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Associations between mental health, diet, and risk of Alzheimer's disease highlight the need to investigate whether dietary patterns moderate the relationship between symptoms of depression and anxiety, and neurodegeneration-related blood-based biomarkers. Cognitively unimpaired participants (n = 89) were included from the Australian Imaging, Biomarkers and Lifestyle study (mean age 75.37; 44 % male). Participants provided dietary, depressive and anxiety symptom data, and had measurement of blood-based biomarkers. Dietary pattern scores (Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension diet (DASH), and Western diet) were generated. Moderation and simple slope analyses were employed. In males with mean and below mean MeDi adherence, depressive symptoms were associated with higher neurofilament light (NfL) levels. In Apolipoprotein E ε4 non-carriers with lower than mean and mean MeDi adherence, depressive symptoms were associated with higher NfL and Aβ40 levels. No associations were observed between DASH and Western diets and neurodegeneration-related biomarkers. MeDi adherence is potentially a moderator of the relationship between depressive symptoms and neurodegeneration-related blood-based biomarkers, with sex- and genotype-specific approaches important to consider within this relationship. [Display omitted] • Examined diet's role in depression and neurodegeneration risk. • Included 89 cognitively healthy older adults, mean age 75.37 years. • Males with low MeDi adherence showed higher NfL with depressive symptoms. • High-risk individuals with depression and poor MeDi had elevated biomarker levels. • MeDi may moderate the depression and neurodegeneration relationship. [ABSTRACT FROM AUTHOR]

• Participant Characteristics: T1: Older (46.91 yrs) & higher BMI (31.53 kg/m2); T3: Younger (33.58 yrs) & lower BMI (26.6 kg/m2). • Sperm Concentration: T2 had highest concentration (57.53 M/ml); T3 lowest (11.92 M/ml) with significant differences (p < 0.001). • Dietary Habits: T3 showed highest whole grain (0.61 servings/day) & lowest red meat (1.4 servings/day) consumption. • Regression Analysis: T3 had lower odds for sperm concentration (OR = 0.03) and total number (OR = 0.017) compared to T1. • Correlation Analysis: Positive correlation with aMDS for sperm concentration (B = 1.32) & total motility (B = 0.71). While numerous studies have examined the impact of individual or combined nutrients on semen quality, research on the correlation between overall dietary patterns and semen quality remains limited. This cross-sectional study investigates the relationship between adherence to the alternative Mediterranean diet (aMED) and semen quality. A total of 274 men, presenting with both normal and abnormal semen parameters, participated in this study. Dietary data were collected using a 147-item semi-quantitative food frequency questionnaire (FFQ). Participants were divided into three groups based on their adherence to the Mediterranean diet (T1, T2, and T3). Statistical analyses, including ANOVA for numerical data and Chi-square tests for categorical data, were conducted. Multivariable logistic regression models were employed to estimate the association between aMED scores and abnormal semen parameters. Participants in the highest adherence group (T3) were younger and had lower BMI compared to those in the other tertiles. Significant differences in sperm parameters were observed across the tertiles. T3 recorded the highest levels of sperm concentration, total sperm count, motility, progressive motility, and normal morphology (57.53 ± 36.16, 213.8 ± 158.9, 73.4 ± 25.9, 61.2 ± 24.6, and 6.42 ± 1.51, respectively), whereas T1 had the lowest values (11.92 ± 22.29, 43.3 ± 73.8, 36.7 ± 33.8, 4.6 ± 5.7, respectively). No significant differences were found in semen volume and viscosity. The regression analysis revealed a significant positive correlation between aMED scores and sperm concentration (B = 1.32, P = 0.001), total sperm count (B = 1.12, P = 0.001), and total motility (B = 0.71, P = 0.001). Adherence to a high-quality Mediterranean diet is positively associated with improved semen quality and increased male fertility potential. Promoting healthy dietary patterns may be an effective strategy to enhance sperm motility and overall male reproductive health. [ABSTRACT FROM AUTHOR]

Higher diet quality scores are associated with a lower risk for many chronic diseases and all-cause mortality; however, it is unclear if diet quality is associated with aging biology. This study aimed to examine the association between diet quality and a measure of biological aging known as epigenetic aging. A cross-sectional data analysis was used to examine the association between three diet quality scores based on self-reported food frequency questionnaire data and five measures of epigenetic aging based on DNA methylation (DNAm) data from peripheral blood. This study included 4,500 postmenopausal women recruited from multiple sites across the United States (1993-98), aged 50 to 79 years, with food frequency questionnaire and DNAm data available from the Women's Health Initiative baseline visit. Five established epigenetic aging measures were generated from HumanMethylation450 Beadchip DNAm data, including AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno, AgeAccelGrim, and DunedinPACE. Linear mixed models were used to test for associations between three diet quality scores (Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores) and epigenetic aging measures, adjusted for age, race and ethnicity, education, tobacco smoking, physical activity, Women's Health Initiative substudy from which DNAm data were obtained, and DNAm-based estimates of leukocyte proportions. Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores were all inversely associated with AgeAccelPheno, AgeAccelGrim, and DunedinPACE (P < 0.05), with the largest effects with DunedinPACE. A one standard deviation increment in diet quality scores was associated with a decrement (β ± SE) in DunedinPACE z score of –0.097 ± 0.014 (P = 9.70 x 10-13) for Healthy Eating Index, –0.107 ± 0.014 (P = 1.53 x 10-14) for Dietary Approaches to Stop Hypertension, and –0.068 ± 0.013 (P = 2.31 x 10-07) for the alternate Mediterranean diet. In postmenopausal women, diet quality scores were inversely associated with DNAm-based measures of biological aging, particularly DunedinPACE. [ABSTRACT FROM AUTHOR]

• Changes across time in diet indices did not differ by groups in 12-week study. • Compared to the healthy US group, vegetarians had greater increases in fiber. • Compared to the healthy US group, vegetarians had greater increases in riboflavin. • Compared to the healthy US group, vegetarians had greater increases in folate. • Diet indices had varying associations with health outcomes. The goal of this study was to examine the relationship between diet quality, nutrients, and health outcomes among participants in the Dietary Guidelines: 3 Diets study (3-group randomized 12-week intervention; African American; Southeastern virtual teaching kitchen). Participants (n = 63; ages 18-65 y, BMI 25-49.9 kg/m2) were randomized to the Healthy U.S. (H-US), Mediterranean (Med), or Vegetarian (Veg) groups. Hypotheses tested included (1) that the more plant-based diet patterns (Veg and Med) would have greater improvements in all diet quality indices (Dietary Approaches to Stop Hypertension (DASH), Dietary Inflammatory Index (DII), alternate Mediterranean Diet Index (aMED), healthy Plant-based Dietary Index (hPDI) assessed via three dietary recalls) as compared to the H-US pattern and (2) that each index would separately predict changes in weight loss, hemoglobin A1c (HbA1c), and blood pressure (BP). None of the group-by-time interactions for any of the diet indices were significant. Compared to the H-US group, Veg participants had greater increases in fiber (difference between groups 5.72 ± 2.10 5 g/day; P =.01), riboflavin (0.38 ± 0.19 mg/day; P =.05), and folate (87.39 ± 40.36 mcg/day; P =.03). For every one-point increase in hPDI, there was a 1.62 ± 0.58 mmHg decrease in systolic BP, for every one-point increase in aMED there was a 1.45 ± 0.70 mmHg decrease in diastolic BP, and for every one-point increase in hPDI, there was a 1.15 ± 0.38 mmHg decrease in diastolic BP. Findings indicate that there is significant overlap in the dietary recommendations of the three dietary patterns presented in the USDG and similarities in how African American adults adopt those diet patterns. Clinical Trials registry at clinicaltrials.gov: NCT04981847. African American adults (n = 63) were randomized to the US Dietary Guidelines patterns: Healthy US, Mediterranean, and Vegetarian. Vegetarians had greater increases in fiber, riboflavin, and folate (compared to Healthy US). Increases in the healthy Plant-based Dietary Index were associated with decreases in systolic and diastolic blood pressure. Increases in alternate Mediterranean Diet Index were associated with decreases in diastolic blood pressure. [Display omitted] [ABSTRACT FROM AUTHOR]

Undernutrition may negatively impact cognitive function, but evidence of this relationship is not yet consolidated. Under the "PROtein enriched MEDiterranean diet to combat undernutrition and promote healthy neuroCOGnitive ageing" (PROMED-COG) project, we evaluated the association between undernutrition, and cognitive decline and incident dementia in older adults. Retrospective data harmonization was performed on three Italian population-based studies: the Italian Longitudinal Study of Ageing (ILSA), the Progetto Veneto Anziani (Pro.V.A.), and the Bollate Eye Study-Follow-Up (BEST-FU). The associations between undernutrition, operationalized using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and decline on the Mini-Mental State Examination (MMSE) or dementia incidence follow-up were evaluated with Cox proportional hazard regression models. The pooled cohort comprised 9071 individuals (52% females) aged between 42 and 101 years. The prevalence of undernutrition at the baseline was 14.3%, significantly higher among females (15.4% vs 13%) and in older age, ranging from 3.5% in those aged <60 years to 28.8% in those 85+ years. Undernutrition was associated with both cognitive decline over a median 8.3-year follow-up (Hazard Ratio (HR) 1.20, 95% Confidence Interval (CI) 1.02–1.41, p = 0.028) and incidence of dementia over a median 8.6-year follow-up (HR = 1.57, 95%CI 1.01–2.43, p = 0.046). For cognitive decline, the association with undernutrition was more marked in males than females (HR = 1.36, 95%CI 1.05–1.77, p = 0.019 vs HR = 1.10, 95% CI 0.89–1.36, p = 0.375). Undernutrition is prevalent among older people and is associated with an increased risk of experiencing cognitive decline and dementia. The prevention and early identification of undernutrition could be an important nonpharmacologic strategy to counteract neurodegeneration. [ABSTRACT FROM AUTHOR]

Steatotic liver disease (SLD), characterized by elevated liver fat content (LFC), is influenced by genetics and diet. However, whether diet has a differential effect based on genetic risk is not well-characterized. We aimed to determine how genetic factors interact with diet to affect SLD in a large national biobank. We included UK Biobank participants with dietary intake measured by 24-hour recall and genotyping. The primary predictors were dietary pattern, PNPLA3 -rs738409-G, TM6SF2 -rs58542926-T, a 16-variant hepatic steatosis polygenic risk score (PRS), and gene-environment interactions. The primary outcome was LFC, and secondary outcomes were iron-controlled T1 time (cT1, a measure of liver inflammation and fibrosis) and liver-related events/mortality. A total of 21,619 participants met inclusion criteria. In non-interaction models, Mediterranean diet and intake of fruit/vegetables/legumes and fish associated with lower LFC, while higher red/processed meat intake and all genetic predictors associated with higher LFC. In interaction models, all genetic predictors interacted with Mediterranean diet and fruit/vegetable/legume intake, while the steatosis PRS interacted with fish intake and the TM6SF2 genotype interacted with red/processed meat intake, to affect LFC. Dietary effects on LFC were up to 3.8-fold higher in PNPLA3 -rs738409-GG vs. –CC individuals, and 1.4-3.0-fold higher in the top vs. bottom quartile of the steatosis PRS. Gene-diet interactions were stronger in participants with vs. without overweight. The steatosis PRS interacted with Mediterranean diet and fruit/vegetable/legume intake to affect cT1 and most dietary and genetic predictors associated with risk of liver-related events or mortality by age 70. Effects of diet on LFC and cT1 were markedly accentuated in patients at increased genetic risk for SLD, implying dietary interventions may be more impactful in these populations. Genetic variants and diet both influence risk of hepatic steatosis, inflammation/fibrosis, and hepatic decompensation; however, how gene-diet interactions influence these outcomes has previously not been comprehensively characterized. We investigated this topic in the community-based UK Biobank and found that genetic risk and dietary quality interacted to influence hepatic steatosis and inflammation/fibrosis on liver MRI, so that the effects of diet were greater in people at elevated genetic risk. These results are relevant for patients and medical providers because they show that genetic risk is not fixed (i.e. modifiable factors can mitigate or exacerbate this risk) and realistic dietary changes may result in meaningful improvement in liver steatosis and inflammation/fibrosis. As genotyping becomes more routinely used in clinical practice, patients identified to be at high baseline genetic risk may benefit even more from intensive dietary counseling than those at lower risk, though future prospective studies are required. [Display omitted] • Poor diet quality and specific genetic alleles are associated with steatotic liver disease. • Diet has a much greater impact on hepatic steatosis in those at higher genetic risk. • These effects were seen for both liver fat content and iron-controlled T1 time (a measure of fibrosis and inflammation). • Hence, dietary interventions may have a greater impact in populations at higher genetic risk. [ABSTRACT FROM AUTHOR]

Healthy dietary patterns and exercise practices have been associated with improved metabolic and inflammatory profiles. However, studies regarding the combined effect of these interventions on plasma biomarkers and metabolome in older adults are sparser. The primary aim of this study was to investigate the impact of a combined Mediterranean Diet-based Sustainable Healthy Diet (SHD) and Multicomponent Training (MT) intervention on the plasma biomarkers and metabolome and how dietary intake and exercise could modulate these effects. SHD intervention included a weekly supply of Mediterranean Diet-based SHD food and four nutrition sessions involving a Mediterranean-Diet culinary workshop, and the exercise program included 50-min MT group sessions, held three times a week, lasting both 12 weeks. Plasma biomarkers were obtained through standard biochemical analysis. A proton (1H) nuclear magnetic resonance (NMR) spectroscopy-based metabolomics approach was used to study the metabolome in blood plasma. Repeated measures ANOVA were performed and adjusted for confounders. SHD + MT intervention significantly decreased HDL-C and calcium. SHD + MT showed some changes in common with the SHD and MT group, namely a significant decrease in citrate levels (p = 0.009 for SHD + MT; p = 0.037 for SHDT) and an increase in pyruvate (p < 0.001 for MT and SHD + MT). The SHD + MT group also revealed specific changes in the levels of some amino acids (decrease in alanine, glutamine and lysine: p = 0.026; p < 0.001; p = 0.038, respectively). Increases in formate (p = 0.025) and unsaturated lipids (p = 0.011) are consistent with changes in energy and lipoprotein metabolism. Our data show that a combined lifestyle intervention program, including a Mediterranean Diet-based SHD and MT, could modulate biomarker and metabolome and there seems to be a metabolic path associated to these interventions in older adults. Due to its wide-ranging relevance, it is pertinent to assess to what extent combined SHD and MT can contribute to better clinical profiles. [ABSTRACT FROM AUTHOR]

• There are lifestyle changes in women before and during pregnancy. • During pregnancy, adherence to the Mediterranean diet increases, tobacco and alcohol consumption decreases. • Pregnancy does not have a favourable impact on physical inactivity and sedentary lifestyles. • We must increase health promotion campaigns during pregnancy to improve the health of women and their newborns. To explore health-related lifestyles in women before and during pregnancy, and to determine the potential differences between both and the relevant factors. A cross-sectional observational study including 348 women with a child <5 years of age was conducted in six health areas. The following variables were recorded: sociodemographic (age, educational level, marital status, social class, type of cohabitation, nationality), health-related habits (physical activity, diet, tobacco use, alcohol consumption), health conditions, and medication intake. Four lifestyle habits were compared between the pre-conception and pregnancy periods: diet, physical activity, and alcohol and tobacco use. The proportion of women who consumed alcohol (42.8 % vs 3.4 %) or smoked (19.3 % vs 12.4 %) was significantly higher before conception (p < 0.01). Conversely, the proportion of inactive women was lower before pregnancy, with 23.3 % (CI95%: 18.7–27.9) formerly classified as active versus 35.3 % (CI95%: 30.2–40.5) (p < 0.01). Similarly, adherence to the Mediterranean diet increased during pregnancy (62.9 % vs 75.0 %; p < 0.01). Furthermore, 53.2 % (CI95%: 47.8–58.5) of women reported a change from non-healthy to healthy in at least one of the evaluated habits. Logistic regression analyses revealed the variables associated with a positive change, which were being national Spanish (OR: 6.9) and experiencing the first pregnancy (OR: 1.8). The lifestyles of women undergo changes between the pre-gestation and pregnancy periods. However, such variations do not affect all health-related habits similarly. A positive change was observed in diet, alcohol consumption, and smoking habit, whereas pregnancy negatively impacted on physical activity and sedentary behaviours. [ABSTRACT FROM AUTHOR]

• Mediterranean diet with EVOO and pistachios in pregnancy reduces GDM by 29.2% • Limited evidence is available, further studies required. To determine if introducing the Mediterranean diet in pregnancy reduces the incidence of gestational diabetes. Systematic review and meta -analysis of randomised controlled trials (RCTs). A literature search was conducted using the following databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and CINAHL with no language or date restrictions. Studies were deemed eligible if the population was pregnant women, the intervention was the Mediterranean diet, and the outcome was gestational diabetes. Quality assessment was carried out using the Cochrane risk of bias tool. A random effects model using Revman software was used to pool results, generating a summary risk ratio with 95 % confidence intervals (95 %CI). The search identified three eligible studies. Across the trials, 2348 women were included. Two of the three trials defined the intervention as the Mediterranean diet supplemented with extra virgin olive oil (EVOO) and pistachios, with the control group being Mediterranean diet alone. Meta-analysis of these trials found a significant reduction in the incidence of gestational diabetes in the intervention group compared to the control group (risk ratio=0.71, 95% confidence interval=(0.57, 0.88)). In addition, this was consistent with the results of the remaining eligible trial which defined the intervention as Mediterranean diet and the control as a standard UK diet (risk ratio = 0.71, 95% confidence interval = (0.55, 0.90)). At present evidence is scarce regarding whether adopting a Mediterranean diet reduces the risk of gestational diabetes. A large multi-centre randomised controlled trial is needed to definitively determine the impact of the Mediterranean diet in pregnancy on the incidence of gestational diabetes [ABSTRACT FROM AUTHOR]

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• Spanish university students show low adherence to Mediterranean diet (MedDiet). • MedDiet was positively associated with academic achievement (AA). • Olive oil, vegetables, legumes, and fish suggest a positive association with AA. • Public health must emphasize MedDiet in all stages of age. The objective was to assess the association of the overall score and different items of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire with academic achievement in Spanish university students. We hypothesized that university students with greater adherence to the Mediterranean Diet (MedDiet) would have better academic achievement. A cross-sectional study was performed involving 266 first-year students from the University of Castilla-La Mancha, Spain, during the 2017–2018 academic year. Adherence to the Mediterranean diet was evaluated with the 14-item MEDAS questionnaire. As an indicator variable for academic achievement, the average marks of the examinations required for access to Spanish universities were used. A total of 63 participants (23.6%) adhered to MedDiet recommendations. Analysis of covariance models showed that participants with higher adherence to the MedDiet had significantly higher scores on academic achievement than their peers with low adherence (P <.001) after controlling for potential confounders. Additionally, the evaluation of each item of the MEDAS questionnaire showed that a diet rich in olive oil, vegetables, fruits, legumes, fish and shellfish, and a low consumption of sweets and carbonated beverages were positively associated with academic achievement; nevertheless, wine intake was inversely associated. This study showed that Spanish university students had a low prevalence of good adherence to the MedDiet. Additionally, our results suggested that higher adherence to the MedDiet is associated with better academic achievement in Spanish university students. From a public health perspective and because of low adherence, it is important to continue to focus on promoting adherence to the MedDiet as part of a healthy lifestyle pattern to improve the academic performance of young university students. Our cross-sectional study from 266 Spanish university students reveals that 76.4% had low adherence to the MedDiet. High adherence to the MedDiet was positively associated with academic achievement independent of potential confounders. Olive oil, vegetables, legumes, fish or shellfish, and low consumption of sweets and carbonated beverages were positively associated with academic achievement. Wine was negatively associated with academic achievement. Abbreviation: MedDiet, Mediterranean diet. [Display omitted] [ABSTRACT FROM AUTHOR]

Among the often-neglected features of healthy diets, such as the Mediterranean diet, is the preparation and sharing of food, which is (or was) done in a social environment governed by social rules rather than by time constraints. The act of eating is a daily human practice that is not limited to meeting nutritional and energy needs but also involves a constructed social dimension of sharing meals that is part of the process of human civilization and food cultures around the world. In this narrative review, we outline the importance of conviviality in steering part of the health effects of healthful diets, with special reference to the Mediterranean diet. Based on the available evidence, we suggest that public health initiatives (such as nudging to promote conviviality) to improve people's eating and living styles, reduce loneliness, and promote the sharing of meals could improve health. Interventions aimed at directly increasing/improving people's social relationships, networking, and conviviality can—directly and indirectly—improve both psychological well-being and general health. Schematic representation of conviviality and its various health-promoting activities. Because modern society is increasingly characterized by social isolation and loneliness, research should focus less on parametric factors that contribute to health, such as sociability and social interactions. Public health interventions aimed at improving people's social relationships, networking, and sociability can improve both mental well-being and overall health. [Display omitted] • An often neglected feature of a healthy diet is the preparation and sharing of meals. • Conviviality can be distinguished from commensality. • Conviviality is the quality of being friendly and lively. • Commensality is the practice of eating together. • Conviviality is a mediator of health benefits. • The release of neurochemicals, such as oxytocin and endorphins, might explain such benefits. • We call for public health initiatives to promote the sharing of meals. [ABSTRACT FROM AUTHOR]

• MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet pattern. • Neuroprotective phytonutrients called carotenoids may be a distinguishing feature. • MIND diet accordance was disproportionately related to carotenoid intake. • MIND accordance was the strongest predictor of lutein + zeaxanthin and β-carotene. • These carotenoids might be vital in dietary patterns for promoting cognitive health. The Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) dietary pattern is associated with reduced cognitive decline and dementia risk. However, the nutrient features that distinguish the MIND from other patterns are unknown. We investigated the relationship between accordance to the MIND pattern and carotenoid intake (phytonutrients hypothesized to confer neuroprotection) relative to the Mediterranean, DASH, and Healthy Eating Index (HEI-2020). We hypothesized that MIND diet accordance would be a stronger predictor of carotenoid intake relative to other diet indices. A total of 396 adults (aged 19–82 years) completed the Dietary History Questionnaire to assess carotenoid intake and adherence to each diet index. Stepwise regressions with adjustment for covariates followed by the Meng's Z-test were used to compare correlation strength between each diet pattern and carotenoid. All diet patterns were positively associated with lutein and zeaxanthin, β-carotene, α-carotene, and β-cryptoxanthin (all βs ≥0.38, P s <.01). Effect size comparisons revealed that MIND accordance predicted a greater proportion of variance in lutein and zeaxanthin (all Z s ≥ 3.3, P s <.001) and β-carotene (all Z s ≥ 2.6, P s <.01) relative to the Mediterranean, DASH, and HEI-2020. MIND accordance explained a greater proportion of variance in α-carotene (Z = 3.8, P <.001) and β-cryptoxanthin (Z = 3.6, P <.001) relative to the HEI-2020. MIND diet accordance was disproportionately related to carotenoid intake, indicating the MIND index places greater emphasis on carotenoid-rich foods, particularly those containing lutein, zeaxanthin, and β-carotene, relative to other diet indices. Future research is needed to define the role of these carotenoids in nutritional interventions for cognitive health. Greater adherence to the MIND diet pattern was disproportionately associated with higher dietary lutein + zeaxanthin and β-carotene intake relative to the Mediterranean, DASH, and HEI-2020 patterns among 396 healthy adults. Carotenoid intake is important to consider in dietary pattern interventions for supporting cognitive health. Abbreviations: DASH, Dietary Approaches to Stop Hypertension; HEI-2020, Healthy Eating Index 2020; MIND, Mediterranean-DASH Intervention for Neurodegenerative Delay. [Display omitted] [ABSTRACT FROM AUTHOR]

To date, there are no studies demonstrating the impact of the Mediterranean diet on the risk of diabetic foot ulcer. The aim of this research was to examine the connection between adherence to the Mediterranean diet and the level of risk of diabetic foot ulcers in individuals with type 2 diabetes. Observational pilot study collecting sociodemographic, anthropometric, lifestyle, and type 2 diabetes-related data. Loss of protective sensation was assessed using the Semmes Weinstein 5.07–10 g monofilament, considered altered when not perceived in four points. Vascular status was assessed by palpating pulses and ankle-brachial index, indicating peripheral arterial disease if ankle-brachial index was less than 0.9 or if both pulses were absent. Foot deformities were recorded. The risk of diabetic foot ulcers was stratified into two categories: no risk and risk of diabetic foot ulcers. Adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Screener-14 questionnaire (good adherence with score >7). Of the 174 patients with type 2 diabetes mellitus who participated (61.5% men and 38.5% women) with a mean age of 69.56 ± 8.86 years and a mean duration of type 2 diabetes of 15.34 ± 9.83 years. Non-adherent patients to the Mediterranean diet exhibited a higher association of diabetic foot ulcers (p = 0.030) and a lower average score on the Mediterranean Diet Adherence Screener-14 (p = 0.011). Additionally, a lower incidence of diabetic foot ulcers was observed in those who consumed nuts three or more times a week (p = 0.003) and sautéed foods two or more times a week (p = 0.003). Multivariate analysis highlighted the importance of physical activity (OR = 0.25, 95% CI 0.11–0.54; p < 0.001), podiatric treatment (OR = 2.59, 95% CI 1.21–5.56; p = 0.014), and duration of type 2 diabetes (OR = 3.25, 95% CI 1.76–5.99; p < 0.001) as significantly associated factors related to the risk of diabetic foot ulcers. Adhering to the Mediterranean diet correlates with a lower incidence of diabetic foot ulcers in individuals diagnosed with type 2 diabetes mellitus. Furthermore, factors such as regular physical activity, podiatric treatment, and the duration of type 2 diabetes mellitus emerge as pivotal in preventing diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models. After one year of intervention, the kcal/day consumed was significantly reduced (−125,1 kcal/day), adherence to a MD pattern was improved (+0,9) and the environmental impact due to the diet was significantly reduced (GHG: −361 g/CO2-eq; Acidification:-11,5 g SO2-eq; Eutrophication:-4,7 g PO4-eq; Energy use:-842,7 kJ; and Land use:-2,2 m2). Higher adherence to MD (high vs. low) was significantly associated with lower environmental impact both at baseline and one year follow-up. Meat products had the greatest environmental impact in all the factors analysed, both at baseline and at one-year follow-up, in spite of the reduction observed in their consumption. A program promoting a MD, after one year of intervention, significantly reduced the environmental impact in all the factors analysed. Meat products had the greatest environmental impact in all the dimensions analysed. [ABSTRACT FROM AUTHOR]

Sleep Apnea-Hypopnea Syndrome (SAHS) is a common sleep disorder influenced by factors like age, gender, and obesity. The Mediterranean Diet (MedDiet) and physical activity have shown health benefits in lung diseases, but their effects on SAHS remain underexplored. In a cross-sectional analysis of 678 middle-aged individuals with low-to-moderate cardiovascular risk from the ILERVAS cohort, we assessed adherence to the MedDiet and physical activity levels using validated tools. Sleep parameters, SAHS severity, and excessive daytime sleepiness were evaluated through non-attended cardiorespiratory polygraphy and the Epworth Sleepiness Scale. Multinomial logistic regression models were employed to assess the relationship between MedDiet adherence, physical activity, and SAHS severity. The prevalence of severe, moderate, and mild SAHS was 15.5%, 23.2% and 36.1%, respectively. We found no significant associations between adherence to the MedDiet, physical activity levels, and the presence or severity of SAHS. However, we noted a significant interaction between MedDiet and physical activity with minimum SpO2 values (p = 0.049). Notably, consuming more than one serving of red meat per day was independently associated with a higher risk of moderate SAHS [OR = 2.65 (1.29–5.44), p = 0.008]. Individually, MedDiet adherence and physical activity did not show independent correlations with SAHS. However, when considered together, a minimal but significant effect on minimum SpO2 was observed. Additionally, red meat consumption was associated with a moderate risk of SAHS. Further research is necessary to comprehend the intricate connections between lifestyle factors and sleep-breathing disorders, with a focus on personalized approaches for high-risk populations. • Sleep can encompass respiratory disruptions which can be influenced by factors such as diet and physical activity. • Among the components of the MedDiet, increased consumption of red meat was associated with a higher risk of moderate SAHS. • A significant interaction between adherence to the MeDiet and physical activity with minimum SpO2 level values. • It exists a complexity among factors contributing to SAHS as age, gender and BMI but also the specific dietary composition. [ABSTRACT FROM AUTHOR]

Here, we investigated whether fractional anisotropy (FA) of hippocampus-relevant white-matter tracts mediates the association between baseline Mediterranean diet adherence (MeDiAd) and verbal episodic memory over four years. Participants were healthy older adults with and without subjective cognitive decline and patients with amnestic mild cognitive impairment from the DELCODE cohort study (n = 376; age: 71.47 ± 6.09 years; 48.7 % female). MeDiAd and diffusion data were obtained at baseline. Verbal episodic memory was assessed at baseline and four yearly follow-ups. The associations between baseline MeDiAd and white matter, and verbal episodic memory's mean and rate of change over four years were tested with latent growth curve modeling. Baseline MeDiAd was associated with verbal episodic memory four years later (95 % confidence interval, CI [0.01, 0.32]) but not with its rate of change over this period. Baseline Fornix FA mediated – and, thus, explained – that association (95 % CI [0.002, 0.09]). Fornix FA may be an appropriate response biomarker of Mediterranean diet interventions on verbal memory in older adults. [Display omitted] • Adherence to the Mediterranean diet (MeDiAd) can benefit verbal memory in older age. • White matter properties can help explain the relation between MeDiAd and cognition. • Baseline MeDiAd was associated with (latent) verbal episodic memory four years later. • Baseline fornix fractional anisotropy mediated that association. • Fornix mediation was independent of the known mediation by hippocampal volume. [ABSTRACT FROM AUTHOR]

• MASLD treatment requires lifestyle intervention and control of metabolic co-factors. • A Mediterranean-like dietary pattern aimed at calorie restriction is advised. • A personalized approach for physical exercise is required to improve compliance. • Fibrosing MASH is a progressive disease requiring a pharmacological approach. • A variety of new experimental drugs are currently investigated in phase 3 studies. Metabolic-dysfunction Associated Steatotic Liver Disease (MASLD) is a disease spectrum encompassing liver injury with progressive severity, tightly connected to the metabolic syndrome. Management of MASLD mostly relies on lifestyle change aiming at improving metabolic homeostasis and insulin resistance. A Mediterranean-like dietary pattern and individualized lifestyle interventions are the cornerstone of MASLD treatment. A careful evaluation of alcohol intake and active treatment of all metabolic co-morbidities are recommended. In the MASLD spectrum, the population with liver inflammation and enhanced fibrogenesis (MASH – Metabolic-dysfunction associated steatohepatitis) can progress to advanced liver disease and has been addressed as "at-risk MASH", eligible to pharmacological treatment according to FDA and EMA. Currently there is a robust therapeutic pipeline across a variety of new targets to resolve MASH or reverse fibrosis, or both. Some of these therapies have beneficial effects that extend beyond the liver, such as effects on glycaemic control, lipid profile and weight loss. For "at-risk" MASH, reversal of fibrosis by one stage or resolution of MASH with no worsening in fibrosis as a surrogate end-point will need to be accompanied by overall survival benefits. In this review, we summarize the current evidence on lifestyle interventions in MASLD as well as pharmacological approaches for fibrosing MASH that have progressed to phase II and phase III clinical trials. [ABSTRACT FROM AUTHOR]

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Recent investigations suggest that specific dietary patterns during adolescence may predict cardiometabolic complications later in life. In this study, we aimed to examine the association between Mediterranean diet score (MDS) during adolescence and cardiometabolic outcomes when participants reached adulthood. This cohort study was conducted on 668 subjects, aged 10–19 years, in framework of the Tehran Lipid and Glucose Study. The MDS was determined based on eight components using a validated food-frequency questionnaire. Anthropometric measurements, fasting blood glucose (FBG), and lipid profile data were measured both at baseline and after a 6.8 ± 2.9-year follow-up. Using multivariable linear regression, we explored the association between MDS and changes in cardiometabolic risk factors. Moreover, multivariable-adjusted cox proportional hazard regression was used to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) for cardiometabolic complications across MDS tertiles. The mean ± SD age of participants (43.5 % men) was 15.8 ± 2.47 years. The mean ± SD of MDS was 4.03 ± 1.56, with a median of 4.00 among all participants. Higher MDS was inversely associated with 6.8-year changes in waist circumference (WC), FBG, total cholesterol (TC), and high-density lipoprotein-cholesterol (P trend <0.05). Based on the HR analysis, after controlling for potential confounders, individuals in the highest tertile of MDS had a significantly lower risk of high-TC(HR = 0.36,95%CI:0.18–0.74,P trend = 0.004) compared to those in the lowest tertile. However, no significant association was observed between MDS and other cardiometabolic risk factors. Greater adolescent adherence to a Mediterranean-type diet was associated with favorable cardiometabolic factors in adulthood, including improving the levels of WC, FBG, TC, as well as reduced risk of high-TC. • Higher adherence to MD score in adolescence was associated with lower WC level in adulthood. • Higher adherence to MD score in adolescence was associated with lower FBS level in adulthood. • Higher adherence to MD score in adolescence was associated with lower TC level in adulthood. • Higher adherence to MD score in adolescence was associated with lower HDL-C level in adulthood. • Higher adherence to MD score in adolescence did not predict changes in BMI, TGs, and LDL-C in adulthood. [ABSTRACT FROM AUTHOR]

Although lifestyle factors have been repeatedly examined for their role on cardiovascular diseases, their composite effect has not been frequently explored. We aimed to investigate the relation of dietary patterns (DPs) and a health behavior index (HBI) with cardiovascular biomarkers. A cross-sectional analysis with data from 3461 US residents, participants in the Health and Retirement Study (HRS), was performed. Nutritional data were obtained with a food frequency questionnaire, while adherence to Mediterranean Diet (MD) was determined by the Mediterranean Diet Score. A posteriori DPs were estimated using principal component analysis and the HBI was constructed combining adherence to MD, smoking status, physical activity levels, alcohol consumption and body mass index. Multiple linear regression models were performed to examine the relation between DPs or HBI and levels of C-reactive protein (CRP), glycosylated hemoglobin (HbA1C), cystatin C (Cys C), total cholesterol (TC), high density lipoprotein (HDL) and TC:HDL in blood. Multiple linear regression showed that the "healthy" DP and the MD had a significant negative association with CRP and Cys C (p < 0.05), while the "Western-type" DP had a significant positive association with TC:HDL ratio, CRP and Cys C. Moreover, the HBI was positively associated with HDL (p < 0.05) and negatively associated with TC:HDL ratio, CRP and Cys C (p < 0.05). Adherence to MD and to a healthy dietary pattern was negatively associated with biomarkers of inflammation, while the HBI was associated with a better cardiometabolic profile, assessed with blood biomarkers. • A priori healthy dietary pattern and Mediterranean diet negatively associated with inflammation indices. • A western-type dietary pattern is positively associated with total cholesterol to HDL ratio, C-reactive protein, and cystatin C. • A health behavior index constructed according to Mediterranean diet, smoking, physical activity, body mass index and alcohol consumption. • The health behavior index is associated with both lipid and inflammatory biomarkers. • Accounting for multiple lifestyle factors in a single index can better explain the cardiometabolic profile of middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Differences of dietary pattern adherence across the novel diabetes endotypes are unknown. This study assessed adherence to pre-specified dietary patterns and their associations with cardiovascular risk factors, kidney function, and neuropathy among diabetes endotypes. The cross-sectional analysis included 765 individuals with recent-onset (67 %) and prevalent diabetes (33 %) from the German Diabetes Study (GDS) allocated into severe autoimmune diabetes (SAID, 35 %), severe insulin-deficient diabetes (SIDD, 3 %), severe insulin-resistant diabetes (SIRD, 5 %), mild obesity-related diabetes (MOD, 28 %), and mild age-related diabetes (MARD, 29 %). Adherence to a Mediterranean diet score (MDS), Dietary Approaches to Stop Hypertension (DASH) score, overall plant-based diet (PDI), healthful (hPDI) and unhealthful plant-based diet index (uPDI) was derived from a food frequency questionnaire and associated with cardiovascular risk factors, kidney function, and neuropathy using multivariable linear regression analysis. Differences in dietary pattern adherence between endotypes were assessed using generalized mixed models. People with MARD showed the highest, those with SIDD and MOD the lowest adherence to the hPDI. Adherence to the MDS, DASH, overall PDI, and hPDI was inversely associated with high-sensitivity C-reactive protein (hsCRP) among people with MARD (β (95%CI): −9.18 % (−15.61; −2.26); −13.61 % (−24.17; −1.58); −19.15 % (−34.28; −0.53); −16.10 % (−28.81; −1.12), respectively). Adherence to the PDIs was associated with LDL cholesterol among people with SAID, SIRD, and MOD. Minor differences in dietary pattern adherence (in particular for hPDI) and associations with markers of diabetes-related complications (e.g. hsCRP) were observed between endotypes. So far, evidence is insufficient to derive endotype-specific dietary recommendations. Clinicaltrials.gov: NCT01055093. • The diabetes endotypes showed minor differences in adherence to dietary patterns. • Associations of dietary patterns with cardiovascular risk factors varied among them. • Evidence is still insufficient to derive endotype-specific dietary recommendations. [ABSTRACT FROM AUTHOR]

Elevated C-reactive protein (CRP) during pregnancy, a marker of inflammation, is associated with adverse outcomes. Better understanding the relationship between CRP and modifiable factors, including diet, is essential to assist early pregnancy lifestyle interventions. The aim of this study was to assess the relationship between adherence to the Dietary Approaches to Stop Hypertension diet (DASH-diet) and the Mediterranean diet (MED-diet) during pregnancy with maternal plasma CRP in early and late pregnancy. Secondary analysis of the Creatine and Pregnancy Outcomes (CPO) study was undertaken. Women (n = 215) attending antenatal clinics through Monash Health, Melbourne were recruited at 10–20 weeks gestation. Medical history and blood samples were collected at 5 antenatal visits. Adapted DASH-diet and MED-diet scores were calculated from Food Frequency Questionnaires completed at early ([mean ± SD]) (15 ± 3 weeks) and late (36 ± 1 week) pregnancy. CRP was measured in maternal plasma samples collected at the same time points. Adjusted linear regression models assessed associations of early-pregnancy DASH and MED-diet scores with early and late pregnancy plasma CRP. There were no statistically significant changes in DASH-diet score from early (23.5 ± 4.8) to late (23.5 ± 5.2) pregnancy (p = 0.97) or MED-diet score from early (3.99 ± 1.6) to late pregnancy (4.08 ± 1.8) (p = 0.41). At early-pregnancy, there was an inverse relationship between DASH-diet scores and MED-diet scores with plasma CRP; (β = −0.04 [95%CI = −0.07, −0.00], p = 0.044), (β = −0.12 [95%CI = −0.21, −0.02], p = 0.023). Adherence to the DASH-diet and MED-diet during early pregnancy may be beneficial in reducing inflammation. Assessment of maternal dietary patterns may assist development of preventive strategies, including dietary modification, to optimise maternal cardiometabolic health in pregnancy. • Med-diet adherence associated with reduced maternal CRP in early pregnancy. • Diet quality assessment in early pregnancy is crucial for preventive interventions. • Screening CRP in pregnancy can aid early detection of cardiometabolic complications. [ABSTRACT FROM AUTHOR]

Nutrition and diet quality play key roles in preventing and slowing cognitive decline and have been linked to multiple brain disorders. This review compiles available evidence from preclinical studies and clinical trials on the impact of nutrition and interventions regarding major psychiatric conditions and some neurological disorders. We emphasize the potential role of diet-related microbiome alterations in these effects and highlight commonalities between various brain disorders related to the microbiome. Despite numerous studies shedding light on these findings, there are still gaps in our understanding due to the limited availability of definitive human trial data firmly establishing a causal link between a specific diet and microbially mediated brain functions and symptoms. The positive impact of certain diets on the microbiome and cognitive function is frequently ascribed with the anti-inflammatory effects of certain microbial metabolites or a reduction of proinflammatory microbial products. We also critically review recent research on pro- and prebiotics and nondietary interventions, particularly fecal microbiota transplantation. The recent focus on diet in relation to brain disorders could lead to improved treatment outcomes with combined dietary, pharmacological, and behavioral interventions. [ABSTRACT FROM AUTHOR]

• Higher MIND diet adherence corresponded to lower serum selenium concentrations. • Higher MIND diet adherence corresponded to higher urinary selenium excretion. • MIND diet adherence was inversely associated with serum Selenoprotein P. Selenium is a trace element found in many chemical forms. Selenium and its species have nutritional and toxicologic properties, some of which may play a role in the etiology of neurological disease. We hypothesized that adherence to the Mediterranean-Dietary Approach to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet could influence intake and endogenous concentrations of selenium and selenium species, thus contributing to the beneficial effects of this dietary pattern. We carried out a cross-sectional study of 137 non-smoking blood donors (75 females and 62 males) from the Reggio Emilia province, Northern Italy. We assessed MIND diet adherence using a semiquantitative food frequency questionnaire. We assessed selenium exposure through dietary intake and measurement of urinary and serum concentrations, including speciation of selenium compound in serum. We fitted non-linear spline-based regression models to investigate the association between MIND diet adherence and selenium exposure concentrations. Adherence to the MIND diet was positively associated with dietary selenium intake and urinary selenium excretion, whereas it was inversely associated with serum concentrations of overall selenium and organic selenium, including serum selenoprotein P-bound selenium, the most abundant circulating chemical form of the metalloid. MIND diet adherence also showed an inverted U-shaped relation with inorganic selenium and particularly with its hexavalent form, selenate. Our results suggest that greater adherence to the MIND diet is non-linearly associated with lower circulating concentrations of selenium and of 2 potentially neurotoxic species of this element, selenoprotein P and selenate. This may explain why adherence to the MIND dietary pattern may reduce cognitive decline. In this cross-sectional study of 137 nonsmoking blood donors, Mediterranean-Dietary Approach to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet adherence was assessed using a semiquantitative food frequency questionnaire. Selenium (Se) exposure was assessed through diet, urine, and serum. The MIND diet was associated with low circulating levels of Se and specifically of selenoprotein P and selenate (Made using Biorender). [Display omitted] [ABSTRACT FROM AUTHOR]

Atherosclerosis is the leading underlying cause of coronary heart disease (CHD). In patients with CHD, intima-media thickness of common carotid arteries (IMT-CC) is a reliable, validated, and non-invasive marker of the progression of atherosclerosis. Dietary intervention may affect IMT-CC evolution through different pathways. There is a lack of clinical trials evaluating the effect of total dietary antioxidant content of diets on IMT-CC, especially in patients with CHD. We evaluated the correlation between the diet's total antioxidant content and the changes in IMT-CC produced after 5 years of dietary intervention following two healthy diet models (Mediterranean diet and low-fat diet). We also evaluated whether the diet's total antioxidant content was related to the total redox capacity of the participants. From the total participants of the CORDIOPREV study (clinical trial register NCT00924937), 805 participants completed the IMT-CC measurement and the dietary antioxidant evaluation at baseline and after 5 years of dietary intervention. IMT-CC was carried out by ultrasound and the dietary antioxidant evaluation was performed by the Dietary Antioxidant Index (DAI). Additionally, direct redox balance was evaluated in a subset of population by the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSH) by colorimetric assay. We observed an inverse correlation between evolution of DAI and IMT-CC after 5-years of dietary intervention. The mean of the DAI index augmented in the Mediterranean Diet group, whereas it decreased in the Low-fat group. DAI was correlated to the GSH/GSSG ratio, supporting DAI as an adequate estimator of diet's antioxidant content. When looking for individual components of the DAI that were associated to the changes in IMT-CC, an inverse correlation was found for carotenoids, vitamin E, vitamin C, and zinc and the IMT-CC. Our study indicates that, after five years of dietary intervention, changes in DAI inversely correlate with changes in IMT-CC in patients with CHD. Overall effect of Mediterranean diet resulted in an increase of DAI, conversely to low-fat. Specific elements included in the DAI index were inversely correlated with IMT-CC. [Display omitted] • Decrease of IMT-CC was associated with a higher consumption of dietary antioxidants. • DAI could be proposed as a useful tool to estimate the antioxidant content of a diet. • Intervention based on Mediterranean diet increased the content of dietary antioxidant. [ABSTRACT FROM AUTHOR]

[Display omitted] Notre étude avait pour objectif la revue systématique des données sur les effets de l'alimentation ou des compléments alimentaires sur l'activité de la maladie dans la spondyloarthrite (SpA). Une revue systématique de la littérature (RSL) a été menée dans les bases de données MEDLINE, Embase, Cochrane et Scopus, conformément au format « PEO » (population, exposition, critère d'évaluation). La population était constituée de patients atteints de SpA (axiale [SpAax] ou périphérique [SpAp] et rhumatisme psoriasique [RPso]), l'intervention était tout type de régime/complément alimentaire et le critère d'évaluation était l'activité de la maladie. Les critères d'inclusion étaient les suivants : patients adultes, essais comparatifs randomisés (ECR) et études longitudinales (permettant de disposer d'une évaluation pré- et post-intervention), articles en anglais. Le risque de biais (RoB) a été évalué avec différents instruments selon la conception des études. La recherche de la littérature a identifié 1390 publications dont 15 ont finalement été incluses : 12 études interventionnelles et trois études observationnelles. Parmi les publications ayant un faible RoB : a) deux ECR, RoB indéterminé pour l'un et faible pour l'autre, n'ont pas montré de bénéfice des probiotiques dans la SpA ; b) deux ECR ayant un RoB indéterminé ont démontré que la perte de poids, mais pas l'adoption d'un régime hypocalorique, était associée à l'obtention d'une activité modérée de la maladie (AMM) dans le RPso. Le RoB était élevé dans les autres études interventionnelles. Une étude observationnelle sur le régime méditerranéen a démontré l'existence d'une association entre l'observance du régime alimentaire et une diminution ≥ 20 % du score ASDAS dans la SpAax. La qualité des deux autres études observationnelles a été jugée médiocre. Il semble que la perte de poids a un effet sur l'activité de la maladie dans le RPso et que les probiotiques sont inutiles dans la SpA ; les données concernant les comportements alimentaires sont peu nombreuses et hétérogènes. Our study aimed to systematically review the evidence about the effect of diet or dietary supplements on spondyloarthritis (SpA) disease activity. A systematic literature review (SLR) was conducted in MEDLINE, EMBASE, Cochrane and SCOPUS according to the "PEO" format (Population, Exposure, Outcome). The population was SpA (axial or peripheral, axSpA/pSpA, including Psoriatic Arthritis-PsA); the intervention any kind of diet/dietary supplement; the outcome disease activity. Inclusion criteria were: adult patients, Randomized Controlled Trials (RCTs) and longitudinal studies (so that a pre- and post-intervention assessment were available), papers in English. Risk of bias (RoB) was conducted with different tools according to the design of the study. Literature search yielded 1,390 publications, of which 15 were finally inlcuded: 12 interventional and 3 observational studies. Among those with the lower RoB: a) 2 RCTs, one at unclear and one at low RoB, failed to show benefit of probiotics in SpA; b) Two RCT at unclear RoB provided evidence that weight loss, but not hypocaloric diet, was associated to MDA achievement in PsA. The remaining interventional studies were at high RoB. Among the observational studies, one study on Mediterranean diet demonstrated an association between diet adherence and a ≥ 20 % decrease of ASDAS in axSpA. The other two observational studies were judged of poor quality. Weight loss seem to be able to impact disease activity in PsA, while probiotics do not seem useful in SpA; evidence for dietary behaviors is scarce and heterogeneous. [ABSTRACT FROM AUTHOR]

Dietary modifications are essential strategies for cardiovascular disease prevention. However, studies are needed to investigate the diet quality of individuals undergoing secondary prevention in cardiology and who received dietary intervention based on cardiovascular disease management. We prospectively evaluated the diet quality in the Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial). We hypothesized that the BALANCE Program could improve patients' dietary pattern according to different indices of diet quality such as the Dietary Inflammatory Index (DII); the dietary total antioxidant capacity; overall, healthful, and unhealthful Plant-Based Diet Index (PDI, hPDI, and uPDI, respectively); and modified Alternative Healthy Eating Index (mAHEI). This multicenter randomized, controlled trial included patients aged ≥45 years randomly assigned to either the experimental or control group. Data from 2185 participants at baseline and after 12, 24, 36, and 48 months showed that the intervention group (n = 1077) had lower mean values of DII and higher dietary total antioxidant capacity, PDI, hPDI, and mAHEI than the control group. The results also showed differences between the follow-up times for DII, hPDI, and uPDI (48 months vs baseline) and for PDI and mAHEI (24 months vs baseline), regardless of group. The interaction analysis demonstrated that the intervention group showed better results than the control group at 12, 24, 36, and 48 months for the DII and at months 12, 36, and 48 for the mAHEI. Our results provide prospective evidence that the BALANCE Program improved the diet quality in those in secondary cardiovascular prevention according to different indices, with the intervention group showing better results than the control group. The BALANCE Program Trial was positively evaluated according to indices of diet quality. The intervention group had lower mean values of DII and higher dTAC, PDI, hPDI, and mAHEI than the control group. The results also showed differences between the follow-up times for all indices, except for dTAC, regardless of group. Finally, the interaction analysis (group × time effect) demonstrated that the intervention group showed better results than the control group for DII and mAHEI. *48 months vs baseline; **24 months vs baseline. CAD, coronary artery disease; CVD, cardiovascular disease; DII, Dietary Inflammatory Index; dTAC, dietary total antioxidant capacity; hPDI, healthy Plant-Based Diet Index; mAHEI, modified Alternative Healthy Eating Index; PAD, peripheral arterial disease; PDI, overall Plant-Based Diet Index; uPDI, unhealthy Plant-Based Diet Index. [Display omitted] [ABSTRACT FROM AUTHOR]

Only few studies have assessed longitudinal dietary trends in relation to cardiovascular disease (CVD) risk. We aimed to evaluate the association between adherence to the Mediterranean diet, both baseline and longitudinal, and 20-year CVD incidence. This was a prospective study among 1988 Greek adults (50% men, age: 45 ± 14years). Adherence to the Mediterranean diet was evaluated at baseline and 10 years through the MedDietScore, based on which longitudinal Mediterranean diet trajectories were identified. CVD incidence was recorded at 20 years. Each one-unit increase in baseline MedDietScore was associated with an 8% reduction in 20-year CVD incidence. Compared to subjects in the lowest tertile of baseline MedDietScore, those in the highest exhibited a 44% lower 20-year CVD risk (relative risk: 0.56, 95% confidence interval: 0.32, 0.97) adjusted for age, sex, baseline body mass index, smoking, physical activity, presence of hypercholesterolemia, hypertension and diabetes mellitus, and family history of CVD; further adjustment for high-sensitivity C-reactive protein, uric acid and estimated glomerular filtration rate attenuated this association. Results were similar in models adjusted for longitudinal changes in body weight, physical activity and smoking, and 10-year medical status. Mediterranean diet trajectory analysis revealed that 24.7%, 8.6%, 45.8% and 20.9% of participants longitudinally sustained a low adherence, moved closer, moved away or sustained a high adherence, respectively; among those, the corresponding CVD incidence was 63.3%, 65.5%, 28.1% and 9.4% (p-value<0.001). The Mediterranean diet offers long-term protection against CVD, part of which is mediated by inflammation, uricemia and renal function. • The Mediterranean diet offers long-term protection against CVD. • For each one-unit increase in MedDietScore, the 20-year CVD risk is reduced by 8%. • Inflammation, hyperuricemia and renal dysfunction might mediate this effect. • Over 10 years, 50% of the study population moved away from the Mediterranean diet. • Subjects sustaining a high adherence had the lowest 20-year CVD risk. [ABSTRACT FROM AUTHOR]

Females are twice as likely as males to receive a diagnosis of post-traumatic stress disorder (PTSD). One hypothesis for this sex disparity is that ovarian hormones, including estrogen and progesterone, contribute to PTSD risk. Alternatively, sex differences in lifestyle factors, such as diet and exercise, may play a role in PTSD risk. Using data from the Atlantic Partnership for Tomorrow's Health (PATH) cohort (n = 16,899), the relationship between endogenous hormone fluctuations (e.g., menarche, pregnancy, and menopause), exogenous hormone use (e.g., hormonal contraception and hormone replacement therapy (HRT)) and lifestyle variables (diet and exercise habits, as measured by the Mediterranean Diet Adherence Screener, Healthy Eating Index, and International Physical Activity Questionnaire) with PTSD diagnosis and treatment were analyzed. While several hormonal variables, including contraceptive use, higher total number of pregnancies, younger menarche age, and having undergone menopause increased the risk of PTSD, no lifestyle variables contributed to an increased risk of PTSD diagnosis. These findings support the theory that ovarian hormones contribute to the sex-linked disparity in PTSD diagnosis. [ABSTRACT FROM AUTHOR]

We conducted a systematic review and meta-analysis of the effects of Mediterranean diet on female reproductive health outcomes over the life-course. We searched PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov to identify eligible studies published till February 2022. Eligible references from identified studies and review articles were also considered. Randomized controlled trials, prospective cohort studies, or nested case-control studies examining Mediterranean diet and major female reproductive outcomes over the lifespan, including clinical outcomes from childhood to adulthood (menarche, polycystic ovary syndrome, endometriosis, and outcomes related to fertility, pregnancy, and menopause), were included for review. Two independent reviewers screened and performed data extraction and risk-of-bias assessment. We performed random-effects meta-analysis to obtain summary relative risks and 95% confidence intervals for major female reproductive outcomes. Subgroup analyses were performed for several pregnancy outcomes according to timing of the interventions for randomized controlled trials and timing of the dietary assessment for observational studies. Thirty-two studies (9 randomized controlled trials, 22 prospective cohort studies, and 1 nested case-control study) involving 103,204 predominantly White women (>95%) were included. The pooled relative risk (95% confidence interval) comparing randomization to Mediterranean diet vs a control diet based on 7 randomized controlled trials was 0.74 (0.55–0.99) for gestational diabetes mellitus, 0.45 (0.26–0.76) for preterm birth, 0.71 (0.51–1.00) for gestational hypertension, and 0.82 (0.54–1.22) for preeclampsia; the effect sizes for preterm birth were greater in randomized controlled trials that initiated the interventions in first trimester vs after first trimester (P heterogeneity=.02). We observed inverse associations for all the above-mentioned pregnancy outcomes based on 9 cohort studies. There was suggestive evidence of favorable associations between Mediterranean diet adherence with fertility and gestational weight management. Limited studies suggested associations between higher Mediterranean diet adherence and later time to menarche and fewer vasomotor menopausal symptoms, null associations for polycystic ovary syndrome-like phenotype and pregnancy loss, and positive associations for luteal phase deficiency. Adherence to Mediterranean diet may lower risks of adverse pregnancy outcomes among predominantly White populations. For fertility-related outcomes, available evidence supporting potential beneficial effects is suggestive yet limited. For other reproductive outcomes across the lifespan, data remains sparse. [ABSTRACT FROM AUTHOR]

Functional Gastrointestinal Disorders (FGIDs) are common in pediatric age. To estimate the prevalence of FGIDs in Italian children and evaluate the impact of diet. Healthy children aged 4–18 years were recruited in a multicenter cross-sectional study. We evaluated their eating habits and the presence of FGIDs, using Rome IV criteria, 3-day food diaries and Mediterranean Diet Quality Index (KIDMED) questionnaires. Seven hundred forty subjects were enrolled:369 children aged 4–9 years (Group A), and 371 adolescents 10–18 years old (Group B). The overall prevalence of FGIDs was 26.4% in Group A and 26.2% in Group B, with a significant higher prevalence in females in both groups. The most frequent disorders were functional constipation, functional dyspepsia, and abdominal migraine. No significant difference in FGIDs prevalence was found between Northern and Southern Italy, despite significant variation in diet. In Group A there was a significant difference in KIDMED between North and South (5.3 ± 1 vs 6 ± 1.2, respectively; p = 0.001). A significant association between FGIDs and KIDMED was found in Group A (OR=0.83, p = 0.034), but not in Group B (OR=0.89, p = 0.166). FGIDs are common in Italian children, with a higher prevalence in females. Despite significant differences in dietary habits between North and South, FGIDs prevalence does not vary significantly. [ABSTRACT FROM AUTHOR]

Vitamin B 12 plays a crucial role in cognition, but its effect might be regulated by the presence of other micronutrients, such as folate. The aim was to evaluate the effects of vitamin B 12 on cognitive performance according to adherence to the Mediterranean diet, and whether the Mediterranean diet also results in increased folate or vitamin B12 levels. This is a cohort study nested in a randomized controlled clinical trial performed in Hospital Clinic in Barcelona, Spain. A total of 170 participants of the PREDIMED trial (Barcelona – Hospital Clinic site) aged 55–80 years at high cardiovascular risk were included. Adherence to the Mediterranean diet was assessed using a validated 14-item questionnaire, memory function was evaluated with a battery of neuropsychological tests and serum vitamin B 12 and folate were determined using an automated electrochemiluminiscence immunoassay system. In the multivariable adjusted linear regression model, serum vitamin B 12 concentration presented a significant correlation with memory function (r2 = 0.57; P = 0.028) in participants with high adherence to the Mediterranean diet whereas the correlation was weak and inverse for those who presented a low adherence to the Mediterranean diet (r2 = 0.37, P = 0.731). Mediterranean diet adherence showed a positive association with serum folate, but not with serum vitamin B 12. In an older Mediterranean population at high cardiovascular risk, changes in serum vitamin B 12 correlate with better memory function only in the context of a high adherence to the Mediterranean pattern, suggesting that the effects of vitamin B 12 goes further than a mere nutritional requirement. The study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Institutional Review Board of the 11 participating centres. The study was registered with the International Standard Randomized Controlled Trial Number (ISRCTN) 35739639 (https://www.isrctn.com/ISRCTN35739639). [ABSTRACT FROM AUTHOR]

Background: Adherence to prehabilitation is crucial for optimal benefit, but reasons for low adherence to home-based programs remain unexplored. Our aim was to identify and explore barriers and facilitators to prehabilitation adherence among patients undergoing abdominal surgery. Methods: Nested in a single-center randomized controlled trial on prehabilitation (Perioperative Optimization With Enhanced Recovery (POWER)), this study had an explanatory sequential design with a connect integration. Patients randomized to the intervention arm were included in the quantitative analysis, and a subset of them was invited for a semi-structured interview. The exposure was the frequency of barriers to physical activity and healthy eating, and the outcome was adherence to those components of prehabilitation. Logistic or linear regression was used as appropriate. Results: Among 133 participants in the intervention arm, 116 (87.2%) completed the initial survey ((56.9% women, median age 61 years old (IQR 49.0; 69.4)). The most frequent barriers to exercise and healthy eating were medical issues (59%) and lack of motivation (31%), respectively. There was no significant association between the barriers to physical activity score and adherence to this component of the program (OR 0.89, 95% CI 0.78–1.02, p=0.09). Higher barriers to healthy eating scores were associated with lower Mediterranean diet scores pre- and post-intervention (coef.: −0.32, 95% CI: −0.49; −0.15, p<0.001; and coef.: −0.27, 95% CI: −0.47; −0.07, p=0.01, respectively). Interviews with 15 participants revealed that participating in prehabilitation was a motivator for healthy eating and exercising through goal setting, time-efficient workouts, and promoting self-efficacy. Conclusions: We identified key barriers to be addressed and facilitators to be leveraged in future prehabilitation programs. Trial Registration: NCT04504266 [ABSTRACT FROM AUTHOR]

The Mediterranean diet (MedDiet) has been associated with better brain health and reduced incidence of dementia. Few studies have compared the effects of the MedDiet in early Alzheimer's disease or compared the effects of the diet within and outside of the Mediterranean region. The Mediterranean diet adherence screener (MEDAS) and MEDAS continuous scores were calculated at the baseline visit of the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (n = 1625). The scores were included in linear regression models to test for associations with hippocampal volume, log-transformed white matter lesion volume, cerebrospinal fluid pTau 18 , and Aβ 42. Higher MEDAS scores were associated with lower log-transformed white matter lesion volume (β: −0.07, standard error [SE]: 0.02, p < 0.001). This association was only seen in the Mediterranean region (β: −0.12, SE: 0.03, p < 0.001). In the non-Mediterranean region, higher MEDAS continuous scores were associated with lower cerebrospinal fluid Aβ 42 (β: −68.30, SE: 14.32, p < 0.001). More research is needed to understand the differences in the associations seen with the MedDiet and Alzheimer's disease biomarkers in different European regions. • Mediterranean diet (MedDiet) has been associated with lower incidence of dementia. • Higher MedDiet scores were associated with lower white matter lesion volume. • This finding was only significant in the Mediterranean region. • In the non-Mediterranean, higher MedDiet scores were associated with lower Aβ 42. • There are different effects of MedDiet on brain health by biogeographical region. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) affects approximately 30% of adults worldwide, with chronic low-grade inflammation being a key pathophysiological feature of progression. The Mediterranean diet (MedDiet) is recognized for improving metabolic and hepatic outcomes in people with diabetes and NAFLD, in part, via anti-inflammatory properties. The aim of this study was to determine the effect of an ad libitum MedDiet versus low-fat diet (LFD) on inflammatory markers in adults with NAFLD. It was hypothesized that the MedDiet, and its individual components, would improve inflammation. This multicenter, randomized controlled trial, randomized participants to a MedDiet or LFD intervention for 12 weeks. Primary outcomes included change from baseline to 12 weeks for serum high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, adiponectin, leptin, and resistin. Forty-two participants (60% female; age 52.3 ± 12.6 years; body mass index, 32.2 ± 6.2 kg/m²) were randomized to the MedDiet (n = 19) or low-fat diet (n = 23). At 12 weeks, the LFD showed a greater decrease in leptin compared with the MedDiet (–1.20 ± 3.9 ng/mL vs 0.64 ± 3.5 ng/mL, P =.010). Adiponectin significantly improved within the MedDiet (13.7 ± 9.2 µg/mL to 17.0 ± 12.5 µg/mL, P =.016), but not within the LFD group. No statistically significant changes were observed for other inflammatory markers following the MedDiet or LFD. Adherence to the MedDiet significantly improved in both study arms, although greater improvements were seen in the MedDiet group. Adiponectin significantly improved following a Mediterranean diet intervention, in the absence of weight loss. The low-fat diet did not elicit improvements in inflammatory markers. High-quality clinical trials appropriately powered to inflammatory markers are required in this population. [Display omitted] In a 12-week intervention of individuals with nonalcoholic fatty liver disease, participants who were randomized to the Mediterranean diet group significantly improved levels of serum adiponectin. A greater absolute reduction in leptin levels was observed in the low-fat diet group when compared with the Mediterranean diet group. No statistically significant changes were observed for other inflammatory markers following the Mediterranean or low-fat diet intervention. Abbreviations: %E, percentage of total energy intake; CHO, carbohydrate; hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; kJ, kilojoules; TNF-α, tumor necrosis factor-alpha. [ABSTRACT FROM AUTHOR]

Diet is a modifiable risk factor for pancreatic cancer. We hypothesized that specific dietary patterns would increase/decrease pancreatic cancer risk. We evaluated the association of dietary patterns with pancreatic cancer risk in the UK Women's Cohort Study. Dietary patterns were assessed at enrollment using: (1) self-reported practice of vegan/vegetarian dietary habits, (2) diet quality indices (World Health Organization Healthy Diet Indicator and Mediterranean Diet Score), and (3) principal component analysis-derived dietary patterns. The association of dietary patterns with pancreatic cancer incidence was quantified using Cox regression survival analysis. Over a median follow-up of 19 years of 35,365 respondents, there were 136 incident cases of pancreatic cancer. No association between dietary habits/quality and pancreatic cancer incidence was evident after adjustments (hazard ratio (95% confidence interval): self-reported omnivores vs vegan/vegetarian dietary habit: 1.13 (0.73-1.76); per-unit increase in World Health Organization Healthy Diet Indicator scores: 0.99 (0.91-1.09); per-unit increase in Mediterranean Diet Score: 0.92 (0.83-1.02). Similarly, no association of principal component analysis-derived dietary patterns with pancreatic cancer risk was evident ("prudent:" 1.02 [0.94-1.10]; ''meat-based:'' 1.00 [0.92-1.09]; ''fast-food, sugar-sweetened beverages, and carbohydrate-rich snacks:'' 0.96 [0.86-1.07]; ''cereal and dairy-rich:'' 1.04 [0.94-1.16], and ''low-diversity and lowfat:'' 1.00 [0.89-1.13]). In this prospective cohort of women, several major dietary patterns were of poor quality. There was no evidence of a prospective association between any of the dietary patterns explored and pancreatic cancer incidence. Dietary patterns in the United Kingdom (UK) Women's Cohort Study were assessed in 3 ways: (1) self-reported vegan/vegetarian practice, (2) World Health Organization and Mediterranean Diet Scores, and (3) data-driven approach. Major dietary patterns in the UK Women's Cohort Study described using these 3 methods showed no association with pancreatic cancer risk. [Display omitted] [ABSTRACT FROM AUTHOR]

Non-pharmacological measures are recommended as the first-line treatment for individuals with high-normal blood pressure (BP) or mild hypertension. Studies directly comparing the BP effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on a salt restriction background are currently lacking. Thus, our purpose was to assess the BP effects of a 3-month intensive dietary intervention implementing salt restriction either alone or in the context of the DASH, and the MedDiet compared to no/minimal intervention in adults with high normal BP or grade 1 hypertension. We randomly assigned never drug-treated individuals to a control group (CG, n = 60), a salt restriction group (SRG, n = 60), a DASH diet with salt restriction group (DDG, n = 60), or a MedDiet with salt restriction group (MDG, n = 60). The primary outcome was the attained office systolic BP difference among the randomized arms during follow-up. A total of 240 patients were enrolled, while 204 (85%) completed the study. According to the intention-to-treat analysis, compared to the CG, office and 24 h ambulatory systolic and diastolic BP were reduced in all intervention groups. A greater reduction in the mean office systolic BP was observed in the MDG compared to all other study groups (MDG vs. CG: mean difference = −15.1 mmHg; MDG vs. SRG: mean difference = −7.5 mmHg, and MDG vs. DDG: mean difference = −3.2 mmHg, all P-values <0.001). The DDG and the MDG did not differ concerning the office diastolic BP and the 24 h ambulatory systolic and diastolic BP; however, both diets were more efficient in BP-lowering compared to the SRG. On a background of salt restriction, the MedDiet was superior in office systolic BP-lowering, but the DASH and MedDiet reduced BP to an extent higher than salt restriction alone. [ABSTRACT FROM AUTHOR]

childhood obesity and sleep disorders have a well-established cross-sectional association, but lifestyle interventions' effects on sleep quality remain under-researched. This study aimed to evaluate the sleep quality of 122 participants (7–16 years) with abdominal obesity after a 2-year necessary lifestyle intervention. participants were assigned to either the intervention group (moderate hypocaloric Mediterranean Diet) or the usual care group (standard recommendations on a healthy diet). Sleep was objectively assessed using triaxial accelerometry, and sleep parameters analyzed included latency, efficiency, wake after sleep onset, total time in bed, total sleep time, number of awakenings, and awakening duration. the results showed that the intervention group significantly improved sleep latency at 12 and 24 months and improved sleep efficiency at 2 and 12 months, compared to the usual care group. Wake after sleep onset and the number of awakenings were significantly reduced at 24 months in the intervention group. Wake after sleep onset and leptin levels were positively associated in all participants. Total time in bed was inversely associated with triglycerides and metabolic score, and total sleep time was inversely associated with leptin, triglycerides, and metabolic score after the 2-month intervention. Triglyceride levels were inversely associated with total time in bed and total sleep time at one year, while the metabolic score was directly associated with wake after sleep onset and the number of awakenings and inversely associated with efficiency. In conclusion, the multidisciplinary intervention in children and adolescents with abdominal obesity reduced anthropometric parameters and improved sleep habits. • Children in this study slept the recommended hours of sleep. • The intervention reduced anthropometric parameters and improved sleep quality. • Sleep latency and efficiency improved significantly in the intervention group. • WASO decreased significantly in the intervention group. • Metabolic score was associated to WASO and number of awakenings. [ABSTRACT FROM AUTHOR]

L'étude du rôle de l'alimentation dans la genèse des maladies inflammatoires chroniques de l'intestin (MICI) suscite un intérêt grandissant. Les patients atteints de MICI associent souvent leur alimentation à leurs symptômes ou à un risque de rechute. Ainsi, ces croyances conduisent à des régimes restrictifs afin de limiter l'exposition à certains composants alimentaires. Les facteurs de risque de cette restriction alimentaire sont maintenant établis et sont liés à la pathologie, à l'activité de la maladie, à la santé psychique des patients mais également à des sources d'information nutritionnelles divergentes. Ces régimes restrictifs sont à risque de dénutrition, de carence mais également de troubles anxio-dépressifs. Les études épidémiologiques ont pu démontrer le rôle de facteurs alimentaires dans le risque de développer une MICI. Globalement, les régimes méditerranéens réduisent le risque de développer une MICI. À l'inverse, le régime « occidental » (riche en graisses, en sucres, en sel, en protéines animales et en aliments ultra-transformés) majore le risque de survenue d'une MICI. Les études expérimentales démontrent la capacité des nutriments à moduler la réponse inflammatoire intestinale en jouant sur la composition du microbiote intestinal, la fonction de barrière intestinale ou les différents acteurs de l'immunité. Le niveau de preuves scientifiques est actuellement insuffisant pour proposer un régime anti-inflammatoire pour les patients atteints de MICI. Cependant, des pistes de recherche clinique prometteuses méritent d'être investiguées à l'avenir par le biais d'études interventionnelles randomisées. Comme l'ESPEN l'indique dans ses recommandations avec un consensus fort, chaque patient devrait bénéficier d'un suivi diététique par un professionnel de santé dans le cadre d'une approche multidisciplinaire. Diet is suspected to play a key role in IBD natural history. IBD patients often believe that diet is associated with symptoms and flares, leading to restrictive diets avoiding dietary components considered as potentially harmful. The risk factors of this restrictive eating disorder are now reported and result from disease activity, from patients' psychological health and from confusing dietary advice. These restrictive diets are at risk of undernutrition, nutritional deficiencies and of mixed anxiety-depressive disorders. Epidemiological studies have highlighted the role of dietary factors in IBD risk. Mediterranean diets tend to reduce the risk of developing IBD. Conversely, the "Western" diet (high intakes of fat, sugar, salt, animal protein and ultra-processed foods) increases the risk of developing IBD. Experimental studies demonstrate the ability of nutrients to modulate the intestinal inflammatory response by influencing the composition of the intestinal microbiota, the function of the intestinal barrier or various actors of immunity. The level of scientific evidence is currently insufficient to propose an anti-inflammatory diet for IBD patients. Nevertheless, promising avenues of clinical research deserve to be investigated in the future through randomised interventional studies. As recommended by ESPEN statements with a strong consensus, every patient should benefit from dietary follow-up by a health professional as part of a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Short telomeres have been observed in chronic disease patients. Identifying environmental and lifestyle factors that could reduce telomere attrition is crucial for disease prevention. The aim of this work was to determine whether weight-loss induced by an energy-reduced Mediterranean diet (erMedDiet) and physical activity (PA) could modify telomere length (TL). In 317 randomized non-smoker participants (mean age, 65.8 ± 4.98 years) with metabolic syndrome from two "Prevención con Dieta Mediterránea-Plus" (PREDIMED-Plus) trial centers, we evaluated MedDiet adherence, PA, anthropometric variables and TL at baseline and after a 3-year intervention using an intensive lifestyle program (IG) with an erMedDiet and PA or an unrestricted MedDiet without PA promotion (CG). Participants in the IG displayed greater 3-year weight reductions (−3.7 ± 4 kg, P < 0.001) compared to those in the CG. No differences in TL changes between groups were observed in the cohort as a whole. However, an interaction was observed between the intervention group and sex for TL changes (p interaction = 0.039). Women in the IG showed an increase in TL after 3-y (+0.25 ± 0.9, relative units) compared to women in the CG (−0.07 ± 1.0) (p ANCOVA = 0.036), whereas no differences between groups were observed in men. Women in the IG had a lower risk of telomere shortening after the intervention (OR = 0.17, 95%CI: 0.05–0.64, p = 0.008) compared to women in the CG. A 3-year lifestyle intervention based on an erMedDiet and PA slowed telomere shortening in women but not in men. ISRCTN, ISRCTN89898870. Registered 24 July 2014- Retrospectively registered, https://www.isrctn.com/ISRCTN89898870. [ABSTRACT FROM AUTHOR]

[Display omitted] • The crosstalk between the gut and the brain serves as a route for the spread of PD pathology in a bottom-up or top-down manner. • Gut dysbiosis is evident in PD patients and animal models and is associated with alterations in gut-derived microbial products and immune pathways promoting disease pathology. • Diet induces changes in the GM, with western diet evoking and Mediterranean diet preventing neuroinflammation and neurodegeneration associated with PD. • Gut-derived microbial products can be involved in the regulation of the immune system, the inflammation of both the intestine and the brain, and the integrity of intestinal epithelium and blood–brain barrier (BBB). • Therapeutic strategies that function by reversing gut dysbiosis and mitochondrial dysfunction may prove beneficial to treat PD pathology. Parkinson's disease (PD) is a disease of ⍺-synuclein aggregation-mediated dopaminergic neuronal loss in the substantia nigra pars compacta, which leads to motor and non-motor symptoms. Through the last two decades of research, there has been growing consensus that inflammation-mediated oxidative stress, mitochondrial dysfunction, and cytokine-induced toxicity are mainly involved in neuronal damage and loss associated with PD. However, it remains unclear how these mechanisms relate to sporadic PD, a more common form of PD. Both enteric and central nervous systems have been implicated in the pathogenesis of sporadic PD, thus highlighting the crosstalk between the gut and brain. of Review: In this review, we summarize how alterations in the gut microbiome can affect PD pathogenesis. We highlight various mechanisms increasing/decreasing the risk of PD development. Based on the previous supporting evidence, we suggest how early interventions could protect against PD development and how controlling specific factors, including our diet, could modify our perspective on disease mechanisms and therapeutics. We explain the strong relationship between the gut microbiota and the brain in PD subjects, by delineating the multiple mechanisms involved in neuroinflammation and oxidative stress. We conclude that the neurodetrimental effects of western diet (WD) and the neuroprotective effects of Mediterranean diets should be further explored in humans through clinical trials. Key Scientific Concepts of Review : Alterations in the gut microbiome and associated metabolites may contribute to pathogenesis in PD. In some studies, probiotics have been shown to exert anti-oxidative effects in PD via improved mitochondrial dynamics and homeostasis, thus reducing PD-related consequences. However, there is a significant unmet need for randomized clinical trials to investigate the effectiveness of microbial products, probiotic-based supplementation, and dietary intervention in reversing gut microbial dysbiosis in PD. [ABSTRACT FROM AUTHOR]

The effects of following the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet on metabolic health remains understudied. This cross-sectional analysis of 163 adults investigated associations between adherence to the MIND, Mediterranean, DASH, and Healthy Eating Index (HEI-2015) diets and metabolic syndrome (MetS) features and visceral adiposity. We hypothesized that the MIND diet would show the most beneficial associations with MetS risk factors. Diet adherence was assessed using the Dietary History Questionnaire II. Visceral adipose was assessed using dual-energy X-ray absorptiometry. Waist circumference and systolic and diastolic blood pressures were obtained. Fasting blood triglycerides, high-density lipoprotein cholesterol, and glucose concentrations were determined. Stepwise regression analyses were applied. Waist circumference was inversely associated with DASH (β = –0.21, P <.01), HEI-2015 (β = –0.18, P =.01), and MIND (β = –0.19, P <.01). Triglycerides were inversely associated with DASH (β = –0.19, P =.01), HEI-2015 (β = –0.18, P =.02), and MIND (β = –0.23, P <.01). High-density lipoprotein cholesterol was positively associated with Mediterranean (β = 0.18, P =.02) and MIND (β = 0.21, P <.01). Systolic blood pressure was inversely associated with Mediterranean (β = –0.18, P =.02), DASH (β = –0.30, P <.01), HEI-2015 (β = –0.24, P <.01), and MIND (β = –0.25, P <.01). Diastolic blood pressure was inversely associated with Mediterranean (β = –0.26, P <.01), DASH (β = –0.34, P <.01), HEI-2015 (β = –0.24, P <.01), and MIND (β = –0.31, P <.01). Fasting glucose was inversely associated with MIND (β = –0.19, P =.02). Visceral adiposity was inversely associated with Mediterranean (β = –0.19, P <.01), DASH (β = –0.22, P <.01), HEI-2015 (β = –0.22, P <.01), and MIND (β = –0.28, P <.01). Although each diet exhibited potential benefits for metabolic outcomes, only greater MIND diet adherence was associated with lower visceral adiposity and each MetS feature in adults. [Display omitted] Adherence to the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) was inversely associated with visceral adipose, waist circumference, systolic and diastolic blood pressure, blood triglycerides and fasting glucose, and positively associated with high-density lipoprotein cholesterol (all P <.05). MIND adherence was associated with more metabolic syndrome (MetS) features than the DASH, Mediterranean, and Healthy Eating Index (HEI-2015). [ABSTRACT FROM AUTHOR]

Can preconception adherence to a Mediterranean diet influence the rate of poor response to ovarian stimulation in IVF cycles? The impact of dietary habits on the success of IVF is controversial. Inconsistencies may be explained by confounders associated with the use of pregnancy as an outcome as well as by a reductionist view of diet that focuses on single components rather than on food patterns. This cross-sectional study analysed adherence to a Mediterranean diet in women with unexpected poor response to ovarian stimulation. Main inclusion criteria were: age 18–39 years, normal weight, preserved ovarian reserve and starting dose of gonadotrophins of 150–225 IU/day. Adherence to the Mediterranean diet was assessed through a Mediterranean diet score (MDS). Unexpected poor ovarian response was defined as the retrieval of ≤3 suitable oocytes. A total of 296 women were included, of whom 47 (15.9%) showed an unexpected poor response. A clear dose-related association with tertiles of MDS was not observed in the univariate analysis. However, in the multivariate analysis, the risk of unexpected poor response was significantly lower for women in the second tertile of MDS compared with the first tertile (adjusted odds ratio [OR] 0.29, 95% confidence interval [CI] 0.11–0.76) and for women in the second and third tertiles, grouped together, compared with the first tertile (adjusted OR 0.34, 95% CI 0.14–0.82). Low adherence to a Mediterranean diet could be a risk factor for unexpected poor ovarian response. [ABSTRACT FROM AUTHOR]

Anemia is prevalent in pregnant women, and the causes include inadequate diet, increased demand for iron, and inflammation. We hypothesized that gestational diabetes mellitus (GDM) and hepcidin-related gene polymorphisms may contribute to maternal anemia and that an anti-inflammatory diet can alleviate this negative effect. The aim of this study was to investigate the association of an inflammatory diet, GDM, and single nucleotide polymorphisms (SNPs) in hepcidin-related genes, which are key regulators of iron, with maternal anemia. This was a secondary data analysis of a prospective prenatal diet and pregnancy outcome study in Japan. The Energy-Adjusted Dietary Inflammatory Index was calculated using a brief self-administered diet history questionnaire. We analyzed 121 SNPs in 4 genes: TMPRS6 (43 SNPs), TF (39 SNPs), HFE (15 SNPs), and MTHFR (24 SNPs). Multivariate regression analysis was conducted to determine the association between the first variable and maternal anemia. The prevalence of anemia in first, second, and third trimesters were 5.4%, 34.9%, and 45.8%, respectively. The pregnant women with GDM had a significantly higher incidence of moderate anemia than those without GDM (40.0% vs. 11.4%, P =.029). In multivariate regression analysis, Energy-adjusted Dietary Inflammatory Index (β = −0.057, P =.011) and GDM (β = −0.657, P =.037) were significantly associated with hemoglobin levels during the third trimester. Using Stata's qtlsnp command, TMPRSS6 rs2235321 was found to be associated with hemoglobin levels during the third trimester. These results indicate that inflammatory diets, GDM, and TMPRSS6 rs2235321 polymorphism are associated with maternal anemia. This result suggests that a pro-inflammatory diet and GDM are associated with maternal anemia. Dietary quality was assessed using the Energy-Adjusted Dietary Inflammatory Index (E-DII) in a cohort of 169 pregnant Japanese women. Moderate anemia (hemoglobin <10.0 g/dL) was more frequently observed in the gestational diabetes mellitus (GDM) group than in the non-GDM group. Lower hemoglobin levels during the third trimester were attributed to both high E-DII score (B = −0.057) and GDM (B = −0.657). Additionally, hemoglobin levels during the third trimester were significantly associated with the rs2235321 variant of TMPRSS6. [Display omitted] [ABSTRACT FROM AUTHOR]

Atherosclerosis is the major risk factor for cardiovascular disease (CVD), the first cause of death worldwide. Chronic low-grade inflammation and a sustained oxidative milieu are causatively related to atherosclerosis onset and progression, and therefore, dietary patterns rich in bioactive compounds with anti-inflammatory and antioxidant activities might likely contribute to revert or slowing the progression of atherosclerosis. The aim of this study is to analyse the association between fruit and vegetables intake, quantitatively measured through carotene plasma concentrations, and atherosclerotic burden, as a surrogate biomarker of CVD, in free-living subjects from the DIABIMCAP cohort study. The 204 participants of the DIABIMCAP Study cohort (Carotid Atherosclerosis in Newly Diagnosed Type 2 Diabetic Individuals, ClinicalTrials.gov Identifier: NCT01898572), were included in this cross-sectional study. Total, α-, and β-carotenes were quantified by HPLC-MS/MS. Lipoprotein analysis in serum was performed by 2D- 1H NMR- DOSY, and atherosclerosis and intima media thickness (IMT) were measured through standardized bilateral carotid artery ultrasound imaging. Subjects with atherosclerosis (n = 134) had lower levels of large HDL particles than subjects without atherosclerosis. Positive associations were found between α-carotene and both large and medium HDL particles, and inverse associations were found between β- and total carotene, and VLDL and its medium/small particles. Subjects with atherosclerosis presented significantly lower plasma concentrations of total carotene compared with subjects without atherosclerosis. Plasma concentrations of carotene decreased as the number of atherosclerotic plaques increased, although after multivariate adjustment, the inverse association between β- and total carotene with plaque burden remained significant only in women. A diet rich in fruit and vegetables results in higher plasmatic carotene concentrations, which are associated with a lesser atherosclerotic plaque burden. [ABSTRACT FROM AUTHOR]