MEDITERRANEAN DIET AND LIPIDS

Cilj istraživanja: Cilj istraživanja bio je ispitati postoji li povezanost između mediteranske prehrane i razine lipida u krvi u populaciji otoka Korčule i grada Splita te uz to istražiti obrazac mediteranske prehrane u navedenoj populaciji. Materijali i metode: Presječno istraživanje, provedeno u okviru projekta „Pleitropija, genske mreže i putevi u izoliranim ljudskim populacijama: 10.001 Dalmatinac“ (HRZZ 8875), obuhvatilo je 2145 ispitanika s otoka Korčule i grada Splita. Upitnikom koji su ispitanici ispunili prikupljeni su podaci o dobi, spolu, zdravstvenom statusu, socioekonomskom statusu te prehrambenim i ostalim navikama (konzumacija alkohola, pušenje, tjelesna aktivnost). Pridržavanje mediteranskom načinu prehrane određeno je indeksom koji uključuje 14 skupina namirnica koje predstavljaju osnovne sastavnice mediteranske prehrane (108). Nadalje, ispitanicima je izmjerena tjelesna masa i visina, opseg struka i kukova, sistolički i dijastolički tlak te izračunat indeks tjelesne mase. Svaki ispitanik je nakon potpisivanja informiranog pristanka dao uzorak krvi na tašte te su biokemijskom analizom dobivene vrijednosti glukoze, kreatinina, urične kiseline, ukupnog kolesterola, LDL kolesterola, HDL kolesterola i triglicerida u krvi. U statističkoj analizi podataka korišten je hi-kvadrat test, Kruskal-Wallis test i Spearmanov test rang korelacije te logistička regresija. Rezultati su smatrani statistički značajnima ukoliko je P vrijednost iznosila 30 kg/m2 povezan s nižom razinom HDL-a i s višom razinom triglicerida u krvi. Pušenje je bilo povezano s nižom koncentracijom HDL-a (OR=2,46; 95% CI 1,57-3,86) i većom koncentracijom triglicerida (OR=1,73; 95% CI 1,22-2,45). U skupini ispitanika koji imaju jednu ili više kroničnih bolesti u anamnezi ITM >25 kg/m2 bio je povezan s većom razinom triglicerida u krvi (OR=1,63; 95% CI 1,01-2,64), dok je učinak na smanjenje HDL-a bio vidljiv samo kod ispitanika s ITM >30 kg/m2 (OR=4,64; 95% CI 2,07-10,38). Nije se pronašla statistički značajna povezanost između nižeg indeksa mediteranske prehrane i vrijednosti lipidnih markera u krvi niti kod zdravih ispitanika niti onih koji imaju od ranije dijagnosticiranu jednu ili više kroničnih bolesti. Zaključak: Dob, indeks tjelesne mase i pušenje predstavljaju rizične čimbenike za povećanje lipida u krvi. S obzirom na trend povećanja potrošnje hipolipemika u populaciji sve većeg broja osoba s dislipidemijom te rastuće pojavnosti „zapadnjačkog“ načina života i prehrane, upravo bi integriranje mediteranske prehrane u svakodnevni život moglo biti ključ ostvarenja nekih na zdravlje povoljnih učinaka. Nažalost, u istraživanoj populaciji pronađena je niska razina pridržavanja smjernica mediteranske prehrane, a visoka učestalost rizičnih čimbenika za kronične bolesti, kao i tih bolesti također, zbog čega postoji jasna potreba za javnozdravstvenom intervencijom i promocijom tradicionalnog i zdravog mediteranskog stila života i prehrane.
Objectives: The main objective of this study was to examine whether there is a link between the Mediterranean diet and blood lipid levels in the population of the island of Korcula and the city of Split, and in addition to examine the pattern of the Mediterranean diet in that population. Patients and Methods: A cross-sectional study, conducted in the framework of the project "Pleiotropy, gene networks and pathways in isolated human populations: 10 001 Dalmatians" (HRZZ 8875), included 2,145 respondents from the island of Korcula and the city of Split. Using the survey, data was collected on age, sex, health status, level of education, dietary and other habits (drinking, smoking, physical activity). Adherence to the Mediterranean dietary pattern was determined by index score, which includes 14 groups of foods that are basic components of the Mediterranean diet (108). Furthermore, the respondents were measured body weight and height, waist circumference and hip circumference, systolic and diastolic blood pressure, and body mass index was calculated. After signing the informed consent, fasting blood sample was taken from each participant and the biochemical analysis was performed in order to measure glucose, creatinine, uric acid, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. In statistical analysis of the data chi-square test, Kruskal-Wallis's test, Spearman's rank correlation test and logistic regression were used. Results were considered statistically significant if the P value was 30 kg/m2 was associated with lower concentration of HDL and higher levels of triglycerides in the blood. Smoking was associated with a lower concentration of HDL (OR = 2.46; 95% CI 1.57 to 3.86) and a higher concentration of triglycerides (OR = 1.73; 95% CI 1.22 to 2.45). In the group of subjects having one or more chronic disease in their history, BMI >25 kg/m2 was associated with higher triglyceride levels (OR = 1.63; 95% CI 1.01 to 2.64), while the effect on decrease in HDL was seen only in patients with a BMI >30 kg/m2 (OR = 4.64; 95% CI 2.07 to 10.38). Statistically significant association between a lower index value of the Mediterranean diet and lipid markers in blood was not found in healthy subjects nor in those who have previously been diagnosed with one or more chronic diseases. Conclusion: Age, body mass index and smoking are risk factors for the increase in blood lipids. Given the trend of increasing consumption of lipid lowering drugs in the population of a growing number of people with dyslipidemia and the growing incidence of "Western" lifestyle and diet, just integrating the Mediterranean diet in everyday life could be the key to achieving some beneficial effects on health. Unfortunately, a low level of compliance with the guidelines of the Mediterranean diet was found in the studied population along with a high prevalence of risk factors for chronic diseases, and of these diseases as well, therefore there is a clear need for public health intervention and promotion of traditional and healthy Mediterranean lifestyle and diet.