabolic health, oxidative stress (OS), inflammation, and cardiovascular function. A search of Medline, PEDro, and EBSCO identified 2251 articles, with 159 studies published between 1999 and 2025 included after screening. Low-intensity exercise improved insulin sensitivity, reduced OS markers (e.g., MDA, 8-OHdG), and enhanced antioxidant enzyme activity. Moderate-intensity exercise showed similar benefits with notable reductions in inflammatory markers (e.g., IL-1β, TNF-α). HIIT promoted fat loss and improved metabolic markers but temporarily increased OS and inflammation. Dietary strategies also play a critical role. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diets are well established, emphasizing nutrient-dense foods like unsaturated fats and fiber to reduce inflammation and manage weight. The ketogenic diet (KD), a high-fat, low-carbohydrate approach, has recently gained attention for its metabolic benefits. KD induces ketosis, improving insulin sensitivity, reducing triglycerides, and enhancing fat oxidation. Studies show KD effectively reduces body weight and glucose levels, though long-term adherence and nutrient deficiencies remain challenges. Intermittent fasting also showed potential benefits, though effects on glucose metabolism were inconsistent. This review underscores the need for tailored approaches combining exercise, diet, and fasting to optimize MetS outcomes, offering integrative strategies for prevention and management. Full article

Background/Objectives: This systematic review and meta-analysis evaluates the surgical, functional, and aesthetic outcomes of scapular free flaps in maxillary reconstruction. The primary objective is to assess early surgical complications, fistula formation, donor site morbidity, dental restoration, normal dietary intake, aesthetic compromise, and eye-related issues. Secondary objectives include total free flap necrosis, the need for revision procedures, and functional performance of the upper limb. Methods: A systematic review was conducted following the PRISMA guidelines. Eligible studies were identified by searching PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar, with the last search conducted on 10th February 2025. Inclusion criteria were studies reporting on patients undergoing maxillary reconstruction with scapular free flaps, and which provided data on at least one of the primary or secondary outcomes. A single-arm meta-analysis was performed to assess the outcomes of scapular free flap reconstruction. The risk of bias was assessed using the Newcastle–Ottawa Quality Assessment Scale, with two independent reviewers performing the assessment. Results: From an initial search of 310 articles, 6 studies were included in the qualitative and quantitative synthesis, encompassing 231 patients with a mean age of 52.9 years (95% CI 44.9–60.8). Early general surgical complications occurred in 24% (95% CI 13–40) of patients, while 12% (95% CI 4–31) experienced fistula formation. Donor site morbidity was reported in 10% (95% CI 6–17) of cases, with a mean DASH score of 10.49, indicating low upper limb impairment. Dental rehabilitation was achieved in 56% (95% CI 42–70), and 52% (95% CI 31–72) of patients resumed a normal diet. Aesthetic compromise was observed in 27% (95% CI 9–58), and 36% (95% CI 28–44) reported eye-related issues. Conclusions: Scapular free flap is a reliable option for maxillary reconstruction with favourable outcomes, particularly in complex composite defects requiring both bone and soft tissue reconstruction. However, the evidence is limited by risk of bias, significant heterogeneity, and imprecision due to the small number of studies and participants. Larger, more robust trials are needed to confirm these findings. Full article

Cardiovascular (CV) diseases remain a leading global health challenge, being influenced by diet and systemic inflammation. Adherence to healthy dietary patterns, such as the Mediterranean (MED), Dietary Approaches to Stop Hypertension (DASH), and Anti-inflammatory (AnMED) diets, may reduce the CV risk. Background/Objectives: We aimed to evaluate the association between the adherence to healthy dietary patterns and CV treatments. Methods: This cross-sectional study was conducted in the Valencian Community, Spain. Nutritional data were collected using a food frequency questionnaire to assess the adherence to MED, DASH, and AnMED dietary patterns. Statistical analyses, including Kruskal–Wallis tests and linear regression models, evaluated dietary adherence, nutrient intake, the Dietary Inflammatory Index (DII), and medication use. Results: Of 468 participants initially recruited, were included in the final analysis after applying inclusion and exclusion criteria (88.48% female, mean age: 66.16 ± 9.59 years). A significant association was observed between the DII and antihypertensive use (p-value < 0.001), with higher DII scores correlating with increased antihypertensive consumption. Among dietary patterns, the AnMED diet exhibited the strongest association with the DII (p-adjust < 0.001). Predictive modeling revealed a 14.28% increase in antihypertensive use per unit rise in the DII. The AnMED diet was the only pattern significantly linked to improved micronutrient intake, including calcium, magnesium, sodium, and potassium. Conclusions: The DII is a useful tool for assessing the inflammatory potential of diets. Diets with lower DII scores, such as the AnMED diet, may reduce systemic inflammation and improve CV health. Adherence to the AnMED diet may lower blood pressure and reduce reliance on antihypertensive medications, supporting anti-inflammatory dietary patterns for CV disease prevention and management. Full article

Diet has a profound impact on brain health, particularly in middle-aged and older adults, who are at increased risk of cognitive decline and neurodegenerative diseases. Various dietary patterns, including the Mediterranean diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets, have been linked to improved cognitive function. While the relative effectiveness of these diets on brain health is generally supported by evidence, variability in study results suggests that further research is needed to fully understand their effects across diverse populations. The objective of this descriptive narrative review is to examine the role of dietary patterns in supporting brain health in aging populations and to propose practical dietary strategies for promoting cognitive well-being. A comprehensive review of the existing literature was conducted on PubMed in October 2024, with no restrictions on language, publication date (1966–2024), or geographic location. A total of 18 articles were included in this review, covering the years 2013–2023. Studies assessing the impact of the MedDiet, DASH, MIND, and Western diets on cognitive function in middle-aged and older adults were prioritized. The research findings were synthesized to identify common and unique recommendations across these dietary patterns. The MedDiet consistently showed beneficial effects on cognitive health, including improved memory, processing speed, and long-term protection against neurodegenerative conditions. The DASH and MIND diets demonstrated potential benefits, particularly for specific cognitive domains, but the results were more mixed and inconclusive. In contrast, adherence to a Western diet was associated with negative cognitive outcomes, including cognitive decline and smaller brain volumes. These findings underscore the importance of adopting healthy dietary patterns as a modifiable lifestyle factor to support cognitive aging and inform future public health strategies and clinical guidelines. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a public health concern, linked with immune-metabolic dysfunction. While lifestyle and dietary modifications remain the cornerstone of MASLD management, the optimal dietary approach remains uncertain. Objectives: This systematic review aims to investigate the impact of model dietary patterns on metabolic outcomes in patients with MASLD and evaluate their effects in individuals with coexisting metabolic conditions, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). Methods: To conduct the review, PubMed, Scopus, Google Scholar, Cochrane CENTRAL, and ClinicalTrials.gov databases were searched for Randomized Controlled Trials (RCTs) on the adult population, published between January 2019 and September 2024, following PRISMA principles. The quality of the included RCTs was assessed qualitatively based on study characteristics. Results: The main findings of this review demonstrated that the use of interventions with dietary model based on Mediterranean diet (MED) and intermittent fasting (IF) approaches, such as alternative-day fasting (ADF) and time-restricted feeding regimens (TRF) may have potential in reducing body weight, BMI, and waist circumference, with additional benefits of improving glycemic control and reducing inflammation. The effects on hepatic functions, although limited, may be linked with reduced enzyme activity and liver stiffness. Additionally, the use of lacto-ovo-vegetarian diet (LOV-D) and the Dietary Approaches to Stop Hypertension (DASH) diet may offer additional health benefits, including blood pressure management. Conclusions: This review suggests that MED and IF-based strategies may reduce BW, improve glycemic control, and lower inflammation, with potential benefits for hepatic function. Further long-term studies are needed to confirm these effects and underlying mechanisms, which will allow for the optimization of protocols and ensure their safety in MASLD. Full article

Background/Objectives: Eggs, a nutritious and affordable food, are not widely consumed by adolescents, who show many nutrient inadequacies. Modeling dietary substitutions with eggs and their costs can provide dietary insights while considering economic constraints. This study theoretically modeled the impact of substituting an egg for another protein source, considering nutrient quality and cost, using exemplary menus with application to adolescents. Methods: The substitution was modeled in four different seven-day exemplary menus: (1) the Healthy U.S.-Style Dietary Pattern (HUSS), (2) Harvard Medical School’s Heathy Eating Guide, (3) the National Heart, Lung, and Blood Institute’s Dietary Approaches to Stop Hypertension (DASH) diet and (4) the Healthy U.S.-Style Vegetarian Dietary Pattern (HVEG). One egg replaced the gram amount and nutrient profile of a protein source food in each menu. Micronutrient quality was assessed using the Food Nutrient Index (FNI), scored 0–100. The Center for Nutrition Policy and Promotion Food Price Database informed the food prices. Pairwise t-tests compared the effects of egg substitution on micronutrient scores and daily costs. Results: The daily egg substitution increased FNI scores for choline and vitamin D in the HUSS (83 to 95 and 69 to 75, respectively), DASH (80 to 91 and 55 to 59, respectively), and HVEG (91 to 100 and 44 to 51, respectively), and choline alone (89 to 98) in the Harvard menu. Daily menu prices were not significantly different after the egg substitution (p > 0.01). Conclusions: Substituting one egg for another protein source food increased the micronutrient quality of choline and vitamin D in exemplary menus without increasing the cost; however, factors such as food preferences and the economic accessibility of eggs in different contexts should also be considered. Full article

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a wide range of substantial advantages. The best evidence for dyslipidemia management is offered by the Mediterranean Diet, the Plant-Based Diet, the High-Fiber Diet and the Anti-inflammatory Diet, while the DASH Diet and the Ketogenic Diet have also been shown to target additional pathological features like hypertension and other comorbidities. The bioactive compounds that are enriched in these nutrition patterns and able to manage dyslipidemia include monounsaturated fatty acids such as ω-3, polyphenols such as oleuropein, resveratrol, flavonoids, and catechins, carotenoids, phytosterols and soluble and unsoluble fibers. Diets rich in these compounds can improve lipid profile by mitigating oxidative stress, reducing low-grade chronic inflammation, modulating macronutrient absorption and other mechanisms, thereby supporting cardiovascular health. Additionally, lifestyle interventions such as regular physical activity, weight loss, reduced alcohol consumption and smoking cessation further ameliorate lipid metabolism and manage circulated lipid profile. Furthermore, emerging insights from nutrigenomics underscore the potential for proper diet to address genetic factors and optimize treatment outcomes. The pivotal role of nutrition interventions in the context of dyslipidemia and its cardiometabolic implications is discussed in this review, emphasizing evidence-based and personalized approaches. Full article

Polycystic ovary syndrome (PCOS) is an endocrine disorder that causes cardiometabolic and reproductive disorders in women of reproductive age. Women with PCOS are more likely to have obesity, type 2 diabetes mellitus, and cardiovascular disease. There is an inconclusive consensus on which dietary modification could be most effective in PCOS prevention and treatment. This review aimed to examine the effects of diverse dietary patterns on PCOS in women according to randomized controlled trials (RCTs) with and without an isocaloric dietary design. A literature search was performed in the PubMed^®®/MEDLINE^®® database up to 14 November 2024. A total of 21 RCTs were reviewed after screening the records, including 15 RCTs with a calorie-restricted dietary design and 6 RCTs with a non-calorie-restricted dietary design. This review found beneficial effects of the calorie-restricted Dietary Approaches to Stop Hypertension (DASH) diet on weight loss and glucose control in women with PCOS in four RCTs with an isocaloric dietary design. The calorie-restricted low-glycemic index (GI) diets from three RCTs and high-protein diets from four RCTs with an isocaloric dietary design showed no significant differences in anthropometric parameters, glucose control, lipids, and gonadal parameters compared with the control diet in women with PCOS. Non-calorie-restricted low-carbohydrate diets from four RCTs with an isocaloric dietary design showed similar results to the calorie-restricted low-GI diets and high-protein diets. However, the existing number of RCTs is insufficient to conclude the association between dietary patterns and PCOS in women. Further, well-designed dietary intervention studies are needed to assess the role of dietary patterns in PCOS beyond calorie restriction. Full article