Abstract Title: Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Abstract Source: J Nutr. 2020 Feb 6. Epub 2020 Feb 6. PMID: 32027740 Abstract Author(s): Oliver M Shannon, Inês Mendes, Christina Köchl, Mohsen Mazidi, Ammar W Ashor, Sofia Rubele, Anne-Marie Minihane, John C Mathers, Mario Siervo Article Affiliation: Oliver M Shannon Abstract: BACKGROUND: The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. METHODS: Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. RESULTS: Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)-the reference method for noninvasive, clinical measurement of endothelial function-by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). CONCLUSIONS: MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD. This study has the PROSPERO registration number: CRD42018106188. Article Published Date : Feb 05, 2020

Abstract Title: The effect of a Mediterranean diet on metabolic parameters in patients with non-alcoholic fatty liver disease: A systematic review of randomized controlled trials. Abstract Source: Clin Nutr ESPEN. 2020 Feb ;35:40-46. Epub 2019 Nov 15. PMID: 31987120 Abstract Author(s): Seyedeh Parisa Moosavian, Arman Arab, Zamzam Paknahad Article Affiliation: Seyedeh Parisa Moosavian Abstract: BACKGROUND: Dietary habit can play a key role in the prevention and treatment of fatty liver disease (NAFLD). Although many studies have investigated the effect of Mediterranean diet on NAFLD, findings are inconsistent and there is no systematic review on this topic. Therefore, the aim of this systematic review is to summarize the effect of Mediterranean diet on serum metabolic indices and anthropometric measures among NAFLD patients. METHODS: We searched titles, abstracts, and keywords of articles indexed in Science Direct, MEDLINE, and Google Scholar databases up to October 2018 to identify eligible RCT studies. Randomized clinical trials assessing the effects of MD on NAFLD were included. RESULTS: The present study included 10 randomized controlled trials, which involved a total of 856 adults with NAFLD. According to the result, MD may improve anthropometric measures, lipid profile, glycemic indices, liver enzyme, and NAFLD severity indices among patients with NAFLD. CONCLUSION: We found that MD could alleviate NAFLD severity parameters but differences between studies should be taken into account. Finally, in order to draw a firm link between MD and NAFLD, more clinical trials with adequate sample size and better methodology should be done. Article Published Date : Jan 31, 2020

Abstract Title: One-year Mediterranean diet promotes epigenetic rejuvenation with country- and sex-specific effects: a pilot study from the NU-AGE project. Abstract Source: Geroscience. 2020 Jan 24. Epub 2020 Jan 24. PMID: 31981007 Abstract Author(s): Noémie Gensous, Paolo Garagnani, Aurelia Santoro, Cristina Giuliani, Rita Ostan, Cristina Fabbri, Maddalena Milazzo, Davide Gentilini, Anna Maria di Blasio, Barbara Pietruszka, Dawid Madej, Agata Bialecka-Debek, Anna Brzozowska, Claudio Franceschi, Maria Giulia Bacalini Article Affiliation: Noémie Gensous Abstract: Mediterranean diet has been proposed to promote healthy aging, but its effects on aging biomarkers have been poorly investigated. We evaluated the impact of a 1-year Mediterranean-like diet in a pilot study including 120 elderly healthy subjects from the NU-AGE study (60 Italians, 60 Poles) by measuring the changes in their epigenetic age, assessed by Horvath's clock. We observed a trend towards epigenetic rejuvenation of participants after nutritional intervention. The effect was statistically significant in the group of Polish females and in subjects who were epigenetically older at baseline. A genome-wide association study of epigenetic age changes after the intervention did not return significant (adjusted p value< 0.05) loci. However, we identified small-effect alleles (nominal p value< 10-4), mapping in genes enriched in pathways related to energy metabolism, regulation of cell cycle, and of immune functions. Together, these findings suggest that Mediterranean diet can promote epigenetic rejuvenation but with country-, sex-, and individual-specific effects, thus highlighting the need for a personalized approach to nutritional interventions. Article Published Date : Jan 23, 2020

Abstract Title: Adherence to Mediterranean diet and subsequent cognitive decline in men with cardiovascular disease. Abstract Source: Nutr Neurosci. 2020 Jan 22:1-9. Epub 2020 Jan 22. PMID: 31965911 Abstract Author(s): Miri Lutski, Galit Weinstein, Shelly Ben-Zvi, Uri Goldbourt, David Tanne Article Affiliation: Miri Lutski Abstract: Evidence from recent years highlighted the importance of the Mediterranean diet for brain health. We investigated the association between adherence to Mediterranean diet and change in cognitive functions two decades later in patients with cardiovascular disease (CVD).Participants were men with a history of CVD, who previously participated in the Bezafibrate Infarction Prevention (BIP) trial between 1990 and 1997, had a food diary record, and underwent cognitive evaluations 14.6 ± 1.9 years (T1) and 19.9 ± 1.0 years after baseline (T2) as part of the BIP Neurocognitive study (= 200, mean age at 57.3 ± 6.3 years). Adherence to the Mediterranean diet was determined from the self-administered 4-day food diary record, with patients categorized into high, middle and poor levels of adherence if they received>5, 4-5 and<4 points, respectively. Cognitive function was assessed using the NeuroTrax computerized battery. Linear mixed models were applied.Among the 200 patients, 52 (26%) had poor adherence, 98 (49%) had middle adherence and 50 (25%) had high levels of adherence to the Mediterranean diet. Those categorized to the poor adherence level had poorer cognitive function at T1 compared to the other groups. Additionally, poor vs. high level of adherence was associated with a greater decline in overall cognitive performance [-score = -0.23 and 95% confidence interval (CI), -0.43;-0.04; = 0.021] and in visual spatial functions (-0.46 95% CI, -0.86;-0.06; = 0.023).This study stresses the possible role of the Mediterranean diet in men with a high vascular burden and may set the ground for future intervention to reduce their risk for cognitive decline. Article Published Date : Jan 21, 2020

Abstract Title: Mediterranean diet components are linked to greater endothelial function and lower inflammation in a pilot study of ethnically diverse women. Abstract Source: Nutr Res. 2020 Jan 13 ;75:77-84. Epub 2020 Jan 13. PMID: 32045786 Abstract Author(s): Riddhi Shah, Nour Makarem, Memet Emin, Ming Liao, Sanja Jelic, Brooke Aggarwal Article Affiliation: Riddhi Shah Abstract: The Mediterranean Diet, characterized by higher intakes of plant foods including plant proteins, monounsaturated fat, fish, and lower consumption of animal products and saturated fat, has long been associated with reduced cardiovascular risk, but the molecular mechanisms underlying these associations have not been fully elucidated. We conducted a pilot study to evaluate associations of an Alternate Mediterranean Diet Score, reflective of adherence to this diet pattern and adapted for US populations, and its components, with markers of endothelial inflammation directly measured in endothelial cells harvested from a diverse sample of women (n = 25, mean ± SD age 33 ± 10.5y, 68% racial/ethnic minorities). Cardiovascular risk markers including nuclear factor kappa B (NF-κB)-a marker of inflammation, as well as oxidative stress and endothelial nitric oxide synthase (eNOS) gene expression-markers of endothelial function, wereevaluated in harvested endothelial cells. We hypothesized that the Mediterranean diet pattern would be associated with lower inflammation and oxidative stress and higher eNOS expression in endothelial cells. Results showed that lower oxidative stress was associated with higher plant-based protein (Exp(β) = 0.96; P = .007), overall protein (Exp(β) = 0.99; P = .007), and red and processed meat intake (Exp(β) = 0.93; P = .012). Lower NF-κB was associated with higher legume (Exp(β) = 0.79; P = .045) intake, and higher eNOS was associated with higher red and processed meat intake (Exp(β) = 1.13; P = .005). Our findings suggest potential novel mechanisms through which certain Mediterranean dietary components may influence pre-clinical vascular alterations that may be associated with cardiovascular risk through lower endothelial oxidative stress, lower inflammation, and greater endothelial functioning. These findings warrant confirmation, prospectively in a larger sample. Article Published Date : Jan 12, 2020

Abstract Title: The Mediterranean Diet is Associated with an Improved Quality of Life in Adults with Type 1 Diabetes. Abstract Source: Nutrients. 2020 Jan 2 ;12(1). Epub 2020 Jan 2. PMID: 31906543 Abstract Author(s): Minerva Granado-Casas, Mariona Martin, Montserrat Martínez-Alonso, Nuria Alcubierre, Marta Hernández, Núria Alonso, Esmeralda Castelblanco, Didac Mauricio Article Affiliation: Minerva Granado-Casas Abstract: This study aimed to assess the potential association between dietary patterns (i.e., the Mediterranean Diet (MedDiet) and healthy eating) and patient-reported quality of life (QoL) and treatment satisfaction (TS) in adults with type 1 diabetes (T1D). A food frequency questionnaire, the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19), and the Diabetes Treatment Satisfaction Questionnaire-status version (DTSQ-s) were administered via personal interviews to 258 participants with T1D. Multivariable analysis showed that a moderate or high adherence to the MedDiet was associated with greater diabetes-specific QoL (β = 0.32, 95% CI = 0.03; 0.61;= 0.029). None of the dietary quality indexes (i.e., the alternate Mediterranean Diet Score (aMED) and the alternate Healthy Eating Index (aHEI)) were associated with the overall TS. However, the aHEI was positively associated with the specific items of TS"convenience"and"flexibility"(β = 0.03, 95% CI = 0.00; 0.06;= 0.042 andβ = 0.04; 95% CI = 0.01; 0.06;= 0.011, respectively). On the other hand, the aHEI was negatively associated with the dimension"recommend to others"(β = -0.5, 95% CI = -0.99; -0.02;= 0.042). In conclusion, a moderate and high adherence to the MedDiet was associated with greater QoL. Although neither aMED nor aHEI were associated with the overall TS, some specific items were positively (i.e.,"convenience","flexibility") or negatively ("recommend to others") related to the aHEI. Further research is needed to assess how to improve medical nutrition therapy and its impact on patient-reported outcomes in people with T1D. Article Published Date : Jan 01, 2020

Abstract Title: Impulsiveness in children with attention-deficit/hyperactivity disorder after an 8-week intervention with the Mediterranean diet and/or omega-3 fatty acids: A randomised clinical trial. Abstract Source: Neurologia. 2019 Dec 26. Epub 2019 Dec 26. PMID: 31883771 Abstract Author(s): I San Mauro Martin, S Sanz Rojo, L González Cosano, R Conty de la Campa, E Garicano Vilar, J A Blumenfeld Olivares Article Affiliation: I San Mauro Martin Abstract: INTRODUCTION: The Barratt Impulsiveness Scale (BIS) is a self-administered instrument designed to assess the personality/behavioural construct of impulsiveness. Impulsiveness has been associated with several psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). This study assesses the progression of impulsive behaviour in children with ADHD after an 8-week dietary intervention with the Mediterranean diet and/or omega-3 fatty acid supplementation, by using a version of the 11-item BIS adapted for children (BIS-11c). METHODS: This cross-sectional study includes 60 children with ADHD from the region of Madrid, Spain. Participants were divided into 4 groups, with one control group (G1) and 3 intervention groups (Mediterranean diet [G2]; omega-3 supplementation [G3]; and Mediterranean diet plus omega-3 supplementation [G4]). A personalised Mediterranean diet was designed for members of groups 2 and 4. The BIS-11c was administered to determine the level of impulsiveness, and the KIDMED test was used to assess adherence to the Mediterranean diet. RESULTS: The supplementation group showed a fairly significant decrease in the total BIS-11c (P=.049). Total cognitive score slightly decreased in the diet and supplementation groups. Only the control group showed a considerable decrease in the total motor score. Total nonplanning scores were lower in all groups after the intervention. Baseline and final BIS-11c scores were positively correlated with treatments (r>0.9). CONCLUSION: An intake of 550mg EPA fatty acid and 225mg DHA fatty acid per day for 8 weeks is associated with less marked impulsive behaviour in children with ADHD. A Mediterranean diet may improve BIS scores, although our results are not conclusive in this population. Article Published Date : Dec 25, 2019

Abstract Title: Role of Mediterranean diet in preventing platinum based gastrointestinal toxicity in gynecolocological malignancies: A single Institution experience. Abstract Source: World J Clin Oncol. 2019 Dec 24 ;10(12):391-401. PMID: 31890648 Abstract Author(s): Eleonora Ghisoni, Valentina Casalone, Gaia Giannone, Gloria Mittica, Valentina Tuninetti, Giorgio Valabrega Article Affiliation: Eleonora Ghisoni Abstract: BACKGROUND: Gynecological malignancies represent a major cause of death in women and are often treated with platinum-based regimens. Patients undergoing chemotherapy suffer from alterations in nutritional status which may worsen gastrointestinal (GI) toxicities, quality of life and affect the overall prognosis. Indeed, assuring a good nutritional status and limiting toxicities during treatment are still major goals for clinicians. AIM: To assess the role of Mediterranean Diet (MD) in reducing GI toxicities in patients with gynecological cancers treated with platinum-based regimens. METHODS: We conducted an observational study on 22 patients with gynecological tumors treated with a platinum-based chemotherapy at Candiolo Cancer Institute FPO/IRCCS between January 2018 and June 2018. The food and frequency (FFQ) and the Patient-Reported Outcomes Common Terminology Criteria For Adverse Events (PRO-CTCAE) questionnaires were administered at baseline and at every Day 1 of each cycle. To evaluate the differences in GI toxicities the study population was divided in two groups according to the currently validated Mediterranean Diet Serving Score (MDSS) at baseline. RESULTS: Patients with high MDSS reported a trend toward lower GI toxicities according to PRO-CTCAE at each timepoint (first evaluation:= 0.7; second:= 0.52; third:= 0.01). In particular, difference in nausea frequency and gravity (<0.001), stomach pain frequency and gravity (= 0.01 and= 0.02), abdomen bloating frequency and gravity (= 0.02 and= 0.03), and interference with daily activities (= 0.02) were highly statistically significant at the end of treatment. More than 60% of patients changed their food habits during chemotherapy mainly because of GI toxicities. A higher reduction of food intake, both in terms of caloric (= 0.29) and of single nutrients emerged in the group experiencing higher toxicity. CONCLUSION: Our results show that adherence to MD possibly reduces GI toxicity and prevents nutritional status impairment during chemotherapy treatment. Bigger studies are needed to confirm our results. Article Published Date : Dec 23, 2019

Abstract Title: The Mediterranean Diet Slows Down the Progression of Aging and Helps to Prevent the Onset of Frailty: A Narrative Review. Abstract Source: Nutrients. 2019 Dec 21 ;12(1). Epub 2019 Dec 21. PMID: 31877702 Abstract Author(s): Cristiano Capurso, Francesco Bellanti, Aurelio Lo Buglio, Gianluigi Vendemiale Article Affiliation: Cristiano Capurso Abstract: The aging population is rapidly increasing all over the world. This results in significant implications for the planning and provision of health and social care. Aging is physiologically characterized by a decrease in lean mass, bone mineral density and, to a lesser extent, fat mass. The onset of sarcopenia leads to weakness and a further decrease in physical activity. An insufficient protein intake, which we often observe in patients of advanced age, certainly accelerates the progression of sarcopenia. In addition, many other factors (e.g., insulin resistance, impaired protein digestion and absorption of amino acids) reduce the stimulation of muscle protein synthesis in the elderly, even if the protein intake is adequate. Inadequate intake of foods can also cause micronutrient deficiencies that contribute to the development of frailty. We know that a healthy eating style in middle age predisposes to so-called"healthy and successful"aging, which is the condition of the absence of serious chronic diseases or of an important decline in cognitive or physical functions, or mental health. The Mediterranean diet is recognized to be a"healthy food"dietary pattern; high adherence to this dietary pattern is associated with a lower incidence of chronic diseases and lower physical impairment in old age. The aim of our review was to analyze observational studies (cohort and case-control studies) that investigated the effects of following a healthy diet, and especially the effect of adherence to a Mediterranean diet (MD), on the progression of aging and on onset of frailty. Article Published Date : Dec 20, 2019

Abstract Title: Impact of adherence to a Mediterranean Diet pattern on patients with first acute myocardial infarction. Abstract Source: Nutr Metab Cardiovasc Dis. 2019 Dec 6. Epub 2019 Dec 6. PMID: 32007333 Abstract Author(s): Marco Magnoni, Paola Scarano, Vittoria Vergani, Martina Berteotti, Guglielmo Gallone, Nicole Cristell, Attilio Maseri, Domenico Cianflone Article Affiliation: Marco Magnoni Abstract: BACKGROUND AND AIMS: The Mediterranean diet (MD) affects the risk of myocardial infarction and long-term prognosis after a coronary event. Limited data are available regarding the influence of MD on short-term prognosis. We assessed the impact of the MD adherence on in-hospital and short-term outcome in patients with first ST-elevation Myocardial Infarction (STEMI). METHODS AND RESULTS: As many as 533 European patients with STEMI and no previous history of coronary artery disease were included in this analysis. Previous dietary habits of each patient were collected with a food frequency questionnaire from which we calculated the FAMI Mediterranean Diet Score (FAMI MD Score), according to the MD adherence. A blood sample was drawn to each patient within 6 h of symptoms onset. Levels of high-sensitivity C-Reactive Protein (hsCRP), Interleukin-6 (IL-6) were measured. Clinical outcome at 180 days and myocardial reperfusion were assessed. Patients with higher FAMI MD Score had lower levels of hsCRP; there were no differences between IL-6 level among FAMI MD Score quintiles. There were no associations between adherence to MD and 180-day adverse events. Lower FAMI MD Score was associated with a higher risk of ineffective myocardial reperfusion after thrombolysis or percutaneous coronary intervention. Similar results were observed for daily consumption of ≥4 portions of fruit and vegetable. CONCLUSIONS: A positive effect of the Mediterranean diet, and fruit and vegetable intake was observed on hsCRP and the occurrence of effective myocardial reperfusion. These findings confirm the favorable impact of Mediterranean diet adherence not only in primary but also in secondary prevention. Article Published Date : Dec 05, 2019

Abstract Title: Evaluation of nutritional profile and total antioxidant capacity of the Mediterranean diet of southern Spain. Abstract Source: Food Sci Nutr. 2019 Dec ;7(12):3853-3862. Epub 2019 Oct 28. PMID: 31890163 Abstract Author(s): Carmen Maria González, Lorena Martínez, Gaspar Ros, Gema Nieto Article Affiliation: Carmen Maria González Abstract: The objective of this study was to determine the antioxidant capacity of a Mediterranean diet consisting typical dishes from southern Spain. For that, a 5-day diet was developed with typical dishes of Murcia. The antioxidant capacity of the diet was measured using ORAC, FRAP, and DPPH methods, and the total phenolic compound content of this diet was estimated by Folin-Ciocalteu. About 50% of the antioxidant capacity and 29% of the phenolic compounds per day came from sample 14 (artichokes with ham), whereas only 1% and a 4%, respectively, proceed from sample 16 (gypsy pot). The total antioxidant capacity of the diet was estimated as 9,506.33 ET/100 g/person/day by the ORACmethod, and the total phenolic consume was estimated as 1,839.05 mg GAE/person/day. The proposed diet can be considered an excellent strategy for improving the nutritional status of the population because of its high antioxidant activity and phenolic compound content. Article Published Date : Nov 30, 2019

Abstract Title: The Fluid Aspect of the Mediterranean Diet in the Prevention and Management of Cardiovascular Disease and Diabetes: The Role of Polyphenol Content in Moderate Consumption of Wine and Olive Oil. Abstract Source: Nutrients. 2019 Nov 19 ;11(11). Epub 2019 Nov 19. PMID: 31752333 Abstract Author(s): Paola Ditano-Vázquez, José David Torres-Peña, Francisco Galeano-Valle, Ana Isabel Pérez-Caballero, Pablo Demelo-Rodríguez, José Lopez-Miranda, Niki Katsiki, Javier Delgado-Lista, Luis A Alvarez-Sala-Walther Article Affiliation: Paola Ditano-Vázquez Abstract: A growing interest has emerged in the beneficial effects of plant-based diets for the prevention of cardiovascular disease, diabetes and obesity. The Mediterranean diet, one of the most widely evaluated dietary patterns in scientific literature, includes in its nutrients two fluid foods: olive oil, as the main source of fats, and a low-to-moderate consumption of wine, mainly red, particularly during meals. Current mechanisms underlying the beneficial effects of the Mediterranean diet include a reduction in inflammatory and oxidative stress markers, improvement in lipid profile, insulin sensitivity and endothelial function, as well as antithrombotic properties. Most of these effects are attributable to bioactive ingredients including polyphenols, mono- and poly-unsaturated fatty acids. Polyphenols are a heterogeneous group of phytochemicals containing phenol rings. The principal classes of red wine polyphenols include flavonols (quercetin and myricetin), flavanols (catechin and epicatechin), anthocyanin and stilbenes (resveratrol). Olive oil has at least 30 phenolic compounds. Among them, the main are simple phenols (tyrosol and hydroxytyrosol), secoroids and lignans. The present narrative review focuses on phenols, part of red wine and virgin olive oil, discussing the evidence of their effects on lipids, blood pressure, atheromatous plaque and glucose metabolism. Article Published Date : Nov 18, 2019

Abstract Title: Adherence to the Mediterranean Diet and Its Association with Body Composition and Physical Fitness in Spanish University Students. Abstract Source: Nutrients. 2019 Nov 19 ;11(11). Epub 2019 Nov 19. PMID: 31752296 Abstract Author(s): Ana Isabel Cobo-Cuenca, Miriam Garrido-Miguel, Alba Soriano-Cano, Asunción Ferri-Morales, Vicente Martínez-Vizcaíno, Noelia María Martín-Espinosa Article Affiliation: Ana Isabel Cobo-Cuenca Abstract: The aims of this study were to assess the association of adherence to the Mediterranean diet (MD) with physical fitness and body composition in Spanish university students and to determine the ability to predict the MD adherence of each Mediterranean Diet Adherence Screener (MEDAS) item. A cross-sectional study was performed involving 310 first-year university students. Adherence to the MD was evaluated with MEDAS-14 items. Anthropometric variables, body composition, and physical fitness were assessed. Muscle strength was determined based on handgrip strength and the standing long jump test. Cardiorespiratory fitness (CRF) was measured using the Course-Navette test. Only 24% of the university students had good adherence to the MD. The ANCOVA models showed a significant difference between participants with high adherence to the MD and those with medium and low adherence in CRF (= 0.017) and dynamometry (= 0.005). Logistic binary regression showed that consuming>2 vegetables/day (OR = 20.1; CI: 10.1-30.1;<0.001), using olive oil (OR = 10.6; CI: 1.4-19.8;= 0.021), consuming<3 commercial sweets/week (OR = 10.1; IC: 5.1-19.7;<0.001), and consuming≥3 fruits/day (OR = 8.8; CI: 4.9-15.7;<0.001) were the items most associated with high adherence to the MD. In conclusion, a high level of adherence to the MD is associated with high-level muscular fitness and CRF in Spanish university students. Article Published Date : Nov 18, 2019

Abstract Title: Metabolic syndrome and its association with the Dietary Inflammatory Index (DII)in a Croatian working population. Abstract Source: J Hum Nutr Diet. 2019 Oct 11. Epub 2019 Oct 11. PMID: 31602707 Abstract Author(s): G Kenđel Jovanović, S Pavičić Žeželj, S Klobučar Majanović, I Mrakovcic-Sutic, I Šutić Article Affiliation: G Kenđel Jovanović Abstract: BACKGROUND: Metabolic syndrome (MetS) is a global public health concern, although its association with the inflammatory potential of the diet is still indefinite. The main objective of the present study was to investigate the association of MetS and its components with the inflammatory potential of the diet in a Croatian working population with sedentary occupations. METHODS: In a cross-sectional study, Croatian workers (n = 366) self-administrated questionnaires for sociodemographic and health-related data. Their anthropometric measurements and fasting blood samples were collected for evaluation of MetS. The inflammatory potential of the diet was assessed with a Dietary Inflammatory Index (DII), scored using dietary data collected from a food frequency questionnaire. Multivariable logistic regression analysis, adjusted for sex, age, body mass index, education, smoking, physical activity and energy intake, was used to establish the association between DII and MetS. RESULTS: MetS prevalence was 25% and was significantly associated with a pro-inflammatory diet [mean (SD) 3.28 (1.45); P < 0.01]. The pro-inflammatory diet was statistically associated with women, university degree, moderate physical activity, snacking between meals, central obesity, hypertriglyceridaemia, hypertension, low high-density lipoprotein-cholesterol, MetS prevalence and lower adherence to a Mediterranean diet. Multivariable logistic regression analysis showed a statistically positive association for a one-unit increase in the DII and MetS prevalence (odds ratio = 2.31; 95% confidence interval = 1.61-3.31; P < 0.01) and hypertension (odds ratio = 1.28; 95% confidence interval = 1.01-1.64; P = 0.04). CONCLUSIONS: Further longitudinal studies in different parts of Croatia, including inflammation biomarkers, are needed to enable a more defined view of the inflammatory potential of a diet and its association with various inflammatory-based health conditions. The results obtained in the present study indicate the need for the development of anti-inflammatory dietary interventions for population health protection. Article Published Date : Oct 10, 2019

Abstract Title: Dietary n-3 polyunsaturated fatty acids, fish intake and healthy ageing. Abstract Source: Int J Epidemiol. 2019 Sep 28. Epub 2019 Sep 28. PMID: 31563961 Abstract Author(s): Esther García-Esquinas, Rosario Ortolá, Jose Ramón Banegas, Esther Lopez-García, Fernando Rodríguez-Artalejo Article Affiliation: Esther García-Esquinas Abstract: BACKGROUND: Seafood consumption and dietary intake of n-3 polyunsaturated fatty acids (PUFA) protect from cardiovascular disease, muscle wasting and mortality; however, their role in delaying unhealthy ageing is uncertain. METHODS: A prospective cohort study with 1592 community-dwelling individuals aged≥60 years recruited in 2008-2010, and followed through 2015. Intake of seafood and n-3 PUFA [eicosapentanoic acid (EPA) and docosahexanoic acid (DHA)] was estimated using a validated diet history and food composition tables. Unhealthy ageing was assessed across the domains of physical and cognitive function, mental health, morbidity, self-rated health and vitality. RESULTS: Higher blue fish consumption was negatively associated with unhealthy ageing in 2015 [multivariateß (95% confidence interval) per interquartile range (IQR) increase of fish: -0.49 (-0.90; -0.08)] and, specifically, was associated with lower accumulation of functional impairments [-1.00 (-1.71; -0.28)] and morbidities [-0.30 (-0.73; 0.13)]. Individuals with high intakes of EPA (≥0.47 g/day)and DHA (≥0.89 g/day) presented the highest reductions in age-related deficits accumulation: -1.61 (-3.01; -0.22) and -1.34 (-2.76; 0.08), respectively. Intake of EPA and DHA were negatively associated with the accumulation of functional deficits [results per IQR increase: -0.79 (-1.64; -0.06) and -0.84 (-1.67; -0.01), respectively] and morbidities [-0.60 (-1.10; -1.11) and -0.60 (-1.09; -0.11)]. No associations were observed between n-3 PUFA and self-rated or mental health, or between white fish and unhealthy ageing. CONCLUSIONS: In this cohort of Spanish individuals with elevated intake of fish and a high adherence to the Mediterranean diet, consumption of blue fish and n-3 PUFA had a prospective protective association with deficits accumulation. Article Published Date : Sep 27, 2019

Abstract Title: Metabolic and Vascular Effect of the Mediterranean Diet. Abstract Source: Int J Mol Sci. 2019 Sep 23 ;20(19). Epub 2019 Sep 23. PMID: 31547615 Abstract Author(s): Antonino Tuttolomondo, Irene Simonetta, Mario Daidone, Alba Mogavero, Antonella Ortello, Antonio Pinto Article Affiliation: Antonino Tuttolomondo Abstract: Several studies indicated how dietary patterns that were obtained from nutritional cluster analysis can predict disease risk or mortality. Low-grade chronic inflammation represents a background pathogenetic mechanism linking metabolic risk factors to increased risk of chronic degenerative diseases. A Mediterranean diet (MeDi) style has been reported as associated with a lower degree of inflammation biomarkers and with a protective role on cardiovascular and cerebrovascular events. There is heterogeneity in defining the MedDiet, and it can, owing to its complexity, be considered as an exposome with thousands of nutrients and phytochemicals. Recently, it has been reported a novel positive association between baseline plasma ceramide concentrations and cardiovascular events and how adherence to a Mediterranean Diet-style may influence the potential negative relationship between elevated plasma ceramide concentrations and cardiovascular diseases (CVD). Several randomized controlled trials (RCTs) showed the positive effects of the MeDi diet style on several cardiovascular risk factors, such as body mass index, waist circumference, blood lipids, blood pressure, inflammatory markers and adhesion molecules, and diabetes and how these advantages of the MeDi are maintained in comparison of a low-fat diet. Some studies reported a positive effect of adherence to a Mediterranean Diet and heart failure incidence, whereas some recent studies, such as the PREDIMED study, showed that the incidence of major cardiovascular events was lower among those assigned to MeDi supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet. New studies are needed to better understand the molecular mechanisms, whereby the MedDiet may exercise its effects. Here, we present recent advances in understanding the molecular basis of MedDiet effects, mainly focusing on cardiovascular diseases, but also discussing other related diseases. We review MedDiet composition and assessment as well as the latest advances in the genomic, epigenomic (DNA methylation, histone modifications, microRNAs, and other emerging regulators), transcriptomic (selected genes and whole transcriptome), and metabolomic and metagenomic aspects of the MedDiet effects (as a whole and for its most typical food components). We also present a review of the clinical effects of this dietary style underlying the biochemical and molecular effects of the Mediterranean diet. Our purpose is to review the main features of the Mediterranean diet in particular its benefits on human health, underling the anti-inflammatory, anti-oxidant and anti-atherosclerotic effects to which new knowledge about epigenetic and gut-microbiota relationship is recently added. Article Published Date : Sep 22, 2019

Abstract Title: An Early, Universal Mediterranean Diet-Based Intervention in Pregnancy Reduces Cardiovascular Risk Factors in the"Fourth Trimester". Abstract Source: J Clin Med. 2019 Sep 19 ;8(9). Epub 2019 Sep 19. PMID: 31546914 Abstract Author(s): Carla Assaf-Balut, Nuria Garcia de la Torre, Alejandra Durán, Elena Bordiu, Laura Del Valle, Cristina Familiar, Johanna Valerio, Inés Jimenez, Miguel Angel Herraiz, Nuria Izquierdo, Isabelle Runkle, María Paz de Miguel, Carmen Montañez, Ana Barabash, Martín Cuesta, Miguel Angel Rubio, Alfonso Luis Calle-Pascual Article Affiliation: Carla Assaf-Balut Abstract: An early antenatal dietary intervention could play an important role in the prevention of metabolic diseases postpartum. The aim of this study is to evaluate whether an early, specific dietary intervention reduces women's cardiovascular risk in the"fourth trimester". This prospective cohort study compares 1675 women from the standard-care group (ScG/n = 676), who received standard-care dietary guidelines, with the intervention group (IG/n = 999), who received Mediterranean diet (MedDiet)-based dietary guidelines, supplemented with extra-virgin olive oil and nuts. Cardiovascular risk was determined by the presence of metabolic syndrome (MetS) and insulin resistance syndrome (IrS) (HOMA-IR 3.5) at 12-14 weeks postpartum. MetS was less frequent in the IG (11.3 vs. 19.3%,<0.05). The intervention was associated with a reduction in the relative risk of having MetS: 0.74 (95% CI, 0.60-0.90), but not in the risk of IrS. When analyzing the presence of having one or more components of the MetS, the IG had significantly higher rates of having 0 components and lower rates of having≥1 (-trend = 0.029). An early MedDiet-based nutritional intervention in pregnancy is associated with reductions in postpartum rates of MetS. Article Published Date : Sep 18, 2019

Abstract Title: Mediterranean diet adherence and congestive heart failure: Relationship with clinical severity and ischemic pathogenesis. Abstract Source: Nutrition. 2019 Sep 13 ;70:110584. Epub 2019 Sep 13. PMID: 31759318 Abstract Author(s): Antonino Tuttolomondo, Domenico Di Raimondo, Alessandra Casuccio, Mariachiara Velardo, Giovanni Salamone, Marco Cataldi, Francesca Corpora, Vincenzo Restivo, Rosaria Pecoraro, Vittoriano Della Corte, Carlo Maida, Irene Simonetta, Anna Cirrincione, Valerio Vassallo, Antonio Pinto Article Affiliation: Antonino Tuttolomondo Abstract: OBJECTIVES: To our knowledge, no study has addressed the relationship between adherence to a Mediterranean diet style and severity of heart failure. The aim of this retrospective study was to evaluate the relationship between adherence to the Mediterranean diet assessed using the calculation of Mediterranean diet score and congestive heart failure (CHF), its severity, and pathogenesis. METHODS: We analyzed charts and collected data of all consecutive patients with a diagnosis of CHF at admission to our Internal Medicine Ward from 2008 to 2014. RESULTS: We analyzed 209 patients with CHF and 200 controls. Patients with CHF showed a significantly lower mean MeDi score than controls. At receiver operating characteristic curve analysis, we found a good sensitivity and specificity of mean MeDi score to predict CHF. We also observed a significant positive correlation between MeDi score and ischemic pathogenesis of CHF, a positive relationship between New York Heart Association (NYHA) class and ischemic heart disease, and a significant negative relationship between NYHA class and MeDi score. CONCLUSION: The beneficial effects of adherence to the Mediterranean diet suggest a possible answer to the question of the biochemical bases of our data, which should be seen as the direct consequence of the anti-inflammatory, antioxidant, and anti-remodeling effects linked to the diet. Article Published Date : Sep 12, 2019

Abstract Title: Evaluating Mediterranean diet adherence in university student populations: Does this dietary pattern affect students' academic performance and mental health? Abstract Source: Int J Health Plann Manage. 2019 Sep 12. Epub 2019 Sep 12. PMID: 31514237 Abstract Author(s): Marina Antonopoulou, Maria Mantzorou, Aspasia Serdari, Konstantinos Bonotis, Giorgos Vasios, Eleni Pavlidou, Christina Trifonos, Konstantinos Vadikolias, Dimitris Petridis, Constantinos Giaginis Article Affiliation: Marina Antonopoulou Abstract: Adherence to a healthy diet such as Mediterranean Diet (MD) may exert beneficial effects in university students, promoting their academic performance and quality of life, as well as their mental and physical health status. In this aspect, the present study aimed to critically analyze the current epidemiological evidence concerning MD adherence of university students' populations. PubMed database was comprehensively searched, using relative keywords. Students' dietary habits are moving away from MD guidelines towards unhealthy eating patterns, especially for those living away from home and even for students with a Mediterranean country origin. Most of the available studies have documented that poorer students' health status was associated with lower MD adherence. Higher MD adherence was correlated with lower depression risk, while higher perceived stress score with lower fruit and vegetables intake. The access of students to information and knowledge provided by courses and lectures did not effectively enhance their compliance to MD. Alarmingly enough, the majority of students, even from medical and nutritional university departments, showed inadequate knowledge on healthy eating habits. Due to the influence of diet on the quality of life and the mental and physical health of students, it is crucial to redirect research focus on this important aspect. Article Published Date : Sep 11, 2019

Abstract Title: Mediterranean dietary pattern and skin cancer risk: A prospective cohort study in French women. Abstract Source: Am J Clin Nutr. 2019 Aug 5. Epub 2019 Aug 5. PMID: 31380561 Abstract Author(s): Yahya Mahamat-Saleh, Iris Cervenka, Marie Al Rahmoun, Isabelle Savoye, Francesca Romana Mancini, Antonia Trichopoulou, Marie-Christine Boutron-Ruault, Marina Kvaskoff Article Affiliation: Yahya Mahamat-Saleh Abstract: BACKGROUND: The Mediterranean diet (MD) has been reported to be associated with lower cancer risk. However, while previous studies explored major single components of the MD, only 1 previous study has investigated adherence to the MD in relation to melanoma risk. OBJECTIVE: The aim of this study was to explore the relations between adherence to the MD and the risk of skin cancer, including melanomas, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). DESIGN: Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) is a prospective cohort of 98,995 French women aged 40-65 y in 1990. Dietary data were collected via a validated food questionnaire in 1993. Adherence to the MD was assessed using a 9-unit dietary score that incorporates intakes of fruit, vegetables, legumes, cereal products, olive oil, fish, dairy products, meat products, and alcohol. We used Cox proportional hazards regression models to compute HRs and 95% CIs adjusted for age and main known skin cancer risk factors. RESULTS: From 1993 to 2008, a total of 2003 skin cancer cases were ascertained among 67,332 women, including 404 melanomas, 1367 BCCs, and 232 SCCs. Score of adherence to the MD was associated with lower risk of skin cancer (HR: 0.83; 95% CI: 0.73, 0.93 for high compared with low score, Ptrend = 0.001). MD score was also inversely and linearly associated with risks of melanoma (HR: 0.72; 95% CI: 0.54, 0.96; Ptrend = 0.02) and BCC (HR: 0.77; 95% CI: 0.66, 0.90; Ptrend = 0.0006) but not SCC (HR: 1.08; 95% CI: 0.75, 1.55; Ptrend = 0.68), although with no heterogeneity across skin cancer types (Pheterogeneity = 0.23). CONCLUSION: These findings suggest that adherence to the MD is associated with a lower skin cancer risk in women, particularly melanoma and BCC. If confirmed in future research, these findings may have important implications in skin cancer prevention. Article Published Date : Aug 05, 2019

Abstract Title: Pre-Pregnancy Adherence to the Mediterranean Diet and Gestational Diabetes Mellitus: A Case-Control Study. Abstract Source: Nutrients. 2019 May 1 ;11(5). Epub 2019 May 1. PMID: 31052474 Abstract Author(s): Rocío Olmedo-Requena, Julia Gómez-Fernández, Carmen Amezcua-Prieto, Juan Mozas-Moreno, Khalid S Khan, José J Jiménez-Moleón Article Affiliation: Rocío Olmedo-Requena Abstract: Gestational diabetes mellitus (GDM), an important public health problem that affects mothers and offspring, is a common metabolic disorder. We evaluated the effect of the pre-pregnancy Mediterranean diet (MD) level of exposure on the odds of GDM development. A case-control study (291 GDM cases and 1175 controls without GDM) was conducted in pregnant women. Pre-pregnancy dietary intake was assessed using a validated food frequency questionnaire to calculate an MD adherence index (range score 0-9: low≤ 2; middle 3-4; high 5-6; very high ≥ 7). Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were estimated using multivariable logistic regression models including age, BMI, family history of diabetes mellitus, previous GDM, miscarriages, and gravidity. Overall, middle-high MDadherence was 216/291 (74.2%) and very high adherence was 17/291 (5.8%) in cases. In controls the corresponding figures were 900/1175 (76.6%) and 73/1175 (6.2%), respectively. Compared to low adherence, high MD adherence was associated with GDM reduction (aOR 0.61, 95% CI 0.39,0.94;= 0.028), and very high MD adherence was even more strongly associated (aOR 0.33, 95% CI 0.15, 0.72;= 0.005). The protective effect of adherence to the MD prior to pregnancy should be considered as a preventive tool against the development of GDM. Article Published Date : Apr 30, 2019

Abstract Title: Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials. Abstract Source: Crit Rev Food Sci Nutr. 2019 Jan 24:1-21. Epub 2019 Jan 24. PMID: 30676058 Abstract Author(s): Nerea Becerra-Tomás, Sonia Blanco Mejía, Effie Viguiliouk, Tauseef Khan, Cyril W C Kendall, Hana Kahleova, Dario Rahelić, John L Sievenpiper, Jordi Salas-Salvadó Article Affiliation: Nerea Becerra-Tomás Abstract: To update the clinical practice guidelines for nutrition therapy of the European Association for the Study of Diabetes, we conducted a systematic review and meta-analysis of prospective cohort studies and randomized clinical trials (RCTs) to evaluate the effect of the Mediterranean diet (MedDiet) on the prevention of cardiovascular disease (CVD) incidence and mortality. We searched Medline, EMBASE (through April 20, 2018) and Cochrane (through May 7, 2018) databases. Pooled relative risks (RRs) and 95% confidence interval (CI) were calculated by the generic inverse variance method. A total of 41 reports (3 RCTs and 38 cohorts) were included. Meta-analyses of RCTs revealed a beneficial effect of the MedDiet on total CVD incidence (RR: 0.62; 95% CI: 0.50, 0.78) and total myocardial infarction (MI) incidence (RR: 0.65; 95% CI: 0.49, 0.88). Meta-analyses of prospective cohort studies, which compared the highest versus lowest categories of MedDiet adherence, revealed an inverse association with total CVD mortality (RR: 0.79; 95% CI: 0.77, 0.82), coronary heart disease (CHD) incidence (RR: 0.73; 95% CI: 0.62, 0.86), CHD mortality (RR: 0.83; 95% CI: 0.75, 0.92), stroke incidence (RR: 0.80; 95% CI: 0.71, 0.90), stroke mortality (RR: 0.87; 95% CI: 0.80, 0.96) and MI incidence (RR: 0.73; 95% CI: 0.61, 0.88). The present study suggests that MedDiet has a beneficial role on CVD prevention in populations inclusive of individuals with diabetes. Article Published Date : Jan 23, 2019

Abstract Title: The Mediterranean Diet And Cardioprotection: Historical Overview And Current Research. Abstract Source: J Multidiscip Healthc. 2019 ;12:805-815. Epub 2019 Sep 27. PMID: 31632049 Abstract Author(s): Pierluca Minelli, Maria Rosa Montinari Article Affiliation: Pierluca Minelli Abstract: Ancient Greece was the cradle of the Mediterranean food tradition, characterized by the Mediterranean"eternal trinity"wheat - olive oil - wine, the very essence of the country's traditional agricultural and dietary regime, enriched by a culture of sharing and commensality. This food model, subsequently adopted and spread by the Romans, was rediscovered at the end of the Second World War by two American researchers, Leland Allbaugh and Ancel Keys. With the famous Seven Countries Study, Keys demonstrated for the first time that populations practicing a Mediterranean diet - such as the Greeks and southern Italians - showed low mortality rates from ischemic heart disease compared to the peoples of Northern Europe and North America. Since then, numerous subsequent epidemiological studies and randomized clinical trials have confirmed the beneficial effects of the Mediterranean diet both in primary and secondary prevention of cardiovascular diseases. This review will focus on the origins of the Mediterranean diet from its roots and its relationship to cardiovascular disease, with a brief overview of the nutritional mechanisms that influence atherosclerosis. Article Published Date : Dec 31, 2018

Abstract Title: Antioxidant and Antiproliferative Activities of Bioactive Compounds Contained inUsed in the Mediterranean Diet. Abstract Source: Evid Based Complement Alternat Med. 2019 ;2019:7623830. Epub 2019 Nov 16. PMID: 31827560 Abstract Author(s): Mohammed Bourhia, Fatima Ezzahra Laasri, Hind Aourik, Aicha Boukhris, Riaz Ullah, Ahmed Bari, Syed Saeed Ali, Mohammed El Mzibri, Laila Benbacer, Said Gmouh Article Affiliation: Mohammed Bourhia Abstract: Background: is a medicinal plant called rosemary, largely used in the Mediterranean diet for many decades ago. Objective: The aim of the present study was to investigate the polyphenolic content, the antioxidant activity, and the antiproliferative effect against human prostate cancer cell lines (LNCaP) of carnosol and carnosic acid as bioactive compounds contained ingrowing in Morocco. Materials and Methods: Polyphenolic content ofethanolic extract was studied using colorimetric assay. Carnosol and carnosic acid contained inextract were quantified using high-performance liquid chromatography (HPLC). The antiproliferative effect of the studied extracts on LNCaP was evaluated by WST-1 bioassay, and the antioxidant activity was assessed using DPPH assay. Results: The extracts ofshowed an important polyphenolic content ranging from 74.15 g·GAE/mg to 146.63 g·GAE/mg. The percentage of carnosol and carnosic acid in rosemary crops ranges from 11.7 to 17.3% and 1.09% to 3%, respectively. The extracts ofexhibited a promoting antioxidant activity with ICranging from 0.236 mg/mL to 0.176 mg/mL. Regarding the antiproliferative effect, the WST-1 assay revealed that all the tested extracts reduced notably the cell viability with ICvalues ranging from 14.15 to 15. 04 g/mL. Conclusion: In the current work, carnosol and carnosic acid exhibit antioxidant and antiproliferative activities in a concentration-dependent manner. Article Published Date : Dec 31, 2018

Abstract Title: Natural Products from Mediterranean Diet: From Anti-hyperlipidemic Agents to Dietary Epigenetic Modulators. Abstract Source: Curr Pharm Biotechnol. 2019 ;20(10):825-844. PMID: 31264546 Abstract Author(s): Deligiannidou Georgia-Eirini, Sygkouna Athina, Vanden Berghe Wim, Kontogiorgis Christos, Constantinides Theodoros Article Affiliation: Deligiannidou Georgia-Eirini Abstract: BACKGROUND: Cardiovascular Diseases (CVD) are, currently, the major contributor to global mortality and will continue to dominate mortality rates in the future. Hyperlipidemia refers to the elevated levels of lipids and cholesterol in the blood, and is also identified as dyslipidemia, manifesting in the form of different disorders of lipoprotein metabolism. These abnormalities may lead to the development of atherosclerosis, which can lead to coronary artery disease and stroke. In recent years, there is a growing interest in the quest for alternative therapeutic treatments based on natural products, offering better recovery and the avoidance of side effects. Recent technological advances have further improved our understanding of the role of epigenetic mechanisms in hyperlipidemic disorders and dietary prevention strategies. OBJECTIVE: This is a comprehensive overview of the anti-hyperlipidemic effects of plant extracts, vegetables, fruits and isolated compounds thereof, with a focus on natural products from the Mediterranean region as well as the possible epigenetic changes in gene expression or cardiometabolic signaling pathways. METHODS: For the purpose of this study, we searched the PubMed, Scopus and Google Scholar databases for eligible articles and publications over the last five years. The keywords included:"hyperlipidemia","plant extract","herbs","natural products","vegetables","cholesterol"and others. We initially included all relevant articles referring to in vitro studies, animal studies, Randomized Controlled Trials (RCTs) and previous reviews. CONCLUSION: Many natural products found in the Mediterranean diet have been studied for the treatment of hyperlipidemia. The antihyperlipidemic effect seems to be dose and/or consumption frequency related, which highlights the fact that a healthy diet can only be effective in reversing disease markers if it is consistent and within the framework of a healthy lifestyle. Finally, epigenetic biomarkers are increasingly recognized as new lifestyle management tools to monitor a healthy dietary lifestyle for the prevention of hyperlipidaemic disorders and comorbidities to promote a healthy life. Article Published Date : Dec 31, 2018

Abstract Title: A Mediterranean Diet with an Enhanced Consumption of Extra Virgin Olive Oil and Pistachios Improves Pregnancy Outcomes in Women Without Gestational Diabetes Mellitus: A Sub-Analysis of the St. Carlos Gestational Diabetes Mellitus Prevention Study. Abstract Source: Ann Nutr Metab. 2018 Dec 14 ;74(1):69-79. Epub 2018 Dec 14. PMID: 30554220 Abstract Author(s): Carla Assaf-Balut, Nuria García de la Torre, Alejandra Duran, Manuel Fuentes, Elena Bordiú, Laura Del Valle, Cristina Familiar, Johanna Valerio, Inés Jiménez, Miguel A Herraiz, Nuria Izquierdo, María J Torrejon, MariaÁngeles Cuadrado, Isabel Ortega, Francisco J Illana, Isabelle Runkle, Paz de Miguel, Inmaculada Moraga, Carmen Montañez, Ana Barabash, Martín Cuesta, Miguel A Rubio, Alfonso L Calle-Pascual Article Affiliation: Carla Assaf-Balut Abstract: AIMS: The aim of the study was to evaluate the effect of a Mediterranean diet (MedDiet), enhanced with extra virgin olive oil (EVOO) and nuts, on a composite of adverse maternofoetal outcomes of women with normoglycemia during pregnancy. METHODS: This was a sub-analysis of the St Carlos gestational diabetes mellitus Prevention Study. Only normoglycemic women were analysed (697). They were randomized (at 8-12th gestational weeks) to: standard-care control group (337), where fat consumption was limited to 30% of total caloric intake; or intervention group (360), where a MedDiet, enhanced with EVOO and pistachios (40-42% fats of total caloric intake) was recommended. The primary outcome was a composite of maternofoetal outcomes (CMFOs): at least having 1 event of emergency C-section, perineal trauma, pregnancy-induced hypertension and preeclampsia, prematurity, large-for-gestational-age and small-for gestational-age. RESULTS: Crude relative risk showed that the intervention was associated with a significant reduction in the risk of CMFOs (0.48 [0.37-0.63]; p = 0.0001), with a number-needed-to-treat = 5. Risk of urinary tract infections, emergency C-sections, perineal trauma, large-for-gestational-age and small-for gestational age new-borns were also significantly reduced. CONCLUSION: A MedDiet, enhanced with EVOO and nuts, was associated with a risk reduction of CMFOs in over 50% in normoglycemic pregnant women. Therefore, it might be a potentially adequate diet for pregnant women. TRIAL REGISTRATION: Identifier ISRCTN84389045. The study was registered on September 27, 2013. Last edited on September 26, 2018. Article Published Date : Dec 13, 2018

Abstract Title: Mediterranean diet and knee osteoarthritis outcomes: A longitudinal cohort study. Abstract Source: Clin Nutr. 2018 Dec 4. Epub 2018 Dec 4. PMID: 30553579 Abstract Author(s): Nicola Veronese, Ai Koyanagi, Brendon Stubbs, Cyrus Cooper, Giuseppe Guglielmi, Renè Rizzoli, Leonardo Punzi, Domenico Rogoli, Maria Gabriella Caruso, Ornella Rotolo, Maria Notarnicola, Nasser Al-Daghri, Lee Smith, Jean-Yves Reginster, Stefania Maggi Article Affiliation: Nicola Veronese Abstract: OBJECTIVES: Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. METHODS: Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes included incident (1) ROA, (2) SxOA, as the new onset of a combination of a painful knee and ROA, (3) knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam of≥14%. RESULTS: 4330 subjects (mean age: 61.1 years; 58.0% females) were included. Based on a multivariable Poisson regression analysis, during a mean follow-up period of 4 years, participants who were more highly adherent to a Mediterranean diet (Q5) reported lower risk of pain worsening (relative risk, RR = 0.96; 95% CI: 0.91-0.999) compared to those in Q1. In 2994 people free from SxOA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk for SxOA during follow-up by 9% (Q5 vs. Q1; RR = 0.91; 95% CI: 0.82-0.998). No significant associations emerged between aMEDand incident ROA. CONCLUSION: Higher adherence to Mediterranean diet is associated with a lower risk of pain worsening and symptomatic forms of knee OA. Article Published Date : Dec 03, 2018

Abstract Title: Influence of Mediterranean Diet on Blood Pressure. Abstract Source: Nutrients. 2018 Nov 7 ;10(11). Epub 2018 Nov 7. PMID: 30405063 Abstract Author(s): Giovanni De Pergola, Annunziata D'Alessandro Article Affiliation: Giovanni De Pergola Abstract: Hypertension is the main risk factor for cardiovascular disease (CVD) and all-cause mortality. Some studies have reported that food typical of the Mediterranean diet (MedDiet), such as whole grains, vegetables, fruits, nuts, and extra virgin olive oil, have a favorable effect on the risk of hypertension, whereas food not typical of this dietary pattern such as red meat, processed meat, and poultry has an unfavorable effect. In this review, we have summarized observational and intervention studies, meta-analyses, and systematic reviews that have evaluated the effects of the MedDiet as a pattern towards blood pressure (BP). However, the number of such studies is small. In general terms, the MedDiet has a favorable effect in reducing BP in hypertensive or healthy people but we do not have enough data to declare how strong this effect is. Many more studies are required to fully understand the BP changes induced by the MedDiet. Article Published Date : Nov 06, 2018

Abstract Title: Adherence to Mediterranean diet and prostate cancer risk in Sicily: population-based case-control study. Abstract Source: Int J Impot Res. 2018 Oct 18. Epub 2018 Oct 18. PMID: 30337696 Abstract Author(s): Giorgio Ivan Russo, Tatiana Solinas, Daniele Urzì, Salvatore Privitera, Daniele Campisi, Andrea Cocci, Marco Carini, Massimo Madonia, Sebastiano Cimino, Giuseppe Morgia Article Affiliation: Giorgio Ivan Russo Abstract: Prostate cancer (PCa) is the second most frequently diagnosed cancer and the sixth leading cause of death from cancer worldwide. Countries following a Mediterranean-type dietary pattern, has been reported to have lower PCa incidence and mortality compared with other European regions. A population-based case-control study has been conducted from January 2015 to December 2016 in a single institution of the municipality of Catania, southern Italy. A total of 118 PCa and 238 population-based controls were collected. Controls had significantly higher adherence to the Mediterranean diet, which was evident for several subgroups (including age groups, overweight and obese men, current smokers, alcohol intake, low and medium physical activity levels). PCa cases were found to consume lower amount of vegetables (223 g/d vs. 261 g/d; p = 0.001), legumes (34.26 g/d vs. 53.55 g/d; p = 0.003), and fish (47.75 g/d vs. 58.3 g/d) than controls; other differences emerged were related to alcohol intake (12.37 g/d vs 5.07 g/d; p < 0.01), cereals (254.06 g/d vs.235.94 g/d; p < 0.001), dairy (196 g/d vs. 166 g/d; p < 0.001), and meat consumption (98.09 g/d vs. 70.15 g/d; p < 0.001). However, no statistically significant differences between cases and controls were found regarding fruit, legumes, and olive oil consumption. The Mediterranean diet score was inversely associated with lower likelihood of having PCa in a linear manner (odds ratio [OR]: 0.86 [95% CI 0.77-0.96]). Specifically, individuals in the highest group of adherence had 78% less likelihood of have PCa and 14% less likelihood for each point increase of the score. The model adjusted for total polyphenol intake showed still a significant inverse association between adherence to the Mediterranean dietand PCa, but the relation was no more linear and not significant for one-point increase of the score (OR: 0.88 [95% CI 0.77-1.01]). In our cohorts of Italian men, we observed that high adherence to the Mediterranean diet was inversely associated with likelihood of having PCa cancer. Article Published Date : Oct 17, 2018

Abstract Title: Consumption of Mediterranean versus Western Diet Leads to Distinct Mammary Gland Microbiome Populations. Abstract Source: Cell Rep. 2018 Oct 2 ;25(1):47-56.e3. PMID: 30282037 Abstract Author(s): Carol A Shively, Thomas C Register, Susan E Appt, Thomas B Clarkson, Beth Uberseder, Kenysha Y J Clear, Adam S Wilson, Akiko Chiba, Janet A Tooze, Katherine L Cook Article Affiliation: Carol A Shively Abstract: Recent identification of a mammary gland-specific microbiome led to studies investigating bacteria populations in breast cancer. Malignant breast tumors have lower Lactobacillus abundance compared with benign lesions, implicating Lactobacillus as a negative regulator of breast cancer. Diet is a main determinant of gut microbial diversity. Whether diet affects breast microbiome populations is unknown. In a non-human primate model, we found that consumption of a Western or Mediterranean diet modulated mammary gland microbiota and metabolite profiles. Mediterranean diet consumption led to increased mammary gland Lactobacillus abundance compared with Western diet-fed monkeys. Moreover, mammary glands from Mediterranean diet-fed monkeys had higher levels of bile acid metabolites and increased bacterial-processed bioactive compounds. These data suggest that diet directly influences microbiome populations outside the intestinal tract in distal sites such as the mammary gland. Our study demonstrates that diet affects the mammary gland microbiome, establishing an alternative mechanistic pathway for breast cancer prevention. Article Published Date : Oct 01, 2018

Abstract Title: Adherence to a Mediterranean diet, lifestyle and age-related macular degeneration: the Coimbra Eye Study - report 3. Abstract Source: Acta Ophthalmol. 2018 Sep 14. Epub 2018 Sep 14. PMID: 30218481 Abstract Author(s): Miguel Raimundo, Filipe Mira, Maria da Luz Cachulo, Patrícia Barreto, Luísa Ribeiro, Cláudia Farinha, Inês Laíns, Sandrina Nunes, Dalila Alves, João Figueira, Bénédicte Mj Merle, Cécile Delcourt, Lèlita Santos, Rufino Silva Article Affiliation: Miguel Raimundo Abstract: PURPOSE: To characterize the lifestyle and nutritional risk profile associated with the Mediterranean diet in a Portuguese population with and without age-related macular degeneration (AMD). METHODS: Nested case-control study (n = 883) within the Coimbra Eye Study, including 434 subjects with AMD and 449 age- and sex-matched subjects without AMD. All enrolled subjects underwent a full risk assessment, including lifestyle-related risk factors and a thorough food frequency questionnaire. This allowed us to build an adherence score to the Mediterranean diet (mediSCORE, range 0-9) constructed from individual food intakes. Food intake was also further analysed by conversion to micronutrient consumption. RESULTS: Our results suggest that physical activity has a protective role in AMD [p = 0.018 after multivariate adjustment, OR: 0.69 (0.51-0.93)]. High (mediSCORE ≥6) was also found to be protective [p = 0.041, OR: 0.62 (95% CI: 0.38-0.97)]. Food group analysis unveiled a specific protective role for increased fruits consumption (p = 0.029). Finally, micronutrient analysisrevealed a protective role associated with increased consumption of caffeine, fibres, beta-carotene, vitamin C and vitamin E (p < 0.05). CONCLUSION: High mediSCORE appears to confer protection against the development of AMD in a Mediterranean population. This effect is driven by increased consumption of fruits and some antioxidant micronutrients, which emerged as statistically significant protective factors. Further studies are required to establish dietary recommendations with clinical application. Article Published Date : Sep 13, 2018

Abstract Title: Dietary patterns based on the Mediterranean diet and DASH diet are inversely associated with high aggressive prostate cancer in PCaP. Abstract Source: Ann Epidemiol. 2018 Sep 5. Epub 2018 Sep 5. PMID: 30268488 Abstract Author(s): Lara Schneider, L Joseph Su, Lenore Arab, Jeannette T Bensen, Laura Farnan, Elizabeth T H Fontham, Lixin Song, James Hussey, Anwar T Merchant, James L Mohler, Susan E Steck Article Affiliation: Lara Schneider Abstract: BACKGROUND: Several foods and nutrients have been linked to the development of prostate cancer, but the association between healthy dietary patterns and prostate cancer aggressiveness is less studied. The aim of this study was to evaluate the relationship between the Mediterranean diet (MED) and Dietary Approaches to Stop Hypertension (DASH) diet scores and prostate cancer aggressiveness by race. METHODS: Data from the population-based, case-only North Carolina-Louisiana Prostate Cancer Project (PCaP) were used to examine the association between diet quality, measured by MED and DASH scores, and prostate cancer aggressiveness in 1899 African American (AA) and European American (EA) research subjects. Dietary intake was assessed using a modified National Cancer Institute Diet History Questionnaire. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for high versus low-intermediate aggressive prostate cancer. RESULTS: Higher MED scores were inversely associated with high aggressive prostate cancer overall (OR: 0.66; 95% CI: 0.46, 0.95 for high versus low scores); results were similar for AA and EA men. A weaker inverse association between DASH scores and prostate cancer aggressiveness was found (OR: 0.76; 95% CI: 0.55, 1.06). CONCLUSIONS: Higher diet quality, as represented by a Mediterranean-style diet or DASH diet, may reduce the odds of high aggressive prostate cancer. Article Published Date : Sep 04, 2018

Abstract Title: Mediterranean Diet Pattern and Sleep Duration and Insomnia Symptoms in the Multi-Ethnic Study of Atherosclerosis (MESA). Abstract Source: Sleep. 2018 Aug 22. Epub 2018 Aug 22. PMID: 30137563 Abstract Author(s): Cecilia Castro-Diehl, Alexis C Wood, Susan Redline, Michelle Reid, Dayna A Johnson, Janice E Maras, David R Jacobs, Steven Shea, Allison Crawford, Marie-Pierre St-Onge Article Affiliation: Cecilia Castro-Diehl Abstract: Sleep duration and sleep quality are important predictors of risk for cardiovascular disease (CVD). One potential link between sleep health and CVD is through lifestyle factors such as diet. To clarify the association between diet and sleep, we assessed the associations of sleep duration and insomnia symptoms with current Mediterranean-style diet (aMed), and with historical changes in aMed score.Actigraphy-measured sleep duration and self-reported insomnia symptoms categorized as insomnia with short sleep (<6 h/night), insomnia without short sleep, no insomnia with short sleep and no insomnia or short sleep, were obtained from 2068 individuals who also had dietary intake data. A 10-point aMed score, derived from a self-report food frequency questionnaire, was collected concurrently with the sleep assessment, and 10 y before.Compared to individuals who currently reported a low aMed score, those with a moderate-high aMed score were more likely to sleep 6-7 h/night vs.<6 h/night (p<0.01) and less likely to report insomnia symptoms occurring with short sleep (vs. no insomnia or short sleep alone) (p<0.05). An increase in aMed score over the preceding 10 y was not associated with sleep duration or insomnia symptoms. However, compared to those with decreasing aMed score, individuals with an unchanging score reported fewer insomnia symptoms (p≤0.01).These results suggest that a Mediterranean-style diet is associated with adequate sleep duration, less insomnia symptoms, and less likely to have insomnia accompanied by short sleep. Further research should identify possible mediators through which diet may promote adequate sleep duration and reduce the risk of insomnia. Article Published Date : Aug 21, 2018

Abstract Title: Mediterranean diet and incidence of advanced AMD: The EYE-RISK CONSORTIUM. Abstract Source: Ophthalmology. 2018 Aug 13. Epub 2018 Aug 13. PMID: 30114418 Abstract Author(s): Bénédicte Mj Merle, Johanna M Colijn, Audrey Cougnard-Grégoire, Alexandra P M de Koning-Backus, Marie-Noëlle Delyfer, Jessica C Kiefte-de Jong, Magda Meester-Smoor, Catherine Féart, Timo Verzijden, Cécilia Samieri, Oscar H Franco, Jean-François Korobelnik, Caroline C W Klaver, Cécile Delcourt, Article Affiliation: Bénédicte Mj Merle Abstract: OBJECTIVE: To investigate associations of adherence to the Mediterranean diet (MeDi) with incidence of advanced AMD (the symptomatic form of AMD) in two European population-based prospective cohorts. DESIGN: Prospective cohorts: the Rotterdam Study I (RS-I) and the Alienor Study. PARTICIPANTS: 4 446 participants aged≥55 years from RS-I (The Netherlands) and 550 French adults aged 73 years or older from Alienor Study with complete ophthalmologic and dietary data were included in the present study. METHODS: Examinations were performed approximately every 5 years over a 21-year period (1990 to 2011) in RS-I and every 2 years over a 4-year period (2006 to 2012) in Alienor Study. Adherence to the MeDi was evaluated using a 9 component score based on intake of vegetables, fruits, legumes, cereals, fish, meat, dairy products, alcohol and the monounsaturated-to-saturated fatty acids ratio. Associations of incidence of AMD with MeDi were estimated using multivariate Cox proportional Hazard models. MAIN OUTCOMES MEASURES: Incidence of advanced AMD based on retinal fundus photographs. RESULTS: Among the 4 996 included participants, 155 developed advanced incident AMD (117 from RS-I and 38 from Alienor Study). The mean follow-up time was 9.9 years (range 0.6 to 21.7) in RS-I and 4.1 years (range 2.5 to 5.0) in Alienor Study. Pooling data for both RS-I and Alienor study, participants with a high (6-9) MeDi score had a significantly reduced risk for incident advanced AMD compared to participants with a low (0-3) MeDi score in the fully-adjusted Cox model (HR, 0.59 [95% CI, 0.37-0.95], p for trend=0.04). CONCLUSION: Pooling data from RS-I and Alienor, higher adherence to the MeDi was associated with a 41% reduced risk of incident advanced AMD. These findings support the role of a diet rich in healthful nutrient-rich foods such as fruits, vegetables, legumes and fish in the prevention of AMD. Article Published Date : Aug 12, 2018

Abstract Title: Impact of a Mediterranean Dietary Pattern and Its Components on Cardiovascular Risk Factors, Glucose Control, and Body Weight in People with Type 2 Diabetes: A Real-Life Study. Abstract Source: Nutrients. 2018 Aug 10 ;10(8). Epub 2018 Aug 10. PMID: 30103444 Abstract Author(s): Marilena Vitale, Maria Masulli, Ilaria Calabrese, Angela Albarosa Rivellese, Enzo Bonora, Stefano Signorini, Gabriele Perriello, Sebastiano Squatrito, Raffaella Buzzetti, Giovanni Sartore, Anna Carla Babini, Giovanna Gregori, Carla Giordano, Gennaro Clemente, Sara Grioni, Pasquale Dolce, Gabriele Riccardi, Olga Vaccaro, Article Affiliation: Marilena Vitale Abstract: This study evaluates the relation of a Mediterranean dietary pattern and its individual components with the cardiovascular risk factors profile, plasma glucose and body mass index (BMI) in people with type 2 diabetes. We studied 2568 participants at 57 diabetes clinics. Diet was assessed with the EPIC (European Prospective Investigation into Cancer and Nutrition) questionnaire, adherence to the Mediterranean diet was evaluated with the relative Mediterranean diet score (rMED). A high compared to a low score was associated with a better quality of diet and a greater adherence to the nutritional recommendations for diabetes. However, even in the group achieving a high score, only a small proportion of participants met the recommendations for fiber and saturated fat (respectively 17% and 30%). Nonetheless, a high score was associated with lower values of plasma lipids, blood pressure, glycated hemoglobin, and BMI. The relationship of the single food items components of the rMED score with the achievement of treatment targets for plasma lipids, blood pressure, glucose, and BMI were also explored. The study findings support the Mediterranean dietary model as a suitable model for type 2 diabetes and the concept that the beneficial health effects of the Mediterranean diet lie primarily in its synergy among various nutrients and foods rather than on any individual component. Article Published Date : Aug 09, 2018

Abstract Title: Improvement of Main Cognitive Functions in Patients with Alzheimer's Disease after Treatment with Coconut Oil Enriched Mediterranean Diet: A Pilot Study. Abstract Source: J Alzheimers Dis. 2018 Jul 20. Epub 2018 Jul 20. PMID: 30056419 Abstract Author(s): José Enrique de la Rubia Ortí, Mar Rsquo Ia Pilar García-Pardo, Eraci Drehmer, David Sancho Cantus, Mariano Julián Rochina, Maria Asunción Aguilar Calpe, Iván Hu Yang Article Affiliation: José Enrique de la Rubia Ortí Abstract: BACKGROUND: Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder (mainly in women), and new therapies are needed. In this way, ketone bodies are a direct source of cellular energy and can be obtained from coconut oil, postulating that coconut oil could be a new non-pharmacological alternative in AD patients. OBJECTIVE: The aim of this study is to detect changes in the main cognitive functions of patients with AD after following a coconut oil enriched Mediterranean diet, and to determine whether there are differences in function of stage or sex. METHODS: A prospective, longitudinal, qualitative, analytic, experimental study was carried out in 44 patients with AD, who were randomly divided into two homogenous groups of 22 patients each: an experimental group of patients who followed a coconut oil enriched Mediterranean diet for 21 days and a control group. In order to determine the cognitive changes after the intervention, we carried out the 7 Minute Screen, which analyses temporal orientation, visuospatial and visuoconstructive abilities, and semantic and episodic memory. RESULTS: After intervention with coconut oil, improvements in episodic, temporal orientation, and semantic memory were observed, and it seems that the positive effect is more evident in women with mild-moderate state, although other improvements in males and severe state were also shown. CONCLUSIONS: The isocaloric coconut oil enriched Mediterranean diet seems to improve cognitive functions in patients with AD, with differences according to patient sex and degree of severity of the disease, although more studies in this line are needed. Article Published Date : Jul 19, 2018

Abstract Title: Mediterranean dietary components are inversely associated with advanced colorectal polyps: A case-control study. Abstract Source: World J Gastroenterol. 2018 Jun 28 ;24(24):2617-2627. PMID: 29962818 Abstract Author(s): Naomi Fliss-Isakov, Revital Kariv, Muriel Webb, Dana Ivancovsky, Dana Margalit, Shira Zelber-Sagi Article Affiliation: Naomi Fliss-Isakov Abstract: AIM: To evaluate the association between the Mediterranean diet (MD) pattern and its components, and advanced colorectal polyps (adenoma and serrated adenoma). METHODS: A case-control study among patients undergoing screening, diagnostic or surveillance colonoscopies during 2010-2015 at the Tel-Aviv Medical Center, Gastroenterology Department. Cases with advanced polyps were defined as: Advanced adenoma [>10 mm, with features of high grade dysplasia (HGD) or villous histology], advanced serrated adenoma (>10 mm or with dysplasia) or multiple (≥ 3) non-advanced adenomas or serrated adenomas. Cases of non-advanced adenomas were defined as adenomas<10 mm, without features of HGD or villous histology. Controls were defined as those without polyps at the current colonoscopy and without a history of colorectal polyps. Data collection included: anthropometrics measured according to a standardized protocol, fasting blood tests performed at the same lab, medical history recorded by a structured interview and dietary intake evaluated by a 116-item food frequency questionnaire. Adherence to the MD components was evaluated according to intake above/below the sample median, for potentially beneficial/detrimental components respectively, as accepted. RESULTS: We recruited 206 cases with advanced polyps, 192 cases with non-advanced adenoma and 385 controls. The number of adhered MD components was inversely associated with a diagnosis of advanced polyps in a dose-response manner (OR = 0.34, 95%CI: 0.17-0.65; OR = 0.22, 95%CI: 0.11-0.43; and OR = 0.18, 95%CI: 0.07-0.47 for 3-4, 5-7 and 8-10 components, respectively), but not with non-advanced adenomas (OR = 0.54, 95%CI: 0.25-1.13; OR = 0.48, 95%CI: 0.23-0.99; and OR = 0.43, 95%CI: 0.16-1.12 for 3-4, 5-7 and 8-10 components, respectively). Low intake of sugar-sweetened beverages and red meat, as well as high intake of fish, were inversely associated with advanced polyps (OR = 0.56, 95%CI: 0.36-0.87; OR = 0.63, 95%CI: 0.42-0.95; and OR = 0.66, 95%CI: 0.44-0.99, respectively), while only low intake of red meat was inversely associated with non-advanced adenomas (OR = 0.71, 95%CI: 0.49-0.97). CONCLUSION: A better adherence to the MD, specifically low intake of sugar-sweetened beverages and red meat as well as high intake of fish, is related to lower odds for advanced polyps. Article Published Date : Jun 27, 2018

Abstract Title: Mediterranean diet and depression among older individuals: The multinational MEDIS study. Abstract Source: Exp Gerontol. 2018 May 24 ;110:67-72. Epub 2018 May 24. PMID: 29775747 Abstract Author(s): Maria F Masana, Josep Maria Haro, Anargiros Mariolis, Suzanne Piscopo, Giuseppe Valacchi, Vassiliki Bountziouka, Foteini Anastasiou, Akis Zeimbekis, Dimitra Tyrovola, Efthimios Gotsis, George Metallinos, Anna Polystipioti, Josep-Antoni Tur, Antonia-Leda Matalas, Christos Lionis, Evangelos Polychronopoulos, Labros S Sidossis, Stefanos Tyrovolas, Demosthenes B Panagiotakos Article Affiliation: Maria F Masana Abstract: BACKGROUND: Depression has been linked to a large and growing economic and societal burden worldwide. In Europe, depression is one of the most frequent mental disorders across all age groups, but particularly in people aged 65 years and over, and higher depressive symptoms have been reported among individuals with chronic diseases (e.g., diabetes and heart disease). AIM: To evaluate the role of adherence to the Mediterranean diet (MedDiet) in depression in a sample of older people living in the Mediterranean basin. METHODS: Standard procedures were used to determine socio-demographic, lifestyle, and clinical characteristics of the participants, as well as their dietary habits, and depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Multi-adjusted logistic and linear regression analyses were carried out to evaluate the associations between participants' characteristics and depression. RESULTS: Participants classified as having mild or severe depression were less educated and physically active, and more diabetic, and they reported less adherence to the MedDiet. Adherence to the MedDiet was associated with the absence of depression [(OR, 95% CI): 0.65, 0.50-0.85]. In addition, daily tea drinking was also related to the absence of depression [(OR, 95% CI): 0.51, 0.40-0.65]. CONCLUSIONS: Greater adherence to the MedDiet and daily tea drinking seem to have a beneficial effect on depressive symptoms in older adults. Article Published Date : May 23, 2018

Abstract Title: Mediterranean diet and 3-year Alzheimer brain biomarker changes in middle-aged adults. Abstract Source: Neurology. 2018 May 15 ;90(20):e1789-e1798. Epub 2018 Apr 13. PMID: 29653991 Abstract Author(s): Valentina Berti, Michelle Walters, Joanna Sterling, Crystal G Quinn, Michelle Logue, Randolph Andrews, Dawn C Matthews, Ricardo S Osorio, Alberto Pupi, Shankar Vallabhajosula, Richard S Isaacson, Mony J de Leon, Lisa Mosconi Article Affiliation: Valentina Berti Abstract: OBJECTIVE: To examine in a 3-year brain imaging study the effects of higher vs lower adherence to a Mediterranean-style diet (MeDi) on Alzheimer disease (AD) biomarker changes (brainβ-amyloid load viaC-Pittsburgh compound B [PiB] PET and neurodegeneration viaF-fluorodeoxyglucose [FDG] PET and structural MRI) in midlife. METHODS: Seventy 30- to 60-year-old cognitively normal participants with clinical, neuropsychological, and dietary examinations and imaging biomarkers at least 2 years apart were examined. These included 34 participants with higher (MeDi+) and 36 with lower (MeDi-) MeDi adherence. Statistical parametric mapping and volumes of interest were used to compare AD biomarkers between groups at cross section and longitudinally. RESULTS: MeDi groups were comparable for clinical and neuropsychological measures. At baseline, compared to the MeDi+ group, the MeDi- group showed reduced FDG-PET glucose metabolism (CMRglc) and higher PiB-PET deposition in AD-affected regions (<0.001). Longitudinally, the MeDi--group showed CMRglc declines and PiB increases in these regions, which were greater than those in the MeDi+ group (<0.001). No effects were observed on MRI. Higher MeDi adherence was estimated to provide 1.5 to 3.5 years of protection against AD. CONCLUSION: Lower MeDi adherence was associated with progressive AD biomarker abnormalities in middle-aged adults. These data support further investigation of dietary interventions for protection against brain aging and AD. Article Published Date : May 14, 2018

Abstract Title: Mediterranean diet and risk of frailty syndrome among women with type 2 diabetes. Abstract Source: Am J Clin Nutr. 2018 May 1 ;107(5):763-771. PMID: 29722845 Abstract Author(s): Esther Lopez-Garcia, Kaitlin A Hagan, Teresa T Fung, Frank B Hu, Fernando Rodríguez-Artalejo Article Affiliation: Esther Lopez-Garcia Abstract: Background: Previous research indicates that patients with type 2 diabetes are at higher risk of becoming frail. Emerging evidence also indicates that the Mediterranean diet may prevent frailty in the older population. Objective: The aim of this study was to assess whether a Mediterranean-style diet pattern was associated with lower risk of frailty among older women with diabetes. Design: This was a prospective cohort study in 8970 women aged≥60 y with type 2 diabetes from the Nurses' Health Study. Adherence to the alternate Mediterranean diet (aMED) score was first measured in 1990 and repeated every 4 y until 2010. Frailty occurrence was ascertained up to 2012 and was defined as having ≥3 of the following 5 criteria from the fatigue, resistance, aerobic, illnesses, loss of weight (FRAIL) scale: Fatigue, low Resistance, low Aerobic capacity, having ≥5 Illnesses, and weight Loss of ≥5%. Those with frailty at baseline were excluded. Results: During follow-up, we identified 569 incident cases of frailty. After adjustment for lifestyle factors and medication use, the HR (95% CI) of frailty was 1 for the lowest quartile of the aMED score, 0.88 (0.71, 1.10) for the second quartile, 0.69 (0.53, 0.88) for the third quartile, and 0.54 (0.42, 0.71) for the highest quartile (P-trend<0.001). A 2-point (∼1 SD) increase in the aMED score was associated with a 28% (95% CI: 19%, 36%) reduced risk of frailty. The largest reduction in the risk was observed for a higher consumption of vegetables and fruit, as well as for alcohol intake. Conclusions: A Mediterranean-style diet pattern was associated with reduced risk of frailty syndrome in older women with type 2 diabetes. Article Published Date : Apr 30, 2018

Abstract Title: Microbiome-Mediated Effects of the Mediterranean Diet on Inflammation. Abstract Source: Adv Nutr. 2018 May 1 ;9(3):193-206. PMID: 29767701 Abstract Author(s): Melisa A Bailey, Hannah D Holscher Article Affiliation: Melisa A Bailey Abstract: The Mediterranean diet pattern is increasingly associated with improved metabolic health. Two mechanisms by which consuming a Mediterranean diet pattern may contribute to improved metabolic health are modulation of the gastrointestinal (GI) microbiota and reduction of metabolic endotoxemia. Metabolic endotoxemia, defined as a 2- to 3-fold increase in circulating levels of bacterial endotoxin, has been proposed as a cause of inflammation during metabolic dysfunction. As the largest source of endotoxins in the human body, the GI microbiota represents a crucial area for research on strategies for reducing endotoxemia. Diets high in saturated fat and low in fiber contribute to metabolic endotoxemia through several mechanisms, including changes in the GI microbiome and bacterial fermentation end products, intestinal physiology and barrier function, and enterohepatic circulation of bile acids. Thus, the Mediterranean diet pattern, rich in unsaturated fats and fiber, may be one dietary strategy to reduce metabolic endotoxemia. Preclinical studies have demonstrated the differential effects of dietary saturated and unsaturated fats on the microbiota and metabolic health, but human studies are lacking. The role of dietary fiber and the GI microbiome in metabolic endotoxemia is underinvestigated. Clinical research on the effects of different types of dietary fat and fiber on the GI microbiota and GI and systemic inflammation is necessary to determine efficacious dietary strategies for reducing metabolic endotoxemia, inflammation, and subsequent metabolic disease. Article Published Date : Apr 30, 2018

Abstract Title: Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Abstract Source: Nutr Diabetes. 2018 Apr 25 ;8(1):22. Epub 2018 Apr 25. PMID: 29695712 Abstract Author(s): Claudia Agnoli, Sabina Sieri, Fulvio Ricceri, Maria Teresa Giraudo, Giovanna Masala, Melania Assedi, Salvatore Panico, Amalia Mattiello, Rosario Tumino, Maria Concetta Giurdanella, Vittorio Krogh Article Affiliation: Claudia Agnoli Abstract: Excessive calorie intake and physical inactivity are considered key determinants of the rapid worldwide increase in obesity prevalence, however the relationship between diet and weight gain is complex. We investigated associations between adherence to a Mediterranean diet and long-term changes in weight and waist circumference in volunteers recruited to the Italian section of the prospective European Prospective Investigation into Cancer and Nutrition (EPIC). We investigated 32,119 cohort members who provided anthropometric measures at recruitment and updated information on recall a mean of 12 years later. Adherence to a Mediterranean diet was assessed using the Italian Mediterranean Index (score range 0-11). Associations between index score and weight and waist changes were assessed by multivariate linear regression models. Risks of developing overweight/obesity and abdominal obesity were investigated by multivariate logistic models. Increasing Italian Mediterranean Index score (indicating better adherence) was associated with lower 5-year weight change in volunteers of normal weight at baseline (β -0.12, 95% CI -0.16 to -0.08 for 1 tertile increase in score), but not in those overweight/obese at baseline (P interaction between Index score and BMI 0.0001). High adherence was also associated with reduced risk of becoming overweight/obese (OR 0.91, 95% CI 0.84-0.99 third vs. first tertile); smaller 5-year change in waist circumference (β -0.09, 95% CI -0.14 to -0.03 for 1 tertile increase in score); and lower risk of abdominal obesity (OR 0.91, 95% CI 0.84-0.99 third vs. first tertile). Adherence to a traditional Italian Mediterranean diet may help prevent weight gain and abdominal obesity. Article Published Date : Apr 24, 2018

Abstract Title: Mediterranean diet and hip fracture incidence among older adults: the CHANCES project. Abstract Source: Osteoporos Int. 2018 Apr 14. Epub 2018 Apr 14. PMID: 29656347 Abstract Author(s): V Benetou, P Orfanos, D Feskanich, K Michaëlsson, U Pettersson-Kymmer, L Byberg, S Eriksson, F Grodstein, A Wolk, N Jankovic, L C P G M de Groot, P Boffetta, A Trichopoulou Article Affiliation: V Benetou Abstract: : The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk. INTRODUCTION: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults. METHODS: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis. RESULTS: A two-point increase in the score was associated with a significant 4% decrease in hip fracture risk (pooled adjusted HR 0.96; 95% confidence interval (95% CI) 0.92-0.99, p = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95% CI 0.87-0.99) and high (HR 0.94; 95% CI 0.87-1.01) adherence to the score compared with those with low adherence. CONCLUSIONS: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence. Article Published Date : Apr 13, 2018

Abstract Title: Randomization to 6-month Mediterranean diet compared with a low-fat diet leads to improvement in Dietary Inflammatory Index scores in patients with coronary heart disease: the AUSMED Heart Trial. Abstract Source: Nutr Res. 2018 Apr 14. Epub 2018 Apr 14. PMID: 29754829 Abstract Author(s): Hannah L Mayr, Colleen J Thomas, Audrey C Tierney, Teagan Kucianski, Elena S George, Miguel Ruiz-Canela, James R Hebert, Nitin Shivappa, Catherine Itsiopoulos Article Affiliation: Hannah L Mayr Abstract: A higher dietary inflammatory index (DII®) score is associated with inflammation and incidence of coronary heart disease (CHD). We hypothesized that a Mediterranean diet (MedDiet) intervention would reduce DII score. We assessed dietary data from a randomized controlled trial comparing 6-month MedDiet versus low-fat diet intervention, inpatients with CHD. We aimed to determine the DII scores of the prescribed diets' model meal plans, followed by whether dietary intervention led to lower (i.e., more anti-inflammatory) DII scores and consequently lower high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (hs-IL-6). DII scores were calculated from 7-day food diaries. The MedDiet meal plan had a markedly lower DII score than the low-fat diet meal plan (-4.55 vs. -0.33, respectively). In 56 participants who completed the trial (84% male, mean age 62 ± 9 years), the MedDiet group significantly reduced DII scores at6 months (n = 27; -0.40 ± 3.14 to -1.74 ± 2.81, P = .008) and the low-fat diet group did not change (n = 29; -0.17 ± 2.27 to 0.05 ± 1.89, P = .65). There was a significant post-intervention adjusted difference in DII score between groups (compared to low-fat, MedDiet decreased by -1.69 DII points; P = .004). When compared to the low-fat diet, the MedDiet non-significantly reduced hs-IL-6 (-0.32 pg/mL, P = .29) and increased hs-CRP (+0.09 mg/L, P = .84). These findings demonstrated that MedDiet intervention significantly reduced DII scores compared to a low-fat diet. However, in this small cohort of patients with CHD this did not translate to a significant improvement in measured inflammatory markers. The effect of improvement in DII with MedDiet should be tested in larger intervention trials and observational cohorts. Article Published Date : Apr 13, 2018

Abstract Title: Mediterranean Diet and Cognitive Status in Free-Living Elderly: A Cross-Sectional Study in Northern Italy. Abstract Source: J Am Coll Nutr. 2018 Apr 5:1-7. Epub 2018 Apr 5. PMID: 29621433 Abstract Author(s): Ramona De Amicis, Alessandro Leone, Andrea Foppiani, Diana Osio, Lidia Lewandowski, Valentina Giustizieri, Paolo Cornelio, Ferdinando Cornelio, Susanna Fusari Imperatori, Stefano F Cappa, Alberto Battezzati, Simona Bertoli Article Affiliation: Ramona De Amicis Abstract: OBJECTIVE: Few data are available on the Italian elderly population with regard to adherence to the Mediterranean diet (MD) and cognitive impairment. Our aim was to investigate adherence to the MD and its association with cognitive function in an Italian urban sample. METHODS: A cross-sectional study of 279 participants aged≥ 65 years (80 men, 199 women) was carried out at a nutritional center. Adherence to the MD was evaluated using a 14-item questionnaire. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). RESULTS: The clinical and nutritional assessments performed revealed 30.1% to have a dietary pattern in accordance with the MD; 13.6% had suspected or mild cognitive impairment (MMSE score≤ 23). The MD pattern was associated with a lower risk of cognitive impairment (odds ratio [OR] = 0.39; 95% confidence interval [CI], 0.15-0.99; p = 0.045), as was the consumption of wine (OR = 0.37; 95% CI, 0.16-0.84; p = 0.018) and nuts (OR = 0.30; 95% CI, 0.13-0.69, p = 0.005). No association was found with other food groups. CONCLUSION: A closer adherence to the MD was associated with a better cognitive status. Further cohort studies and randomized controlled trials are warranted. Article Published Date : Apr 04, 2018

Abstract Title: Improved Diet Quality Associates With Reduction in Liver Fat-Particularly in Individuals With High Genetic Risk Scores for Nonalcoholic Fatty Liver Disease. Abstract Source: Gastroenterology. 2018 Mar 28. Epub 2018 Mar 28. PMID: 29604292 Abstract Author(s): Jiantao Ma, Rachel Hennein, Chunyu Liu, Michelle T Long, Udo Hoffmann, Paul F Jacques, Alice H Lichtenstein, Frank B Hu, Daniel Levy Article Affiliation: Jiantao Ma Abstract: BACKGROUND & AIMS: Dietary modification has been recommended for treatment of nonalcoholic fatty liver disease (NAFLD), although it is not clear whether improving diet quality can prevent its development. We performed a prospective study to examine the association between diet quality change and change in liver fat change. We also examined the association between genetic risk score and liver fat change in individuals with different levels of diet quality change. METHODS: Our study included 1521 participants who attended the seventh and eighth examinations (1998-2001 and 2005-2008) of the second-generation cohort or attended the first and second examinations (2002-2005 and 2008-2011) of the third-generation cohort in the Framingham Heart Study. The self-administered semi-quantitative 126-item Harvard food frequency questionnaire was used to determine dietary intake in the year leading up to an examination. We assessed levels of liver fat using liver-phantom ratio (LPR) and computed tomography images from 2002 through 2005 and again from 2008 through 2011. LPR values are inversely related to liver fat-increased LPR indicates decreased liver fat. We examined associations of changes in 2 diet scores-the Mediterranean-style diet score (MDS) and Alternative Healthy Eating Index (AHEI)-with changes in liver fat and new-onset fatty liver. We evaluated interactions between diet score change and a weighted genetic risk score for NAFLD, determined based on multiple single nucleotide polymorphisms identified in genome-wide association studies of NAFLD. The primary outcome was change in LPR between baseline and follow-up measurement. RESULTS: For each 1-standard deviation increase in MDS, the LPR increased (meaning liver fat decreased) by 0.57 (95% CI, 0.27-0.86; P<.001) and the odds for incident fatty liver decreased by 26% (95% CI, 10%-39%; P=.002). For each 1-standard deviation increase in AHEI, LPR increased by 0.56 (95% CI, 0.29-0.84; P<.001) and the odds for incident fatty liver decreased by 21% (95% CI, 5%-35%; P=.02). Increased diet scores were also associated with reduced odds of developing more-advanced fatty liver. Higher genetic risk scores were associated with increased liver fat accumulation in participants who had decreased MDS (P<.001) or AHEI scores (P=.001), but not in those with stable or improved diet scores (P for gene-diet interaction<.001). CONCLUSIONS: In an analysis of participants in the Framingham Heart Study, increasing diet quality, determined based on MDS and AHEI scores, is associated with less liver fat accumulation and reduced risk for new-onset fatty liver. An improved diet is particularly important for individuals with a high genetic risk for NAFLD. Article Published Date : Mar 27, 2018

Abstract Title: Low adherence to the western and high adherence to the mediterranean dietary patterns could prevent colorectal cancer. Abstract Source: Eur J Nutr. 2018 Mar 26. Epub 2018 Mar 26. PMID: 29582162 Abstract Author(s): Adela Castelló, Pilar Amiano, Nerea Fernández de Larrea, Vicente Martín, Maria Henar Alonso, Gemma Castaño-Vinyals, Beatriz Pérez-Gómez, Rocío Olmedo-Requena, Marcela Guevara, Guillermo Fernandez-Tardon, Trinidad Dierssen-Sotos, Cristobal Llorens-Ivorra, Jose María Huerta, Rocío Capelo, Tania Fernández-Villa, Anna Díez-Villanueva, Carmen Urtiaga, Jesús Castilla, Jose Juan Jiménez-Moleón, Víctor Moreno, Verónica Dávila-Batista, Manolis Kogevinas, Nuria Aragonés, Marina Pollán, Article Affiliation: Adela Castelló Abstract: PURPOSE: To assess if the associations found between three previously identified dietary patterns with breast, prostate and gastric cancer are also observed for colorectal cancer (CRC). METHODS: MCC-Spain is a multicase-control study that collected information of 1629 incident cases of CRC and 3509 population-based controls from 11 Spanish provinces. Western, Prudent and Mediterranean data-driven dietary patterns-derived in another Spanish case-control study-were reconstructed in MCC-Spain. Their association with CRC was assessed using mixed multivariable logistic regression models considering a possible interaction with sex. Risk by tumor site (proximal colon, distal colon, and rectum) was evaluated using multinomial regression models. RESULTS: While no effect of the Prudent pattern on CRC risk was observed, a high adherence to the Western dietary pattern was associated with increased CRC risk for both males [OR(95% CI): 1.45 (1.11;1.91)] and females [OR(95% CI): 1.50 (1.07;2.09)] but seem to be confined to distal colon [OR(95% CI): 2.02 (1.44;2.84)] and rectal [OR(95% CI): 1.46 (1.05;2.01)] tumors. The protective effect of the Mediterranean dietary pattern against CRC was observed for both sexes [males: OR(95% CI): 0.71 (0.55;0.92); females: OR(95% CI): 0.56 (0.40;0.77)] and for all cancer sites: proximal colon [OR(95% CI): 0.70 (0.51;0.97)], distal colon [OR(95% CI): 0.65 (0.48;0.89)], and rectum (OR(95% CI): 0.60 (0.45;0.81)]. CONCLUSION: Our results are consistent with most of the associations previously found between these patterns and breast, prostate and gastric cancer risk and indicate that consuming whole fruits, vegetables, legumes, olive oil, nuts, and fish and avoiding red and processed meat, refined grains, sweets, caloric drinks, juices, convenience food, and sauces might reduce CRC risk. Article Published Date : Mar 25, 2018

Abstract Title: Adherence to a Mediterranean diet and its association with age-related macular degeneration. The Coimbra Eye Study-Report 4. Abstract Source: Nutrition. 2018 Jul - Aug;51-52:6-12. Epub 2018 Mar 13. PMID: 29547735 Abstract Author(s): Sandrina Nunes, Dalila Alves, Patrícia Barreto, Miguel Raimundo, Maria da Luz Cachulo, Cláudia Farinha, Inês Laíns, João Rodrigues, Carlos Almeida, Luísa Ribeiro, João Figueira, Lelita Santos, Rufino Silva Article Affiliation: Sandrina Nunes Abstract: OBJECTIVES: This study aimed to characterize the association of lifestyle and nutritional risk profiles with age-related macular degeneration (AMD) in two subpopulations with differing AMD prevalence. METHODS: This case-control study (n = 1992) included 768 patients with AMD and 1224 age- and sex-matched participants without AMD with a single visit at a primary health care unit. Enrolled participants completed a validated lifestyle and food frequency questionnaire. A score to measure adherence to the Mediterranean diet (mediSCORE; Range, 0-9) was constructed from individual food intakes, which were further analyzed by conversion to nutrient consumption. RESULTS: Higher adherence to the Mediterranean diet (mediSCORE≥6) was significantly associated with no AMD (odds ratio [OR] = 0.73; P = 0.009). The subpopulation with lower AMD prevalence presented significantly higher adherence to the Mediterranean diet in relation to all individual food groups that comprised the mediSCORE (P < 0.014) with the exception of cereals. Food group analysis showed significant associations between the increased consumption of vegetables (OR = 0.63; P < 0.001) and fruit and nuts (OR = 0.78; P = 0.010) with no AMD. Nutrient analysis revealed that an increased ingestion of water, fibers, total fat, monounsaturated and polyunsaturated fatty acids, linoleic acid, vitamins A and C, carotene, alpha-tocopherol, folate, magnesium, iron, and zincwere significantly associated with no AMD (P < 0.0013). Finally, regular physical activity was associated with no AMD (P = 0.003). CONCLUSIONS: High adherence to a Mediterranean diet and regular physical activity seem to be protective factors for AMD in a Portuguese population. The effect of the diet is likely driven by the increased consumption of vegetables, fruits, and nuts. Article Published Date : Mar 12, 2018

Abstract Title: Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. Abstract Source: Eur J Nutr. 2018 Mar 7. Epub 2018 Mar 7. PMID: 29516224 Abstract Author(s): Ujué Fresán, Maira Bes-Rastrollo, Gina Segovia-Siapco, Almudena Sanchez-Villegas, Francisca Lahortiga, Pedro-Antonio de la Rosa, Miguel-Angel Martínez-Gonzalez Article Affiliation: Ujué Fresán Abstract: PURPOSE: To prospectively evaluate the association of the Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet and the Mediterranean diet (and their components), and depression risk. METHODS: We followed-up (median 10.4 years) 15,980 adults initially free of depression at baseline or in the first 2 years of follow-up. Food consumption was measured at baseline through a validated food-frequency questionnaire, and was used to compute adherence to the MIND and the Mediterranean diets. Relationships between these two diets and incident depression were assessed through Cox regression models. RESULTS: We identified 666 cases of incident depression. Comparing the highest versus the lowest quartiles of adherence, we found no association of the MIND diet and incident depression. This relation was statistically significant for the Mediterranean diet {hazard ratio (HR) 0.75, [95% confidence interval (95% CI) 0.61, 0.94]; p < 0.01}, although with departure from linearity. A reduced depression risk was associated with higher consumption of both fruits and nuts [HR 0.82 (95% CI 0.69, 0.96); p = 0.02], moderate nuts consumption [HR 0.77 (95% CI 0.64, 0.93); p = 0.01], and avoidance of fast/fried food [HR 0.63 (95% CI 0.41, 0.96); p = 0.03]. CONCLUSIONS: The Mediterranean diet was associated with reduced depression risk, but we found no evidence of such an association for the MIND diet. Article Published Date : Mar 06, 2018

Abstract Title: Dietary Phytoestrogen Intake is Inversely Associated with Hypertension in a Cohort of Adults Living in the Mediterranean Area. Abstract Source: Molecules. 2018 Feb 9 ;23(2). Epub 2018 Feb 9. PMID: 29425149 Abstract Author(s): Justyna Godos, Sonia Bergante, Angela Satriano, Francesca Romana Pluchinotta, Marina Marranzano Article Affiliation: Justyna Godos Abstract: BACKGROUND: Dietary polyphenols, including phytoestrogens are abundantly present in a balanced diet. Evidence for their role in preventing non-communicable diseases is emerging. METHODS: We examined the association between estimated habitual intakes of dietary phytoestrogens and hypertension in a cohort study. The baseline data included 1936 men and women aged 18 years and older. Intakes of total phytoestrogens, isoflavones, and lignans were calculated from validated food frequency questionnaire. Data on the polyphenols content in foods were retrieved from the Phenol-Explorer database. RESULTS: Individuals in the highest quartile of dietary phytoestrogens intake were less likely to be hypertensive (OR: 0.66, 95% CI: 0.44-0.98); moreover, the association showed a significant decreasing trend. Isoflavones and lignans were not associated with lower odds of hypertension; however, some individual compounds, such as biochanin A and pinoresinol showed an independent inverse association with hypertension. CONCLUSIONS: Dietary phytoestrogens are associated with lower likelihood of hypertension in adults living in the Mediterranean area. Future studies are needed to confirm the present findings (i.e., prospective cohort studies) and to better understand the mechanisms underlying such associations. Article Published Date : Feb 08, 2018

Abstract Title: Adherence to the Mediterranean Diet and the Risk of Frailty in Old People: A Systematic Review and Meta-Analysis. Abstract Source: J Nutr Health Aging. 2018 ;22(5):613-618. PMID: 29717762 Abstract Author(s): Y Wang, Q Hao, L Su, Y Liu, S Liu, B Dong Article Affiliation: Y Wang Abstract: BACKGROUND: Frailty is a common geriatric syndrome in old people. It remains controversial whether Mediterranean diet could prevent old people from developing into frailty. The aim of this study is to summarize the relevant studies and assess the effectiveness of adherence to Mediterranean diet on frailty in old people. METHOD: A systematic search of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials was conducted to identify all relevant studies up to Oct 2017. We included studies regarding the associations between adherence to Mediterranean diet and risk of frailty among elders. A meta-analysis was performed to explore the effects of Mediterranean diet on frailty. RESULTS: Six studies matched the inclusion criteria, of which five were prospective and one was cross-sectional. A total of 10,210 participants from the five prospective cohort studies were included to perform the meta-analyses. In comparison with lowest adherence to Mediterranean diet, elders with highest adherence to Mediterranean diet were significantly associated with lower risk of frailty in the future (RR= 0.56, 95% CI=0.36-0.89, p=0.015). Furthermore, the pooled estimates from four studies performed among participants in western countries (European and North American) showed that higher adherence to Mediterranean diet was associated with a 52% reduced risk of frailty (RR= 0.48, 95% CI=0.32-0.72, p<0.001). However, one study showed no association between Mediterranean diet and frailty among Asian elders (RR=1.06, 95% CI=0.83-1.36, p=0.638). CONCLUSION: A higher adherence to Mediterranean diet is associated with a lower risk of frailty in old people. Meanwhile, the benefits may be more obvious among elders from western countries. Article Published Date : Dec 31, 2017

Abstract Title: Mediterranean Diet, Food Consumption and Risk of Late-Life Depression: The Mugello Study. Abstract Source: J Nutr Health Aging. 2018 ;22(5):569-574. PMID: 29717755 Abstract Author(s): G Pagliai, F Sofi, F Vannetti, S Caiani, G Pasquini, R Molino Lova, F Cecchi, S Sorbi, C Macchi Article Affiliation: G Pagliai Abstract: OBJECTIVES: To investigate eating habits and adherence to Mediterranean Diet (MD) in relation to the risk of depression in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status. DESIGN: Cross-sectional study. SETTING: Homes and nursing homes in the Mugello area, Florence, Italy. PARTICIPANTS: Subjects aged 90-99 years [N=388 (271F; 117M) mean age: 92.7±3.1]. MEASUREMENTS: All subjects were evaluated through questionnaires and instrumental examinations. Adherence to MD was assessed through the Mediterranean Diet Score. A shorter version of the Geriatric Depression Scale (GDS) was used to detect the possible presence of depressive symptoms. In addition, cognitive and functional status was assessed using the Mini-Mental State Examination, the Clock Drawing Test, as well as the Basic and Instrumental Activities of Daily Living test. RESULTS: Depressed subjects (DS) (GDS score≥5, 43.8%) were older, females and widows, than non-depressed subjects (NDS). DS reported a slightly but not statistically significant lower MD score than NDS (33.9±3.9 vs. 34.6±3.3, p=0.149). Subjects who reported to consume a greater amount of olive oil and fruit were associated with a lower risk of depression (OR=0.35, 95%CI=0.20-0.59, p<0.001 and OR=0.46, 95%CI=0.26-0.84, p=0.011, respectively) after adjustment for many possible confounders. Similar results were obtained for women, while no statistically significant differences emerged for men. CONCLUSION: Our results support the hypothesis that a diet rich in olive oil and fruit, characteristics of MD, may protect against the development of depressive symptoms in older age. Article Published Date : Dec 31, 2017

Abstract Title: Aging and Adherence to the Mediterranean Diet: Relationship with Cardiometabolic Disorders and Polypharmacy. Abstract Source: J Nutr Health Aging. 2018 ;22(1):73-81. PMID: 29300425 Abstract Author(s): R Vicinanza, G Troisi, R Cangemi, M De Martino, D Pastori, S Bernardini, F Crisciotti, F Di Violante, A Frizza, M Cacciafesta, P Pignatelli, V Marigliano Article Affiliation: R Vicinanza Abstract: OBJECTIVES: To investigate the association between adherence to the Mediterranean Diet (Med-Diet), cardiometabolic disorders and polypharmacy. DESIGN: Cross-sectional study. SETTING: Geriatrics outpatient clinic, Policlinico Umberto I, Sapienza University of Rome. PARTICIPANTS: 508 patients (219 male, 289 female) aged 50 to 89 who were evaluated for cardiovascular and metabolic disorders. METHODS AND MEASUREMENTS: Patients underwent a comprehensive medical assessment including medical history and the use of medications. Adherence to Med-Diet was assessed using the validated Med-Diet 14-item questionnaire; for the analysis, patients were divided in high (≥8) and medium-low (<8) adherence. Polypharmacy was defined as taking≥5 medications. RESULTS: 476 patients completed the study. Mean age was 70.4 years; 58% female. Median Med-Diet score was 8 (interquartile range, 6-9). Patients with medium-low adherence had higher body mass index (p=0.029) and higher prevalence of arterial hypertension (p<0.001), previous coronary (p=0.002) and cerebrovascular events (p=0.011), diabetes, (p<0.001) and dyslipidemia (p=0.001) compared to those at high adherence. Med-Diet score decreased with the number of cardiometabolic disorders (p<0.001). The prevalence of polypharmacy was 39%. Consumption of olive oil (p=0.005), vegetables, (p<0.001), wine (p=0.017), legumes (p=0.028), fish (p=0.046) and nuts (p=0.045) were all inversely associated with the overall number of medications. In a multivariable regression model, medium-low adherence to Med-Diet was independently associated to polypharmacy (O.R.:1.859; 95% CI 1.142 to 3.025; p=0.013), after adjusting for possible confounding factors. CONCLUSION: Med-Diet was inversely associated with cardiometabolic disorders and with polypharmacy, suggesting that improved Med-Diet adherence might potentially delay the onset of age-related health deterioration and reduce the need of multiple medications. Article Published Date : Dec 31, 2017

Abstract Title: Impact of Consuming Extra-Virgin Olive Oil or Nuts within a Mediterranean Diet on DNA Methylation in Peripheral White Blood Cells within the PREDIMED-Navarra Randomized Controlled Trial: A Role for Dietary Lipids. Abstract Source: Nutrients. 2017 Dec 23 ;10(1). Epub 2017 Dec 23. PMID: 29295516 Abstract Author(s): Ana Arpón, Fermín I Milagro, Cristina Razquin, Dolores Corella, Ramón Estruch, Montserrat Fitó, Amelia Marti, Miguel A Martínez-González, Emilio Ros, Jordi Salas-Salvadó, José-Ignacio Riezu-Boj, J Alfredo Martínez Article Affiliation: Ana Arpón Abstract: DNA methylation could be reversible and mouldable by environmental factors, such as dietary exposures. The objective was to analyse whether an intervention with two Mediterranean diets, one rich in extra-virgin olive oil (MedDiet + EVOO) and the other one in nuts (MedDiet + nuts), was influencing the methylation status of peripheral white blood cells (PWBCs) genes. A subset of 36 representative individuals were selected within the PREvención con DIeta MEDiterránea (PREDIMED-Navarra) trial, with three intervention groups in high cardiovascular risk volunteers: MedDiet + EVOO, MedDiet + nuts, and a low-fat control group. Methylation was assessed at baseline and at five-year follow-up. Ingenuity pathway analysis showed routes with differentially methylated CpG sites (CpGs) related to intermediate metabolism, diabetes, inflammation, and signal transduction. Two CpGs were specifically selected: cg01081346-CPT1B/CHKB-CPT1B and cg17071192-GNAS/GNASAS, being associated with intermediate metabolism. Furthermore, cg01081346 was associated with PUFAs intake, showing a role for specific fatty acids on epigenetic modulation. Specific components of MedDiet, particularly nuts and EVOO, were able to induce methylation changes in several PWBCs genes. These changes may have potential benefits in health; especially those changes in genesrelated to intermediate metabolism, diabetes, inflammation and signal transduction, which may contribute to explain the role of MedDiet and fat quality on health outcomes. Article Published Date : Dec 22, 2017

Abstract Title: Mediterranean diet improves endothelial function in patients with diabetes and prediabetes: A report from the CORDIOPREV study. Abstract Source: Atherosclerosis. 2017 Dec 8 ;269:50-56. Epub 2017 Dec 8. PMID: 29274507 Abstract Author(s): Jose D Torres-Peña, Antonio Garcia-Rios, Nieves Delgado-Casado, Purificacion Gomez-Luna, Juan F Alcala-Diaz, Elena M Yubero-Serrano, Francisco Gomez-Delgado, Ana Leon-Acuña, Javier Lopez-Moreno, Antonio Camargo, Francisco J Tinahones, Javier Delgado-Lista, Jose M Ordovas, Pablo Perez-Martinez, Jose Lopez-Miranda Article Affiliation: Jose D Torres-Peña Abstract: BACKGROUND AND AIMS: Endothelial dysfunction (ED) plays a key role in the development of atherosclerotic cardiovascular disease (ASCVD). Likewise, type 2 diabetes (T2D) is a major CVD risk factor. Therefore, our objective was to explore whether long-term consumption of a Mediterranean diet (MedDiet) rich in olive oil or a low-fat diet (LF diet) was associated with an improvement in ED and whether the potential benefits were similar in patients with or without T2D in the CORDIOPREV clinical trial (NCT00924937). METHODS: Endothelial function was measured in 805 participants who had completed follow-up ultrasound image studies, using ultrasonography of brachial artery to calculate flow mediated vasodilatation (FMD) before and after 1.5 years of intervention with a MedDiet [35% of calories from fat (22% monounsaturated) and 50% from carbohydrates] and LF diet [28% fat (12% monounsaturated) and 55% of calories from carbohydrates]. We categorized participants as patients with T2D, prediabetes, and without T2D according to the American Diabetes Association (ADA) criteria. RESULTS: MedDiet increased FMD in patients with T2D [5.2 ± 0.4 at 1.5 years vs. 3.8 ± 0.4 at baseline; p=0.04] and prediabetes [4.9 ± 0.4 vs. 3.8 ± 0.4; p=0.04] and induced an improvement in FMD compared to LF diet in patients with diabetes [5.2 ± 0.4 (MedDiet) vs.3.7 ± 0.4 (LF diet); p=0.01]; whereas both diets maintained FMD stablein patients without diabetes. CONCLUSIONS: Habitual consumption of a MedDiet rich in extra virgin olive oil improves endothelial function in patients with prediabetes and diabetes. This takes great importance given that diet must be the cornerstone of treatment of patients with diabetes at high cardiovascular risk. Article Published Date : Dec 07, 2017

Abstract Title: Diet and endometrial cancer: a focus on the role of fruit and vegetable intake, Mediterranean diet and dietary inflammatory index in the endometrial cancer risk. Abstract Source: BMC Cancer. 2017 Nov 13 ;17(1):757. Epub 2017 Nov 13. PMID: 29132343 Abstract Author(s): Fulvio Ricceri, Maria Teresa Giraudo, Francesca Fasanelli, Dario Milanese, Veronica Sciannameo, Laura Fiorini, Carlotta Sacerdote Article Affiliation: Fulvio Ricceri Abstract: BACKGROUND: Endometrial cancer is the fourth most common cancer in European women. The major risk factors for endometrial cancer are related to the exposure of endometrium to estrogens not opposed to progestogens, that can lead to a chronic endometrial inflammation. Diet may play a role in cancer risk by modulating chronic inflammation. METHODS: In the framework of a case-control study, we recruited 297 women with newly diagnosed endometrial cancer and 307 controls from Northern Italy. Using logistic regression, we investigated the role of fruit and vegetable intake, adherence to the Mediterranean diet (MD), and the dietary inflammatory index (DII) in endometrial cancer risk. RESULTS: Women in the highest quintile of vegetable intake had a statistically significantly lower endometrial cancer risk (adjusted OR 5th quintile vs 1st quintile: 0.34, 95% CI 0.17-0.68). Women with high adherence to the MD had a risk of endometrial cancer that was about half that of women with low adherence to the MD (adjusted OR: 0.51, 95% CI 0.39-0.86). A protective effect was detected for all the lower quintiles of DII, with the highest protective effect seen for the lowest quintile (adjusted OR 5th quintile vs 1st quintile: 3.28, 95% CI 1.30-8.26). CONCLUSIONS: These results suggest that high vegetable intake, adherence to the MD, and a low DII are related to a lower endometrial cancer risk, with several putative connected biological mechanisms that strengthen the biological plausibility of this association. Article Published Date : Nov 12, 2017

Abstract Title: Vitamin C Intake is Inversely Associated with Cardiovascular Mortality in a Cohort of Spanish Graduates: the SUN Project. Abstract Source: Nutrients. 2017 Aug 29 ;9(9). Epub 2017 Aug 29. PMID: 28850099 Abstract Author(s): Nerea Martín-Calvo, MiguelÁngel Martínez-González Article Affiliation: Nerea Martín-Calvo Abstract: Observational studies have found a protective effect of vitamin C on cardiovascular health. However, results are inconsistent, and residual confounding by fiber might be present. The aim of this study was to assess the association of vitamin C with the incidence of cardiovascular disease (CVD) and cardiovascular mortality (CVM) while accounting for fiber intake and adherence to the Mediterranean dietary pattern. We followed up 13,421 participants in the Seguimiento Universidad de Navarra (University of Navarra follow-up) (SUN) cohort for a mean time of 11 years. Information was collected at baseline and every two years through mailed questionnaires. Diet was assessed with a validated semi-quantitative food frequency questionnaire. Incident CVD was defined as incident fatal or non-fatal myocardial infarction, fatal or non-fatal stroke, or death due to any cardiovascular cause. CVM was defined as death due to cardiovascular causes. Events were confirmed by physicians in the study team after revision of medical records. Cox proportional hazard models were fitted to assess the associations of (a) energy-adjusted and (b) fiber-adjusted vitamin C intake with CVD and CVM. We found energy-adjusted vitamin C was inversely associated with CVD and CVM after adjusting for several confounding factors, including fiber from foods other than fruits and vegetables, and adherence to the Mediterranean dietary pattern. On the other hand, when vitamin C was adjusted for total fiber intake using the residuals method, we found a significant inverse association with CVM (HR (95% confidence interval (CI)) for the third tertile compared to the first tertile, 0.30 (0.12-0.72), but not with CVD in the fully adjusted model. Article Published Date : Aug 28, 2017

Abstract Title: Mediterranean dietary pattern is associated to low risk of aggressive prostate cancer: MCC-Spain study. Abstract Source: J Urol. 2017 Aug 22. Epub 2017 Aug 22. PMID: 28842246 Abstract Author(s): Adela Castelló, Elena Boldo, Pilar Amiano, Gemma Castaño-Vinyals, Nuria Aragonés, Inés Gómez-Acebo, Rosana Peiró, Jose Juan Jimenez-Moleón, Juan Alguacil, Adonina Tardón, Lluís Cecchini, Virginia Lope, Trinidad Dierssen-Sotos, Lourdes Mengual, Manolis Kogevinas, Marina Pollán, Beatriz Pérez-Gómez, Article Affiliation: Adela Castelló Abstract: PURPOSE: To explore the association of the previously described Western, Prudent and Mediterranean dietary patterns with prostate cancer risk by tumor aggressiveness and extension. METHODS: MCC-Spain is a population-based multicase-control study, carried out in 7 Spanish provinces between September 2008 and December 2013. It collected anthropometric, epidemiologic and dietary information on 754 histologically confirmed incident cases of prostate cancer and 1277 controls aged 38 to 85 years. Three previously identified dietary patterns -Western, Prudent and Mediterranean- were reconstructed using MCC-Spain data. The association between each pattern and prostate cancer risk was assessed using logistic regression models with random province-specific intercepts. Risk according to tumor aggressiveness (Gleason score grade =6 vs>6) and extension (cT1-cT2a vs cT2b-cT4) was evaluated with multinomial regression models. RESULTS: High adherence to Mediterranean dietary pattern -rich in fruits and vegetables, but also in fish, legumes and olive oil- was specifically associated to lower risk of prostate cancer with Gleason score>6: RRRQuartile3(Q3)vsQuartile1(Q1)=0.66; 95%CI:0.46-0.96 and RRRQuartile4(Q4)vsQuartile1=0.68;95%CI:0.46-1.01;p-trend=0.023) or with higher clinical stage (cT2b-T4: RRRQuartile4vsQuartile1=0.49; 95%CI:0.25-0.96; p-trend=0.024). This association was not observed with Prudent pattern, which combines vegetables and fruits with low fat dairy products, whole grains and juices. Western pattern did not show any association with prostate cancer risk. CONCLUSIONS: Nutritional recommendations for prostate cancer prevention should consider whole dietary patterns instead of individual foods. We found important differences between Mediterranean dietary pattern, which was associated to lower risk of aggressive prostate cancer, and Western and Prudent dietary patterns, that had no relationship with prostate cancer risk. Article Published Date : Aug 21, 2017

Abstract Title: Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score. Abstract Source: Antiviral Res. 2005 Apr;66(1):9-12. PMID: 12242583 Abstract Author(s): Miguel A Martínez-González, Elena Fernández-Jarne, Manuel Serrano-Martínez, Amelia Marti, J Alfredo Martinez, José M Martín-Moreno Abstract: BACKGROUND: Although an important secondary prevention trial reported an impressive protection by a Mediterranean dietary pattern on reinfarction and cardiovascular death, scarce direct epidemiologic evidence is currently available regarding the role of the Mediterranean diet in the aetiology of coronary heart disease. AIMS: The aim of the study was to quantify the risk reduction of incident myocardial infarction provided by a Mediterranean dietary pattern. METHODS: We included 342 subjects (171 patients who suffered their first acute myocardial infarction and 171 matched controls) in a case-control study. A validated semi-quantitative food frequency questionnaire (136 items) was used. We defined an a priori Mediterranean dietary pattern. We assessed six food items that we considered protective: 1) olive oil, 2) fiber, 3) fruits, 4)vegetables, 5) fish and 6) alcohol. For each of these six dietary factors, we calculated the distribution according to quintiles within the study and assigned each participant a score of 1 to 5 corresponding to the quintile of intake, with 1 representing the lowest and 5 representing the highest quintile. We also estimated the quintiles of two other elements assumed to be associated with a higher risk: 7) meat/meat products and 8) some items with high glycaemic load (white bread, pasta and rice). For these two elements we inversely ranked the score, with 1 representing the highest and 5 representing the lowest quintile. Finally, we summed up the eight quintile values for each participant.A second score ( post hoc pattern) was built using only a single cut-off point for these eight elements. The cut-off points for each element in this post hoc pattern were decided according to the dose-response relationships between the consumption of each food item and the risk of myocardial infarction observed in the analyses that used quintiles of each food item. RESULTS: For both patterns, we found that the higher the score, the lower the odds ratio of myocardial infarction. A significant linear trend was apparent after adjustment for the main cardiovascular risk factors. For each additional point in the a priori Mediterranean pattern (observed range: 9-38) the odds ratio (95 % confidence intervals) was 0.92 (0.86-0.98). This estimate was 0.55 (0.42-0.73) when we used the post hoc pattern (range: 0-8). CONCLUSIONS: Our data support the hypothesis that a Mediterranean diet (that emphasizes olive oil, fiber, fruits, vegetables, fish and alcohol and reduces meat/meat products) can be an effective measure for reducing the risk of myocardial infarction. However, our results support the exclusion of refined cereals with a high glycaemic load as healthy elements of this pattern. Article Published Date : Apr 01, 2005

Abstract Title: Reducing Breast Cancer Recurrence: The Role of Dietary Polyphenolics. Abstract Source: Nutrients. 2016 ;8(9). Epub 2016 Sep 6. PMID: 27608040 Abstract Author(s): Andrea J Braakhuis, Peta Campion, Karen S Bishop Article Affiliation: Andrea J Braakhuis Abstract: Evidence from numerous observational and clinical studies suggest that polyphenolic phytochemicals such as phenolic acids in olive oil, flavonols in tea, chocolate and grapes, and isoflavones in soy products reduce the risk of breast cancer. A dietary food pattern naturally rich in polyphenols is the Mediterranean diet and evidence suggests those of Mediterranean descent have a lower breast cancer incidence. Whilst dietary polyphenols have been the subject of breast cancer risk-reduction, this review will focus on the clinical effects of polyphenols on reducing recurrence. Overall, we recommend breast cancer patients consume a diet naturally high in flavonol polyphenols including tea, vegetables (onion, broccoli), and fruit (apples, citrus). At least five servings of vegetables and fruit daily appear protective. Moderate soy protein consumption (5-10 g daily) and the Mediterranean dietary pattern show the most promise for breast cancer patients. In this review, we present an overview of clinical trials on supplementary polyphenols of dietary patterns rich in polyphenols on breast cancer recurrence, mechanistic data, and novel delivery systems currently being researched. Article Published Date : Dec 31, 2015

Abstract Title: Adherence to Mediterranean Diet and Metabolic Syndrome in BRCA Mutation Carriers. Abstract Source: Integr Cancer Ther. 2017 Jul 1:1534735417721015. Epub 2017 Jul 1. PMID: 28741383 Abstract Author(s): Eleonora Bruno, Siranoush Manoukian, Elisabetta Venturelli, Andreina Oliverio, Francesca Rovera, Giovanna Iula, Daniele Morelli, Bernard Peissel, Jacopo Azzolini, Eliana Roveda, Patrizia Pasanisi Article Affiliation: Eleonora Bruno Abstract: BACKGROUND: Insulin resistance is associated with higher breast cancer (BC) penetrance in BRCA mutation carriers. Metabolic syndrome (MetS), an insulin resistance syndrome, can be reversed by adhering to the Mediterranean diet (MedDiet). In a dietary intervention trial on BRCA mutation carriers, we evaluated adherence to the MedDiet, and the association with the MetS, by analyzing data from the Mediterranean Diet Adherence Screener (MEDAS). METHODS: BRCA mutation carriers, with or without BC, aged 18 to 70 years, were eligible for the trial. After the baseline examinations, women were randomized to a dietary intervention or to a control group. Both groups completed the MEDAS at baseline and at the end of the dietary intervention. RESULTS: A total of 163 women completed the 6 months of dietary intervention. Compared with controls, the women in the intervention group significantly reduced their consumption of red meat ( P<.01) and commercial sweets ( P<.01) and their MEDAS score rose significantly (+1.3 vs +0.55, P = .02). The number of MetS parameters decreased with increasing points of adherence to the MEDAS score ( P = .01). In the intervention group, there was a significant association with the greater reduction of MetS. CONCLUSION: BRCA mutation carriers in the intervention group experienced greater improvement in their MedDiet and MetS parameters. Article Published Date : Jun 30, 2017

Abstract Title: High adherence to a Mediterranean diet and lower risk of frailty among French older adults community-dwellers: Results from the Three-City-Bordeaux Study. Abstract Source: Clin Nutr. 2017 May 31. Epub 2017 May 31. PMID: 28629899 Abstract Author(s): Berna Rahi, Soufiane Ajana, Maturin Tabue-Teguo, Jean-François Dartigues, Karine Peres, Catherine Feart Article Affiliation: Berna Rahi Abstract: BACKGROUND & AIMS: Mediterranean diet (MeDi) is considered as a key component for healthy aging, including prevention of age-related disability, while its association with frailty, independent of disability has never been assessed. Our objective was to investigate the relation between MeDi adherence and frailty incidence among persons aged≥75 years participating at the prospective population-based French Three-City Study. METHODS: The study sample consisted of 560 initially non-frail participants of the Three-City-Bordeaux center, seen at the 2009-2010 follow-up, and re-examined two years later. Adherence to MeDi was computed from a food frequency questionnaire (scored as 0-9). Frailty was defined as having at least three out of the following five slightly modified Fried frailty criteria: involuntary weight loss, exhaustion, slowness, weakness and low physical activity. Logistic regression models adjusted for sociodemographic and clinical covariates, including cognitive performance and depressive symptomatology, were used to assess the association between MeDi score and subsequent frailty risk. RESULTS: Over the 2-year follow-up, 79 participants (14%) became frail. Older adults with the highest MeDi adherence (score 6-9) had a significantly 68% frailty risk reduction (95% CI: 28-86%, p = 0.006) compared to those in the lowest MeDi category (score 0-3). Regarding the frailty criterion separately, the highest MeDi adherence was associated with a significantly reduced risk of incident slowness (OR = 0.45; 95% CI: 0.20-0.99, p = 0.04), poor muscle strength (OR = 0.44; 95% CI:0.20-0.98, p = 0.04) and low physical activity (OR = 0.39; 95% CI: 0.18-0.82, p = 0.01), compared to the lowest MeDi adherence. CONCLUSION: In addition to its well-documented beneficial effects on health, adherence to MeDi might contribute to prevent the onset of frailty, even at late stages of life. Article Published Date : May 30, 2017

Abstract Title: Adherence to Mediterranean diet and risk of gastric cancer: results of a case-control study in Italy. Abstract Source: Eur J Cancer Prev. 2017 May 24. Epub 2017 May 24. PMID: 28542079 Abstract Author(s): Jovana Stojanovic, Luca Giraldi, Dario Arzani, Roberta Pastorino, Alberto Biondi, Roberto Persiani, Stefania Boccia, Emanuele Leoncini Article Affiliation: Jovana Stojanovic Abstract: The aim of this study is to evaluate the association between adherence to Mediterranean diet (MD) and gastric cancer (GC). A case-control study was carried out at the Fondazione Policlinico 'A. Gemelli' (Rome, Italy) from 2003 to 2015. A total of 223 incident cases and 223 controls were interviewed. Dietary intake was assessed through a validated food frequency questionnaire that collected information on more than 25 food items. The association between adherence to MD and risk of GC was quantified by calculating Odds Ratios (OR) and 95% confidence intervals (CI). The analysis reports that a higher adherence to MD is associated with a reduced risk of GC (OR: 0.70; 95% CI: 0.61-0.81). A high consumption of vegetables (OR: 0.34; 95% CI: 0.14-0.85), legumes (OR: 0.13; 95% CI: 0.06-0.29), and fish (OR: 0.33; 95% CI: 0.15-0.68), as well as low consumption of meat (OR: 0.29; 95% CI: 0.10-0.85) and alcohol (OR: 0.46; 95% CI: 0.24-0.90) are consistently related to a lower risk of GC. Our study indicates a protective role of the MD eating pattern and MD individual components against GC. Our results showed a beneficial role of high vegetable, legume, and fish consumption, along with low intake of alcohol and meat in the development of GC. Article Published Date : May 23, 2017

Abstract Title: Changes in fatty liver index after consuming a Mediterranean diet: 6-year follow-up of the PREDIMED-Malaga trial. Abstract Source: Med Clin (Barc). 2017 Jan 23. Epub 2017 Jan 23. PMID: 28126231 Abstract Author(s): Raquel Cueto-Galán, Francisco Javier Barón, Pedro Valdivielso, Xavier Pintó, Emili Corbella, Enrique Gómez-Gracia, Julia Wärnberg, Article Affiliation: Raquel Cueto-Galán Abstract: OBJECTIVE: To analyze the effect of an intervention with a Mediterranean diet supplemented with either extra virgin olive oil or nuts, on the fatty liver index (FLI), compared to a low-fat control diet. METHODS: Participants of the PREDIMED-Malaga trial, free from cardiovascular disease at baseline, but with a high risk to develop it, were included in this study. Anthropometric measurements were assessed and blood samples were taken to calculate participants' FLI at study baseline and after one, 3, 5 and 6 years. Mixed linear models were used to explore the fixed effects of the 3 intervention groups on the FLI as well as their interaction with time. RESULTS: A total of 276 participants were included in the study. Average participant age was 67 years, with 66% of participants being women. The baseline prevalence of NAFL was 57%. The change in the FLI of the control group increased significantly over time (1.13±0.41; P=.006). In the MedDiet+EVOO group, the time trend of the change in the FLI was similar to that of the control group, although it was seen to be lower (-3.90±1.9; P=.038). In the MedDiet+Nuts group, the trend was significantly lower than that of the control group (-1.63±0.62; P=.009). In the MedDiet+Nuts group, the trend of changes in participants' BMI was 0.100 points lower per year compared to the control group (P=.004). In the control group, the change in waist circumference increased significantly over time (0.61±0.16cm/year; P<.001) in contrast to the MedDiet+EVOO group, in which this variable remained stable (-0.51±0.22; P=.019). CONCLUSIONS: A dietary intervention consisting of a Mediterranean diet could delay or slow down the natural progression of NAFL, thus, being beneficial for its prevention and treatment. However, further studies supporting these conclusions have yet to be carried out. Article Published Date : Jan 22, 2017

Abstract Title: Mediterranean-type diet and brain structural change from 73 to 76 years in a Scottish cohort. Abstract Source: Neurology. 2017 Jan 4. Epub 2017 Jan 4. PMID: 28053008 Abstract Author(s): Michelle Luciano, Janie Corley, Simon R Cox, Maria C Valdés Hernández, Leone C A Craig, David Alexander Dickie, Sherif Karama, Geraldine M McNeill, Mark E Bastin, Joanna M Wardlaw, Ian J Deary Article Affiliation: Michelle Luciano Abstract: OBJECTIVE: To assess the association between Mediterranean-type diet (MeDi) and change in brain MRI volumetric measures and mean cortical thickness across a 3-year period in older age (73-76 years). METHODS: We focused on 2 longitudinal brain volumes (total and gray matter; n = 401 and 398, respectively) plus a longitudinal measurement of cortical thickness (n = 323), for which the previous cross-sectional evidence of an association with the MeDi was strongest. Adherence to the MeDi was calculated from data gathered from a food frequency questionnaire at age 70, 3 years prior to the baseline imaging data collection. RESULTS: In regression models adjusting for relevant demographic and physical health indicators, we found that lower adherence to the MeDi was associated with greater 3-year reduction in total brain volume (explaining 0.5% of variance, p<0.05). This effect was half the size of the largest covariate effect (i.e., age). Cross-sectional associations between MeDi and baseline MRI measures in 562 participants were not significant. Targeted analyses of meat and fish consumption did not replicate previous associations with total brain volume or total gray matter volume. CONCLUSIONS: Lower adherence to the MeDi in an older Scottish cohort is predictive of total brain atrophy over a 3-year interval. Fish and meat consumption does not drive this change, suggesting that other components of the MeDi or, possibly, all of its components in combination are responsible for the association. Article Published Date : Jan 03, 2017

Abstract Title: Protection by extra virgin olive oil against oxidative stress in vitro and in vivo. Chemical and biological studies on the health benefits due to a major component of the Mediterranean diet. Abstract Source: PLoS One. 2017 ;12(12):e0189341. Epub 2017 Dec 28. PMID: 29283995 Abstract Author(s): Miriam Rossi, Francesco Caruso, Lorraine Kwok, Grace Lee, Alessio Caruso, Fabio Gionfra, Elena Candelotti, Stuart L Belli, Nora Molasky, Kathleen M Raley-Susman, Stefano Leone, Tomáš Filipský, Daniela Tofani, Jens Pedersen, Sandra Incerpi Article Affiliation: Miriam Rossi Abstract: We report the results of in vivo studies in Caenorhabditis elegans nematodes in which addition of extra virgin olive oil (EVOO) to their diet significantly increased their life span with respect to the control group. Furthermore, when nematodes were exposed to the pesticide paraquat, they started to die after two days, but after the addition of EVOO to their diet, both survival percentage and lifespans of paraquat-exposed nematodes increased. Since paraquat is associated with superoxide radical production, a test for scavenging this radical was performed using cyclovoltammetry and the EVOO efficiently scavenged the superoxide. Thus, a linear correlation (y = -0.0838x +19.73, regression factor = 0.99348) was observed for superoxide presence (y) in the voltaic cell as a function of aliquot (x) additions of EVOO, 10μL each. The originally generated supoeroxide was approximately halved after 10 aliquots (100 μL total). The superoxide scavenging ability was analyzed, theoretically, using Density Functional Theory for tyrosol and hydroxytyrosol, two components of EVOO and was also confirmed experimentally for the galvinoxyl radical, using Electron Paramagnetic Resonance (EPR) spectroscopy. The galvinoxyl signal disappeared after adding 1 μL of EVOO to the EPR cell in 10 minutes. In addition, EVOO significantly decreased the proliferation of human leukemic THP-1 cells, while it kept the proliferation at about normal levels in rat L6 myoblasts, a non-tumoral skeletal muscle cell line. The protection due to EVOO was also assessed in L6 cells and THP-1 exposed to the radical generator cumene hydroperoxide, in which cell viability was reduced. Also in this case the oxidative stress was ameliorated by EVOO, in line with results obtained with tetrazolium dye reduction assays, cell cycle analysis and reactive oxygen species measurements. We ascribe these beneficial effects to EVOO antioxidant properties and our results are in agreement with a clear health benefit of EVOO use in the Mediterranean diet. Article Published Date : Dec 31, 2016

Abstract Title: Mediterranean Diet Score and Its Association with Age-Related Macular Degeneration: The European Eye Study. Abstract Source: Ophthalmology. 2016 Nov 5. Epub 2016 Aug 5. PMID: 27825655 Abstract Author(s): Ruth E Hogg, Jayne V Woodside, Alanna McGrath, Ian S Young, Jesus L Vioque, Usha Chakravarthy, Paulus T de Jong, Mati Rahu, Johan Seland, Gisele Soubrane, Laura Tomazzoli, Fotis Topouzis, Astrid E Fletcher Article Affiliation: Ruth E Hogg Abstract: PURPOSE: To examine associations between adherence to a Mediterranean diet and prevalence of age-related macular degeneration (AMD) in countries ranging from Southern to Northern Europe. DESIGN: Cross-sectional, population-based epidemiologic study. PARTICIPANTS: Of 5060 randomly sampled people aged 65 years or older from 7 study centers across Europe (Norway, Estonia, United Kingdom, France, Italy, Greece, and Spain), full dietary data were available in 4753. The mean age of participants was 73.2 years (standard deviation, 5.6), and 55% were women. METHODS: Participants underwent an eye examination and digital retinal color photography. The images were graded at a single center. Dietary intake during the previous 12 months was assessed by using a semiquantitative food-frequency questionnaire (FFQ). A previously published Mediterranean Diet Score (MDS) was used to classify participants according to their responses on the FFQ. Multivariable logistic regression was used to investigate the association of the MDS score and AMD, taking account of potential confounders and the multicenter study design. MAIN OUTCOME MEASURES: Images were graded according to the International Classification System for age-related maculopathy and stratified using the Rotterdam staging system into 5 exclusive stages (AMD 0-4) and a separate category of large drusen (≥125 μm). Age-related macular degeneration 4 included neovascular AMD (nvAMD) and geographic atrophy (GA). RESULTS: Increasing MDS was associated with reduced odds of nvAMD in unadjusted and confounder-adjusted analysis. Compared with the lowest MDS adherence (≤4 score), those in the highest category MDS adherence (>6 score) showed lower odds of nvAMD (odds ratio, 0.53; 0.27-1.04; P trend = 0.01). The association with MDS did not differ by Y204H risk allele (P = 0.89). For all early AMD (grade 1-3), there was no relationship with MDS (P trend = 0.9). There was a weak trend (P = 0.1) between MDS and large drusen; those in the highest category of MDS had 20% reduced odds comparedwith those in the lowest (P = 0.05). CONCLUSIONS: This study adds to the limited evidence of the protective effect of adherence to a Mediterranean dietary pattern in those with late AMD, although it does not support previous reports of a relationship with genetic susceptibility. Interventions to encourage the adoption of the Mediterranean diet should be developed, and methods by which such behavior change can be achieved and maintained investigated. Article Published Date : Nov 04, 2016

Abstract Title: Telomerase RNA Component Genetic Variants Interact With the Mediterranean Diet Modifying the Inflammatory Status and its Relationship With Aging: CORDIOPREV Study. Abstract Source: J Gerontol A Biol Sci Med Sci. 2016 Oct 5. Epub 2016 Aug 5. PMID: 27707805 Abstract Author(s): Francisco Gomez-Delgado, Javier Delgado-Lista, Javier Lopez-Moreno, Oriol Alberto Rangel-Zuñiga, Juan Francisco Alcala-Diaz, Ana Leon-Acuña, Andreea Corina, Elena Yubero-Serrano, Jose David Torres-Peña, Antonio Camargo, Antonio Garcia-Rios, Javier Caballero, Justo Castaño, Jose M Ordovas, Jose Lopez-Miranda, Pablo Perez-Martinez Article Affiliation: Francisco Gomez-Delgado Abstract: BACKGROUND: Leukocyte telomere length (LTL) attrition has been associated with age-related diseases. Telomerase RNA Component (TERC) genetic variants have been associated with LTL; whereas fatty acids (FAs) can interact with genetic factors and influence in aging. We explore whether variability at the TERC gene locus interacts with FA profile and two healthy diets (low-fat diet vs Mediterranean diet [MedDiet]) modulating LTL, glucose metabolism, and inflammation status in coronary heart disease (CHD) patients. METHODS: Inflammation status (high-sensitivity C-reactive protein [hsCRP], glucose metabolism-glucose, insulin, and glycated hemoglobin [HbA1c], and homeostasis model assessment of insulin resistance [HOMA-IR]), LTL, FAs, and single nucleotide polymorphisms (SNPs) of the TERC gene (rs12696304, rs16847897, and rs3772190) were determined in 1,002 patients from the CORDIOPREV study (NCT00924937). RESULTS: We report an interaction of the TERC rs12696304 SNP with monounsaturated fatty acid (MUFA) affecting LTL (p interaction = .01) and hsCRP (p interaction = .03). Among individuals with MUFA levels above the median, CC individuals showed higher LTL and lower hsCRP than G-allele carriers. Moreover, MedDiet interacted with TERC rs12696304 SNP (p interaction = .03). Specifically, CC individuals displayed a greater decrease in hsCRP than G-allele carriers. These results were not adjusted for multiple statistical testing and p less than .05 was considered significant. CONCLUSIONS: Our findings suggest that the TERC rs12696304 SNP interacts with MUFA improving inflammation status and telomere attrition related with CHD. Moreover, the MedDiet intervention improves the inflammatory profile in CC individuals compared with the G-allele carriers. These interactions could provide a right strategy for personalized nutrition in CHD patients. Article Published Date : Oct 04, 2016

Abstract Title: Adherence to the Mediterranean diet is associated with better quality of life: data from the Osteoarthritis Initiative. Abstract Source: Am J Clin Nutr. 2016 Sep 28. Epub 2016 Sep 28. PMID: 27680996 Abstract Author(s): Nicola Veronese, Brendon Stubbs, Marianna Noale, Marco Solmi, Claudio Luchini, Stefania Maggi Article Affiliation: Nicola Veronese Abstract: BACKGROUND: The Mediterranean diet has positively influenced various medical conditions, but only a paucity of studies has considered the relation between the Mediterranean diet and quality of life (QOL) among people living in North America. OBJECTIVE: We investigated whether a higher adherence to the Mediterranean diet (aMED) was associated with better QOL and decreased pain, stiffness, disability, and depression in a large cohort of North Americans from the Osteoarthritis Initiative. DESIGN: aMED was evaluated through a validated Mediterranean diet score categorized into quintiles. Outcomes of interest were QOL [assessed with the 12-Item Short-Form Health Outcome Survey (SF-12)]; disability, pain, and stiffness [assessed in both knees with the Western Ontario and McMaster Universities Arthritis Index (WOMAC)]; and depressive symptoms [assessed with the Center for Epidemiologic Studies Depression Scale (CES-D)]. RESULTS: Of the 4470 participants (2605 women; mean age: 61.3 y), those with a higher aMED had significantly more favorable scores on all outcomes investigated (P<0.0001 for all comparisons). After adjustment for potential confounders in linear regression analyses, a higher aMED was significantly associated with a higher SF-12 physical composite scale value (β: 0.10; 95% CI: 0.05, 0.15; P<0.0001), lower WOMAC scores (except for stiffness), and lower CES-D scores (β: -0.05; 95% CI: -0.09, -0.01; P = 0.01). An adjusted logistic regression analysis, taking as reference those in the 2 highest quintiles of the aMED score, confirmed these findings. CONCLUSION: Higher aMED is associated with better QOL and decreased pain, disability, and depressive symptoms. This trial was registered at clinicaltrials.gov as NCT00080171. Article Published Date : Sep 27, 2016

Abstract Title: Mediterranean diets supplemented with virgin olive oil and nuts enhance plasmatic antioxidant capabilities and decrease xanthine oxidase activity in people with metabolic syndrome: The PREDIMED study. Abstract Source: Mol Nutr Food Res. 2016 Sep 7. Epub 2016 Sep 7. PMID: 27600061 Abstract Author(s): Antoni Sureda, Maria Del Mar Bibiloni, Miquel Martorell, Pilar Buil-Cosiales, Amelia Marti, Antoni Pons, Josep A Tur, MiguelÁngel Martinez-Gonzalez Article Affiliation: Antoni Sureda Abstract: SCOPE: This study assessed plasmatic antioxidant capabilities and xanthine oxidase activity in metabolic syndrome (MetS) patients after 5 years intervention with Mediterranean Diet (MeDiet) supplemented with extra-virgin olive oil (MeDiet+EVOO) or with nuts or with low-fat diet (the PREDIMED study). METHODS AND RESULTS: 75 participants were randomly selected. Daily energy and nutrient intake were assessed with a validated 137-item food frequency questionnaire, and adherence to the MeDiet was assessed using a 14-item questionnaire. Catalase, superoxide dismutase, myeloperoxidase, xanthine oxidase activities and protein levels, and protein carbonyl derivatives, nitrotyrosine, nitrite and nitrate levels were determined in overnight fasting venous blood samples. The plasma activity and protein levels of superoxide dismutase and catalase were significantly higher and xanthine oxidase activity lower in MeDiet+EVOO and MeDiet+nuts than in the control group. Participants in both MeDiet groups showed higher plasma nitrate levels than in the control group. Adherence to the MeDiet showed a positive correlation with superoxide dismutase and catalase plasma antioxidant activities. CONCLUSION: A MeDiet enriched with either virgin olive oil or nuts enhances the plasma antioxidant capabilities and decreases xanthine oxidase activity in patients with the metabolic syndrome but we did not observe changes in myeloperoxidase or markers of oxidative damage. This article is protected by copyright. All rights reserved. Article Published Date : Sep 06, 2016

Abstract Title: Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence. Abstract Source: Adv Nutr. 2016 Sep ;7(5):889-904. Epub 2016 Sep 15. PMID: 27633105 Abstract Author(s): Sara Danuta Petersson, Elena Philippou Article Affiliation: Sara Danuta Petersson Abstract: A growing body of evidence suggests that adherence to the Mediterranean diet (MD) may protect against cognitive decline and dementia. Many epidemiologic studies and several randomized controlled trials (RCTs) have found positive effects of the MD on cognitive function, but findings remain inconsistent. The aim of this systematic review was to provide an update on the current knowledge of the effects of the MD on cognitive function, cognitive impairment, Alzheimer disease (AD), and all-type dementia. Five databases were searched-PubMed, Embase, CINAHL, CENTRAL, and PsycINFO (1806 to 25 May 2015)-with the use of prespecified criteria. Human studies that were published in English without any restriction on study type, population assessed, intervention period, follow-up time, or publication date, and that examined the association between adherence to the MD and cognitive function or dementia symptoms (as measured by cognitive function tests), were included. Only primary publication types were included. Thirty-two studies from 25 unique cohorts, including 5 RCTs and 27 observational studies, met the inclusion criteria. The majority of studies showed that the MD was associated with improved cognitive function, a decreased risk of cognitive impairment or decreased risk of dementia, or AD. Three studies found no correlation between the MD and AD, 3 further studies found no association between the MD and cognitive impairment, and 5 studies found no association between the MD and cognitive function. There was large heterogeneity, and studies differed with regard to quality. Based on the findings and the limitations in study design, we conclude that adherence to the MD is associated with better cognitive performance. However, it should be noted that the majority of findings come from epidemiologic studies that provide evidence for a correlation between the MD and cognition but not for a cause-and-effect relation. More controlled trials are required to establish a causational relation. Article Published Date : Aug 31, 2016

Abstract Title: Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies. Abstract Source: Int J Food Sci Nutr. 2016 Aug 25:1-11. Epub 2016 Aug 25. PMID: 27557591 Abstract Author(s): Justyna Godos, Gaetano Zappalà, Sergio Bernardini, Ilio Giambini, Maira Bes-Rastrollo, Miguel Martinez-Gonzalez Article Affiliation: Justyna Godos Abstract: Diet plays a role in the onset and progression of metabolic disorders, including metabolic syndrome (MetS). We aimed to systematically review and conduct a quantitative meta-analysis of results from observational cross-sectional and prospective cohort studies on adherence to the Mediterranean dietary pattern and risk of MetS. Literature databases including PubMed, SCOPUS and EMBASE were searched from the beginning to May 2016. Eight cross-sectional and four prospective studies were included in this meta-analysis, accounting for a total of 33,847 individuals and 6342 cases of MetS. High adherence to the Mediterranean diet was associated with a risk of MetS (RR: 0.81, 95%CI: 0.71, 0.92). Regarding individual components of the MetS, the inverse associations were significant for waist circumference, blood pressure and low HDL-C levels. In conclusion, adoption of a Mediterranean dietary pattern was associated with lower risk of the MetS and it can be proposed for the primary prevention of the MetS. Article Published Date : Aug 24, 2016

Abstract Title: Adherence to a Mediterranean-Style Diet and Its Influence on Cardiovascular Risk Factors in Postmenopausal Women. Abstract Source: J Acad Nutr Diet. 2016 Aug 25. Epub 2016 Aug 25. PMID: 27568885 Abstract Author(s): Jessica D Bihuniak, Anna Ramos, Tania Huedo-Medina, Heather Hutchins-Wiese, Jane E Kerstetter, Anne M Kenny Article Affiliation: Jessica D Bihuniak Abstract: BACKGROUND: A Mediterranean-style diet (MedSD) is associated with positive health outcomes, particularly reduced risk of cardiovascular disease. It is of interest to assess the feasibility of adherence to a MedSD in a subset of older adults in the United States. OBJECTIVE: To assess the efficacy of implementing a MedSD intervention in a subset of postmenopausal women living in the United States, and to detect the influence of this dietary pattern on blood lipid levels. DESIGN: A partial feeding, nutrition counseling, pilot study with a one-group longitudinal design. PARTICIPANTS: Sixteen healthy, postmenopausal, American women living in suburban communities in Farmington, CT, with a mean±standard deviation age of 77±6.8 years and a body mass index of 26.1±3.1. INTERVENTION: Participants were counseled by a registered dietitian nutritionist on how to follow a MedSD, which included increased sources of n-3 polyunsaturated fatty acids, fruits, and vegetables, and decreased saturated fat, n-6 polyunsaturated fatty acids, and simple sugars for 12 weeks. To maintain isocaloric conditions, participants were asked to substitute sources of saturated fat and refined carbohydrates for extra virgin olive oil (3 T/day), walnuts (1.5 oz/day), and fatty fish (3 to 5 servings/wk), which were provided at 3-week intervals. MAIN OUTCOME MEASURES: Dietary adherence measures included the Mediterranean Diet Score, 3-day diet records, and serum fatty acid and lipid profiles. STATISTICAL ANALYSES: Mixed model longitudinal analyses were conducted to assess changes over time (Weeks 0, 12, and 24) in the outcome variables. RESULTS: Mediterranean Diet Score increased by 8.9 points (P<0.001) after the MedSD phase. Dietary sugar decreased by 10.8 g (P<0.05), total dietary n-3 increased by 1.6 g (P<0.01), total dietary n-6 increased by 5.5 g (P<0.01), and dietary n-6:n3 ratio decreased by 3.6 units (P<0.01). In serum, 22:6 (n-3), 20:5 (n-3), and 18:3 (n-3) increased (P<0.001, P<0.01, and P<0.001, respectively), and 14:0, 16:0, 17:0, 20:4 (n-6), 22:4 (n-6) declined after the intervention (P<0.01, P<0.001, P<0.01, P<0.01, and P<0.001, respectively), which support a change in dietary intake toward a MedSD. Serum high-density lipoprotein cholesterol levels increased by 3.8 mg/dL (0.098 mmol/L) (P<0.05) and serum triglyceride levels decreased by 11.6 mg/dL (0.131 mmol/L) (P<0.10). CONCLUSIONS: A pilot study of a 12-week MedSD intervention with counseling from a registered dietitian nutritionist can favorably influence the dietary pattern and lipid profile of postmenopausal women living in the United States. Article Published Date : Aug 24, 2016

Abstract Title: Mediterranean diet and life expectancy; beyond olive oil, fruits, and vegetables. Abstract Source: Curr Opin Clin Nutr Metab Care. 2016 Aug 23. Epub 2016 Aug 23. PMID: 27552476 Abstract Author(s): Miguel A Martinez-Gonzalez, Nerea Martin-Calvo Article Affiliation: Miguel A Martinez-Gonzalez Abstract: PURPOSE TO REVIEW: The recent relevant evidence of the effects of the Mediterranean diet (MedDiet) and lifestyle on health (2015 and first months of 2016). RECENT FINDINGS: Large observational prospective epidemiological studies with adequate control of confounding and two large randomized trials support the benefits of the Mediterranean dietary pattern to increase life expectancy, reduce the risk of major chronic disease, and improve quality of life and well-being. Recently, 19 new studies from large prospective studies showed - with nearly perfect consistency - strong benefits of the MedDiet to reduce the risk of myocardial infarction, stroke, total mortality, heart failure, and disability. Interestingly, two large and well conducted cohorts reported significant cardiovascular benefits after using repeated measurements of diet during a long follow-up period. In addition, Prevención con Dieta Mediterránea, the largest randomized trial with MedDiet, recently reported benefits of this dietary pattern to prevent cognitive decline and breast cancer. SUMMARY: In the era of evidence-based medicine, the MedDiet represents the gold standard in preventive medicine, probably because of the harmonic combination of many elements with antioxidant and anti-inflammatory properties, which overwhelm any single nutrient or food item. The whole seems more important than the sum of its parts. Article Published Date : Aug 22, 2016

Abstract Title: Mediterranean diet and colorectal cancer risk: a pooled analysis of three Italian case-control studies. Abstract Source: Br J Cancer. 2016 Aug 18. Epub 2016 Aug 18. PMID: 27537381 Abstract Author(s): Valentina Rosato, Valentina Guercio, Cristina Bosetti, Eva Negri, Diego Serraino, Attilio Giacosa, Maurizio Montella, Carlo La Vecchia, Alessandra Tavani Article Affiliation: Valentina Rosato Abstract: BACKGROUND: Adherence to the Mediterranean diet (MD) is associated with a reduced risk of several cancers. However, studies conducted in Mediterranean regions are scanty. METHODS: To investigate the relation between MD and colorectal cancer risk in Italy, we pooled data from three case-control studies, including a total of 3745 colorectal cancer cases and 6804 hospital controls. Adherence to the MD was assessed using an a priori Mediterranean Diet Score (MDS), based on nine components. RESULTS: Compared with the lowest adherence to the MD (0-2 MDS), the odds ratio (OR) was 0.52 (95% confidence interval (CI) 0.43-0.62) for the highest adherence (7-9 MDS), with a significant inverse trend in risk (P<0.0001). The OR for a 1-point increment in the MDS was 0.89 (95% CI 0.86-0.91). The inverse association was consistent across studies, cancer anatomical subsites and strata of selected covariates. CONCLUSIONS: This Italian study confirms a favourable role of MD on colorectal cancer risk.British Journal of Cancer advance online publication, 18 August 2016; doi:10.1038/bjc.2016.245 www.bjcancer.com. Article Published Date : Aug 17, 2016

Abstract Title: Effects of Mediterranean diet on sexual function in people with newly diagnosed type 2 diabetes: The MÈDITA trial. Abstract Source: J Diabetes Complications. 2016 Aug 12. Epub 2016 Aug 12. PMID: 27614727 Abstract Author(s): Maria Ida Maiorino, Giuseppe Bellastella, Mariangela Caputo, Filomena Castaldo, Maria Rosaria Improta, Dario Giugliano, Katherine Esposito Article Affiliation: Maria Ida Maiorino Abstract: AIMS: To assess the long-term effect of Mediterranean diet, as compared with low-fat diet, on sexual function in patients with newly diagnosed type 2 diabetes. METHODS: In a randomized clinical trial, with a total follow-up of 8.1years, 215 men and women with newly diagnosed type 2 diabetes were assigned to Mediterranean diet (n=108) or a low-fat diet (n=107). The primary outcome measures were changes of erectile function (IIEF) in diabetic men and of female sexual function (FSFI) in diabetic women. RESULTS: There was no difference in baseline sexual function in men (n=54 vs 52) or women (n=54 vs 55) randomized to Mediterranean diet or low-fat diet, respectively (P=0.287, P=0.815). Over the entire follow-up, the changes of the primary outcomes were significantly lower in the Mediterranean diet group compared with the low-fat group: IIEF and FSFI showed a significantly lesser decrease (1.22 and 1.18, respectively, P=0.024 and 0.019) with the Mediterranean diet. Baseline C-reactive protein levels predicted erectile dysfunction in men but not female sexual dysfunction in women. CONCLUSIONS: Among persons with newly diagnosed type 2 diabetes, a Mediterranean diet reduced the deterioration of sexual function over time in both sexes. Article Published Date : Aug 11, 2016

Abstract Title: Adherence to the Mediterranean diet is associated with reduced risk of incident chronic kidney diseases among Tehranian adults. Abstract Source: Hypertens Res. 2016 Aug 11. Epub 2016 Aug 11. PMID: 27511053 Abstract Author(s): Golaleh Asghari, Hossein Farhadnejad, Parvin Mirmiran, Alireza Dizavi, Emad Yuzbashian, Fereidoun Azizi Article Affiliation: Golaleh Asghari Abstract: Greater adherence to the Mediterranean diet has beneficial effects on the prevention of chronic diseases. In the current study, we investigated the association between the Mediterranean diet score (MDS) and the 6-year incidence of chronic kidney disease (CKD), conducted in the framework of the Tehran Lipid and Glucose Study with 1212 adults, aged 30-71 years. Dietary intake was assessed using a valid and reliable food-frequency questionnaire, and all subjects received scores between 0 and 8 points based on the traditional MDS. The components of the MDS were fruits and nuts, vegetables, legumes, cereals, fish, meat, dairy products and the monounsaturated to saturated fatty acid ratio. The odds ratio (OR) for the occurrence of CKD according to the quartiles of the MDS was assessed by multivariable logistic regression. The mean (s.d.) age of participants (51% male) at baseline was 43.5 (9.4) years. The median (25-75 interquartile range) of MDS for all subjects was 4 (3-5).The incidence of CKD was 19%. After adjustment for all potential confounding variables, individuals in the highest quartile of the MDS were 51% less likely to have CKD than those in the lowest quartile (OR=0.49; 95% confidence interval (CI): 0.30-0.82). Additionally, after further adjustment for baseline estimated glomerular filtration rate (GFR), the inverse association between the MDS and the 6-year incidence of CKD remained significant (OR=0.53; 95% CI: 0.31-0.91). Our findings demonstrate a significant inverse association between the MDS and the risk of incident CKD, indicating that adherence to the Mediterranean diet has favorable effects on the prevention of kidney dysfunction.Hypertension Research advance online publication, 11 August 2016; doi:10.1038/hr.2016.98. Article Published Date : Aug 10, 2016

Abstract Title: Mediterranean diet and nonalcoholic fatty liver disease: molecular mechanisms of protection. Abstract Source: Int J Food Sci Nutr. 2016 Aug 2:1-10. Epub 2016 Aug 2. PMID: 27484357 Abstract Author(s): Justyna Godos, Alessandro Federico, Marcello Dallio, Francesca Scazzina Article Affiliation: Justyna Godos Abstract: Nutritional habits modifications have shown an important impact in preventing and ameliorating metabolic alterations, such as nonalcoholic fatty liver disease (NAFLD). Among several dietary approaches that exert positive effects in NAFLD patients, the Mediterranean dietary pattern has shown notable benefits. This review explores the molecular mechanisms through which the Mediterranean diet would improve risk factors associated with metabolic syndrome and NAFLD. The main features of the Mediterranean diet acting on metabolism are represented by its whole-grain and low glycemic index cereal-based items, its fatty acid profile, and its content in phytochemical compounds. Carbohydrate-rich foods high in dietary fiber inducing low glycemic response are able to interact with glucose and insulin metabolism. Unsaturated fatty acids are associated with better hepatic lipid metabolism. Finally, phytochemical compounds, such as dietary polyphenols, are thought to ameliorate inflammation, which is considered one of the mechanisms through which NALFD may evolve into nonalcoholic steatohepatitis (NASH). Article Published Date : Aug 01, 2016

Abstract Title: Association between Mediterranean diet and head and neck cancer: results of a large case-control study in Italy. Abstract Source: Eur J Cancer Prev. 2016 Aug 1. Epub 2016 Aug 1. PMID: 27483412 Abstract Author(s): Luca Giraldi, Nikola Panic, Gabriella Cadoni, Stefania Boccia, Emanuele Leoncini Article Affiliation: Luca Giraldi Abstract: The Mediterranean diet (MD) is a known protective factor for head and neck cancer (HNC); however, there is still a lack of studies investigating this association by HNC subsite. The aim of the present study was therefore to evaluate the association between adherence to MD and HNC overall and by cancer subsite, as well as the effect of the individual food components on HNC risk. A case-control study was carried out at the Gemelli Hospital of Rome (Italy). A total of 500 HNC cases and 433 controls were interviewed. Dietary intake was assessed through a validated food frequency questionnaire that collected information on over 25 food items. Odds ratios (ORs) and 95% confidence intervals (CI) of HNC were calculated using a multiple logistic regression model. We found a reduced risk of both oral cavity and pharynx cancer (OR=0.61; CI: 0.54-0.70) and larynx cancer (OR=0.64; CI: 0.56-0.73) with increasing adherence to MD. We also found a high consumption of fruit, vegetables, and legumes to be significantly associated with a lower risk of larynx as well as oral cavity and pharynx cancers. Our study showed that adherence to MD acts protectively against HNC overall and by cancer subsite. Article Published Date : Jul 31, 2016

Abstract Title: Long-Term Immunomodulatory Effects of a Mediterranean Diet in Adults at High Risk of Cardiovascular Disease in the PREvención con DIeta MEDiterránea Randomized Controlled Trial. Abstract Source: J Nutr. 2016 Jul 20. Epub 2016 Jul 20. PMID: 27440261 Abstract Author(s): Rosa Casas, Emilio Sacanella, Mireia Urpí-Sardà, Dolores Corella, Olga Castañer, Rosa-María Lamuela-Raventos, Jordi Salas-Salvadó, Miguel-Angel Martínez-González, Emilio Ros, Ramon Estruch Article Affiliation: Rosa Casas Abstract: BACKGROUND: The Mediterranean diet (MedDiet) has demonstrated short-term anti-inflammatory effects, but little is known about its long-term immunomodulatory properties. OBJECTIVE: Our goal was to assess the long-term effects of the MedDiet on inflammatory markers related to atherogenesis in adults at high risk of cardiovascular disease (CVD) compared with the effects of a low-fat diet (LFD). METHODS: We randomly assigned 165 high-risk participants (one-half men; mean age: 66 y) without overt CVD to 1 of 3 diets: a MedDiet supplemented with extra-virgin olive oil, a MedDiet supplemented with nuts, or an LFD. Follow-up data were collected at 3 and 5 y. Repeated-measures ANOVA, adjusted for potential confounding variables, was used to evaluate changes in diet adherence, CVD risk factors, and inflammatory variables. RESULTS: The 2 MedDiet groups achieved a high degree of adherence to the intervention, and the LFD group had reduced energy intake from fat by 13% by 5 y. Compared with baseline, at 3 and 5 y, both MedDiet groups had significant reductions of≥16% in plasma concentrations of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor α, and monocyte chemoattractant protein 1 (P ≤ 0.04), whereas there were no significant changes in the LFD group. The reductions in CD49d and CD40 expressions in T lymphocytes and monocytes at 3 y were ≥16% greater in both MedDiet groups than were the changes in the LFD group (P<0.001) at 3 y. Compared with baseline, at 3 y, the MedDiet groups had increased HDL-cholesterol (≥8%) and decreased blood pressure (>4%) and total cholesterol, LDL-cholesterol, and triglyceride (≥8%) concentrations. At 5 y, concentrations of glucose (13%) and glycated hemoglobin (8%) had increased with the LFD. CONCLUSIONS: The MedDiet participants had lower cellular and plasma concentrations of inflammatory markers related to atherosclerosis at 3 and 5 y. This anti-inflammatory role of the MedDiet could explain in part the long-term cardioprotective effect of the MedDiet against CVD. This trial was registered at controlled-trials.com as ISRCTN35739639. Article Published Date : Jul 19, 2016

Abstract Title: Mediterranean Diet and Hip Fracture in Swedish Men and Women. Abstract Source: J Bone Miner Res. 2016 Jun 27. Epub 2016 Jun 27. PMID: 27345330 Abstract Author(s): Liisa Byberg, Andrea Bellavia, Susanna C Larsson, Nicola Orsini, Alicja Wolk, Karl Michaëlsson Article Affiliation: Liisa Byberg Abstract: A Mediterranean diet, known to have beneficial effects on cardiovascular health, may also influence the risk of hip fracture although previous studies present discrepant results. We therefore aimed to determine whether the rate of hip fracture was associated with degree of adherence to a Mediterranean diet. We combined two Swedish cohort studies consisting of 37,903 men and 33,403 women (total n = 71,333, mean age 60 years) free of previous cardiovascular disease and cancer who answered a medical and a food-frequency questionnaire in 1997. A modified Mediterranean diet score (mMED; range 0-8 points) was created based on high consumption of fruits and vegetables, legumes and nuts, wholegrains, fermented dairy products, fish, and olive/rapeseed oil, moderate intake of alcohol, and low intake of red and processed meat. Incident hip fractures between 1 January 1998 and 31 December 2012 were retrieved from the National Patient Register. Hazard ratios (HR) and 95% confidence intervals(CI) adjusted for potential confounders were calculated using Cox proportional hazards regression. Differences in age at hip fracture were calculated using multivariable Laplace regression. During follow-up, 3,175 hip fractures occurred at a median age of 73.3 years. One unit increase in the mMED was associated with 6% lower hip fracture rate (adjusted HR = 0.94; 95% CI 0.92-0.96) and with a three months higher median age at hip fracture (50(th) percentile difference = 2.8 months; 95% CI 1.4-4.2). Comparing the highest quintile of adherence to the mMED (6-8 points) with the lowest (0-2 points) conferred an adjusted HR of hip fracture of 0.78 (95% CI 0.69-0.89) and a 12 months higher median age of hip fracture (50(th) percentile difference = 11.6 months; 95% CI 4.2-19.0). Results were similar in men and women. We conclude that higher adherence to a Mediterranean-like diet isassociated with lower risk of future hip fracture. This article is protected by copyright. All rights reserved. Article Published Date : Jun 26, 2016

Abstract Title: Effect of a high-fat Mediterranean diet on bodyweight and waist circumference: a prespecified secondary outcomes analysis of the PREDIMED randomised controlled trial. Abstract Source: Lancet Diabetes Endocrinol. 2016 Jun 6. Epub 2016 Jun 6. PMID: 27283479 Abstract Author(s): Ramon Estruch, Miguel Angel Martínez-González, Dolores Corella, Jordi Salas-Salvadó, Montserrat Fitó, Gemma Chiva-Blanch, Miquel Fiol, Enrique Gómez-Gracia, Fernando Arós, José Lapetra, Lluis Serra-Majem, Xavier Pintó, Pilar Buil-Cosiales, José V Sorlí, Miguel A Muñoz, Josep Basora-Gallisá, Rosa María Lamuela-Raventós, Mercè Serra-Mir, Emilio Ros, Article Affiliation: Ramon Estruch Abstract: BACKGROUND: Because of the high density of fat, high-fat diets are perceived as likely to lead to increased bodyweight, hence health-care providers are reluctant to recommend them to overweight or obese individuals. We assessed the long-term effects of ad libitum, high-fat, high-vegetable-fat Mediterranean diets on bodyweight and waist circumference in older people at risk of cardiovascular disease, most of whom were overweight or obese. METHODS: PREDIMED was a 5 year parallel-group, multicentre, randomised, controlled clinical trial done in primary care centres affiliated to 11 hospitals in Spain. 7447 asymptomatic men (aged 55-80 years) and women (aged 60-80 years) who had type 2 diabetes or three or more cardiovascular risk factors were randomly assigned (1:1:1) with a computer-generated number sequence to one of three interventions: Mediterranean diet supplemented with extra-virgin olive oil (n=2543); Mediterranean diet supplemented with nuts (n=2454); or a control diet (advice to reduce dietary fat; n=2450). Energy restriction was not advised, nor was physical activity promoted. In this analysis of the trial, we measured bodyweight and waist circumference at baseline and yearly for 5 years in the intention-to-treat population. The PREDIMED trial is registered with ISRCTN.com, number ISRCTN35739639. FINDINGS: After a median 4·8 years (IQR 2·8-5·8) of follow-up, participants in all three groups had marginally reduced bodyweight and increased waist circumference. The adjusted difference in 5 year changes in bodyweight in the Mediterranean diet with olive oil group was -0·43 kg (95% CI -0·86 to -0·01; p=0·044) and in the nut group was -0·08 kg (-0·50 to 0·35; p=0·730), compared with the control group. The adjusted difference in 5 year changes in waist circumference was -0·55 cm (-1·16 to -0·06; p=0·048) in the Mediterranean diet with olive oil group and -0·94 cm (-1·60 to -0·27; p=0·006) in the nutgroup, compared with the control group. INTERPRETATION: A long-term intervention with an unrestricted-calorie, high-vegetable-fat Mediterranean diet was associated with decreases in bodyweight and less gain in central adiposity compared with a control diet. These results lend support to advice not restricting intake of healthy fats for bodyweight maintenance. FUNDING: Spanish Government, CIBERobn, Instituto de Salud Carlos III, Hojiblanca, Patrimonio Comunal Olivarero, California Walnut Commission, Borges SA, and Morella Nuts. Article Published Date : Jun 05, 2016

Abstract Title: Quantifying the benefits of Mediterranean diet in terms of survival. Abstract Source: Eur J Epidemiol. 2016 May ;31(5):527-30. Epub 2016 Feb 5. PMID: 26848763 Abstract Author(s): Andrea Bellavia, Thanasis G Tektonidis, Nicola Orsini, Alicja Wolk, Susanna C Larsson Article Affiliation: Andrea Bellavia Abstract: Beneficial effects of Mediterranean diet (MD) have been consistently documented. However, to fully understand the public health implications of MD adherence, an informative step is to quantify these effects in terms of survival time differences. The aim of this study was to evaluate the impact of MD on survival, presenting results in terms of differences in median age at death. We used data from 71,333 participants from a large population-based cohort of Swedish men and women, followed-up between January 1, 1998, and December 31, 2012. A total score of MD, ranging from 0 to 8, was calculated by including information on vegetables and fruits consumption, legumes and nuts, non-refined/high fiber grains, fermented dairy products, fish, red meat, use of olive oil/rapeseed oil, and moderate alcohol intake. Multivariable-adjusted differences in median age at death were estimated with Laplace regression and presented as a function of the MD score. During 15 years of follow-up we documented 14,697 deaths. We observed a linear dose-response association between the MD score and median age at death, with higher score associated with longer survival. The difference in median age at death between participants with the extreme scores (0 vs 8) of MD was up to 2 years (23 months, 95 % CI: 16-29). In this study we documented that adherence to MD may accrue benefits up to 2 years of longer survival. Article Published Date : Apr 30, 2016

Abstract Title: Polyphenol intake from a Mediterranean diet decreases inflammatory biomarkers related to atherosclerosis: A sub-study of The PREDIMED trial. Abstract Source: Br J Clin Pharmacol. 2016 Apr 21. Epub 2016 Apr 21. PMID: 27100393 Abstract Author(s): Alexander Medina-Remón, Rosa Casas, Anna Tressserra-Rimbau, Emilio Ros, Miguel A Martínez-González, Montserrat Fitó, Dolores Corella, Jordi Salas-Salvadó, Rosa M Lamuela-Raventos, Ramón Estruch, Article Affiliation: Alexander Medina-Remón Abstract: BACKGROUND AND AIMS: High dietary polyphenol intake is associated with reduced all-cause mortality and lower incidence of cardiovascular events. However, the mechanisms involved are not fully understood. The aim of this sub-study of the PREDIMED (Prevention with Mediterranean diet) trial was to analyze the relationship of polyphenol intake measured by total urinary polyphenol excretion (TPE), with circulating inflammatory biomarkers and cardiovascular risk factors in elderly individuals. MATERIALS AND METHODS: A sub-study of 1139 high-risk participants was carried out within the PREDIMED trial. The subjects were randomly assigned to a low-fat control diet or to two Mediterranean diets, supplemented with either extra-virgin olive oil or nuts. Dietary intake, anthropometrics, clinical and laboratory assessments including inflammatory biomarkers, and urinary TPE were measured at baseline and after one-year intervention. RESULTS: Participants in the highest tertile of changes in urinary TPE (T3) showed significant lower plasma inflammatory biomarkers [VCAM-1 (-9.47 np/mL), ICAM-1 (-14.71 np/mL), IL-6 (-1.21 pg/mL), TNF-α (-7.05 pg/mL), and MCP-1 (-3.36 pg/mL)] than those in the lowest tertile (T1, P < 0.02; all). A significant inverse correlation existed between urinary TPE and plasma concentration of VCAM-1(r = -0.301; P < 0.001). In addition, systolic and diastolic blood pressure (BP) decreased and plasma HDL-cholesterol increased in parallel with increasing urinary TPE (T3 vs T1)(P < 0.005 and P = 0.004, respectively). CONCLUSIONS: Increases in polyphenol intake measured as urinary TPE are associated with decreased inflammatory biomarkers, suggesting a dose-dependent anti-inflammatory effect of polyphenols. In addition, high polyphenol intake improves cardiovascular risk factors, mainly BP and the lipid profile. This article is protected by copyright. All rights reserved. Article Published Date : Apr 20, 2016

Abstract Title: Mediterranean diet and telomere length in high cardiovascular risk subjects from the PREDIMED-NAVARRA study. Abstract Source: Clin Nutr. 2016 Apr 1. Epub 2016 Apr 1. PMID: 27083496 Abstract Author(s): Sonia García-Calzón, Miguel A Martínez-González, Cristina Razquin, Fernando Arós, José Lapetra, J Alfredo Martínez, Guillermo Zalba, Amelia Marti Article Affiliation: Sonia García-Calzón Abstract: BACKGROUND & AIMS: A healthy lifestyle has been associated with longer telomeres, but whether Mediterranean Diet (MeDiet) affect telomere length (TL) has not been fully elucidated yet. Our aim was to assess the relationship between MeDiet and TL in high cardiovascular risk subjects in the context of a randomized nutritional intervention trial. METHODS: We assessed 520 participants (55-80 years, 55% women) from the PREDIMED-NAVARRA trial. Leukocyte TL was measured by qPCR at baseline and after 5 years of a dietary intervention program where subjects were randomly assigned to a low-fat control diet or to two MeDiets, one supplemented with extra virgin olive oil (MeDiet-EVOO) and the other with mixed nuts (MeDiet-nuts). A validated 14-item questionnaire was used to appraise baseline adherence of participants to the MeDiet. RESULTS: Better adherence to MeDiet (as appraised by the 14-item score) was associated with longer basal telomeres in women in the baseline cross-sectional analysis, whereas the opposite was observed in men (P interaction = 0.036). Female subjects who scored 10 points had longer basal telomeres (0.27, 95% CI: 0.03-0.52) than women scoring ≤6 points at the beginning of the study (-0.46, 95% CI: -0.85 to -0.7) (P = 0.003). However, allocation to the MeDiet-nuts group (-0.24, 95% CI: -0.38 to -0.01) was associated with a higher risk of telomere shortening after 5 years of intervention, whereas no differences were found for the MeDiet-EVOO group (0.14, 95% CI: 0.02-0.27), in comparison with the Control group (0.07, 95% CI: -0.08 to 0.23) (P = 0.003 and P = 0.537, respectively). CONCLUSION: A greater baseline adherence to a Mediterranean dietary pattern was associated with longer telomeres only in women. No beneficial effect of the intervention with the MeDiet for the prevention of telomere shortening in comparison with a low-fat diet was observed. Article Published Date : Mar 31, 2016

Abstract Title: The gut microbial community in metabolic syndrome patients is modified by diet. Abstract Source: J Nutr Biochem. 2016 Jan ;27:27-31. Epub 2015 Aug 20. PMID: 26376027 Abstract Author(s): Carmen Haro, Sonia Garcia-Carpintero, Juan F Alcala-Diaz, Francisco Gomez-Delgado, Javier Delgado-Lista, Pablo Perez-Martinez, Oriol A Rangel Zuñiga, Gracia M Quintana-Navarro, Blanca B Landa, Jose C Clemente, Jose Lopez-Miranda, Antonio Camargo, Francisco Perez-Jimenez Article Affiliation: Carmen Haro Abstract: Intestinal microbiota changes may be involved in the development of metabolic syndrome (MetS), which is a multicomponent disorder frequently associated with obesity. The aim of this study was to test the effect of consuming two healthy diets: a Mediterranean diet and a low-fat high-carbohydrate diet, for 2years in the gut microbiota of MetS patients and those in the control group. We analyzed the differences in the bacterial community structure between the groups after 2years of dietary intervention (Mediterranean or low-fat diet) through quantitative polymerase chain reaction using primers, targeting specific bacterial taxa. We observed, at basal time, that the abundance of Bacteroides, Eubacterium and Lactobacillus genera is lower in the control group than in MetS patients, while Bacteroides fragilis group, Parabacteroides distasonis, Bacteroides thetaiotaomicron, Faecalibacterium prausnitzii, Fusobacterium nucleatum, Bifidobacterium longum, Bifidobacterium adolescentis, Ruminococcus flavefaciens subgroup and Eubacterium rectale are depleted in MetS patients (all P values<.05). Additionally, we found that long-term consumption of Mediterranean diet partially restores the population of P. distasonis, B. thetaiotaomicron, F. prausnitzii, B. adolescentis and B. longum in MetS patients (all P values<.05). Our results suggest that the Mediterranean diet could be a useful tool to restore potentially beneficial members of the gut microbiota, although the stability of these changes over time still remains to be assessed. Article Published Date : Dec 31, 2015

Abstract Title: Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: the EPIC-Norfolk study. Abstract Source: BMC Med. 2016;14(1):135. Epub 2016 Sep 29. PMID: 27679997 Abstract Author(s): Tammy Y N Tong, Nicholas J Wareham, Kay-Tee Khaw, Fumiaki Imamura, Nita G Forouhi Article Affiliation: Tammy Y N Tong Abstract: BACKGROUND: Despite convincing evidence in the Mediterranean region, the cardiovascular benefit of the Mediterranean diet is not well established in non-Mediterranean countries and the optimal criteria for defining adherence are unclear. The population attributable fraction (PAF) of adherence to this diet is also unknown. METHODS: In the UK-based EPIC-Norfolk prospective cohort, we evaluated habitual diets assessed at baseline (1993-1997) and during follow-up (1998-2000) using food-frequency questionnaires (n = 23,902). We estimated a Mediterranean diet score (MDS) using cut-points projected from the Mediterranean dietary pyramid, and also three other pre-existing MDSs. Using multivariable-adjusted Cox regression with repeated measures of MDS and covariates, we examined prospective associations between each MDS with incident cardiovascular diseases (CVD) by 2009 and mortality by 2013, and estimated PAF for each outcome attributable to low MDS. RESULTS: We observed 7606 incident CVD events (2818/100,000 person-years) and 1714 CVD deaths (448/100,000). The MDS based on the Mediterranean dietary pyramid was significantly associated with lower incidence of the cardiovascular outcomes, with hazard ratios (95 % confidence intervals) of 0.95 (0.92-0.97) per one standard deviation for incident CVD and 0.91 (0.87-0.96) for CVD mortality. Associations were similar for composite incident ischaemic heart disease and all-cause mortality. Other pre-existing MDSs showed similar, but more modest associations. PAF due to low dietary pyramid based MDS (<95th percentile) was 3.9 % (1.3-6.5 %) for total incident CVD and 12.5 % (4.5-20.6 %) for CVD mortality. CONCLUSIONS: Greater adherence to the Mediterranean diet was associated with lower CVD incidence and mortality in the UK. This diet has an important population health impact for the prevention of CVD. Article Published Date : Dec 31, 2015

Abstract Title: Predictive role of the Mediterranean diet on mortality in individuals at low cardiovascular risk: a 12-year follow-up population-based cohort study. Abstract Source: J Transl Med. 2016 ;14(1):91. Epub 2016 Apr 12. PMID: 27071746 Abstract Author(s): Simona Bo, Valentina Ponzo, Ilaria Goitre, Maurizio Fadda, Andrea Pezzana, Guglielmo Beccuti, Roberto Gambino, Maurizio Cassader, Laura Soldati, Fabio Broglio Article Affiliation: Simona Bo Abstract: BACKGROUND: Adherence to the Mediterranean diet reduces the risk of all-cause and cardiovascular (CV) mortality and the incidence of CV events. However, most previous studies were performed in high-risk individuals. Our objective was to assess whether the adherence to the Mediterranean diet, evaluated by the MED score, was associated with all-cause and CV mortality and incidence of CV events in individuals at low CV risk from a population-based cohort, after a 12-year mean follow-up. METHODS: A cohort of 1658 individuals completed a validated food-frequency questionnaire in 2001-2003. The MED score was calculated by a 0-9 scale. Anthropometric, laboratory measurements, and the vital status were collected at baseline and during 2014. The baseline CV risk was estimated by the Framingham risk score. Participants were divided into two groups: individuals at low risk (CV < 10) and individuals with CV risk ≥10. RESULTS: During a 12-year mean follow-up, 220 deaths, 84 due to CV diseases, and 125 incident CV events occurred. The adherence to the Mediterranean diet was low in 768 (score 0-2), medium in 685 (score 4-5) and high in 205 (score>6) individuals. Values of BMI, waist circumference, fasting glucose and insulin significantly decreased from low to high diet adherence only in participants with CV risk≥10. In a Cox-regression model, the hazard ratios (HRs) in low-risk individuals per unit of MED score were: HR = 0.83 (95 % CI 0.72-0.96) for all-cause mortality, HR = 0.75 (95 % CI 0.58-0.96) for CV mortality, and HR = 0.79 (95 % CI 0.65-0.97) for CV events, after multiple adjustments. In individuals with CV risk ≥10, the MED score predicted incident CV events (HR = 0.85; 95 % CI 0.72-0.99), while the associations with all-cause (HR = 1.02; 95 % CI 0.90-1.15) and CV mortality (0.94; 95 % CI 0.76-1.15) were not significant. CONCLUSIONS: Greater adherence to the Mediterranean diet was associated with reduced fatal and non fatal CV events, especially in individuals at low CV risk, thus suggesting the usefulness of promoting this nutritional pattern in particular in healthier individuals. Article Published Date : Dec 31, 2015

Abstract Title: Dietary inflammatory index and telomere length in subjects with a high cardiovascular disease risk from the PREDIMED-NAVARRA study: cross-sectional and longitudinal analyses over 5 y. Abstract Source: Am J Clin Nutr. 2015 Oct ;102(4):897-904. Epub 2015 Sep 9. PMID: 26354530 Abstract Author(s): Sonia García-Calzón, Guillermo Zalba, Miguel Ruiz-Canela, Nitin Shivappa, James R Hébert, J Alfredo Martínez, Montserrat Fitó, Enrique Gómez-Gracia, Miguel A Martínez-González, Amelia Marti Article Affiliation: Sonia García-Calzón Abstract: BACKGROUND: Dietary factors can affect telomere length (TL), a biomarker of aging, through oxidation and inflammation-related mechanisms. A Dietary Inflammatory Index (DII) could help to understand the effect of the inflammatory potential of the diet on telomere shortening. OBJECTIVE: This study aimed to determine the association of the DII with TL and to examine whether diet-associated inflammation could modify the telomere attrition rate after a 5-y follow-up of a Mediterranean dietary intervention. DESIGN: This was a prospective study of 520 participants at high cardiovascular disease risk (mean± SD age: 67.0 ± 6.0 y, 45% males) from the PREDIMED-NAVARRA (PREvención con DIeta MEDiterránea-NAVARRA) trial. Leukocyte TL was measured by quantitative real-time polymerase chain reaction at baseline and after 5 y of follow-up. The DII was calculated from self-reported data by using a validated 137-item food-frequency questionnaire. RESULTS: Longer telomeres at baseline were found in participants who had a more anti-inflammatory diet (lowest DII score) (P-trend = 0.012). Longitudinal analyses further showed that a greater anti-inflammatory potential of the diet (i.e., a decrease in the DII) could significantly slow down the rate of telomere shortening. Moreover, the multivariable-adjusted OR for short telomeres (z score≤20th percentile) was 1.80 (95% CI: 1.03, 3.17) in a comparison between the highest (proinflammatory) and the lowest (anti-inflammatory) DII tertiles. Similarly, a greater DII (greatest proinflammatory values) after a 5-y follow-up was associated with almost a 2-fold higher risk of accelerated telomere attrition compared with the highest decrease in DII (greatest anti-inflammatory values) during this period (P-trend = 0.025). CONCLUSIONS: This study showed both cross-sectional and longitudinal associations between the inflammatory potential of the diet and telomere shortening in subjects with a high cardiovascular disease risk. Our findings are consistent with, but do not show, a beneficial effect of adherence to an anti-inflammatory diet on aging and health by slowing down telomere shortening. These results suggest that diet might play a key role as a determinant of TL through proinflammatory or anti-inflammatory mechanisms. This trial was registered at controlled-trials.com as ISRCTN35739639. Article Published Date : Sep 30, 2015

Abstract Title: Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. Abstract Source: JAMA Intern Med. 2015 Sep 14:1-9. Epub 2015 Sep 14. PMID: 26365989 Abstract Author(s): Estefanía Toledo, Jordi Salas-Salvadó, Carolina Donat-Vargas, Pilar Buil-Cosiales, Ramón Estruch, Emilio Ros, Dolores Corella, Montserrat Fitó, Frank B Hu, Fernando Arós, Enrique Gómez-Gracia, Dora Romaguera, Manuel Ortega-Calvo, Lluís Serra-Majem, Xavier Pintó, Helmut Schröder, Josep Basora, José Vicente Sorlí, Mònica Bulló, Merce Serra-Mir, Miguel A Martínez-González Article Affiliation: Estefanía Toledo Abstract: Importance: Breast cancer is the leading cause of female cancer burden, and its incidence has increased by more than 20% worldwide since 2008. Some observational studies have suggested that the Mediterranean diet may reduce the risk of breast cancer. Objective: To evaluate the effect of 2 interventions with Mediterranean diet vs the advice to follow a low-fat diet (control) on breast cancer incidence. Design, Setting, and Participants: The PREDIMED study is a 1:1:1 randomized, single-blind, controlled field trial conducted at primary health care centers in Spain. From 2003 to 2009, 4282 women aged 60 to 80 years and at high cardiovascular disease risk were recruited after invitation by their primary care physicians. Interventions: Participants were randomly allocated to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Main Outcomes and Measures: Breast cancer incidence was a prespecified secondary outcome of the trial for women without a prior history of breast cancer (n = 4152). Results: After a median follow-up of 4.8 years, we identified 35 confirmed incident cases of breast cancer. Observed rates (per 1000 person-years) were 1.1 for the Mediterranean diet with extra-virgin olive oil group, 1.8 for the Mediterranean diet with nuts group, and 2.9 for the control group. The multivariable-adjusted hazard ratios vs the control group were 0.32 (95% CI, 0.13-0.79) for the Mediterranean diet with extra-virgin olive oil group and 0.59 (95% CI, 0.26-1.35) for the Mediterranean diet with nuts group. In analyses with yearly cumulative updated dietary exposures, the hazard ratio for each additional 5% of calories from extra-virgin olive oil was 0.72 (95% CI, 0.57-0.90). Conclusions and Relevance: This is the first randomized trial finding an effect of a long-term dietary intervention on breast cancer incidence. Our results suggest a beneficial effect of a Mediterranean diet supplemented with extra-virgin olive oil in the primary prevention of breast cancer. These results come from a secondary analysis of a previous trial and are based on few incident cases and, therefore, need to be confirmed in longer-term and larger studies. Trial Registration: ISRCTN.org Identifier: ISRCTN35739639. Article Published Date : Sep 13, 2015

Abstract Title: A Mediterranean diet and risk of myocardial infarction, heart failure and stroke: A population-based cohort study. Abstract Source: Atherosclerosis. 2015 Sep 3 ;243(1):93-98. Epub 2015 Sep 3. PMID: 26363438 Abstract Author(s): Thanasis G Tektonidis, Agneta Åkesson, Bruna Gigante, Alicja Wolk, Susanna C Larsson Article Affiliation: Thanasis G Tektonidis Abstract: BACKGROUND AND AIMS: The Mediterranean diet, which is palatable and easily achievable, has been associated with lower all-cause and cardiovascular disease (CVD) incidence and mortality. Data on heart failure (HF) and stroke types are lacking. The aim was to examine a Mediterranean diet in relation to incidence of myocardial infarction (MI), HF and stroke types in a Swedish prospective cohort. METHODS: In a population-based cohort of 32,921 women, diet was assessed through a self-administered questionnaire. The modified Mediterranean diet (mMED) score was created based on high consumption of vegetables, fruits, legumes, nuts, whole grains, fermented dairy products, fish and monounsaturated fat, moderate intakes of alcohol and low consumption of red meat, on a 0-8 scale. Relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox proportional hazards regression models. RESULTS: During 10 y of follow-up (1998-2008), 1109 MIs, 1648 HFs, 1270 ischemic strokes and 262 total hemorrhagic strokes were ascertained. A high adherence to the mMED score (6-8), compared to low, was associated with a lower risk of MI (RR: 0.74, 95% CI: 0.61-0.90, p = 0.003), HF (RR: 0.79, 95% CI: 0.68-0.93, p = 0.004) and ischemic stroke (RR: 0.78, 95% CI: 0.65-0.93, p = 0.007), but not hemorrhagic stroke (RR: 0.88, 95% CI: 0.61-1.29, p = 0.53). CONCLUSIONS: Better adherence to a Mediterranean diet was associated with lower risk of MI, HF and ischemic stroke. The Mediterranean diet is most likely to be beneficial in primary prevention of all major types of atherosclerosis-related CVD. Article Published Date : Sep 02, 2015

Abstract Title: A Mediterranean dietary style influences TNF-alpha and VCAM-1 coronary blood levels in unstable angina patients. Abstract Source: Eur J Nutr. 2005 Sep;44(6):348-54. Epub 2004 Nov 24. PMID: 16151968 Abstract Author(s): Manuel Serrano-Martinez, Mercedes Palacios, Ernesto Martinez-Losa, Roman Lezaun, Cesar Maravi, Maria Prado, Jose Alfredo Martínez, Miguel Angel Martinez-Gonzalez Abstract: BACKGROUND: A Mediterranean dietary pattern has been associated with a reduced risk of coronary heart disease, as well as a reduction of oxidative stress, but studies indicating possible interactions between food intake and inflammatory mediators production at specific sites are lacking. AIM OF THE STUDY: To assess the relationship between Mediterranean diet consumption and inflammatory related molecules production in coronary vessels. METHODS: A previously reported Mediterranean-diet score was computed summing-up the quintiles of eight dietary components from a validated food frequency questionnaire in 24 patients with unstable angina. Tumor necrosis factor (TNF-alpha) and vascular cell adhesion molecule (VCAM-1) concentrations were measured in coronary sinus blood. RESULTS: Both biomarkers showed an inverse association with the Mediterraneandiet score. The association between VCAM-1 and the Mediterranean-diet score had an adjusted beta coefficient of -35.1 ng/ml (95% coefficient interval, CI: -63.5 to -6.7). The adjusted beta coefficient using TNF-alpha as the dependent variable was -41.6 pg/ml (95 % CI: -76.2 to -7.1). The consumption of olive oil as a single item showed a significant inverse association, and a Mediterranean-diet score excluding olive oil was also inversely associated with TNF-alpha and VCAM-1 serum levels in coronary venous blood. CONCLUSIONS: Adherence to a Mediterranean dietary pattern may protect against coronary artery wall production of inflammatory mediators. This finding could provide a novel mechanistic explanation for the recognized lower coronary risk associated with a Mediterranean diet. Article Published Date : Sep 01, 2005

Abstract Title: Low fruit consumption and folate deficiency are associated with LINE-1 hypomethylation in women of a cancer-free population. Abstract Source: Genes Nutr. 2015 Sep ;10(5):480. Epub 2015 Jul 17. PMID: 26183162 Abstract Author(s): Antonella Agodi, Martina Barchitta, Annalisa Quattrocchi, Andrea Maugeri, Carolina Canto, Anna Elisa Marchese, Manlio Vinciguerra Article Affiliation: Antonella Agodi Abstract: Several dietary agents, such as micronutrient and non-nutrient components, the so-called bioactive food components, have been shown to display anticancer properties and influence genetic processes. The most common epigenetic change is DNA methylation. Hypomethylation of long interspersed elements (LINE-1) has been associated with an increased risk of several cancers, although conflicting findings have also been observed. The aim of the present study was to test the hypothesis that a low adherence to the Mediterranean diet (MD) and folate deficiency may cause LINE-1 hypomethylation in blood leukocytes of healthy women, and thus genomic instability. One hundred and seventy-seven non-pregnant women were enrolled. Mediterranean diet score (MDS) and folate intake were calculated using a food frequency questionnaire. LINE-1 methylation level was measured by pyrosequencing analysis in three CpG sites of LINE-1 promoter. According to MDS, only 9.6 % of subjects achieved a high adherence to MD. Taking into account the use of supplements, there was a high prevalence of folate deficiency (73.4 %). Women whose consumption of fruit was below the median value (i.e.,<201 gr/day) were 3.7 times more likely to display LINE-1 hypomethylation than women whose consumption was above the median value (OR 3.7; 95 % CI 1.4-9.5). Similarly, women with folate deficiency were 3.6 times more likely to display LINE-1 hypomethylation than women with no folate deficiency (OR 3.6; 95 % CI 1.1-12.1). A dietary pattern characterized by low fruit consumption and folate deficiency is associated with LINE-1 hypomethylation and with cancer risk. Article Published Date : Aug 31, 2015

Abstract Title: Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study. Abstract Source: Br J Nutr. 2015 Sep ;114(5):804-11. PMID: 26313936 Abstract Author(s): Marialaura Bonaccio, Augusto Di Castelnuovo, Amalia De Curtis, Simona Costanzo, Francesca Bracone, Mariarosaria Persichillo, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello Article Affiliation: Marialaura Bonaccio Abstract: Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation. We conducted a population-based prospective investigation on 19 386 subjects enrolled in the Moli-sani study. Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ. C-reactive protein, leucocyte and platelet counts and the neutrophil:lymphocyte ratio were used as biomarkers of low-grade inflammation. Hazard ratios (HR) were calculated using multivariable Cox proportional hazard models. During a median follow-up of 4·3 years, 334 all-cause deaths occurred. As compared with subjects who never ate nuts, rare intake (≤2 times/month) was inversely associated with mortality (multivariable HR=0·68; 95 % CI 0·54, 0·87). At intake ≥8 times/month, a greater protection was observed (HR=0·53; 0·32, 0·90). Nut intake (v. no intake) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet (MD). A significant reduction in cancer deaths (HR=0·64; 95 % CI 0·44, 0·94) was also observed, whereas the impact on CVD deaths was limited to an inverse, but not significant, trend. Biomarkers of low-grade inflammation were reduced in nut consumers but did not account for the association with mortality. In conclusion, nut intake was associated with reduced cancer and total mortality. The protection was stronger in individuals with lower adherence to MD, whereas it was similar in high-risk groups (diabetics, obese, smokers or those with the metabolic syndrome), as compared with low-risk subjects. Inflammation did not explain the observed relationship. Article Published Date : Aug 31, 2015

Abstract Title: Weight loss with a modified Mediterranean-type diet using fat modification: a randomized controlled trial. Abstract Source: Eur J Clin Nutr. 2015 Aug ;69(8):878-84. Epub 2015 Feb 18. PMID: 25690866 Abstract Author(s): A Austel, C Ranke, N Wagner, J Görge, T Ellrott Article Affiliation: A Austel Abstract: BACKGROUND/OBJECTIVES: There is evidence that Mediterranean diets with a high proportion of olive oil and nuts can be effective for weight management and prevention of cardiovascular disease. It might be difficult for populations with other eating habits to follow such diets. Therefore, a modified Mediterranean-type diet using fat modification through neutral and butter-flavored canola oil, walnuts and walnut oil with two portion-controlled sweet daily snacks was tested in Germany. SUBJECTS/METHODS: Randomized waiting-list control study with overweight/grade 1 obese subjects: 12-week self-help modified Mediterranean-type diet, 6 weeks of diet plans and 6 weeks of weight loss maintenance training. Trial duration was 12 months. Intervention group (IG) included 100 participants (average age of 52.4 years, weight 85.1 kg and body mass index (BMI) 30.1 kg/m(2)), waiting-list control group (CG) included 112 participants (52.6 years, 84.1 kg and 30.1 kg/m(2)). RESULTS: Per-protocol weight loss after 12 weeks was 5.2 kg in IG vs 0.4 kg in CG (P⩽0.0001), BMI -1.8 vs -0.1 kg/m(2) (P⩽0.0001), waist circumference -4.7 vs -0.9 cm (P⩽0.0001). Triglycerides, total cholesterol and LDL cholesterol improved significantly in IG but not in CG. One-year dropouts: 44% in IG and 53% in CG. Weight loss after 12 months: 4.2 kg (pooled data). CONCLUSION: A five-meal modified Mediterranean-type diet with two daily portion-controlled sweet snacks was effective for weight management in a self-help setting for overweight and grade 1 obese subjects. Fat modification through canola oil, walnuts and walnut oil improved blood lipids even at 12 months. Article Published Date : Jul 31, 2015

Abstract Title: New perspectives on bioactivity of olive oil: evidence from animal models, human interventions and the use of urinary proteomic biomarkers. Abstract Source: Proc Nutr Soc. 2015 Aug ;74(3):268-81. PMID: 26186673 Abstract Author(s): S Silva, E Combet, M E Figueira, T Koeck, W Mullen, M R Bronze Article Affiliation: S Silva Abstract: Olive oil (OO) is the primary source of fat in the Mediterranean diet and has been associated with longevity and a lower incidence of chronic diseases, particularly CHD. Cardioprotective effects of OO consumption have been widely related with improved lipoprotein profile, endothelial function and inflammation, linked to health claims of oleic acid and phenolic content of OO. With CVD being a leading cause of death worldwide, a review of the potential mechanisms underpinning the impact of OO in the prevention of disease is warranted. The current body of evidence relies on mechanistic studies involving animal and cell-based models, epidemiological studies of OO intake and risk factor, small- and large-scale human interventions, and the emerging use of novel biomarker techniques associated with disease risk. Although model systems are important for mechanistic research nutrition, methodologies and experimental designs with strong translational value are still lacking. The present review critically appraises the available evidence to date, with particular focus on emerging novel biomarkers for disease risk assessment. New perspectives on OO research are outlined, especially those with scope to clarify key mechanisms by which OO consumption exerts health benefits. The use of urinary proteomic biomarkers, as highly specific disease biomarkers, is highlighted towards a higher translational approach involving OO in nutritional recommendations. Article Published Date : Jul 31, 2015

Abstract Title: A pilot study to investigate if New Zealand men with prostate cancer benefit from a Mediterranean-style diet. Abstract Source: PeerJ. 2015 ;3:e1080. Epub 2015 Jul 2. PMID: 26157638 Abstract Author(s): Sharon Erdrich, Karen S Bishop, Nishi Karunasinghe, Dug Yeo Han, Lynnette R Ferguson Article Affiliation: Sharon Erdrich Abstract: Carcinoma of the prostate is the most commonly diagnosed malignancy and the third leading cause of mortality in New Zealand men, making it a significant health issue in this country. Global distribution patterns suggest that diet and lifestyle factors may be linked to the development and progression of this cancer. Twenty men with diagnosed prostate cancer adhered to a Mediterranean diet, with specific adaptations, for three months. Prostate-specific antigen, C-reactive protein and DNA damage were evaluated at baseline and after three months of following the diet. Dietary data were collated from diet diaries and an adaptation of a validated Mediterranean diet questionnaire. A significant reduction in DNA damage compared to baseline was apparent, with particular benefit noted for overall adherence to the diet (p = 0.013), increased intake of folate (p = 0.023), vitamin C (p = 0.007), legumes (p = 0.004) and green tea (p = 0.002). Higher intakes of red meat and dairy products were inversely associated with DNA damage (p = 0.003 and p = 0.008 respectively). The results from this small feasibility study suggest that a high-antioxidant diet, modelled on Mediterranean traditions, may be of benefit for men with prostate cancer. Protection against DNA damage appears to be associated with the diet implemented, ostensibly due to reduction in reactive oxidant species. These findings warrant further exploration in a longer trial, with a larger cohort. Article Published Date : Dec 31, 2014

Abstract Title: Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial. Abstract Source: BMC Med. 2013 ;11:164. Epub 2013 Jul 16. PMID: 23866098 Abstract Author(s): Marta Guasch-Ferré, Mònica Bulló, MiguelÁngel Martínez-González, Emilio Ros, Dolores Corella, Ramon Estruch, Montserrat Fitó, Fernando Arós, Julia Wärnberg, Miquel Fiol, José Lapetra, Ernest Vinyoles, Rosa Maria Lamuela-Raventós, Lluís Serra-Majem, Xavier Pintó, Valentina Ruiz-Gutiérrez, Josep Basora, Jordi Salas-Salvadó, Article Affiliation: Marta Guasch-Ferré Abstract: BACKGROUND: Prospective studies in non-Mediterranean populations have consistently related increasing nut consumption to lower coronary heart disease mortality. A small protective effect on all-cause and cancer mortality has also been suggested. To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain, a Mediterranean country with a relatively high average nut intake per person. METHODS: We evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions (Mediterranean diets supplemented with nuts or olive oil and control diet) in the PREDIMED ('PREvención con DIeta MEDiterránea') study. Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index. Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess theassociation between yearly repeated measurements of nut consumption and mortality. RESULTS: During a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths and 130 cancer deaths occurred. Nut consumption was associated with a significantly reduced risk of all-cause mortality (P for trend<0.05, all). Compared to non-consumers, subjects consuming nuts>3 servings/week (32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI 0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality was observed. Participants allocated to the Mediterranean diet with nuts group who consumed nuts>3 servings/week at baseline had the lowest total mortality risk (HR 0.37; 95% CI 0.22 to 0.66). CONCLUSIONS: Increased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk.Please see related commentary: http://www.biomedcentral.com/1741-7015/11/165. TRIAL REGISTRATION: Clinicaltrials.gov. International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005. Article Published Date : Dec 31, 2012

Abstract Title: Moderate-to-high-intensity training and a hypocaloric Mediterranean diet enhance endothelial progenitor cells and fitness in subjects with the metabolic syndrome. Abstract Source: Clin Sci (Lond). 2012 Sep ;123(6):361-73. PMID: 22489903 Abstract Author(s): Juan Marcelo Fernández, Daniel Rosado-Álvarez, Marzo Edir Da Silva Grigoletto, Oriol Alberto Rangel-Zúñiga, Leslie Lorena Landaeta-Díaz, Javier Caballero-Villarraso, José López-Miranda, Francisco Pérez-Jiménez, Francisco Fuentes-Jiménez Article Affiliation: Juan Marcelo Fernández Abstract: A reduction in EPC (endothelial progenitor cell) number could explain the development and progression of atherosclerosis in the MetS (metabolic syndrome). Although much research in recent years has focused on the Mediterranean dietary pattern and the MetS, the effect of this diet with/without moderate-to-high-intensity endurance training on EPCs levels and CrF (cardiorespiratory fitness) remains unclear. In the present study, the objective was to assess the effect of a Mediterranean diet hypocaloric model with and without moderate-to-high-intensity endurance training on EPC number and CrF of MetS patients. Thus 45 MetS patients (50-66 years) were randomized to a 12-week intervention with the hypocaloric MeD (Mediterranean diet) or the MeDE (MeD plus moderate-to-high-intensity endurance training). Training included two weekly supervised sessions [80% MaxHR (maximum heart rate); leg and arm pedalling] and one at-home session (65-75% MaxHR; walking controlled by heart rate monitors). Changes in: (i) EPC number [CD34(+)KDR(+) (kinase insert domain-containing receptor)], (ii) CrF variables and (iii) MetS components and IRH (ischaemic reactive hyperaemia) were determined at the end of the study. A total of 40 subjects completed all 12 weeks of the study, with 20 in each group. The MeDE led to a greater increase in EPC numbers and CrF than did the MeD intervention (P≤ 0.001). In addition, a positive correlation was observed between the increase in EPCs and fitness in the MeDE group (r=0.72; r(2)=0.52; P ≤ 0.001). Body weight loss, insulin sensitivity, TAGs (triacylglycerols) and blood pressure showed a greater decrease in the MeDE than MeD groups. Furthermore, IRH was only improved after the MeDE intervention. In conclusion, compliance with moderate-to-high-intensity endurance training enhances the positive effects of a model of MeD on the regenerative capacity of endothelium and on the fitness of MetS patients. Article Published Date : Aug 31, 2012

Abstract Title: Diet and Alzheimer's disease risk factors or prevention: the current evidence. Abstract Source: Expert Rev Neurother. 2011 May ;11(5):677-708. PMID: 21539488 Abstract Author(s): Vincenzo Solfrizzi, Francesco Panza, Vincenza Frisardi, Davide Seripa, Giancarlo Logroscino, Bruno P Imbimbo, Alberto Pilotto Article Affiliation: Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Bari, Italy. Abstract: Preventing or postponing the onset of Alzheimer's disease (AD) and delaying or slowing its progression would lead to a consequent improvement of health status and quality of life in older age. Elevated saturated fatty acids could have negative effects on age-related cognitive decline and mild cognitive impairment (MCI). Furthermore, at present, epidemiological evidence suggests a possible association between fish consumption, monounsaturated fatty acids and polyunsaturated fatty acids (PUFA; in particular, n-3 PUFA) and a reduced risk of cognitive decline and dementia. Poorer cognitive function and an increased risk of vascular dementia (VaD) were found to be associated with a lower consumption of milk or dairy products. However, the consumption of whole-fat dairy products may be associated with cognitive decline in the elderly. Light-to-moderate alcohol use may be associated with a reduced risk of incident dementia and AD, while for VaD, cognitive decline and predementia syndromes, the current evidence is only suggestive of a protective effect. The limited epidemiological evidence available on fruit and vegetable consumption and cognition generally supports a protective role of these macronutrients against cognitive decline, dementia and AD. Only recently, higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline, although the Mediterranean diet (MeDi) combines several foods, micro- and macro-nutrients already separately proposed as potential protective factors against dementia and predementia syndromes. In fact, recent prospective studies provided evidence that higher adherence to a Mediterranean-type diet could be associated with slower cognitive decline, reduced risk of progression from MCI to AD, reduced risk of AD and a decreased all-cause mortality in AD patients. These findings suggested that adherence to the MeDi may affect not only the risk of AD, but also of predementia syndromes and their progression to overt dementia. Based on the current evidence concerning these factors, no definitive dietary recommendations are possible. However, following dietary advice for lowering the risk of cardiovascular and metabolic disorders, high levels of consumption of fats from fish, vegetable oils, nonstarchy vegetables, low glycemic index fruits and a diet low in foods with added sugars and with moderate wine intake should be encouraged. Hopefully this will open new opportunities for the prevention and management of dementia and AD. Article Published Date : May 01, 2011

Abstract Title: Mediterranean diet reduces endothelial damage and improves the regenerative capacity of endothelium. Abstract Source: Am J Clin Nutr. 2011 Feb;93(2):267-74. Epub 2010 Dec 1. PMID: 21123460 Abstract Author(s): Carmen Marin, Rafael Ramirez, Javier Delgado-Lista, Elena Maria Yubero-Serrano, Pablo Perez-Martinez, Julia Carracedo, Antonio Garcia-Rios, Fernando Rodriguez, Francisco Miguel Gutierrez-Mariscal, Purificación Gomez, Francisco Perez-Jimenez, Jose Lopez-Miranda Article Affiliation: Lipids and Atherosclerosis Unit, IMIBIC/Reina Sofía University Hospital, University of Cordoba, Córdoba, Spain. Abstract: BACKGROUND: Endothelial dysfunction is a fundamental step in the atherosclerotic disease process. Activation or injury of the endothelium leads to a variety of inflammatory disorders, including the release of microparticles. Endothelial progenitor cells may contribute to the maintenance of the endothelium by replacing injured mature endothelial cells. OBJECTIVE: We studied the influence of dietary fat on the release of endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) in elderly subjects. DESIGN: Twenty healthy, elderly subjects (10 men and 10 women) consumed 3 diets following a randomized crossover design, each for 4 wk: a saturated fatty acid diet; a low-fat, high-carbohydrate diet; and a Mediterranean diet (MedDiet) enriched in monounsaturated fatty acids. We investigated total microparticles, EMPs from activated endothelial cells (activated EMPs), EMPs from apoptotic endothelial cells (apoptotic EMPs), EPCs, oxidative stress variables, and ischemic reactive hyperemia (IRH). RESULTS: The MedDiet led to lower total microparticle, activated EMP, and apoptotic EMP concentrations and higher EPC numbers than did the other diets (P<0.001). We detected lower superoxide dismutase activity (P<0.001), a higher plasmaβ-carotene concentration (P<0.001), and lower urinary isoprostane and plasma nitrotyrosine concentrations after consumption of the MedDiet than after consumption of the other 2 diets (P<0.05). Furthermore, the occurrence of IRH was higher after consumption of the MedDiet than after consumption of the other 2 diets (P<0.05). CONCLUSION: Consumption of the MedDiet induces a reduction in endothelial damage and dysfunction, which is associated with an improvement in the regenerative capacity of the endothelium, in comparison with 2 other diets. Article Published Date : Feb 01, 2011

Abstract Title: Mediterranean and carbohydrate-restricted diets and mortality among elderly men: a cohort study in Sweden. Abstract Source: Am J Clin Nutr. 2010 Oct;92(4):967-74. Epub 2010 Sep 8. PMID: 20826627 Abstract Author(s): Per Sjögren, Wulf Becker, Eva Warensjö, Erika Olsson, Liisa Byberg, Inga-Britt Gustafsson, Brita Karlström, Tommy Cederholm Article Affiliation: Department of Public Health and Caring Sciences, Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Comparative studies on dietary patterns and long-term mortality are sparse. OBJECTIVE: The objective was to examine the relations between 10-y mortality and adherence to the World Health Organization dietary guidelines [Healthy Diet Indicator (HDI)], a Mediterranean-like diet, and a carbohydrate-restricted (CR) diet in elderly Swedish men. DESIGN: Dietary habits were determined by 7-d dietary records in a population-based longitudinal study of 924 Swedish men (age: 71± 1 y). The HDI score (-1 to 8 points), the Mediterranean Diet Score (MDS; 0-8 points), and the CR score (2-20 points) were calculated for each participant. Nonadequate reporters of energy intake were identified (n = 413). Mortality was registered during a median follow-up of 10.2 y. Cox proportional hazards regression, with multivariable adjustments, was used to determine the effects of adherence to each dietary pattern. RESULTS: Two hundred fifteen and 88 subjects died of all-cause and cardiovascular disease, respectively. In all individuals, risk relations to mortality for each SD increment in the scores were observed for only MDS, with an adjusted hazard ratio (HR) of 0.83 (95% CI: 0.70, 0.99). Among adequate dietary reporters (n = 511), adjusted HRs for each SD increment in scores were enhanced for MDS (ie, 0.71; 95% CI: 0.55, 0.92) for all-cause mortality and 0.63 (95% CI: 0.42, 0.96) for cardiovascular mortality. Corresponding HRs for CR diet score were 1.19 (95% CI: 0.97, 1.45) for all-cause mortality and 1.44 (95% CI: 1.03, 2.02) for cardiovascular mortality. CONCLUSION: Adherence to a Mediterranean-like dietary pattern reduced mortality, whereas adherence to a CR dietary pattern appeared to increase mortality in elderly Swedish men, especially when only adequate dietary reporters were considered. Article Published Date : Oct 01, 2010

Abstract Title: Homocysteine induces VCAM-1 gene expression through NF-kappaB and NAD(P)H oxidase activation: protective role of Mediterranean diet polyphenolic antioxidants. Abstract Source: Chemosphere. 2010 Sep;81(4):464-8. PMID: 17586618 Abstract Author(s): Maria Annunziata Carluccio, Maria Assunta Ancora, Marika Massaro, Marisa Carluccio, Egeria Scoditti, Alessandro Distante, Carlo Storelli, Raffaele De Caterina Article Affiliation: Consiglio Nazionale delle Ricerca Institute of Clinical Physiology, University of Lecce, Lecce, Italy. Abstract: Hyperhomocysteinemia is a recognized risk factor for vascular disease, but pathogenetic mechanisms involved in its vascular actions are largely unknown. Because VCAM-1 expression is crucial in monocyte adhesion and early atherogenesis, we evaluated the NF-kappaB-related induction of VCAM-1 by homocysteine (Hcy) and the possible inhibitory effect of dietary polyphenolic antioxidants, such as trans-resveratrol (RSV) and hydroxytyrosol (HT), which are known inhibitors of NF-kappaB-mediated VCAM-1 induction. In human umbilical vein endothelial cells (HUVEC), Hcy, at 100 micromol/l, but not cysteine, induced VCAM-1 expression at the protein and mRNA levels, as shown by enzyme immunoassay and Northern analysis, respectively. Transfection studies with deletional VCAM-1 promoter constructs demonstrated that the two tandem NF-kappaB motifs in the VCAM-1 promoter are necessary for Hcy-induced VCAM-1 gene expression. Hcy-induced NF-kappaB activation was confirmed by EMSA, as shown by the nuclear translocation of its p65 (RelA) subunit and the degradation of the inhibitors IkappaB-alpha and IkappaB-beta by Western analysis. Hcy also increased intracellular reactive oxygen species by NAD(P)H oxidase activation, as shown by the membrane translocation of its p47(phox) subunit. NF-kappaB inhibitors decreased Hcy-induced intracellular reactive oxygen species and VCAM-1 expression. Finally, we found that nutritionally relevant concentrations of RSV and HT, but not folate and vitamin B6, reduce (by>60% at 10(-6) mol/l) Hcy-induced VCAM-1 expression and monocytoid cell adhesion to the endothelium. These data indicate that pathophysiologically relevant Hcy concentrations induce VCAM-1 expression through a prooxidant mechanism involving NF-kappaB. Natural Mediterranean diet antioxidants can inhibit such activation, suggesting their possible therapeutic role in Hcy-induced vascular damage. Article Published Date : Sep 01, 2010

Abstract Title: Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study. Abstract Source: Am J Epidemiol. 2009 Dec 15;170(12):1518-29. Epub 2009 Nov 10. PMID: 19903723 Abstract Author(s): Genevieve Buckland, Carlos A González, Antonio Agudo, Mireia Vilardell, Antoni Berenguer, Pilar Amiano, Eva Ardanaz, Larraitz Arriola, Aurelio Barricarte, Mikel Basterretxea, María Dolores Chirlaque, Lluís Cirera, Miren Dorronsoro, Nerea Egües, José María Huerta, Nerea Larrañaga, Pilar Marin, Carmen Martínez, Esther Molina, Carmen Navarro, José Ramón Quirós, Laudina Rodriguez, María-José Sanchez, María-José Tormo, Conchi Moreno-Iribas Abstract: No known cohort study has investigated whether the Mediterranean diet can reduce incident coronary heart disease (CHD) events in a Mediterranean population. This study examined the relation between Mediterranean diet adherence and risk of incident CHD events in the 5 Spanish centers of the European Prospective Investigation into Cancer and Nutrition. Analysis included 41,078 participants aged 29-69 years, recruited in 1992-1996 and followed up until December 2004 (mean follow-up:10.4 years). Confirmed incident fatal and nonfatal CHD events were analyzed according to Mediterranean diet adherence, measured by using an 18-unit relative Mediterranean diet score. A total of 609 participants (79% male) had a fatal or nonfatal confirmed acute myocardial infarction (n = 468) or unstable angina requiring revascularization (n = 141). After stratification by center and age and adjustment for recognized CHD risk factors, high compared with low relative Mediterranean diet score was associated with a significant reduction in CHD risk (hazard ratio = 0.60, 95% confidence interval: 0.47, 0.77). A 1-unit increase in relative Mediterranean diet score was associated with a 6% reduced risk of CHD (95% confidence interval: 0.91, 0.97), with similar risk reductions by sex. Mediterranean diet adherence was associated with a significantly reduced CHD risk in this Mediterranean country, supporting its role in primary prevention of CHD in healthy populations. Article Published Date : Dec 15, 2009

Abstract Title: Reduction in systemic and VLDL triacylglycerol concentration after a 3-month Mediterranean-style diet in high-cardiovascular-risk subjects. Abstract Source: J Nutr Biochem. 2009 Dec 3. Epub 2009 Dec 3. PMID: 19962297 Abstract Author(s): Javier S Perona, María-Isabel Covas, Montserrat Fitó, Rosana Cabello-Moruno, Fernando Aros, Dolores Corella, Emilio Ros, Maria Garcia, Ramon Estruch, Miguel A Martinez-Gonzalez, Valentina Ruiz-Gutierrez Abstract: The first results of the PREDIMED (PREvencion con Dieta MEDiterranea) randomized trial, after 3-month intervention, showed that the Mediterranean Diet (MD), supplemented with either virgin olive oil (VOO) or nuts, reduced systolic blood pressure, serum cholesterol and triacylglycerol (TG) concentrations and increased high-density lipoprotein (HDL)-cholesterol when compared to a control (low-fat diet) group. Serum TG levels are an independent risk factor for coronary heart disease and are strongly determined by very low-density lipoprotein (VLDL) composition, which can be specifically modified by dietary lipid source. Within the context of the PREDIMED study, we assessed the VLDL composition in 50 participants after 3 months of intake of two MD, supplemented with VOO or nuts, compared with a low-fat diet. Total and low-density lipoprotein cholesterol concentrations were reduced in subjects on the MD+nuts, whereas HDL-cholesterol increased after consumption of the MD+VOO. Serum TG concentrations were significantly lowered in both intervention groups (either the MD+nuts or MD+VOO). However, only the MD+VOO reduced the VLDL-cholesterol and VLDL-TG content and the TG/apolipoprotein B ratio in VLDL, which was used to estimate particle size. Although VLDL-TG fatty acids were very slightly modified, VLDL-TG molecular species in VLDL after consumption of the MD+nuts were characterized by a higher presence of linoleic acid (18:2, n-6), whereas after the intake of MD+VOO, they were rich in oleic acid (18:1, n-9). Therefore, we conclude that the reduction in systemic TG concentrations observed after consumption of the MD may be explained by reduction of the lipid core of VLDL and a selective modification of the molecular species composition in the particle. Article Published Date : Dec 03, 2009

Abstract Title: A 3 years follow-up of a Mediterranean diet rich in virgin olive oil is associated with high plasma antioxidant capacity and reduced body weight gain. Abstract Source: Eur J Clin Nutr. 2009 Dec;63(12):1387-93. Epub 2009 Aug 26. PMID: 19707219 Abstract Author(s): C Razquin, J A Martinez, M A Martinez-Gonzalez, M T Mitjavila, R Estruch, A Marti Abstract: BACKGROUND/OBJECTIVES: The aim of this study was to analyze the influence of a Mediterranean dietary pattern on plasma total antioxidant capacity (TAC) after 3 years of intervention and the associations with adiposity indexes in a randomized dietary trial (PREDIMED trial) with high cardiovascular risk patients. SUBJECTS/METHODS: 187 subjects were randomly selected from the PREDIMED-UNAV center after they completed 3-year intervention program. Participants were following a Mediterranean-style diet with high intake of virgin olive oil or high intake of nuts, or a conventional low-fat diet. Adiposity indexes were measured at baseline and at year 3. Plasma TAC was evaluated using a commercially available colorimetric assay kit. RESULTS: Plasma TAC in the control, olive oil and nuts groups was 2.01+/-0.15, 3.51+/-0.14 and 3.02+/-0.14 mM Trolox, respectively after adjusting for age and sex. The differences between the Mediterranean diet and control groups were statistically significant (P<0.001). Moreover higher levels of TAC were significantly associated with a reduction in body weight after 3 years of intervention among subjects allocated to the virgin olive oil group (B=-1.306; 95% CI=-2.439 to -0.173; P=0.025, after adjusting for age, sex and baseline body mass index). CONCLUSIONS: Mediterranean diet, especially rich in virgin olive oil, is associated with higher levels of plasma antioxidant capacity. Plasma TAC is related to a reduction in body weight after 3 years of intervention in a high cardiovascular risk population with a Mediterranean-style diet rich in virgin olive oil. Article Published Date : Dec 01, 2009

Abstract Title: Mediterranean diets are associated with a lower incidence of metabolic syndrome one year following renal transplantation. Abstract Source: Kidney Int. 2009 Dec;76(11):1199-206. Epub 2009 Sep 9. PMID: 19741589 Abstract Author(s): Mohsen Nafar, Nazanin Noori, Sara Jalali-Farahani, Farhad Hosseinpanah, Fatemeh Poorrezagholi, Pedram Ahmadpoor, Fariba Samadian, Ahmad Firouzan, Behzad Einollahi Abstract: Considering the high prevalence of metabolic syndrome and its association with cardiovascular mortality, we prospectively evaluated the role of diet in the incidence of metabolic syndrome in renal transplant recipients. Our prospective cohort of 160 adult renal allograft recipients was followed for 1 year and had no existing metabolic syndrome or diabetes mellitus. Routine dietary intakes were assessed with food-frequency questionnaires, and metabolic syndrome was defined according to the Adult Treatment Panel III guidelines. We identified 3 major patterns by factor analysis, consisting of those recipients predominantly consuming fats and sugars, those predominantly consuming whole grain, and the Mediterranean diet. When analyzed by multivariable logistic regression and after controlling for potential confounders, subjects in the highest tertile of scores for the Mediterranean diet had a significantly lower odds of metabolic syndrome than those in the lowest tertile. Subjects in the highest tertile of scores for consuming fats and sugars had significantly greater odds of metabolic syndrome compared with those in the lowest tertile. Our study shows that the Mediterranean dietary pattern is associated with a reduced risk of metabolic syndrome in renal transplant recipients. Article Published Date : Dec 01, 2009

Abstract Title: Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort. Abstract Source: Am J Clin Nutr. 2009 Dec;90(6):1608-14. Epub 2009 Oct 14. PMID: 19828705 Abstract Author(s): Marcella E Rumawas, James B Meigs, Johanna T Dwyer, Nicola M McKeown, Paul F Jacques Abstract: BACKGROUND: The benefit of the Mediterranean-style dietary pattern in mitigating metabolic risk factors for type 2 diabetes and cardiovascular disease has not been well investigated among nondiabetic Americans. OBJECTIVE: The aim of this study was to examine the prospective association between the Mediterranean-style dietary pattern and metabolic syndrome. DESIGN: The Mediterranean-style dietary pattern score (MSDPS) was used to characterize a Mediterranean-style dietary pattern in the Framingham Heart Study Offspring Cohort. We examined the longitudinal association between MSDPS and metabolic syndrome traits (including homeostasis model assessment-insulin resistance, fasting glucose, waist circumference, triglyceride, HDL cholesterol, and systolic and diastolic blood pressure) among 2730 participants of the Framingham Heart Study Offspring Cohort without type 2 diabetes (baseline median age: 54 y; 55% women), who were followed from the fifth (baseline) to the seventh study examinations (mean follow-up time: 7 y), and metabolic syndrome incidence (according to the National Cholesterol Education Program Adult Treatment Panel III definition) in 1918 participants free of the condition at baseline. RESULTS: A higher MSDPS was associated with lower homeostasis model assessment-insulin resistance (P = 0.02), waist circumference (P<0.001), fasting plasma glucose (P = 0.03), and triglycerides (P<0.001) and higher HDL cholesterol (P = 0.02) after adjustment for the corresponding baseline values and for several confounding factors associated with type 2 diabetes risk. Participants in the highest quintile category of the MSDPS had a lower incidence of metabolic syndrome than those in the lowest quintile category (38.5% compared with 30.1%; P = 0.01). CONCLUSION: Our study suggests that the consumption of a diet consistent with the principles of the Mediterranean-style diet may protect against metabolic syndrome in Americans. Article Published Date : Dec 01, 2009

Abstract Title: Adherence to the Mediterranean diet is associated with renal function among healthy adults: the ATTICA study. Abstract Source: J Ren Nutr. 2009 Oct 9. Epub 2009 Oct 9. PMID: 19819726 Abstract Author(s): Christina Chrysohoou, Demosthenes B Panagiotakos, Christos Pitsavos, John Skoumas, Akis Zeimbekis, Christina-Maria Kastorini, Christodoulos Stefanadis Abstract: BACKGROUND: No data exist regarding the effect of the Mediterranean diet on renal function. We studied the association between adherence to the Mediterranean diet and markers of renal function among 3042 people without any evidence of chronic disease. METHODS: During 2001 and 2002, a random sample was selected of 1514 men and 1528 women (aged 18 to 89 years) from Greece. Urea and creatinine were measured, and the creatinine-clearance (CCr) rate was estimated according to the formula of Cockcroft and Gault. Adherence to the Mediterranean diet was assessed using a validated diet score (MedDietScore) that incorporated the inherent characteristics of this diet. RESULTS: The CCr rate was positively associated with MedDietScore (b+/-SE, 0.24+/-0.09, P=.007). Moreover, urea and creatinine levels were inversely associated with MedDietScore (b+/-SE, -0.05+/-0.02, P=.01, and -0.004+/-0.001, P<.001, respectively). Multiple linear regression analysis revealed that for each 10/55 additional points in diet score, a 3.7-unit increase in CCr rate in women (P<.001) and a 10.1-unit increase in CCr rate in men were evident (P<.001). Further analysis revealed that the CCr rate was positively correlated with the consumption of fruits (rho =0.08, P=.009) and moderate alcohol consumption, and inversely correlated with the consumption of potatoes (rho=-0.11, P<.001), red meat (rho=-0.12, P=.001), and poultry (rho=-0.07, P=.02). CONCLUSIONS: Greater adherence to the Mediterranean diet was independently associated with reduced urea and creatinine and increased CCr rates among healthy men and women. This finding adds to the knowledge regarding the benefits of a traditional Mediterranean diet in human health. Article Published Date : Oct 09, 2009

Abstract Title: Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Abstract Source: Arch Gen Psychiatry. 2009 Oct;66(10):1090-8. PMID: 19805699 Abstract Author(s): Almudena Sánchez-Villegas, Miguel Delgado-Rodríguez, Alvaro Alonso, Javier Schlatter, Francisca Lahortiga, Lluis Serra Majem, Miguel Angel Martínez-González Abstract: CONTEXT: Adherence to the Mediterranean dietary pattern (MDP) is thought to reduce inflammatory, vascular, and metabolic processes that may be involved in the risk of clinical depression. OBJECTIVE: To assess the association between adherence to the MDP and the incidence of clinical depression. DESIGN: Prospective study that uses a validated 136-item food frequency questionnaire to assess adherence to the MDP. The MDP score positively weighted the consumption of vegetables, fruit and nuts, cereal, legumes, and fish; the monounsaturated- to saturated-fatty-acids ratio; and moderate alcohol consumption, whereas meat or meat products and whole-fat dairy were negatively weighted. SETTING: A dynamic cohort of university graduates (Seguimiento Universidad de Navarra/University of Navarra Follow-up [SUN] Project). PARTICIPANTS: A total of 10 094 initially healthy Spanish participants from the SUN Project participated in the study. Recruitment began on December 21, 1999, and is ongoing. MAIN OUTCOME MEASURE: Participants were classified as having incident depression if they were free of depression and antidepressant medication at baseline and reported a physician-made diagnosis of clinical depression and/or antidepressant medication use during follow-up. RESULTS: After a median follow-up of 4.4 years, 480 new cases of depression were identified. The multiple adjusted hazard ratios (95% confidence intervals) of depression for the 4 upper successive categories of adherence to the MDP (taking the category of lowest adherence as reference) were 0.74 (0.57-0.98), 0.66 (0.50-0.86), 0.49 (0.36-0.67), and 0.58 (0.44-0.77) (P for trend<.001). Inverse dose-response relationships were found for fruit and nuts, the monounsaturated- to saturated-fatty-acids ratio, and legumes. CONCLUSIONS: Our results suggest a potential protective role of the MDP with regard to the prevention of depressive disorders; additional longitudinal studies and trials are needed to confirm these findings. Article Published Date : Oct 01, 2009

Abstract Title: Adherence to the Mediterranean diet is associated with lower abdominal adiposity in European men and women. Abstract Source: J Nutr. 2009 Sep;139(9):1728-37. Epub 2009 Jul 1. PMID: 19571036 Abstract Author(s): Dora Romaguera, Teresa Norat, Traci Mouw, Anne M May, Christina Bamia, Nadia Slimani, Noemie Travier, Herve Besson, Jian'an Luan, Nick Wareham, Sabina Rinaldi, Elisabeth Couto, Françoise Clavel-Chapelon, Marie-Christine Boutron-Ruault, Vanessa Cottet, Domenico Palli, Claudia Agnoli, Salvatore Panico, Rosario Tumino, Paolo Vineis, Antonio Agudo, Laudina Rodriguez, Maria Jose Sanchez, Pilar Amiano, Aurelio Barricarte, Jose Maria Huerta, Timothy J Key, Elisabeth A Spencer, H Bas Bueno-de-Mesquita, Frederike L Büchner, Philippos Orfanos, Androniki Naska, Antonia Trichopoulou, Sabine Rohrmann, Rudolf Kaaks, Manuela Bergmann, Heiner Boeing, Ingegerd Johansson, Veronica Hellstrom, Jonas Manjer, Elisabet Wirfält, Marianne Uhre Jacobsen, Kim Overvad, Anne Tjonneland, Jytte Halkjaer, Eiliv Lund, Toni Braaten, Dragun Engeset, Andreani Odysseos, Elio Riboli, Petra H M Peeters Abstract: Given the lack of consistent evidence of the relationship between Mediterranean dietary patterns and body fat, we assessed the cross-sectional association between adherence to a modified Mediterranean diet, BMI, and waist circumference (WC). A total of 497,308 individuals (70.7% women) aged 25-70 y from 10 European countries participated in this study. Diet was assessed at baseline using detailed validated country-specific questionnaires, and anthropometrical measurements were collected using standardized procedures. The association between the degree of adherence to the modified-Mediterranean Diet Score (mMDS) (including high consumption of vegetables, legumes, fruits and nuts, cereals, fish and seafood, and unsaturated:saturated fatty acids ratio; moderate alcohol intake; and low consumption of meat and meat products and dairy products) and BMI (kg.m(-2)) or WC (cm) was modeled through mixed-effects linear regression, controlling for potential confounders. Overall, the mMDS was not significantly associated with BMI. Higher adherence to the Mediterranean diet was significantly associated with lower WC, for a given BMI, in both men (-0.09; 95% CI -0.14 to -0.04) and women (-0.06; 95% CI -0.10 to -0.01). The association was stronger in men (-0.20; 95% CI -0.23 to -0.17) and women (-0.17; 95% CI -0.21 to -0.13) from Northern European countries. Despite the observed heterogeneity among regions, results of this study suggest that adherence to a modified Mediterranean diet, high in foods of vegetable origin and unsaturated fatty acids, is associated with lower abdominal adiposity measured by WC in European men and women. Article Published Date : Sep 01, 2009

Abstract Title: Prenatal and childhood Mediterranean diet and the development of asthma and allergies in children. Abstract Source: Public Health Nutr. 2009 Sep;12(9A):1629-34. PMID: 19689832 Abstract Author(s): Leda Chatzi, Manolis Kogevinas Abstract: OBJECTIVE: To discuss current evidence about the relation between prenatal and childhood Mediterranean diet, and the development of asthma and allergies in children. DESIGN: Review of the literature. SETTING AND RESULTS: Four recent studies conducted in Mediterranean countries (Spain, Greece) and one conducted in Mexico evaluated the association between childhood Mediterranean diet and asthma outcomes in children. All of the studies reported beneficial associations between a high level of adherence to the Mediterranean diet during childhood and symptoms of asthma or allergic rhinitis. Individual foods or food groups contributing to the protective effect of Mediterranean diet included fish, fruits, vegetables, legumes, nuts and cereals, while detrimental components included red meat, margarine and junk food intake. Two studies focused on prenatal Mediterranean diet: the first is a birth cohort in Spain that showed a protective effect of a high adherence to the Mediterranean diet during pregnancy on persistent wheeze, atopic wheeze and atopy at the age of 6.5 years; while the second is a cross-sectional study in Mexico, collecting information more than 6 years after pregnancy, that showed no associations between maternal Mediterranean diet during pregnancy and allergic symptoms in childhood except for current sneezing. CONCLUSIONS: Findings from recent studies suggest that a high level of adherence to the Mediterranean diet early in life protects against the development of asthma and atopy in children. Further studies are needed to better understand the mechanisms of this protective effect, to evaluate the most relevant window of exposure, and to address specific components of diet in relation to disease. Article Published Date : Sep 01, 2009

Abstract Title: Effect of a high monounsaturated fatty acids diet and a Mediterranean diet on serum lipids and insulin sensitivity in adults with mild abdominal obesity. Abstract Source: Nutr Metab Cardiovasc Dis. 2009 Aug 17. Epub 2009 Aug 17. PMID: 19692213 Abstract Author(s): M B Bos, J H M de Vries, E J M Feskens, S J van Dijk, D W M Hoelen, E Siebelink, R Heijligenberg, L C P G M de Groot Abstract: BACKGROUND AND AIMS: Diets high in monounsaturated fatty acids (MUFA) such as a Mediterranean diet may reduce the risk of cardiovascular diseases by improving insulin sensitivity and serum lipids. Besides being high in MUFA, a Mediterranean diet also contains abundant plant foods, moderate wine and low amounts of meat and dairy products, which may also play a role. We compared the effects of a high MUFA-diet with a diet high in saturated fatty acids (SFA) and the additional effect of a Mediterranean diet on insulin sensitivity and serum lipids. METHODS AND RESULTS: A randomized parallel controlled-feeding trial was performed, in 60 non-diabetics (40-65y) with mild abdominal obesity. After a two week run-in diet high in SFA (19 energy-%), subjects were allocated to a high MUFA-diet (20 energy-%), a Mediterranean diet (MUFA 21 energy-%), or the high SFA-diet, for eight weeks. The high MUFA and the Mediterranean diet did not affect fasting insulin concentrations. The high MUFA-diet reduced total cholesterol (-0.41mmol/L, 95% CI -0.74, -0.09) and LDL-cholesterol (-0.38mmol/L, 95% CI -0.65, -0.11) compared with the high SFA-diet, but not triglyceride concentrations. The Mediterranean diet increased HDL-cholesterol concentrations (+0.09mmol/L, 95% CI 0.0, 0.18) and reduced the ratio of total cholesterol/HDL-cholesterol (-0.39, 95% CI -0.62, -0.16) compared with the high MUFA-diet. CONCLUSION: Replacing a high SFA-diet with a high MUFA or a Mediterranean diet did not affect insulin sensitivity, but improved serum lipids. The Mediterranean diet was most effective, it reduced total and LDL-cholesterol, and also increased HDL-cholesterol and reduced total cholesterol/HDL-cholesterol ratio. Article Published Date : Aug 17, 2009

Abstract Title: Effect of Mediterranean diet on the expression of pro-atherogenic genes in a population at high cardiovascular risk. Abstract Source: Atherosclerosis. 2009 Aug 8. Epub 2009 Aug 8. PMID: 19712933 Abstract Author(s): Vicenta Llorente-Cortés, Ramón Estruch, Mari Pau Mena, Emilio Ros, Miguel Angel Martínez González, Montserrat Fitó, Rosa María Lamuela-Raventós, Lina Badimon Abstract: Experimental and epidemiological studies have demonstrated the beneficial effects of the traditional Mediterranean diet (TMD) on the incidence and progression of atherosclerosis. Several genes play a major role in determining atherosclerosis susceptibility. We compared the short-term effects of two TMD diets versus a control diet on the expression of pro-atherogenic genes. One TMD diet was supplemented with virgin olive oil (VOO) (TMD+VOO) and the other with nuts (TMD+nuts). Gene expression was analyzed in monocytes from 49 asymptomatic high cardiovascular-risk participants (23 men, 26 women), aged 55-80 years. Monocytes were isolated from blood before and 3 months after dietary intervention. We analyzed the expression of genes involved in inflammation [cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2) and monocyte chemoattractant protein (MCP-1)], genes involved in foam cell formation [low-density lipoprotein receptor-related protein (LRP1), LDL receptor and CD36], and genes involved in thrombosis [tissue factor (TF) and tissue factor pathway inhibitor (TFPI)]. We found that TMD+VOO intervention prevented an increase in COX-2 and LRP1, and reduced MCP-1 expression compared to TMD+nuts or control diet interventions. TMD+nuts specifically increased the expression of CD36 and TFPI compared to TMD+VOO and control diet intervention. Our findings showed that the Mediterranean diet influences expression of key genes involved in vascular inflammation, foam cell formation and thrombosis. Dietary intervention can thus actively modulate the expression of pro-atherothrombotic genes even in a high-risk population. Article Published Date : Aug 08, 2009

Abstract Title: Close adherence to a Mediterranean diet improves endothelial function in subjects with abdominal obesity. Abstract Source: Am J Clin Nutr. 2009 Aug;90(2):263-8. Epub 2009 Jun 10. PMID: 19515732 Abstract Author(s): Loukianos S Rallidis, John Lekakis, Anastasia Kolomvotsou, Antonios Zampelas, Georgia Vamvakou, Stamatis Efstathiou, George Dimitriadis, Sotirios A Raptis, Dimitrios T Kremastinos Abstract: BACKGROUND: Abdominal obesity (AO) is associated with increased risk of cardiovascular disease and type 2 diabetes, whereas the Mediterranean diet exerts a cardioprotective effect. OBJECTIVE: We examined whether a close adherence to a Mediterranean-style diet improves endothelial function in individuals with AO. DESIGN: We recruited 90 subjects with AO without cardiovascular disease or type 2 diabetes. Participants were randomly assigned to the intervention or control group. Both groups were instructed to follow a Mediterranean-style diet for 2 mo. Subjects in the intervention group additionally had to follow a specific relevant daily and weekly food plan with close supervision by a dietitian and provision of basic foods. Flow-mediated dilatation (FMD), lipids, C-reactive protein (CRP), and insulin resistance with the homeostasis model assessment (HOMA-IR) were measured. RESULTS: After 2 mo, subjects in the intervention group increased their intake of total fat due to higher consumption of monounsaturated fatty acids as well as intakes of dietary fiber, vitamin C, and alcohol compared with the control group (all P<0.05). The intervention group also increased FMD ( 2.05%; 95% CI: 0.97, 3.13%), whereas no effect was found in the control group (-0.32%; 95% CI: -1.31, 0.67%). Changes in lipids and CRP concentrations did not differ between the 2 groups, whereas diastolic blood pressure decreased in the intervention group (-6.44 mm Hg; 95% CI: -8.57, -4.31 mm Hg) compared with the control group (-0.76 mm Hg; 95% CI: -2.83, 1.31 mm Hg). Finally, there was a trend for a reduction in HOMA-IR in the intervention group compared with the control group (P = 0.072). CONCLUSION: Close adherence to a Mediterranean-style diet achieved by close dietetic supervision improves endothelial function in subjects with AO. Article Published Date : Aug 01, 2009

Abstract Title: A protective effect of the Mediterranean diet for cutaneous melanoma. Abstract Source: Eur J Haematol. 2009 Aug;83(2):108-18. Epub 2009 Mar 5. PMID: 18621803 Abstract Author(s): C Fortes, S Mastroeni, F Melchi, M A Pilla, G Antonelli, D Camaioni, M Alotto, P Pasquini Abstract: BACKGROUND: Many studies have investigated the Mediterranean diet as a risk factor for cancer, none of which has included cutaneous melanoma. The latter is usually fatal, rendering knowledge about prevention extremely important. We assessed the role of some food components of the Mediterranean diet and cutaneous melanoma. METHODS: A hospital-based case-control study was conducted in the inpatient wards of IDI-San Carlo Rome, Italy including 304 incident cases of cutaneous melanoma and 305 controls, frequency matched to cases. Information on socio-demographic characteristics, medical history, smoking, sun exposure, pigmentary characteristics and diet was collected. Logistic regression was the method used to estimated odds ratio and 95% CIs. RESULTS: After careful control for several sun exposure and pigmentary characteristics, we found a protective effect for weekly consumption of fish (OR, 0.65, 95%CI = 0.43-0.97), shellfish (OR, 0.53, 95%CI = 0.31-0.89), fish rich in n-3 fatty acids (OR, 0.52, 95%CI = 0.34-0.78), daily tea drinking (OR, 0.42, 95%CI, 0.18-0.95; P(trend) = 0.025) and high consumption of vegetables (OR, 0.50, 95%CI = 0.31-0.80, P(trend) = 0.005) in particular carrots, cruciferous and leafy vegetables and fruits (OR, 0.54, 95%CI =0.33-0.86, P(trend) = 0.013), in particular citrus fruits. No association was found for alcohol consumption and any other food items. CONCLUSION: Overall, our findings suggest that some dietary factors present in the Mediterranean diet might protect from cutaneous melanoma. Article Published Date : Aug 01, 2009

Abstract Title: Multiple sclerosis and cancers in Croatia--a possible protective role of the "Mediterranean diet". Abstract Source: Coll Antropol. 2009 Jun;33(2):539-45. PMID: 19662776 Abstract Author(s): Eris Materljan, Mauro Materljan, Branka Materljan, Helena Vlacić, Zdenka Barićev-Novaković, Juraj Sepcić Abstract: Multiple sclerosis (MS) is an autoimmune disease triggered by a combination of genetic and environmental risk factors which are however individually insufficient to provoke the disease. Previous investigations studied the coexistence of cancer in MS patients, and only a few relations between the geographic distribution of MS and that of cancer. The aim of this research was to find an environmental link between the aetiology of MS and cancers in Croatia. Incidence and prevalence of MS in Croatia were compared with the incidence of the most frequent cancer sites: stomach cancer, cancer of the colon and the rectum, pancreatic cancer, lung cancer, cancer of the kidneys and brain cancer. Data for MS were collected from seven population-based epidemiologic studies which used Poser's diagnostic criteria and reported the number of cases and the magnitude of the studied population. Data for cancers were drawn from the Croatian National Cancer Registry. The analysis was done for single municipalities, grouped in their belonging regions or counties, and separately for the continental and the coastal area. For each rate a 95% confidence interval was calculated. The differences between rates were tested with the chi-square test as well. In addition, MS incidence or prevalence were correlated with the corresponding cancer incidence data. Pearson's correlation coefficients were used to measure the correlation between both diseases. Calculations were done with the statistical package Statistica V 7.1. and the Smith's Statistical Package freeware In the continental area of Croatia the mean annual incidence (per 100,000 inhabitants) of MS was nearly two folds higher than in the coastal area: 2.1 vs. 1.3 (p = 0.0029). The difference was lower when expressed by prevalence: 46.5 vs. 36.7 (p = 0.0601). Among the malignant neoplasms, in the continental area significantly higher incidence rates were found for stomach (32.9 vs. 20.8; p = 3.14E-14) and lung cancer (55.8 vs. 46.4; p = 1.21E-05), whilst colon cancer alone (20.4 vs. 15.7; p = 9.44E-05) or colorectal cancer (38.3 vs. 31.6; p = 8.18E-05) had a significantly higher incidence in the coastal area. The geographic distribution of MS expressed by incidence was significantly correlated with pancreatic (r = 0.62024, df=23, p = 0.00094) and lung cancer (r = 0.46380, df=23, p = 0.01953). This research adds further malignant neoplasms, possibly exposure-related, to the list of diseases with geographic distribution like MS. The similarity of MS distribution with the named malignancies is unlikely to be incidental. MS in Gorski Kotar and Slavonia seems to be associated with a diet rich in meat and fat. A diet rich in fat and meat and poor in vegetables is a risk factor for stomach, colorectum, pancreatic as well as lung cancers. Some authors have documented a possible protective role of the "Mediterranean diet" for the named cancers. Olive oil is the main source of fat in the "Mediterranean diet". Oleocanthal, aphenolic compound of the extra-virgin olive oil was found to inhibit the cyclooxigenase enzymes which are involved in demyelination and tumorigenesis. We hypothesize that the "Mediterranean diet", olive oil and particularly oleocanthal, to have a protective role in MS too. Article Published Date : Jun 01, 2009

Abstract Title: Olive oil consumption and non-alcoholic fatty liver disease. Abstract Source: World J Gastroenterol. 2009 Apr 21;15(15):1809-15. PMID: 19370776 Abstract Author(s): Nimer Assy, Faris Nassar, Gattas Nasser, Maria Grosovski Article Affiliation: Liver Unit, Ziv Medical Centre, Safed, Israel. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: The clinical implications of non-alcoholic fatty liver diseases (NAFLD) derive from their potential to progress to fibrosis and cirrhosis. Inappropriate dietary fat intake, excessive intake of soft drinks, insulin resistance and increased oxidative stress results in increased free fatty acid delivery to the liver and increased hepatic triglyceride (TG) accumulation. An olive oil-rich diet decreases accumulation of TGs in the liver, improves postprandial TGs, glucose and glucagon-like peptide-1 responses in insulin-resistant subjects, and upregulates glucose transporter-2 expression in the liver. The principal mechanisms include: decreased nuclear factor-kappaB activation, decreased low-density lipoprotein oxidation, and improved insulin resistance by reduced production of inflammatory cytokines (tumor necrosis factor, interleukin-6) and improvement of jun N-terminal kinase-mediated phosphorylation of insulin receptor substrate-1. The beneficial effect of the Mediterranean diet is derived from monounsaturated fatty acids, mainly from olive oil. In this review, we describe the dietary sources of the monounsaturated fatty acids, the composition of olive oil, dietary fats and their relationship to insulin resistance and postprandial lipid and glucose responses in non-alcoholic steatohepatitis, clinical and experimental studies that assess the relationship between olive oil and NAFLD, and the mechanism by which olive oil ameliorates fatty liver, and we discuss future perspectives. Article Published Date : Apr 21, 2009

Abstract Title: The maternal Mediterranean dietary pattern is associated with a reduced risk of spina bifida in the offspring. Abstract Source: BJOG. 2009 Feb;116(3):408-15. PMID: 19187373 Abstract Author(s): M Vujkovic, E A Steegers, C W Looman, M C Ocké, P J van der Spek, R P Steegers-Theunissen Abstract: OBJECTIVE: The objective of this study was to test the hypothesis whether a maternal dietary pattern is associated with the risk of spina bifida (SB) in the offspring. DESIGN: Case-control study. SETTING: Eight clinic sites in the Netherlands, 1999-2001. SAMPLE: A total of 50 mothers of children with SB and 81 control mothers. METHODS: Maternal food intakes were obtained by food frequency questionnaires at the standardised study moment of 14 months after the birth of the index child. Principal component factor analysis (PCA) and reduced rank regression (RRR) were used to identify dietary patterns. MAIN OUTCOME MEASURES: Maternal biomarkers were used as response measures in the RRR analysis and composed of serum and red blood cell (RBC) folate, serum vitamin B12 and total plasma homocysteine. The strength of the use of the dietary pattern in association with SB risk was estimated by odds ratios and 95% CI with the highest quartiles of the dietary pattern as reference. RESULTS: A predominantly Mediterranean dietary pattern was identified by both PCA and RRR. Those dietary patterns were highly correlated (r = 0.51, P<0.001) and characterised by joint intakes of fruit, vegetables, vegetable oil, alcohol, fish, legumes and cereals and low intakes of potatoes and sweets. We observed a significantly increased risk of SB offspring in mothers with a weak use of the Mediterranean dietary pattern, OR 2.7 (95% CI 1.2-6.1) and OR 3.5 (95% CI 1.5-7.9). The Mediterranean dietary pattern was correlated with higher levels of serum and RBC folate, serum vitamin B12 and lower plasma homocysteine. CONCLUSION: The Mediterranean dietary pattern seems to be associated with reduction in the risk of offspring being affected by SB. Article Published Date : Feb 01, 2009

Abstract Title: Can a Mediterranean diet moderate the development and clinical progression of coronary heart disease? A systematic review. Abstract Source: Vitam Horm. 2009;81:487-504. PMID: 15278010 Abstract Author(s): Demosthenes B Panagiotakos, Christos Pitsavos, Evangelos Polychronopoulos, Christine Chrysohoou, Antonis Zampelas, Antonia Trichopoulou Abstract: BACKGROUND: It has been suggested that adherence to a Mediterranean diet reduces all causes of mortality, especially death rates due to coronary heart disease. In this review we summarize the findings of observational studies that evaluated the effect of the Mediterranean dietary pattern in the primary and secondary prevention of coronary heart disease. MATERIAL/METHODS: We retrieved published results from prospective and case-control studies which evaluated the association between adherence to a Mediterranean diet and the occurrence of coronary heart disease outcomes. RESULTS: The benefits from the Mediterranean diet were significant in all studies. The reduction in the risk of coronary heart disease varied from 8% to 45%, depending on the increment used by the investigators in the presentation of their results. CONCLUSIONS: The systematically reviewed studies reveal a cardio-protective effect of the Mediterranean diet and point to this dietary pattern as highly appropriate for public health objectives. Article Published Date : Jan 01, 2009

Abstract Title: Mediterranean diet and cardioprotection: wild artichoke inhibits metalloproteinase 9. Abstract Source: Mol Nutr Food Res. 2008 Oct;52(10):1147-52. PMID: 18646006 Abstract Author(s): Stefano Bellosta, Paola Bogani, Monica Canavesi, Claudio Galli, Francesco Visioli Article Affiliation: Department of Pharmacological Sciences, University of Milan, Milan, Italy. Abstract: Metalloproteinases (MMPs) are zinc-dependent endopeptidases responsible for the hydrolysis of various component of extracellular matrix such as gelatin and collagen. MMPs, namely MMP-2 and MMP-9 correlate with cardiovascular events in patients. We sought to determine whether supplementation with polyphenol-rich Cynara cardunculus (wild artichoke, traditional component of the Mediterranean diet) modulates MMP-9 expression and activity in cell cultures. A fully characterized C. cardunculus extract was able to inhibit, in a dose-dependent manner, the gelatinolytic activity of secreted MMP-9 and both secretion and human MMP-9 promoter-driven transcription. Analysis by HPLC of the Cynara extract identified polyphenols such as luteolin, apigenin, and caffeic acid, among others. However, testing a mix of the individual components suggested that the inhibitory effects of C. cardunculus are due to minor constituent fraction(s) as a whole. In promoting the health benefits of the Mediterranean diet, the role of wild plants as important meal components deserves further reappraisal. Article Published Date : Oct 01, 2008

Abstract Title: Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Abstract Source: Br J Cancer. 2008 Jul 8;99(1):191-5. PMID: 18594542 Abstract Author(s): V Benetou, A Trichopoulou, P Orfanos, A Naska, P Lagiou, P Boffetta, D Trichopoulos, Abstract: Adherence to traditional Mediterranean diet (MD) has been reported to be inversely associated with total, as well as cardiovascular, mortality. We have examined the relation between degree of such adherence and incidence of cancer overall in a general population sample of 25 623 participants (10 582 men, 15 041 women) of the Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). All subjects completed a validated, interviewer-administered, semi-quantitative food-frequency questionnaire at enrolment. Degree of adherence to the traditional MD was assessed through a 10-point scale (0 minimal; 9 maximal) that incorporated key dietary characteristics. During a median follow-up of 7.9 years and 188 042 total person-years, 851 medically confirmed incident cancer cases (421 men, 430 women) were recorded. Using proportional hazards regression with adjustment for potential confounders, we found that a higher degree of MD adherence was associated with lower overall cancer incidence. A two-point increase in the score corresponded to a 12% reduction in cancer incidence (adjusted hazard ratio, 0.88 (95% confidence interval 0.80, 0.95)). The association was exposure-dependent and stronger among women. This inverse association with MD adherence was considerably stronger than that predicted on the basis of the associations of the individual components of this diet and points to the value of analysing dietary patterns in cancer studies. Article Published Date : Jul 08, 2008

Abstract Title: Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. Abstract Source: BMJ. 2008 Jun 14;336(7657):1348-51. Epub 2008 May 29. PMID: 18511765 Abstract Author(s): M A Martínez-González, C de la Fuente-Arrillaga, J M Nunez-Cordoba, F J Basterra-Gortari, J J Beunza, Z Vazquez, S Benito, A Tortosa, M Bes-Rastrollo Abstract: OBJECTIVE: To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes among initially healthy participants. DESIGN: Prospective cohort study with estimates of relative risk adjusted for sex, age, years of university education, total energy intake, body mass index, physical activity, sedentary habits, smoking, family history of diabetes, and personal history of hypertension. SETTING: Spanish university department. PARTICIPANTS: 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years. MAIN OUTCOME MEASURES: Dietary habits assessed at baseline with a validated 136 item food frequency questionnaire and scored on a nine point index. New cases of diabetes confirmed through medical reports and an additional detailed questionnaire posted to those who self reported a new diagnosis of diabetes by a doctor during follow-up. Confirmed cases of type 2 diabetes. RESULTS: Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score<3). In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis. CONCLUSION: Adherence to a Mediterranean diet is associated with a reduced risk of diabetes. Article Published Date : Jun 14, 2008

Abstract Title: The effects of polyphenols in olive leaves on platelet function. Abstract Source: Nutr Metab Cardiovasc Dis. 2008 Feb;18(2):127-32. Epub 2007 Mar 7. PMID: 17346951 Abstract Author(s): Indu Singh, Michelle Mok, Anne-Marie Christensen, Alan H Turner, John A Hawley Article Affiliation: School of Medical Sciences, RMIT University, Melbourne, Australia. Abstract: INTRODUCTION: The phenolic compounds of olive leaves and olive oils in the Mediterranean diet have been associated with a reduced incidence of heart disease. Accordingly, antioxidant-rich diets may prevent the deleterious effects of oxidative metabolism by scavenging free radicals, thus inhibiting oxidation and delaying atherosclerosis. The process involves phospholipase C activation and arachidonic acid metabolism, and is thought to reduce hydrogen peroxide (H(2)O(2)). In our study, an extract of Olea europaea L. leaves was used. The active phenolic compounds in this extract are part of the secoiridoid family, known for their capacity to scavenge H(2)O(2). The results from this study will help to improve our understanding of effects of polyphenol antioxidants in olive leaf extract on platelet function. METHODS: Full blood examination (FBE), platelet aggregation, and ATP release were performed on samples from fasting, normal, healthy male subjects. Platelet function at increasing concentrations of oleuropein was investigated through measures of platelet aggregation and ATP release from activated platelets. RESULTS: Blood analysis (n=11) revealed a significant dose-dependant reduction in platelet activity with olive extract concentrations of 1.0% v/v (P<0.001). ATP Release showed a similar pattern (P=0.02). CONCLUSIONS: Olive leaf polyphenols derived from O. europaea L. leaves inhibited in vitro platelet activation in healthy, non-smoking males. Further bioavailability studies need to be undertaken to determine the in vivo effect of extract on platelet function and to validate the present results. Article Published Date : Feb 01, 2008

Abstract Title: Adherence to the mediterranean diet is inversely associated with circulating interleukin-6 among middle-aged men: a twin study. Abstract Source: Circulation. 2008 Jan 15;117(2):169-75. Epub 2007 Dec 17. PMID: 18086924 Abstract Author(s): Jun Dai, Andrew H Miller, J Douglas Bremner, Jack Goldberg, Linda Jones, Lucy Shallenberger, Rocky Buckham, Nancy V Murrah, Emir Veledar, Peter W Wilson, Viola Vaccarino Abstract: BACKGROUND: The Mediterranean diet is protective against cardiovascular disease; a proposed mechanism is through a reduction in systemic inflammation. It is unknown to what extent the association between the Mediterranean diet and inflammation is due to genetic or other familial factors. METHODS AND RESULTS: We administered the Willett food frequency questionnaire to 345 middle-aged male twins and assessed adherence to the Mediterranean diet using a published adherence score. Fasting plasma levels of interleukin-6, C-reactive protein, and known cardiovascular risk factors were measured. Mixed-effect regression analyses were used to examine the relationship between diet score and inflammatory biomarkers after accounting for known cardiovascular risk factors. Adherence to the Mediterranean diet was associated with reduced levels of interleukin-6 (P<0.001) but not C-reactive protein (P=0.10) after adjustment for total energy intake, other nutritional factors, known cardiovascular risk factors, and use of supplements and medications. When the overall association of adherence to the diet with interleukin-6 levels was partitioned into between- and within-pair effects, the between-pair effect was not significant (P=0.9) and the within-pair effect was highly significant (P<0.0001). A 1-unit within-pair absolute difference in the diet score was associated with a 9% (95% CI, 4.5 to 13.6) lower interleukin-6 level. CONCLUSIONS: Shared environmental and genetic factors are unlikely to play a major role in the association between adherence to the Mediterranean diet and systemic inflammation. These results support the hypothesis that reduced inflammation is an important mechanism linking Mediterranean diet to reduced cardiovascular risk. Article Published Date : Jan 15, 2008

Abstract Title: Association between a Mediterranean-type diet and risk of preterm birth among Danish women: a prospective cohort study. Abstract Source: Acta Obstet Gynecol Scand. 2008;87(3):325-30. PMID: 18307073 Abstract Author(s): Tina B Mikkelsen, Marie Louise Osterdal, Vibeke K Knudsen, Margaretha Haugen, Helle M Meltzer, Leiv Bakketeig, Sjurdur F Olsen Article Affiliation: Maternal Nutrition Group, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen S, Denmark. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Thus far, few factors with a causal relation to preterm birth have been identified. Many studies have focused on the woman's diet, but most have been discouraging. The aim of the present study was to examine if maternal intake of a Mediterranean-type diet (MD) is associated with reduced risk of preterm birth. METHODS: The Danish National Birth Cohort assessed diet in mid-pregnancy by food frequency questionnaires (FFQ). Women consuming MD were those who ate fish twice a week or more, used olive or rape seed oil, consumed 5+ fruits and vegetables a day, ate meat (other than poultry and fish) at most twice a week, and drank at most 2 cups of coffee a day. RESULTS: Of 35,530 non-smoking women, 1,137 (3.2%) fulfilled all MD criteria, and 540 (1.5%) none. Odds ratios for preterm birth and early preterm birth were 0.61 (95% Confidence Interval (CI): 0.35-1.05) and 0.28 (0.11-0.76), respectively, in MD women compared to women fulfilling none of the MD criteria. CONCLUSION: Shifting towards a MD during pregnancy may reduce the risk of early delivery in Danish women. Article Published Date : Jan 01, 2008

Abstract Title: Giacomo Castelvetro's salads. Anti-HER2 oncogene nutraceuticals since the 17th century? Abstract Source: Clin Transl Oncol. 2008 Jan;10(1):30-4. PMID: 18208790 Abstract Author(s): R Colomer, R Lupu, A Papadimitropoulou, L Vellón, A Vázquez-Martín, J Brunet, A Fernández-Gutiérrez, A Segura-Carretero, J A Menéndez Article Affiliation: M.D. Anderson International Madrid, Madrid, Spain. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: We are accumulating evidence to suggest that 17(th) century Renaissance foodways -largely based on the old "Mediterranean dietary traditions"- may provide new nutraceutical management strategies against HER2-positive breast cancer disease in the 21st century. Epidemiological and experimental studies begin to support the notion that "The Sacred Law of Salads" (i.e., "raw vegetables... plenty of generous (olive) oil") -originally proposed in 1614 by Giacomo Castelvetro in its book The Fruit, Herbs&Vegetables of Italy- might be considered the first (unintended) example of customised diets for breast cancer prevention based on individual genetic make-up (i.e., nutraceuticals against human breast carcinomas bearing HER2 oncogene amplification/overexpression). First, the so-called salad vegetables dietary pattern (i.e., a high consumption of raw vegetables and olive oil) appears to exert a protective effect mostly confined to the HER2-positive breast cancer subtype, with no significant influence on the occurrence of HER2-negative breast cancers. Second, all the main olive oil constituents (i.e., the omega-9 monounsaturated fatty acid oleic acid and polyphenolic compounds such as the secoiridoid oleuropein or the lignan 1-[+]-acetoxypinoresinol) dramatically reduce HER2 expression and specifically induce apoptotic cell death in cultured HER2- positive breast cancer cells, with marginal effects against HER2-negative cells. Third, an olive oil-rich diet negatively influences experimental mammary tumorigenesis in rats likewise decreasing HER2 expression levels. If early 1600s Castelvetro's salads can be used as dietary protocols capable to protecting women against biologically aggressive HER2-positive breast cancer subtypes is an intriguing prospect that warrants to be evaluated in human pilot studies in the future. Here, at least, we would like to recognise Giacomo Castelvetro as the father of modern nutritional genomics in oncology. Article Published Date : Jan 01, 2008

Abstract Title: Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH-AARP Diet and Health Study. Abstract Source: Arch Intern Med. 2007 Dec 10;167(22):2461-8. PMID: 18071168 Abstract Author(s): Panagiota N Mitrou, Victor Kipnis, Anne C M Thiébaut, Jill Reedy, Amy F Subar, Elisabet Wirfält, Andrew Flood, Traci Mouw, Albert R Hollenbeck, Michael F Leitzmann, Arthur Schatzkin Abstract: BACKGROUND: The Mediterranean diet has been suggested to play a beneficial role for health and longevity. However, to our knowledge, no prospective US study has investigated the Mediterranean dietary pattern in relation to mortality. METHODS: Study participants included 214,284 men and 166,012 women in the National Institutes of Health (NIH)-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study. During follow-up for all-cause mortality (1995-2005), 27,799 deaths were documented. In the first 5 years of follow-up, 5,985 cancer deaths and 3,451 cardiovascular disease (CVD) deaths were reported. We used a 9-point score to assess conformity with the Mediterranean dietary pattern (components included vegetables, legumes, fruits, nuts, whole grains, fish, monounsaturated fat-saturated fat ratio, alcohol, and meat). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using age- and multivariate-adjusted Cox models. RESULTS: The Mediterranean diet was associated with reduced all-cause and cause-specific mortality. In men, the multivariate HRs comparing high to low conformity for all-cause, CVD, and cancer mortality were 0.79 (95% CI, 0.76-0.83), 0.78 (95% CI, 0.69-0.87), and 0.83 (95% CI, 0.76-0.91), respectively. In women, an inverse association was seen with high conformity with this pattern: decreased risks that ranged from 12% for cancer mortality to 20% for all-cause mortality (P = .04 and P<.001, respectively, for the trend). When we restricted our analyses to never smokers, associations were virtually unchanged. CONCLUSION: These results provide strong evidence for a beneficial effect of higher conformity with the Mediterranean dietary pattern on risk of death from all causes, including deaths due to CVD and cancer, in a US population. Article Published Date : Dec 10, 2007

Abstract Title: A MUFA-rich diet improves posprandial glucose, lipid and GLP-1 responses in insulin-resistant subjects. Abstract Source: J Am Coll Nutr. 2007 Oct;26(5):434-44. PMID: 17914131 Abstract Author(s): Juan A Paniagua, Angel Gallego de la Sacristana, Esther Sánchez, Inmaculada Romero, Antonio Vidal-Puig, Francisco J Berral, Antonio Escribano, Maria José Moyano, Pablo Peréz-Martinez, José López-Miranda, Francisco Pérez-Jiménez Article Affiliation: Lipids and Atherosclerosis Research Unit, University Hospital Reina Sofía, Córdoba, Spain. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: To study the effects of three weight-maintenance diets with different macronutrient composition on carbohydrate, lipid metabolism, insulin and incretin levels in insulin-resistant subjects. METHODS: A prospective study was performed in eleven (7 W, 4 M) offspring of obese and type 2 diabetes patients. Subjects had a BMI>25 Kg/m2, waist circumference (men/women)>102/88, HBA1c<6.5% and were regarded as insulin-resistant after an OGTT (Matsuda ISIm<4). They were randomly divided into three groups and underwent three dietary periods each of 28 days in a crossover design: a) diet high in saturated fat (SAT), b) diet rich in monounsaturated fat (MUFA; Mediterranean diet) and c) diet rich in carbohydrate (CHO). RESULTS: Body weight and resting energy expenditure did not changed during the three dietary periods. Fasting serum glucose concentrations fell during MUFA-rich and CHO-rich diets compared with high-SAT diets (5.02 +/- 0.1, 5.03 +/- 0.1, 5.50 +/- 0.2 mmol/L, respectively. Anova<0.05). The MUFA-rich diet improved insulin sensitivity, as indicated by lower homeostasis model analysis-insulin resistance (HOMA-ir), compared with CHO-rich and high-SAT diets (2.32 +/- 0.3, 2.52 +/- 0.4, 2.72 +/- 0.4, respectively, Anova<0.01). After a MUFA-rich and high-SAT breakfasts (443 kcal) the postprandial integrated area under curve (AUC) of glucose and insulin were lowered compared with isocaloric CHO-rich breakfast (7.8 +/- 1.3, 5.84 +/- 1.2, 11.9 +/- 2.7 mmol . 180 min/L, Anova<0.05; and 1004 +/- 147, 1253 +/- 140, 2667 +/- 329 pmol . 180 min/L, Anova<0.01, respectively); while the integrated glucagon-like peptide-1 response increased with MUFA and SAT breakfasts compared with isocaloric CHO-rich meals (4.22 +/- 0.7, 4.34 +/- 1.1, 1.85 +/- 1.1, respectively, Anova<0.05). Fasting and postprandial HDL cholesterol concentrations rose with MUFA-rich diets, and the AUCs of triacylglycerol fell with the CHO-rich diet. Similarly fasting proinsulin (PI) concentration fell, while stimulated ratio PI/I was not changed by MUFA-rich diet. CONCLUSIONS: Weight maintenance with a MUFA-rich diet improves HOMA-ir and fasting proinsulin levels in insulin-resistant subjects. Ingestion of a virgin olive oil-based breakfast decreased postprandial glucose and insulin concentrations, and increased HDL-C and GLP-1 concentrations as compared with CHO-rich diet. Article Published Date : Oct 01, 2007

Abstract Title: Mediterranean diet and Alzheimer disease mortality. Abstract Source: Neurology. 2007 Sep 11 ;69(11):1084-93. PMID: 17846408 Abstract Author(s): Nikolaos Scarmeas, Jose A Luchsinger, Richard Mayeux, Yaakov Stern Article Affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: We previously reported that the Mediterranean diet (MeDi) is related to lower risk for Alzheimer disease (AD). Whether MeDi is associated with subsequent AD course and outcomes has not been investigated. OBJECTIVES: To examine the association between MeDi and mortality in patients with AD. METHODS: A total of 192 community-based individuals in New York who were diagnosed with AD were prospectively followed every 1.5 years. Adherence to the MeDi (0- to 9-point scale with higher scores indicating higher adherence) was the main predictor of mortality in Cox models that were adjusted for period of recruitment, age, gender, ethnicity, education, APOE genotype, caloric intake, smoking, and body mass index. RESULTS: Eighty-five patients with AD (44%) died during the course of 4.4 (+/-3.6, 0.2 to 13.6) years of follow-up. In unadjusted models, higher adherence to MeDi was associated with lower mortality risk (for each additional MeDi point hazard ratio 0.79; 95% CI 0.69 to 0.91; p = 0.001). This result remained significant after controlling for all covariates (0.76; 0.65 to 0.89; p = 0.001). In adjusted models, as compared with AD patients at the lowest MeDi adherence tertile, those at the middle tertile had lower mortality risk (0.65; 0.38 to 1.09; 1.33 years' longer survival), whereas subjects at the highest tertile had an even lower risk (0.27; 0.10 to 0.69; 3.91 years' longer survival; p for trend = 0.003). CONCLUSION: Adherence to the Mediterranean diet (MeDi) may affect not only risk for Alzheimer disease (AD) but also subsequent disease course: Higher adherence to the MeDi is associated with lower mortality in AD. The gradual reduction in mortality risk for higher MeDi adherence tertiles suggests a possible dose-response effect.   Article Published Date : Sep 11, 2007

Abstract Title: Mediterranean diet improves sexual function in women with the metabolic syndrome. Abstract Source: Int J Impot Res. 2007 Sep-Oct;19(5):486-91. Epub 2007 Aug 2. PMID: 17673936 Abstract Author(s): K Esposito, M Ciotola, F Giugliano, B Schisano, R Autorino, S Iuliano, M T Vietri, M Cioffi, M De Sio, D Giugliano Abstract: In the present study, we tested the effect of a Mediterranean-style diet on sexual function in women with the metabolic syndrome. Women were identified in our database of subjects participating in controlled trials evaluating the effect of lifestyle changes and were included if they had a diagnosis of female sexual dysfunction (FSD) associated with a diagnosis of metabolic syndrome, a complete follow-up in the study trial and an intervention focused mainly on dietary changes. Fifty-nine women met the inclusion/exclusion criteria; 31 out of them were assigned to the Mediterranean-style diet and 28 to the control diet. After 2 years, women on the Mediterranean diet consumed more fruits, vegetables, nuts, whole grain and olive oil as compared with the women on the control diet. Female sexual function index (FSFI) improved in the intervention group, from a mean basal value of 19.7+/-3.1 to a mean post-treatment value of 26.1+/-4.1 (P=0.01), and remained stable in the control group. C-reactive protein (CRP) levels were significantly reduced in the intervention group (P<0.02). No single sexual domain (desire, arousal, lubrication, orgasm, satisfaction, pain) was significantly ameliorated by the dietary treatment, suggesting that the whole female sexuality may find benefit from lifestyle changes. A Mediterranean-style diet might be effective in ameliorating sexual function in women with metabolic syndrome.   Article Published Date : Sep 01, 2007

Abstract Title: Mediterranean diet and essential tremor. A case-control study. Abstract Source: Clin Exp Pharmacol Physiol. 2007 May-Jun;34(5-6):399-405. PMID: 18043001 Abstract Author(s): Nikolaos Scarmeas, Elan D Louis Abstract: BACKGROUND: Higher adherence to the Mediterranean diet (MeDi) has been related to lower Alzheimer's disease risk. Some dietary factors have been studied in patients with essential tremor (ET), but the MeDi's effect has not been investigated. METHODS: Adherence to the MeDi was calculated from a food frequency questionnaire administered in a case-control study of environmental epidemiology of ET in the New York Tri-State area. Logistic regression models were used to examine whether adherence to the MeDi predicted ET (vs. control) outcome. The models adjusted for age, gender, ethnicity, education, caloric intake, body mass index, smoking, ethanol consumption, coffee intake and blood harmane concentrations. RESULTS: 148 ET cases adhered less to MeDi (0-9 scale with higher scores indicating higher adherence) than 250 controls (mean 4.3 +/- 1.7 vs. 4.7 +/- 1.7; p = 0.03). Higher adherence to MeDi was associated with lower odds for ET [0.78 (0.61-0.99); p = 0.042]. As compared to subjects at the lowest MeDi adherence tertile, those at the middle tertile had lower ET odds [0.41 (0.16-1.05)], while subjects at the highest tertile had an even lower ET odds [0.29 (0.10-0.82); p for trend 0.021]. CONCLUSIONS: Compared to controls, ET cases adhered less to MeDi. The gradual reduction in ET odds with higher MeDi adherence tertiles suggests a possible dose-response effect. The mechanisms that underlie this association merit further study. Article Published Date : May 01, 2007

Abstract Title: Cortisol secretary pattern and glucocorticoid feedback sensitivity in women from a Mediterranean area: relationship with anthropometric characteristics, dietary intake and plasma fatty acid profile. Abstract Source: Clin Endocrinol (Oxf). 2007 Feb;66(2):185-91. PMID: 17223986 Abstract Author(s): M D García-Prieto, F J Tébar, F Nicolás, E Larqué, S Zamora, M Garaulet Abstract: BACKGROUND: Chronic stress is associated with a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis consisting on disturbances on the cortisol response and lipid metabolism. OBJECTIVE: To evaluate the HPA axis activity in women from a Mediterranean area, comparing three different measurements: daily cortisol secretory variability, postprandial cortisol secretion and glucocorticoid feedback sensitivity. In addition, HPA axis disturbance is correlated with dietary habits and plasma fatty acid profiles. DESIGN: The participants were 41 women born during the first 6 months of 1960 and living in a Mediterranean area (Murcia, Spain). They were of normal weight, with a waist circumference of 80.5 +/- 9.3 cm. Their salivary cortisol levels, 7-day dietary record and plasma fatty acid profile were evaluated. Daily cortisol variability and postlunch cortisol secretion were recorded and a dexamethasone suppression test is performed in order to detect possible HPA disturbance. RESULTS: Both the methods used for HPA axis evaluation were positively correlated (r = 0.448, P = 0.004). Subjects with normal diurnal curves (high cortisol variability) showed significantly higher cortisol values in the morning and postprandial cortisol secretion than women with pathological curves (medium and low variability). Cortisol variability was inversely correlated with waist circumference (r = -0.312, P = 0.047), suggesting that a disturbed HPA axis response may lead to an android pattern of body fat distribution. Dietary fat and saturated fatty acid intake were lower in the high cortisol variability group, while monounsaturated fatty acid intake was higher (P<0.05). No major differences were reported in plasma fatty acid profile. CONCLUSIONS: A disturbed HPA axis is associated with abdominal fat distribution and a higher content of fat and saturated fatty acids in the diet. Women who chose a dietary pattern closer to the Mediterranean diet, with high monounsaturated fatty acid intake, showed lower levels on HPA axis disturbance. Article Published Date : Feb 01, 2007

Abstract Title: Modified Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly study. Abstract Source: Eur J Epidemiol. 2007;22(12):871-81. Epub 2007 Oct 10. PMID: 17926134 Abstract Author(s): A Trichopoulou, C Bamia, T Norat, K Overvad, E B Schmidt, A Tjønneland, J Halkjaer, F Clavel-Chapelon, M-N Vercambre, M-C Boutron-Ruault, J Linseisen, S Rohrmann, H Boeing, C Weikert, V Benetou, T Psaltopoulou, P Orfanos, P Boffetta, G Masala, V Pala, S Panico, R Tumino, C Sacerdote, H B Bueno-de-Mesquita, M C Ocke, P H Peeters, Y T Van der Schouw, C González, M J Sanchez, M D Chirlaque, C Moreno, N Larrañaga, B Van Guelpen, J-H Jansson, S Bingham, K-T Khaw, E A Spencer, T Key, E Riboli, D Trichopoulos Abstract: Mediterranean diet is associated with lower incidence of coronary heart disease, and two randomised trials indicated that it improves prognosis of coronary patients. These trials, however, relied on a total of 100 deaths and evaluated designer diets in the clinical context. We have evaluated the association of adherence to the modified Mediterranean diet, in which unsaturates were substituted for monounsaturates, with survival among elderly with previous myocardial infarction within the European Prospective Investigation into Cancer and nutrition (EPIC) study. As of December 2003, after a median follow-up of 6.7 years, 2671 EPIC participants from nine countries were 60 years or older and had prevalent myocardial infarction but no stroke or cancer at enrolment, complete information on dietary intakes and important covariates and known survival status. Adherence to the modified Mediterranean diet was assessed through a 10-unit-scale. Mortality ratio in relation to modified Mediterranean diet was estimated through Cox regression controlling for possible confounding. Increased adherence to modified Mediterranean diet by two units was associated with 18% lower overall mortality rate (95% confidence interval 7-27%, fixed effects model). There was no significant heterogeneity by sex, age at enrolment, or country, although the association tended to be less evident among northern Europeans. Associations between food groups contributing to the modified Mediterranean diet and mortality were generally weak. A diet inspired by the Mediterranean pattern that can be easily adopted by Western populations is associated with substantial reduction of total mortality of coronary patients in the community. Article Published Date : Jan 01, 2007

Abstract Title: Mediterranean dietary traditions for the molecular treatment of human cancer: anti-oncogenic actions of the main olive oil's monounsaturated fatty acid oleic acid (18:1n-9). Abstract Source: Curr Pharm Biotechnol. 2006 Dec;7(6):495-502. PMID: 17168666 Abstract Author(s): Javier A Menendez, Ruth Lupu Article Affiliation: Fundació d'Investigació Biomèdica de Girona Dr. Josep Trueta (IdIBGi), Girona, Catalonia, Spain. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: The final proof about the specific mechanisms by which the different components of olive oil, the principal source of fat in a typical "Mediterranean diet", exert their potential protective effects on the promotion and progression of several human cancers requires further investigations. A recent discovery that dietary fatty acids can interact with the human genome by regulating the amount and/or activity of transcription factors has opened a whole new line of research aimed to molecularly corroborate the ant-cancer benefits of the olive oil-based Mediterranean diet and the underlying mechanisms. Our most recent findings reveal that oleic acid (OA; 18:1n-9), the main olive oil's monounsaturated fatty acid, can suppress the overexpression of HER2 (erbB-2), a well-characterized oncogene playing a key role in the etiology, invasive progression and metastasis in several human cancers. First, exogenous supplementation with physiological concentrations of OA significantly down-regulates HER2-coded p185(Her-2/neu) oncoprotein in human cancer cells naturally harboring amplification of the HER gene. Second, OA exposure specifically represses the transcriptional activity of the human HER2 gene promoter in tumor-derived cell lines naturally exhibiting HER2 gene amplification and p185(Her-2/neu) protein overexpression but not in cancer cells expressing physiological levels of HER2. Third, OA treatment induces the up-regulation of the Ets protein PEA3 (a transcriptional repressor of the HER2 gene promoter) solely in cancer cells naturally displaying HER2 gene amplification. Fourth, HER2 gene promoter bearing a PEA3 site-mutated sequence cannot be negatively regulated by OA, while treatment with OA fails to repress the expression of a human full-length HER2 cDNA controlled by a SV40 viral promoter. Fifth, OA-induced inhibition of HER2 promoter activity does not occur if HER2 gene-amplified cancer cells do no concomitantly exhibit high levels of Fatty Acid Synthase (FASN; Oncogenic antigen-519) as specific depletion of FASN, which itself similarly suppresses HER2 overexpression by inducing PEA3-dependent repression of HER2 gene promoter, strongly antagonizes the inhibitory effects of OA on HER2 gene promoter activity. Considering that OA treatment efficiently blocks FASN activity and down-regulates FASN protein expression, it is reasonable to suggest that an accumulation of supra-physiological concentrations of the FASN substrate malonyl-CoA, due to its reduced utilization by FASN in the presence of exogenous OA, appears to act as an indicator of "cell fuel" availability capable to suppress HER2 expression via formation of inhibitory "PEA3 protein-PEA3 DNA binding site" complexes on the endogenous HER2 promoter. Indeed, malonyl-CoA on its own dramatically decreases HER2 promoter activity, while OA or malonyl-CoA similarly up-regulates PEA3 gene promoter activity. This previously unrecognized ability of OA to directly affect the expression of a cluster of interrelated human cancer genes (i.e., HER2, FASN and PEA3) should open a new line of research aimed to explore the anti-cancer effects of OA. Certainly, an appropriate dietary intervention reproducing this prominent anti-oncogenic feature of the "Mediterranean diet" must be carried out in animal models and human pilot studies in the future. Only then we will know whether the old "Mediterranean dietary traditions" will become a new molecular approach in the management of cancer disease. Article Published Date : Dec 01, 2006

Abstract Title: Adherence to a Mediterranean diet and survival in a Greek population. Abstract Source: Biol Psychiatry. 2006 Nov 1;60(9):987-90. Epub 2006 Feb 24. PMID: 12826634 Abstract Author(s): Antonia Trichopoulou, Tina Costacou, Christina Bamia, Dimitrios Trichopoulos Abstract: BACKGROUND: Adherence to a Mediterranean diet may improve longevity, but relevant data are limited. METHODS: We conducted a population-based, prospective investigation involving 22,043 adults in Greece who completed an extensive, validated, food-frequency questionnaire at base line. Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the salient characteristics of this diet (range of scores, 0 to 9, with higher scores indicating greater adherence). We used proportional-hazards regression to assess the relation between adherence to the Mediterranean diet and total mortality, as well as mortality due to coronary heart disease and mortality due to cancer, with adjustment for age, sex, body-mass index, physical-activity level, and other potential confounders. RESULTS: During a median of 44 months of follow-up, there were 275 deaths. A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality (adjusted hazard ratio for death associated with a two-point increment in the Mediterranean-diet score, 0.75 [95 percent confidence interval, 0.64 to 0.87]). An inverse association with greater adherence to this diet was evident for both death due to coronary heart disease (adjusted hazard ratio, 0.67 [95 percent confidence interval, 0.47 to 0.94]) and death due to cancer (adjusted hazard ratio, 0.76 [95 percent confidence interval, 0.59 to 0.98]). Associations between individual food groups contributing to the Mediterranean-diet score and total mortality were generally not significant. CONCLUSIONS: Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality. Article Published Date : Nov 01, 2006

Abstract Title: Dietary intake of unsaturated fatty acids and age-related cognitive decline: a 8.5-year follow-up of the Italian Longitudinal Study on Aging. Abstract Source: Neurobiol Aging. 2006 Nov;27(11):1694-704. Epub 2005 Oct 26. PMID: 16256248 Abstract Author(s): Vincenzo Solfrizzi, Anna Maria Colacicco, Alessia D'Introno, Cristiano Capurso, Francesco Torres, Caterina Rizzo, Antonio Capurso, Francesco Panza Abstract: There is evidence from a population-based study of an inverse relationship between monounsaturated fatty acids (MUFA) energy intake and age-related cognitive decline (ARCD), while high polyunsaturated fatty acids (PUFA) intake was positively associated with cognitive impairment in elderly subjects. We investigated the possible role of MUFA and PUFA on age-related cognitive changes. A population-based, prospective study was carried out on 278, 186, and 95 nondemented elderly subjects (65-84 years) evaluated for global cognitive functions (Mini-Mental State Examination, MMSE) at the first (1992-1993), second (1995-1996), and third survey (2000-2001), respectively, from the randomized cohort of Casamassima, Bari, Italy (n=704), one of the eight centers of the Italian Longitudinal Study on Aging (ILSA). MUFA and PUFA intakes were assessed at baseline with a semi-quantitative food frequency questionnaire. High MUFA and PUFA energy intakes and total energy intake were significantly associated with a better cognitive performance in a 8.5-year follow-up. In this prospective population-based study on older nondemented subjects with a typical Mediterranean diet, high MUFA and PUFA intakes appeared to be protective against ARCD. Article Published Date : Nov 01, 2006

Abstract Title: Effects of dietary factors on oxidation of low-density lipoprotein particles. Abstract Source: J Nutr Biochem. 2006 Oct;17(10):645-58. Epub 2006 Feb 3. PMID: 16517144 Abstract Author(s): Annie Lapointe, Charles Couillard, Simone Lemieux Abstract: Oxidized low-density lipoproteins (ox-LDLs) appear to play a significant role in atherogenesis. In fact, circulating ox-LDL concentrations have been recognized as a risk factor for cardiovascular disease (CVD). A higher intake of some nutrients and specific food compounds such as monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs) and flavonoids have also been associated with a lower risk of CVD. These dietary factors could be associated to a lower risk of CVD through a reduction of the atherogenicity of LDL particles through limited oxidation. Therefore, the purpose of this article is to review human clinical studies that evaluated effects of dietary antioxidant vitamins, fatty acids (MUFA, PUFA) and specific flavonoid-rich foods on LDL particle oxidation and describe potential mechanisms by which dietary factors may prevent oxidation of LDL particles. Antioxidant vitamin supplements such as alpha-tocopherol and ascorbic acid as well as beta-carotene and fish-oil supplements have not been clearly demonstrated to prevent oxidation of LDL particles. Moreover, inconsistent documented effects of flavonoid-rich food such as olive oil, tea, red wine and soy on LDL particle oxidizability may be explained by difference in variety and quantity of flavonoid compounds used among studies. However, a healthy food pattern such as the Mediterranean diet, which includes a combination of antioxidant compounds and flavonoid-rich foods, appears effective to decrease LDL particle oxidizability, which may give some insight of the cardiovascular benefits associated with the Mediterranean diet. Article Published Date : Oct 01, 2006

Abstract Title: Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Abstract Source: Ann Intern Med. 2006 Jul 4;145(1):1-11. PMID: 16818923 Abstract Author(s): Ramon Estruch, Miguel Angel Martínez-González, Dolores Corella, Jordi Salas-Salvadó, Valentina Ruiz-Gutiérrez, María Isabel Covas, Miguel Fiol, Enrique Gómez-Gracia, Mari Carmen López-Sabater, Ernest Vinyoles, Fernando Arós, Manuel Conde, Carlos Lahoz, José Lapetra, Guillermo Sáez, Emilio Ros, Abstract: BACKGROUND: The Mediterranean diet has been shown to have beneficial effects on cardiovascular risk factors. OBJECTIVE: To compare the short-term effects of 2 Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk. DESIGN: Substudy of a multicenter, randomized, primary prevention trial of cardiovascular disease (Prevención con Dieta Mediterránea [PREDIMED] Study). SETTING: Primary care centers affiliated with 10 teaching hospitals. PARTICIPANTS: 772 asymptomatic persons 55 to 80 years of age at high cardiovascular risk who were recruited from October 2003 to March 2004. Interventions: Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months. MEASUREMENTS: Body weight, blood pressure, lipid profile, glucose levels, and inflammatory molecules. RESULTS: The completion rate was 99.6%. Compared with the low-fat diet, the 2 Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were -0.39 mmol/L (95% CI, -0.70 to -0.07 mmol/L) and -0.30 mmol/L (CI, -0.58 to -0.01 mmol/L), respectively, for plasma glucose levels; -5.9 mm Hg (CI, -8.7 to -3.1 mm Hg) and -7.1 mm Hg (CI, -10.0 to -4.1 mm Hg), respectively, for systolic blood pressure; and -0.38 (CI, -0.55 to -0.22) and - 0.26 (CI, -0.42 to -0.10), respectively, for the cholesterol-high-density lipoprotein cholesterol ratio. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet. LIMITATIONS: This short-term study did not focus on clinical outcomes. Nutritional education about low-fat diet was less intense than education about Mediterranean diets. CONCLUSION: Compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors. Article Published Date : Jul 04, 2006

Abstract Title: Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. Abstract Source: Indian J Physiol Pharmacol. 2006 Jul-Sep;50(3):241-9. PMID: 18635428 Abstract Author(s): Iris Shai, Dan Schwarzfuchs, Yaakov Henkin, Danit R Shahar, Shula Witkow, Ilana Greenberg, Rachel Golan, Drora Fraser, Arkady Bolotin, Hilel Vardi, Osnat Tangi-Rozental, Rachel Zuk-Ramot, Benjamin Sarusi, Dov Brickner, Ziva Schwartz, Einat Sheiner, Rachel Marko, Esther Katorza, Joachim Thiery, Georg Martin Fiedler, Matthias Blüher, Michael Stumvoll, Meir J Stampfer, Abstract: BACKGROUND: Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. METHODS: In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. RESULTS: The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). CONCLUSIONS: Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions. (ClinicalTrials.gov number, NCT00160108.) Article Published Date : Jul 01, 2006

Abstract Title: Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Abstract Source: Int J Impot Res. 2006 Jul-Aug;18(4):405-10. Epub 2006 Jan 5. PMID:16395320 Abstract Author(s): K Esposito, M Ciotola, F Giugliano, M De Sio, G Giugliano, M D'armiento, D Giugliano Abstract: Men with the metabolic syndrome demonstrate an increased prevalence of erectile dysfunction (ED). In the present study, we tested the effect of a Mediterranean-style diet on ED in men with the metabolic syndrome. Men were identified in our database of subjects participating in controlled trials evaluating the effect of lifestyle changes and were included if they had a diagnosis of ED associated with a diagnosis of metabolic syndrome, complete follow-up in the study trial, and intervention focused mainly on dietary changes. Sixty-five men with the metabolic syndrome met the inclusion/exclusion criteria; 35 out of them were assigned to the Mediterranean-style diet and 30 to the control diet. After 2 years, men on the Mediterranean diet consumed more fruits, vegetables, nuts, whole grain, and olive oil as compared with men on the control diet. Endothelial function score and inflammatory markers (C-reactive protein) improved in the intervention group, but remained stable in the control group. There were 13 men in the intervention group and two in the control group (P=0.015) that reported an IIEF score of 22 or higher. Mediterranean-style diet rich in whole grain, fruits, vegetables, legumes, walnut, and olive oil might be effective per se in reducing the prevalence of ED in men with the metabolic syndrome. Article Published Date : Jul 01, 2006

Abstract Title: Olive oil in the treatment of hypercholesterolemia. Abstract Source: Med Health R I. 2006 Mar;89(3):113. PMID: 16596937 Abstract Author(s): Kathleen Cullinen Abstract: Olive oil consumption increases HDL-cholesterol levels, while decreasing LDL-cholesterol levels, LDL susceptibility to oxidation and lipid peroxidation. The reduction of cellular oxidative stress, thrombogenicity and the formation of atheroma plague can explain the preventive effects of olive oil on atherosclerosis development. In addition to reducing risk factors for coronary heart disease, olive oil might also help prevent certain types of cancers, and beneficially modify immune and inflammatory responses. Article Published Date : Mar 01, 2006

Abstract Title: Effect of traditional Greek Mediterranean meals on platelet aggregation in normal subjects and in patients with type 2 diabetes mellitus. Abstract Source: J Med Food. 2006;9(3):356-62. PMID: 17004898 Abstract Author(s): Smaragdi Antonopoulou, Elizabeth Fragopoulou, Haralabos C Karantonis, Eudokia Mitsou, Marietta Sitara, John Rementzis, Alexandros Mourelatos, Alexandros Ginis, Costas Phenekos Abstract: Patients with type 2 diabetes mellitus have increased risk of cardiovascular disease. Epidemiological studies have shown a correlation between diet and incidence of coronary heart disease. The aim of the study is to determine the effect of a traditional Greek Mediterranean diet on platelet aggregation induced by ADP, arachidonic acid (AA), and especially platelet-activating factor (PAF) on patients with type 2 diabetes mellitus as well as on healthy volunteers. The patients were randomized into two subgroups, A and B. The lipid extracts from traditional Greek Mediterranean-type meals were tested in in vivo for their ability to reduce PAF- or thrombin-induced platelet aggregation. The meals with the most potent anti-aggregating activity were chosen for the diet of both subgroup A and healthy subjects and consumed for a period of 28 days, whereas subgroup B kept to their regular diet that was followed before entering the study. Platelet-rich plasma was isolated before and after the diet, and the ability of platelets to aggregate under the aggregating factors was tested. One-month consumption of diet resulted in a significant reduction in PAF- and ADP-induced aggregation of platelets in both groups of healthy volunteers (PAF and ADP, P<.05) and subgroup A (PAF, P<.001; ADP, P<.05), whereas the AA-induced aggregation was not affected. No effect was observed in subgroup B, which followed the standard diet. Thus the consumption of a traditional Greek Mediterranean diet even for a short period can reduce platelet activity in patients suffering from type 2 diabetes mellitus and in healthy subjects. Article Published Date : Jan 01, 2006

Abstract Title: Effects of moderate Sicilian red wine consumption on inflammatory biomarkers of atherosclerosis. Abstract Source: Eur J Clin Nutr. 2006 Jan;60(1):41-7. PMID: 16132058 Abstract Author(s): G Avellone, V Di Garbo, D Campisi, R De Simone, G Raneli, R Scaglione, G Licata Abstract: OBJECTIVE: The aim of the study is to evaluate the effect of moderate Sicilian red wine consumption on cardiovascular risk factors and, in particular, on some inflammatory biomarkers. METHODS: A total of 48 subjects of both sexes who were nondrinkers or rare drinkers of moderate red wine were selected and randomly subdivided into two groups assigned to receive with a crossover design a Sicilian red wine (Nero d'Avola or Etna Torrepalino) during meals: Group A (n = 24), in whom the diet was supplemented for 4 weeks with 250 ml/day of red wine, followed by 4 weeks when they returned to their usual wine intake; and Group B (n = 24), in whom the usual wine intake was maintained for 4 weeks, followed by 4 weeks when the diet was supplemented with 250 ml/day of red wine. The following were values measured in all tests: blood glucose, total and HDL-cholesterol and triglycerides, LDL-cholesterol, LDL/HDL ratio, apolipoproteins A1 and B, Lp(a), plasma C-reactive protein, TGFbeta1, D-Dimer, Factor VII , PAl Ag, t-PA Ag, fibrinogen, oxidized LDL Ab, total plasma antioxidant capacity. RESULTS: At the end of the red wine intake period, LDL/HDL, fibrinogen, factor VII, plasma C-reactive protein and oxidized LDL Ab were significantly decreased, while HDL-C, Apo A1,TGFbeta1, t-PA, PAI and total plasma antioxidant capacity were significantly increased. CONCLUSIONS: Our results show a positive effect of two Sicilian red wines on many risk factors and on some inflammatory biomarkers, suggesting that a moderate consumption of red wine in the adult population is a positive component of the Mediterranean diet. Article Published Date : Jan 01, 2006

Abstract Title: Mediterranean diet and survival among patients with coronary heart disease in Greece. Abstract Source: Arch Intern Med. 2005 Apr 25;165(8):929-35. PMID: 15851646 Abstract Author(s): Antonia Trichopoulou, Christina Bamia, Dimitrios Trichopoulos Abstract: BACKGROUND: The Mediterranean diet has been hypothesized to reduce fatality among patients with coronary heart disease. METHODS: We examined the association between the degree of adherence to the traditional Mediterranean diet and survival of persons with diagnosed coronary heart disease at enrollment, in a population-based prospective investigation of 1302 Greek men and women, who were followed up for an average of 3.78 years (the European Prospective Investigation Into Cancer and Nutrition cohort). Information on usual dietary intakes during the year preceding enrollment was recorded through a validated food frequency questionnaire. Adherence to the Mediterranean diet was assessed by a 10-unit Mediterranean diet score that incorporates the salient characteristics of this diet. Proportional hazards regression was used to assess the relation of overall degree of adherence to the Mediterranean diet with mortality overall or by cause (cardiac vs noncardiac). RESULTS: Higher adherence to the Mediterranean diet by 2 units was associated with a 27% lower mortality rate among persons with prevalent coronary heart disease at enrollment (total deaths, 131; adjusted mortality ratio, 0.73; 95% confidence interval, 0.58-0.93). The reduced mortality was more evident and amounted to 31% (total deaths, 85; adjusted mortality ratio, 0.69; 95% confidence interval, 0.52-0.93) when only cardiac deaths were considered as the relevant outcome. Associations between individual food groups contributing to the Mediterranean diet score and mortality were generally not significant. CONCLUSION: Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in mortality among individuals diagnosed as having coronary heart disease. Article Published Date : Apr 25, 2005

Abstract Title: Unsaturated fatty acids intake and all-causes mortality: a 8.5-year follow-up of the Italian Longitudinal Study on Aging. Abstract Source: Exp Gerontol. 2005 Apr;40(4):335-43. PMID: 15820615 Abstract Author(s): Vincenzo Solfrizzi, Alessia D'Introno, Anna M Colacicco, Cristiano Capurso, Rosa Palasciano, Sabrina Capurso, Francesco Torres, Antonio Capurso, Francesco Panza Abstract: Recent evidence suggested a protective role of dietary monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) intakes against several chronic diseases and, therefore, an increased human longevity. After a median follow-up of 8.5 years, we investigated the possible role of MUFA, PUFA, and other selected food groups in protecting against all-causes mortality in a population-based, prospective study, conducted in one of the eight centers of the Italian Longitudinal Study on Aging (ILSA), Casamassima, Bari, Italy. Out of 704 elderly subjects (65-84 years), 278 nondemented persons agreed to participate at the first survey (1992-1993). During the follow-up, there were 91 deaths. A semi-quantitative food frequency questionnaire evaluating macronutrient daily intakes were performed at the first survey. Higher MUFA intake was associated with an increase of survival (hazard ratio 0.81, 95% CI 0.66-0.99), a higher unsaturated fatty acids (UFA) to SFA ratio (hazard ratio 1.20, 95% CI 0.99-1.45) increased total mortality only marginally, while no effect about other selected food groups were found. In conclusion, in this prospective study on older nondemented subjects with a typical Mediterranean diet, a higher MUFA intake increased survival, while a higher UFA/SFA ratio increased total mortality, but only marginally. Article Published Date : Apr 01, 2005

Abstract Title: Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project. Abstract Source: JAMA. 2004 Sep 22 ;292(12):1433-9. PMID: 15383513 Abstract Author(s): Kim T B Knoops, Lisette C P G M de Groot, Daan Kromhout, Anne-Elisabeth Perrin, Olga Moreiras-Varela, Alessandro Menotti, Wija A van Staveren Article Affiliation: Kim T B Knoops Abstract: CONTEXT: Dietary patterns and lifestyle factors are associated with mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer, but few studies have investigated these factors in combination. OBJECTIVE: To investigate the single and combined effect of Mediterranean diet, being physically active, moderate alcohol use, and nonsmoking on all-cause and cause-specific mortality in European elderly individuals. DESIGN, SETTING, AND PARTICIPANTS: The Healthy Ageing: a Longitudinal study in Europe (HALE) population, comprising individuals enrolled in the Survey in Europe on Nutrition and the Elderly: a Concerned Action (SENECA) and the Finland, Italy, the Netherlands, Elderly (FINE) studies, includes 1507 apparently healthy men and 832 women, aged 70 to 90 years in 11 European countries. This cohort study was conducted between 1988 and 2000. MAIN OUTCOME MEASURES: Ten-year mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer. RESULTS: During follow-up, 935 participants died: 371 from cardiovascular diseases, 233 from cancer, and 145 from other causes; for 186, the cause of death was unknown. Adhering to a Mediterranean diet (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88), moderate alcohol use (HR, 0.78; 95% CI, 0.67-0.91), physical activity (HR, 0.63; 95% CI, 0.55-0.72), and nonsmoking (HR, 0.65; 95% CI, 0.57-0.75) were associated with a lower risk of all-cause mortality (HRs controlled for age, sex, years of education, body mass index, study, and other factors). Similar results were observed for mortality from coronary heart disease, cardiovascular diseases, and cancer. The combination of 4 low risk factors lowered the all-cause mortality rate to 0.35 (95% CI, 0.28-0.44). In total, lack of adherence to this low-risk pattern was associated with a population attributable risk of 60% of all deaths, 64% of deaths from coronary heart disease, 61% from cardiovascular diseases, and 60% from cancer. CONCLUSION: Among individuals aged 70 to 90 years, adherence to a Mediterranean diet and healthful lifestyle is associated with a more than 50% lower rate of all-causes and cause-specific mortality. Article Published Date : Sep 21, 2004

Abstract Title: Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults: The ATTICA Study. Abstract Source: J Am Coll Cardiol. 2004 Jul 7;44(1):152-8. PMID: 15234425 Abstract Author(s): Christina Chrysohoou, Demosthenes B Panagiotakos, Christos Pitsavos, Undurti N Das, Christodoulos Stefanadis Abstract: OBJECTIVES: We studied the effect of the Mediterranean diet on plasma levels of C-reactive protein (CRP), white blood cell counts, interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, amyloid A, fibrinogen, and homocysteine. BACKGROUND: To the best of our knowledge, the mechanism(s) by which the Mediterranean diet reduces cardiovascular risk are not well understood. METHODS: During the 2001 to 2002 period, we randomly enrolled 1,514 men (18 to 87 years old) and 1,528 women (18 to 89 years old) from the Attica area of Greece (of these, 5% of men and 3% of women were excluded because of a history of cardiovascular disease). Among several factors, adherence to the Mediterranean diet was assessed by a diet score that incorporated the inherent characteristics of this diet. Higher values of the score meant closer adherence to the Mediterranean diet. RESULTS: Participants who were in the highest tertile of the diet score had, on average, 20% lower CRP levels (p = 0.015), 17% lower IL-6 levels (p = 0.025), 15% lower homocysteine levels (p = 0.031), 14% lower white blood cell counts (p = 0.001), and 6% lower fibrinogen levels (p = 0.025), as compared with those in the lowest tertile. The findings remained significant even after various adjustments were made. Borderline associations were found regarding TNF-alpha (p = 0.076), amyloid A levels (p = 0.19), and diet score. CONCLUSIONS: Adherence to the traditional Mediterranean diet was associated with a reduction in the concentrations of inflammation and coagulation markers. This may partly explain the beneficial actions of this diet on the cardiovascular system. Article Published Date : Jul 07, 2004

Abstract Title: A high-score Mediterranean dietary pattern is associated with a reduced risk of peripheral arterial disease in Italian patients with Type 2 diabetes. Abstract Source: J Thromb Haemost. 2003 Aug;1(8):1744-52. PMID: 12911588 Abstract Author(s): E Ciccarone, A Di Castelnuovo, M Salcuni, A Siani, A Giacco, M B Donati, G De Gaetano, F Capani, L Iacoviello, Abstract: BACKGROUND: The 'Mediterranean diet' is considered to exert protective effects on cardiovascular disease, although a wide range of dietary patterns exists among subjects living even in the same Mediterranean country. OBJECTIVE: To investigate the association between specific dietary patterns and peripheral arterial disease (PAD) in Italian Type 2 diabetes patients. DESIGN: From a cohort of 944 patients with Type 2 diabetes, 144 patients with PAD were selected, and matched for age and sex with 288 Type 2 diabetic control patients without macrovascular complications. A dietary score was elaborated from a semiquantitative food frequency questionnaire. The higher the final score, the healthier the eating habit. RESULTS: In multivariate analysis, a higher score was independently associated with a significant reduction in PAD risk [odds ratio (OR) = 0.44; 95% confidence interval (CI) 0.24, 0.83]. Diabetes duration (OR>15 years = 2.49; 95% CI 1.45, 4.25), hypertension (OR = 2.12; 95% CI 1.31, 3.45) and butter consumption (OR = 2.6; 95% CI 1.15, 3.68) were also significantly associated with PAD. The dietary score significantly improved the predictive value of models based on duration of diabetes and hypertension. (LSR = 2.19, DF = 7, P<0.001). The effect of a high dietary score on the risk of PAD was independent of diabetes duration and hypertension. CONCLUSION: In Italian Type 2 diabetics, a higher dietary score has a protective role against PAD. The use of butter increases the risk of PAD even in patients regularly consuming olive oil. Dietary advice may be helpful for the prevention of PAD in diabetics even in populations traditionally accustomed to a Mediterranean dietary habit. Article Published Date : Aug 01, 2003

Abstract Title: Mediterranean diet and all-causes mortality after myocardial infarction: results from the GISSI-Prevenzione trial. Abstract Source: Eur J Clin Nutr. 2003 Apr;57(4):604-11. PMID: 12700623 Abstract Author(s): F Barzi, M Woodward, R M Marfisi, L Tavazzi, F Valagussa, R Marchioli, Abstract: OBJECTIVE: To ascertain whether simple dietary advice to increase the consumption of Mediterranean foods, given in a clinical setting, leads to reduced mortality after a myocardial infarction. DESIGN: Data were used from the GISSI-Prevenzione clinical trial, analysed as a cohort study with adjustment for treatment allocation. SETTING: A total of 172 centres in Italy. SUBJECTS: A total of 11323 men and women with myocardial infarction. All subjects received advice to increase their consumption of fish, fruit, raw and cooked vegetables and olive oil. MEASUREMENTS: The intakes of the five foods were assessed at baseline, 6, 18 and 42 months. Associations of food intakes, a combined dietary score, and the risk of death over 6.5 y were estimated adjusting for several non-dietary variables, using pooled logistic regression. RESULTS: Subjects generally improved their diet according to the advice given. All foods were associated with a significant reduction in risk of death. Compared with people in the worst dietary score quarter, the odds ratio for those in the best score quarter was 0.51 (95% CI 0.44-0.59). A good diet had a protective effect in sub-groups defined by age, sex, smoking, randomized treatment and concomitant drug therapy. CONCLUSIONS: Myocardial infarction patients can respond positively to simple dietary advice, and this can be expected to lead to a substantial reduction in the risk of early death. Regardless of any drug treatment prescribed, clinicians should routinely advise patients with myocardial infarction to increase their frequency of consumption of Mediterranean foods. Article Published Date : Apr 01, 2003

Abstract Title: Olive oil and red wine antioxidant polyphenols inhibit endothelial activation: antiatherogenic properties of Mediterranean diet phytochemicals. Abstract Source: Arterioscler Thromb Vasc Biol. 2003 Apr 1;23(4):622-9. Epub 2003 Feb 20. PMID: 12615669 Abstract Author(s): Maria Annunziata Carluccio, Luisa Siculella, Maria Assunta Ancora, Marika Massaro, Egeria Scoditti, Carlo Storelli, Francesco Visioli, Alessandro Distante, Raffaele De Caterina Article Affiliation: C.N.R. Institute of Clinical Physiology, Lecce, Italy. Abstract: OBJECTIVE: Epidemiology suggests that Mediterranean diets are associated with reduced risk of cardiovascular disease. Because monocyte adhesion to the endothelium is crucial in early atherogenesis, we evaluated whether typical olive oil and red wine polyphenols affect endothelial-leukocyte adhesion molecule expression and monocyte adhesion. METHODS AND RESULTS: Phytochemicals in olive oil and red wine, including oleuropein, hydroxytyrosol, tyrosol, elenolic acid, and resveratrol, with or without antioxidant activity, were incubated with human umbilical vein endothelial cells for 30 minutes, followed by co-incubation with bacterial lipopolysaccharide or cytokines to trigger adhesion molecule expression. At nutritionally relevant concentrations, only oleuropein, hydroxytyrosol, and resveratrol, possessing a marked antioxidant activity, reduced monocytoid cell adhesion to stimulated endothelium, as well as vascular cell adhesion molecule-1 (VCAM-1) mRNA and protein by Northern analysis and cell surface enzyme immunoassay. Reporter gene assays with deletional VCAM-1 promoter constructs indicated the relevance of nuclear factor-kappaB, activator protein-1, and possibly GATA binding sites in mediating VCAM-1 transcriptional inhibition. The involvement of nuclear factor-kappaB and activator protein-1 was finally demonstrated at electrophoretic mobility shift assays. CONCLUSIONS: Olive oil and red wine antioxidant polyphenols at nutritionally relevant concentrations transcriptionally inhibit endothelial adhesion molecule expression, thus partially explaining atheroprotection from Mediterranean diets. Article Published Date : Apr 01, 2003

Abstract Title: [Effect of phenolic compounds of virgin olive oil on LDL oxidation resistance]. Abstract Source: Med Clin (Barc). 2003 Feb 8;120(4):128-31. PMID: 12605836 Abstract Author(s): Juan Antonio Moreno, José López-Miranda, Purificación Gómez, Fatiha Benkhalti, Es-Saddik El Boustani, Francisco Pérez-Jiménez Article Affiliation: Unidad de Lípidos y Arteriosclerosis. Hospital Universitario Reina Sofía. Córdoba. España. Abstract: BACKGROUND AND OBJECTIVE: Several epidemiological and experimental studies have associated the intake of antioxidants, which are abundant in the Mediterranean diet, with a low incidence of cardiovascular disease. One possible mechanism of this action is the oxidative protection in low density lipoproteins (LDL). The aim of our study was to compare the antioxidative activity of diverse phenolic compounds present in virgin olive oil on these lipoproteins. SUBJECTS AND METHOD: LDL was isolated from blood plasma of healthy volunteers by sequential ultracentrifugation. This was followed by oxidation with CuC12 in the presence of different concentrations of phenolic compounds and virgin olive oil extract. Production of conjugated dienes was determined by the continuous monitoring of increased absorbency at 234 nm as an indicator of LDL oxidation. RESULTS: Virgin olive oil extract prolonged the latency phase and significantly lowered the progression rate (p<0.05) at low concentrations (2 g/ml). This antioxidative effect was also observed with low concentrations (2 M) of caffeic acid and oleuropein (p<0.05). However, it was necessary to increase the concentration of flavone up to 50 times to observe a similar effect (p<0.05). CONCLUSION: Both virgin olive oil extract enriched in phenolic compounds and phenolic compounds present in olive oil (caffeic acid and oleuropein) are potent antioxidants at very low concentrations. Thus, the beneficial effects of a Mediterranean diet may be partly due to the protective action of these compounds. Article Published Date : Feb 08, 2003

Abstract Title: Primary prevention of acute coronary events through the adoption of a Mediterranean-style diet. Abstract Source: East Mediterr Health J. 2002 Jul-Sep;8(4-5):593-602. PMID: 15603042 Abstract Author(s): D B Panagiotakos, C Pitsavos, C Chrysohoou, C Stefanadis, P Toutouzas Abstract: We evaluated the role of a Mediterranean-style diet in preventing acute coronary syndromes (ACS). Data from CARDIO2000, a multi-centre retrospective case-control study investigating the association between ACS and demographic, nutritional, lifestyle and medical risk factors were used. We studied 661 patients hospitalized for a first ACS event and 661 matched controls without clinical suspicion of cardiovascular disease. The Mediterranean diet significantly reduced (by 16%) the risk of developing ACS. The association remained significant in the presence of hypertension, hypercholesterolaemia, sedentary lifestyle, diabetes mellitus or a combination of two of these cardiovascular risk factors. Our findings illustrate the importance of the Mediterranean diet in the primary prevention of acute coronary events. Article Published Date : Jul 01, 2002

Abstract Title: Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. Abstract Source: JAMA. 2002 Feb 6;287(5):598-605. PMID: 11829698 Abstract Author(s): Antti Jula, Jukka Marniemi, Risto Huupponen, Arja Virtanen, Merja Rastas, Tapani Rönnemaa Article Affiliation: Research and Development Centre of the Social Insurance Institution, Peltolantie 3, FIN-20720 Turku, Finland. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: CONTEXT: Limited information exists on the interaction between diet and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and the interaction's effect on serum lipid and lipoprotein levels, insulin sensitivity, and circulating antioxidant vitamin and provitamin levels. OBJECTIVE: To evaluate the separate and combined effects of diet and simvastatin therapy on serum levels of lipids, lipoproteins, antioxidants, and insulin. DESIGN, SETTING, AND PARTICIPANTS: Randomized, controlled crossover trial conducted from August 1997 to June 1998 in 120 previously untreated hypercholesterolemic men aged 35 to 64 years who were recruited from the community in Turku, southwestern Finland. INTERVENTIONS: After a 4- to 6-week placebo run-in period, participants were randomly allocated to a habitual diet (n = 60) or dietary treatment group (n = 60), and each of these groups was further randomized in a double-blind crossover fashion to receive simvastatin (20 mg/d) or placebo, each for 12 weeks (n = 30 in each group). The main goals of the dietary treatment were to reduce energy intake from saturated plus trans-unsaturated fats to no more than 10% by replacing them partly with monounsaturated and polyunsaturated fats rich in omega-3 fatty acids and to increase intake of fruits, vegetables, and dietary fiber. MAIN OUTCOME MEASURES: Changes in levels of total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol; triglycerides; apolipoprotein B; insulin; glucose; and antioxidants at week 12 of each treatment period, compared among the 4 groups. RESULTS: Dietary treatment decreased levels of total cholesterol by 7.6% (P<.001), LDL cholesterol by 10.8% (P<.001), HDL cholesterol by 4.9% (P =.01), apolipoprotein B by 5.7% (P =.003), serum insulin by 14.0% (P =.02), and alpha-tocopherol by 3.5% (P =.04). Simvastatin decreased levels of total cholesterol by 20.8%, LDL cholesterol by 29.7%, triglycerides by 13.6%, apolipoprotein B by 22.4%, alpha-tocopherol by 16.2%, beta-carotene by 19.5%, and ubiquinol-10 by 22.0% (P<.001 for all) and increased levels of HDL cholesterol by 7.0% (P<.001) and serum insulin by 13.2% (P =.005). Glucose levels remained unchanged in all groups. The effects of dietary treatment and simvastatin were independent and additive. CONCLUSIONS: A modified Mediterranean-type diet rich in omega-3 fatty acids efficiently potentiated the cholesterol-lowering effect of simvastatin, counteracted the fasting insulin-elevating effect of simvastatin, and, unlike simvastatin, did not decrease serum levels of beta-carotene and ubiquinol-10. Article Published Date : Feb 06, 2002

Abstract Title: Influence of the onion as an essential ingredient of the Mediterranean diet on arterial blood pressure and blood fluidity. Abstract Source: Arzneimittelforschung. 2000 Sep;50(9):795-801. PMID: 11050695 Abstract Author(s): U Kalus, G Pindur, F Jung, B Mayer, H Radtke, K Bachmann, C Mrowietz, J Koscielny, H Kiesewetter Abstract: Mediterranean diet has got a favourable effect on life expectancy. One of the crucial components of the diet are onions. In an open and a randomized, placebo-controlled, double-blind, cross-over phase-I study a spontaneous pharmacological effect 5 h after administration of an onion-olive-oil maceration capsule formulation on arterial blood pressure could be demonstrated in apparently healthy subjects. In addition to a decrease in arterial blood pressure, a significant reduction in plasma viscosity and haematocrit were observed. These results are indicating a vasodilative effect of the onion-olive-oil-maceration product. The stickiness of the platelets was reduced. The effects were stronger in subjects with reduced blood fluidity compared to those subjects with normal rheological parameters. Article Published Date : Sep 01, 2000

Abstract Title: Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Abstract Source: Clin Ter. 1993 Feb;142(2):155-9. PMID: 19721018 Abstract Author(s): Katherine Esposito, Maria Ida Maiorino, Miryam Ciotola, Carmen Di Palo, Paola Scognamiglio, Maurizio Gicchino, Michela Petrizzo, Franco Saccomanno, Flora Beneduce, Antonio Ceriello, Dario Giugliano Abstract: BACKGROUND: Low-carbohydrate and low-fat calorie-restricted diets are recommended for weight loss in overweight and obese people with type 2 diabetes. OBJECTIVE: To compare the effects of a low-carbohydrate Mediterranean-style or a low-fat diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes. DESIGN: Single-center, randomized trial. Randomization was computer-generated and unstratified. Allocation was concealed in sealed study folders held in a central, secure location until participants gave informed consent. Participants and investigators were aware of treatment assignment, and assessors of the primary outcome were blinded. SETTING: Teaching hospital in Naples, Italy. PATIENTS: 215 overweight people with newly diagnosed type 2 diabetes who were never treated with antihyperglycemic drugs and had hemoglobin A(1c) (HbA(1c)) levels less than 11%. INTERVENTION: Mediterranean-style diet (<50% of daily calories from carbohydrates) (n = 108) or a low-fat diet (<30% of daily calories from fat) (n = 107). MEASUREMENTS: Start of antihyperglycemic drug therapy, defined by protocol as indicated for follow-up HbA(1c) level greater than 7% (primary outcome), and changes in weight, glycemic control, and coronary risk factors (secondary outcomes). RESULTS: After 4 years, 44% of patients in the Mediterranean-style diet group and 70% in the low-fat diet group required treatment (absolute difference, -26.0 percentage points [95% CI, -31.1 to -20.1 percentage points]; hazard ratio, 0.63 [CI, 0.51 to 0.86]; hazard ratio adjusted for weight change, 0.70 [CI, 0.59 to 0.90]; P<0.001). Participants assigned to the Mediterranean-style diet lost more weight and experienced greater improvements in some glycemic control and coronary risk measures than did those assigned to the low-fat diet. LIMITATIONS: Investigators responsible for initiating drug therapy were not blinded to treatment assignment. Dietary intake was self-reported. CONCLUSION: Compared with a low-fat diet, a low-carbohydrate, Mediterranean-style diet led to more favorable changes in glycemic control and coronary risk factors and delayed the need for antihyperglycemic drug therapy in overweight patients with newly diagnosed type 2 diabetes. PRIMARY FUNDING SOURCE: Second University of Naples. Article Published Date : Feb 01, 1993