Search Results (141)

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder marked by progressive kidney enlargement and cyst formation, often resulting in end-stage renal disease (ESRD). Oxidative stress (OxS) significantly contributes to renal damage in chronic kidney disease (CKD) and ADPKD. While the Mediterranean diet (Med-diet) is known for its antioxidative and anti-inflammatory effects, its impact on OxS in ADPKD remains unclear. This study aimed to assess the relationship between adherence to the Med-diet, OxS levels, and renal function in ADPKD patients. We enrolled 63 ADPKD patients aged 18–70 years with CKD stages G2–G4. Adherence to the Med-diet was evaluated using the PREDIMED questionnaire. OxS markers (NOX2-derived peptide [sNOX2-dp] and hydrogen peroxide [H₂O₂]) were measured via ELISA. Correlations between these markers, Med-diet adherence, serum creatinine, and estimated glomerular filtration rate (eGFR) were analyzed. Higher adherence to the Med-diet was associated with significantly lower OxS markers (sNOX2, p < 0.001; H₂O₂, p = 0.04). Reduced NOX2 and H₂O₂ levels correlated with lower creatinine and higher eGFR (NOX2, p < 0.001; H₂O₂, p < 0.001), suggesting an inverse relationship between OxS and renal function. In conclusion, adherence to the Mediterranean diet appears to be associated with lower levels of oxidative stress and may slow the progression of chronic kidney disease. These findings suggest that dietary interventions could mitigate disease progression by modulating OxS. Further studies are needed to confirm these results and explore the long-term effects of the Med-diet on disease progression. Full article

Introduction: The Mediterranean Diet is known for its protective effects against cardiovascular and metabolic diseases. Metabolic syndrome, characterized by multiple health risk factors, is increasingly concerning in older populations. Understanding dietary impacts on metabolic health is key for promoting healthy ageing. Objectives: This feasibility study aimed to explore the relationship between adherence to the Mediterranean Diet and metabolic risk factors in older adults participating in a community exercise program and to evaluate the feasibility of applying validated tools in this setting. Methods: A cross-sectional design was used. Adherence to the Mediterranean Diet was evaluated using the PREDIMED questionnaire, while Metabolic Syndrome was evaluated according to National Cholesterol Education Program criteria. Blood samples were taken following WHO guidelines. Results: Ten participants (mean age 73.1 years; 90% women) were included. 50% showed high adherence to the Mediterranean Diet, while 40% had moderate or low adherence. No participants met the full criteria for Metabolic Syndrome. Significant associations were found between Mediterranean Diet adherence and chronic disease (r = 0.869, p < 0.01), and an inverse correlation with the number of Metabolic Syndrome criteria (r = –0.707, p < 0.05). The Mediterranean Diet score was also inversely related to cholesterol (r = –0.740, p < 0.05). Conclusions: Higher adherence to the Mediterranean Diet was associated with better metabolic profiles, highlighting its potential protective role. The study demonstrates the feasibility of incorporating nutritional screening in community exercise programs for older adults. Future research should include larger and longitudinal samples and integrate inflammatory biomarkers. Full article

Background and Objectives: There is adherence to a healthy Mediterranean diet (MedDiet), but adherence varies widely. Precision nutrition is increasingly interested in individual characteristics influencing diet adherence, but few studies have examined personality traits. Our main aim was to investigate the association between personality traits and MedDiet adherence. Our secondary aims were to explore genome-wide genetic variants associated with neuroticism, including replication of previous findings, as well as to explore gene–MedDiet interactions. Methods: We analyzed participants (aged 55–75) in the PREDIMED-Plus-Valencia study and measured clinical, lifestyle, and genetic factors. The Eysenck Personality Questionnaire-Revised (EPQ-R) was used to measure neuroticism, psychoticism, and extraversion. Genotyping was undertaken, and associations with candidate SNPs, genome-wide association studies (GWAS), genetic risk scores (GRS), and gene–MedDiet interactions were explored. Results: Neuroticism was inversely (beta = −0.09; p = 0.001) associated with adherence to the Mediterranean diet (MEDAS-17). Likewise, the probability of low MedDiet adherence increased neuroticism (OR: 1.27; 95% CI: 1.02–1.60; p = 0.031 per SD). In the GWAS for this trait, several SNPs surpassed the suggestive level of statistical significance. The most strongly associated was rs10181407-NDUFA10 (NADH dehydrogenase 1 alpha subcomplex subunit 10) (beta = −2.39; p = 2.70 × 10⁻⁶). The GRS for neuroticism was significantly associated with MedDiet adherence (beta = −0.18; p = 0.020), increasing the causality level. We replicated some candidate SNPs, and among them, the rs2243873-EHMT2 (euchromatic histone lysine methyltransferase 2) gene. The analysis of gene–MedDiet interactions revealed the role of these dietary modulations. Conclusions: Neuroticism was the personality trait most inversely associated with MedDiet adherence, suggesting its integration in precision nutrition analysis. Moreover, neuroticism-related genetics and MedDiet modulations will also be important. Full article

Objectives: Graves’ disease (GD) is the most common cause of hyperthyroidism and is associated with marked changes in body weight and body composition. Although weight loss is frequently reported, the extent and clinical relevance of body composition alterations, as well as their relationship with thyroid function, remain unclear. This study aimed to evaluate body composition and eating habits in patients with newly diagnosed hyperthyroid GD according to pre-morbid weight variation, and to compare these findings with those of matched euthyroid controls. Methods: Forty-four consecutive GD patients were enrolled and stratified based on the presence or absence of pre-morbid weight loss. Anthropometric measurements, thyroid function tests, thyroid volume, dietary habits (PREDIMED score, macronutrient intake and total daily caloric intake) and body composition assessed by bioelectrical impedance analysis (BIA) were collected. Standardized phase angle (SPA) and body cell mass index (BCMI) were calculated as nutritional indices. Body composition parameters and dietary adherence were compared with those of 44 age-, sex- and BMI-matched euthyroid controls. Results: Most GD patients (70.3%) reported weight loss before diagnosis; however, the magnitude of weight change did not correlate with the biochemical severity of thyrotoxicosis. Patients without weight loss showed higher fat mass percentage and higher caloric intake than those who lost weight. SPA was significantly associated with FT3, FT4 and TRAb levels, independently of age, sex, BMI and fat mass. Compared with controls, GD patients exhibited lower phase angle and SPA, higher extracellular water percentage and reduced BCMI, whereas fat mass and adherence to the Mediterranean diet were similar. Conclusions: Hyperthyroid GD patients display increased extracellular water and reduced body cell mass. SPA is inversely associated with GD severity and represents a valuable clinical tool for assessing nutritional status in thyrotoxic patients. Pre-morbid weight changes are not proportional to disease severity and may instead reflect increased caloric intake. Full article

Background: Student-athletes face the dual challenge of balancing academic and athletic commitments, which may simultaneously promote healthy lifestyle habits while increasing psychosocial and physiological stressors, particularly among female student-athletes. Understanding how these competing demands affect key behavioral (e.g., dietary habits, sleep, and chronotype) and psychological (e.g., body image) factors is essential for supporting their overall well-being. Therefore, this cross-sectional study investigated body dissatisfaction, adherence to the Mediterranean diet, sleep quality, and chronotype in female student-athletes compared to sedentary peers. Methods: Twenty-eight female participants voluntarily participated in the study. Twelve volleyball student-athletes (age 21.6 ± 2.4 years) were assessed during their competitive in-season period, and sixteen non-athlete students with a high sitting time (age 24.0 ± 3.2 years) completed the Mediterranean Diet Adherence questionnaire (PREDIMED), Pittsburgh Sleep Quality Index (PSQI), Morningness–Eveningness Questionnaire (MEQ), and Body Image Dimensional Assessment (body dissatisfaction) to assess their overall well-being. Results: Student-athletes showed significantly (p < 0.05) higher adherence to the Mediterranean diet (PREDIMED: 8.5 ± 1.5 score), although experiencing poorer sleep quality (PSQI: 6.8 ± 3.0 score) compared to non-athlete students with higher sitting times (PREDIMED: 6.7 ± 1.6 score; PSQI: 4.6 ± 2.3 score). Conversely, comparative body dissatisfaction was significantly higher in non-athlete students with a high sitting time (19.4 ± 24.5%) than in student-athletes (5.6 ± 10.5%). No significant differences emerged for chronotype or overall body dissatisfaction. Conclusions: These findings highlight a paradoxical health pattern in female student-athletes who combine healthier eating habits with poorer sleep quality. The results emphasize the importance of comprehensive wellness strategies that integrate dietary habits, sleep hygiene, and psychophysiological factors to better support female student-athletes in managing dual-career demands. Full article

Introduction: Subclinical atherosclerosis is increasingly recognized in younger populations, often progressing silently until the onset of overt cardiovascular events. Carotid intima-media thickness (CIMT) is a validated, non-invasive biomarker of early vascular alterations. Although the Mediterranean diet (MD) is well established as cardioprotective, its relationship with CIMT in young adults remains insufficiently studied. Objective: To assess sex-specific adherence to the Mediterranean diet and its association with carotid intima-media thickness in a cohort of university students. Methods: A cross-sectional study was performed involving 60 university students (50% male, aged 17–25 years), selected through stratified probabilistic sampling. Data were collected on sociodemographic characteristics, vascular risk factors, MD adherence via the PREDIMED questionnaire, and CIMT measured using a high-resolution carotid Doppler ultrasound. Statistical analyses included chi-square tests and descriptive statistics, with significance set at ρ ≤ 0.05. Results: A notable 95% of participants showed low adherence to the Mediterranean diet. Significant sex differences in dietary patterns were identified: males consumed more red meat (ρ = 0.023), while females reported higher fish intake (ρ = 0.037). Despite behavioral risk factors, all CIMT values remained within normal ranges (≤0.9 mm). No significant association was found between MD adherence and CIMT (ρ = 0.554). Conclusion: This exploratory study reveals a high prevalence of modifiable cardiovascular risk factors, including poor dietary adherence, among young adults, despite the absence of detectable vascular structural changes. Although no significant association was found, the findings reflect the dietary and behavioral profiles of a young, low-risk population. Full article

Background: Peripheral artery disease (PAD) is a major vascular condition often overlooked in prevention strategies. We aimed to evaluate the association between cardiovascular health, measured by Life’s Simple 7 (LS7), and the risk of PAD in a high-risk Mediterranean population. Methods: This prospective analysis included 7122 participants from the PREDIMED study (Prevención con Dieta Mediterránea) at high cardiovascular risk but free of cardiovascular disease at baseline. LS7 scores (0–14 points) were calculated using seven metrics: smoking status, body mass index, physical activity, blood pressure, total cholesterol, glucose metabolism, and adherence to the Mediterranean diet. Participants were categorized into inadequate (0–5), average (6–8), and optimal (9–14) cardiovascular health. Multivariable Cox regression models and Nelson–Aalen curves assessed the association between LS7 and PAD incidence over a median 4.8-year follow-up. A meta-analysis combining these results with three prior studies was also performed. Results: A total of 87 incident PAD cases were identified. Compared to participants with inadequate cardiovascular health, those with average and optimal LS7 scores exhibited significantly lower PAD risk (adjusted hazard ratio [HR] 0.37; 95% confidence interval [CI]: 0.22–0.61, and HR 0.25; 95% CI: 0.10–0.65, respectively). Each one-point increase in the LS7 score (range 0 to 14) was associated with an 22% lower PAD risk (HR 0.78; 95% CI: 0.68–0.90). The meta-analysis yielded a pooled HR of 0.81 (95% CI: 0.76–0.87), confirming consistent inverse associations across populations. Conclusions: Greater adherence to LS7 metrics is associated with a significantly reduced risk of PAD in high-risk Mediterranean individuals. Promoting LS7 adherence may represent an effective strategy for preventing both cardiovascular disease and PAD. Full article

Background: A significant proportion of post-myocardial infarction (MI) patients do not reach target low-density lipoprotein cholesterol (LDL-C) levels. Suboptimal LDL-C reduction is often attributed to poor adherence to pharmacological therapy and lifestyle recommendations. Methods: In a prospective registry of 179 post-MI patients who completed a Phase 2 Cardiac Rehabilitation Program (CRP), we evaluated the characteristics and predictors of suboptimal LDL-C reduction. Key indicators were assessed before and after CRP: adherence to the Mediterranean diet (using the PREDIMED questionnaire), weekly physical activity (via the IPAQ questionnaire), therapeutic adherence (using the Morisky–Green questionnaire), and peak oxygen consumption (VO₂) on exercise testing. Lipid-lowering therapy (LLT) and LDL-C were recorded prior to MI and both before and after Phase 2 CRP. At the end of Phase 2, we analyzed the difference between measured and theoretical LDL-C (basal LDL-C minus expected LDL-C reduction by LLT), which was defined as “residual difference in LDL-C” (RD-LDL-C). We analyzed the predictors of positive RD-LDL-C (lower than theoretically expected). Results: After CRP, 54 (30.2%) patients exhibited positive RD-LDL-C. Within this subgroup, LLT was uptitrated, and patients received more potent LLT at the conclusion of CRP (theoretical potency: 69.81 ± 7.07 vs. 66.41 ± 7.48%, p = 0.005). However, they were less likely to reach the target LDL-C level <55 mg/dL (66.7% vs. 93.6%, p < 0.001). Male sex (HR 17.96 [2.15, 149.92], p = 0.008) and higher lipoprotein (a) levels (HR 1.02 [1.01, 1.03] per mg/dL, p = 0.001) were associated with a positive RD-LDL-C. Conversely, diabetes mellitus (HR 0.17 [0.06, 0.51], p = 0.002), higher corrected basal LDL-C levels (HR 0.98 [0.97, 0.99] per mg/dL, p = 0.001), and supervised in-hospital training during CRP (HR 0.28 [0.09, 0.86], p = 0.03) were associated with a reduced probability of positive RD-LDL-C. No association was found with adherence to the Mediterranean diet (88.1%), therapeutic adherence (89.1%), reported weekly physical activity (median 3545 [1980, 6132] metabolic equivalents per week), or change in peak VO₂. Conclusions: More than one-third of post-MI patients demonstrated lower than expected LDL-C reduction (positive RD-LDL-C) following CRP, a finding that could not be attributed to poor adherence to pharmacological therapy or lifestyle recommendations. These findings suggest that a personalized approach to prescribing and uptitrating LLT may help achieve LDL-C targets, particularly in MI patients with healthy lifestyle habits who exhibit a lower response to LLT. Full article

Adherence to a healthy diet and an active lifestyle is now a key component of workplace health promotion (WHP) programs. The primary objective of the study is the assessment of the need for the implementation of corrective WHP interventions aimed at improving the lifestyle in students belonging to health-related degree programs. A prospective observational epidemiological study through the recruitment of a sample of 242 young adult-equated workers at the Vanvitelli University in Naples was conducted. Two questionnaires were administered, one related to Mediterranean diet adherence (PREDIMED) and one concerning daily physical activity (IPAQ). A total of 56.6% of the participants were in the intermediate level of adherence to the Mediterranean diet, 24.0% low and 19.4% in the high level, with highly significant differences in the distribution between the groups. The chi-square test revealed a statistically significant association between groups and physical activity level (p = 0.0166). A statistically significant association was also found between gender and physical activity level (men showing high levels of physical activity). The analysis showed significant differences in adherence to the Mediterranean diet between the different students’ groups, with no gender-related differences. This study highlighted the need for a systematic and differentiated approach to WHP, differentiating the various groups. Full article

Olive oil, the primary fat source in the Mediterranean diet (MedDiet), is rich in monounsaturated fatty acids (MUFA), especially oleic acid, which constitutes 70–80% of its composition. Extra-virgin olive oil (EVOO), produced by mechanically pressing olives, is the highest quality olive oil, with an intense flavor and acidity <1%. In contrast, refined olive oil (ROO), a blend of virgin and refined oils, contains fewer antioxidants and anti-inflammatory compounds. EVOO’s health benefits stem largely from its MUFA content, which is linked to reduced risks of cardiovascular disease (CVD), neurodegenerative conditions, and certain cancers. Additionally, EVOO contains minor, but bioactive, components such as polyphenols, tocopherols, and phytosterols, contributing to its oxidative stability, sensory qualities, and health-promoting properties. These include polyphenols, like oleuropein, hydroxytyrosol, and tyrosol, which exhibit anti-inflammatory, cardioprotective, neuroprotective, and anticancer effects. Epidemiological studies suggest an inverse relationship between olive oil intake and CVD, with EVOO-enriched MedDiet interventions showing improved lipid profiles, reduced blood pressure, and lower cardiovascular event risk. The PREDIMED study highlights the significant role of EVOO in reducing cardiometabolic risk. This review explores the impact of EVOO’s chemical components within the MedDiet framework on metabolic variables influencing cardiometabolic health. Full article

Background. Long COVID has been associated with increased cardiovascular risk and chronic low-grade inflammation, raising concerns about its long-term metabolic consequences. Given that the Mediterranean diet (MD) has shown beneficial effects on cardiovascular risk factors and inflammation in various populations, it is important to explore its potential impact on individuals with Long COVID. Therefore, the aim is to determine the association of the MD with cardiovascular risk factors (CVRF) and metabolic syndrome (MetS) in Caucasian subjects diagnosed with Long COVID. Methods. Cross-sectional study, 305 subjects diagnosed with Long COVID were included following the WHO criteria. Adherence to MD was evaluated with the MEDAS (Mediterranean Diet Adherence Screener) with 14 items used in Prevention with Mediterranean Diet study (PREDIMED study). The criteria considered to diagnose MetS were blood pressure, glycemia, triglycerides, HDL cholesterol, and waist circumference. Other CVRFs considered were tobacco consumption, total cholesterol, LDL cholesterol, body mass index, and baseline uric acid levels. The association between MD with CVRF and the number and components of MetS was analyzed using multiple regression models and multinomial regression. Results. The mean age was 52.75 ± 11.94 years (men 55.74 ± 12.22 and women 51.33 ± 11.57; p = 0.002), (68% women). The mean of the MEDAS questionnaire was 7.76 ± 2.37. The presented MetS were 23.6% (39.8% men and 15.9% women p < 0.001). In the multiple regression analysis, after adjusting for age and average time from acute COVID-19 infection to the date of inclusion in this study, the mean MD score showed a negative association with uric acid (β = −0.295; 95% CI: −0.496 to −0.093), BMI (β = −0.049; 95% CI: −0.096 to −0.002), the number of MetS components (β = −0.210; 95% CI: −0.410 to −0.010), and waist circumference (WC) (β = −0.021; 95% CI: −0.037 to −0.003) and a positive association with HDL cholesterol (β = −0.018; 95% CI: 0.001 to −0.037). Conclusions. The findings of this study suggest that higher Mediterranean diet scores are associated with lower levels of uric acid, fewer MetS components, smaller waist circumference, and higher HDL cholesterol levels in individuals with Long COVID. Full article

Background: This study analyzes the effects of bariatric surgery on female sexual function, assessed using the Female Sexual Function Index (FSFI), and explores the impact of adherence to the Mediterranean diet during the postoperative period. Patients and methods: A retrospective observational study was conducted using a prospectively collected database, including heterosexual women with morbid obesity undergoing bariatric procedures. The FSFI questionnaire was applied before the intervention and 24 months after surgery. Adherence to the Mediterranean diet was evaluated using the PREDIMED questionnaire. Results: Among the 240 participants, 70.8% presented preoperative sexual dysfunction, which decreased to 20.5% two years post-surgery. Significant improvements were observed in all FSFI domains except for pain. Good adherence to the Mediterranean diet was associated with higher scores in the lubrication, orgasm, and satisfaction domains. Conclusions: Bariatric surgery significantly improves female sexual function, with the Mediterranean diet enhancing these benefits during the postoperative period. Future studies must investigate additional variables such as psychological factors, physical activity, and other lifestyle changes that may also influence sexual function. Full article

Background: The research on orthorexia nervosa (ON) has thoroughly outlined the connection between it and various mental disorders, including obsessive-compulsive disorders and eating disorders, in addition to stress. However, research has not considered psychophysical stress and other measures of psychophysical health, such as adherence to the Mediterranean diet. Methods: This cross-sectional and case-control research involved 63 students from the University of Parma, aged between 18 and 49 years. The ORTO-15 questionnaire was utilized to categorize the entire sample into two groups: one without orthorexia (score > 35) and another with orthorexia (score < 35). All subjects were assessed with the Psychophysiological Stress Profile (PSP) and completed the Eating Disorder Inventory-3 (EDI-3) and the Symptom Checklist-90-Revised (SCL-90-R). In addition, they were interviewed using the PREDIMED questionnaire to assess adherence to the Mediterranean Diet, and their body mass index (BMI) was calculated. Results: Subjects with orthorexia represented 38.10% of the total sample and reported a higher BMI than controls, although the PREDIMED score did not show a difference in adherence to the Mediterranean diet. The EDI-3 highlighted emotional dysregulation and hypercontrol in students with orthorexia, and a dissociation between subjective and objective measures of stress emerged. Particularly, the psychophysiological parameters of skin conductance, heart rate, and heart rate variability showed greater reactivity to stressful stimuli, but no difference was noted in psychological symptoms. Conclusions: These findings confirmed the presence of alterations in eating behavior in people with orthorexia as well as a higher BMI. It was hypothesized that hypercontrol might favor the perception of psychological well-being at a subjective level, although inadequate management of stress emerged at an objective psychophysiological level. Further studies are needed to highlight the causality between ON, hypercontrol, diet, and psychophysical stress, given that students with orthorexia present a dysregulation of emotions associated with greater autonomic arousal. Full article

Background/Objectives: Food deserts are areas characterized by limited access to affordable and healthy food, often due to significant distances from supermarkets—exceeding 1.6 km in urban areas and 16 km in rural settings. These spatial limitations exacerbate health and socioeconomic disparities. This study aimed to assess diet quality and explore the barriers influencing dietary behaviors among individuals aged 60 and older residing in food deserts in Aragón, Spain. Methods: An exploratory qualitative study using a phenomenological approach was conducted, complemented by descriptive analyses of sociodemographic data and adherence to the Mediterranean diet, assessed through the PREDIMED questionnaire. Data were collected through in-depth interviews and a focus group with residents of food deserts. Results: Half of the participants showed high adherence to the Mediterranean diet, while the other half had moderate adherence. Despite the lack of access to supermarkets and higher food costs, many participants perceived their diet quality positively. Challenges, such as long distances to stores, limited public transport, and economic constraints, were mitigated through strategies like home gardening, hunting, and traditional cooking, which often reduced reliance on processed foods. However, participants also reported increased alcohol consumption as a means of socializing. Conclusions: Diet quality in Aragón’s food deserts reflects a balance between significant access barriers and community-driven resources. While participants leveraged local strategies to maintain diet quality, systemic issues remain. Public policies should focus on improving transportation, enhancing local food systems, and fostering community-based initiatives to reduce inequalities in food access and promote healthier dietary habits in rural areas. Full article

The Mediterranean Diet (MedDiet) is considered an Intangible Cultural Heritage by UNESCO; it is also the world’s most evidence-based eating pattern for promoting health and longevity. This study aims to investigate consumer segmentation based on consumption patterns and identify barriers to adherence to MedDiet. Data were collected in 2020 by telephonic survey based on PREDIMED, using a quota sampling technique by socio-demographic variables, such as gender, age, and regional representation of the Portuguese population. The final sample was composed of a total of 1000 respondents. The main results show that regardless of the awareness of the MedDiet (62%), Portugal witnessed a loss of the traditional MedDiet, with the exception of the stand-out statistic that 95% of respondents still use of olive oil as the main culinary fat. Five segments were identified: (1) MedDiet lifestyle followers (11%), (2) olive oil lovers (20%), (3) low-sugar diet foods seekers (11%), (4) healthy and balanced diet seekers (28%), and (5) low-fat diet foods seekers (30%). The main barriers to adhering to the MedDiet include lack of knowledge about the MedDiet, education level, financial comfort, and specific food preference, which by segment are: (1) being passionate about soda drinks, (2) an excess of sweets, (3) low level of pasta consumption, and a (5) lack of fruit, vegetables, and legumes. Segment (4) holds a leading position in MedDiet adherence. The main obstacle to consuming fish is its high price, taste, and challenges in cooking it. When it comes to bread and oleaginous nuts, the belief that these foods are “fattening” reduces consumption. Results help to tailor education strategy and increase adherence to the Mediterranean lifestyle. Full article