Med Diet Research Articles

A transnational movement to support the sustainable transition towards a healthy and Eco-friendly Agri-Food System through the promotion of MEDIET and its lifestyle in modern society: MEDIET4ALL

Abstract The Mediterranean diet is considered the world’s most evidence-based low processed eating pattern for promoting health and longevity while saving water/energy and conserving land. Unfortunately, due to the modern societal trends, adherence to the Mediterranean diet model is decreasing, while the consumption of takeout and ultra-processed foods and drinks (UPFDs) is exponentially growing, with alarming levels in many European-Mediterranean (EUR-MED) regions. The overall objective of “MEDIET4ALL” is to support the transition from UPFs culture to modern and sustainable Mediterranean diet through the creation of transnational movement aiming at implementing best practices and innovative solutions to enhance the convenience, modernity, competitivity, and shelf life of Mediterranean diet. To achieve this overall objective, different multidisciplinary tailored approaches are proposed. Specifically, multicenter databases of ingredients/food and their providers will be created to promote the accessibility. Additionally, a variety of highly nutritional and antioxidant-rich “Quick & Easy” recipes that respond to modern trends while following the Mediterranean diet and considering sustainability aspects will be developed. To preserve the eco-friendly and food safety characteristics and extend the shelf life of the Mediterranean diet products, active bio-packaging will also be designed. A strategic “MEDIET4ALL” platform and m-app integrating the abovementioned MEDIET4ALL products and combined Mediterranean lifestyle interventions tailored to each user profile will be developed. Traditional and technology-based awareness and motivational campaigns with extensive marketing and advertising actions to promote MEDIET4ALL movement are also programmed. Working under the concept of a multidisciplinary approach consortium, multiple impacts, particularly supporting the transition towards a healthy and sustainable MED diet and lifestyle, are expected.

Effect of the Mediterranean diet on incidence of heart failure in European countries: a systematic review and meta-analysis of cohort studies.

Heart failure (HF) is one of the most common cardiovascular disorders, and its prevalence is increased due to age, genetics, and lifestyle factors. Emerging evidence suggests that the Mediterranean Diet (Med Diet) is linked to lower all-cause mortality in patients with increased cardiovascular disease risk, such as those with HF. To conduct a systematic review and meta-analysis of observational studies into the relationship between the Med Diet on HF risk. Several databases (PubMed, Scopus, Web of Science and Cochrane Library) until the 01st of May 2023 were searched. Our research was conducted based on the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were reported as risk ratios (RRs) with their 95% confidence intervals (CIs) as results of multivariate or univariate analyses. From the original 1206 studies collected, six observational prospective studies were included, with a total of 216,385 European participants without evidence of HF at baseline. Over a mean period of 11 years of follow-up, a 1-point increase in the Med Diet score was associated with a significantly lower risk of HF (RR = 0.940; 95% CI: 0.912-0.969, p < 0.0001; I2 = 42.9%). Categorised by sex, a higher adherence to Med Diet was associated with a significantly lower incidence of HF in women (RR = 0.942; 95% CI: 0.912-0.973, p = 0.001; I2 = 41.8%), but not in men. The overall quality of included studies was good. Higher adherence to Med Diet across European countries is associated with lower risk of HF, particularly in women.

Mediterranean diet and exercise are associated with better disease control in psoriatic arthritis.

Psoriatic arthritis (PsA) is associated with obesity and other related comorbidities, which impose an additional burden on disease activity and response to treatment. We investigated the impact of Mediterranean diet, and exercise on the presentation and severity of PsA. Three hundred fifty-five patients with PsA (n = 279) and psoriasis (PsO) (n = 76) were included in a cross-sectional study. Demographic and clinical characteristics and dietary and exercise patterns were recorded. Patients were grouped into (i) high, moderate, and low Mediterranean diet adherence and (ii) high, medium, and low activity level. Levels of diet and exercise were correlated with disease activity indices. PsA patients had more comorbidities than their PsO counterparts (42.7% vs. 26.3%, p = .038). The majority showed a low exercise pattern (total = 71.3%, PsA = 72.4%, PsO = 67.1%). Approximately half (total = 44.2%, PsA = 43.4%, PsO = 47.4%) did not follow a Mediterranean diet. Disease Activity in Psoriatic Arthritis Score (DAPSA) (p = .004), tender (p = .003) and swollen (p = .015) joint counts, erythrocyte sedimentation rate (ESR) (p = .001), and Psoriasis Area and Severity Index (PASI) (p = .015) had an inverse correlation with exercise. Higher Mediterranean diet adherence was associated with reduced ESR (p = .056), PASI (p = .011), and body surface area (BSA) (p = .009) indices. After adjusting for body mass index (BMI), exercise retained its positive correlation with PsA disease activity, but diet showed significant correlation only with enthesitis (p = 0.015). Uptake of a Mediterranean diet and exercise have positive effects on PsA activity, independently of BMI. These findings support lifestyle recommendations to supplement conventional treatment for improvement in disease outcomes. Key points • Diet and lifestyle are important influencers of health-related outcomes in PsA. • In this cross-sectional study of 355 patients with psoriatic disease, we found that Med Diet and exercise improve outcomes in PsA independently of weight loss. • Our results suggest that diet and lifestyle modifications should supplement conventional medical treatments.

Effects of Consuming White Button and Oyster Mushrooms within a Healthy Mediterranean-Style Dietary Pattern on Changes in Subjective Indexes of Brain Health or Cognitive Function in Healthy Middle-Aged and Older Adults.

Limited research suggests mushroom consumption may improve indexes of brain health. Mushrooms contain bioactive compounds and antioxidants capable of crossing the blood-brain barrier and impacting vital neurological processes. We conducted a randomized controlled feeding trial assessing the effects of adopting a healthy U.S. Mediterranean-style dietary pattern (MED) with or without mushrooms on indexes of brain health and well-being. Sixty adults (aged 46 ± 12 y; BMI 28.3 ± 2.84 kg/m2; mean ± SD) without severe depression consumed a fully controlled MED diet with 84 g/d of mushrooms (4 d/week white button and 3 d/week oyster) or without (control with breadcrumbs) for 8 weeks. At baseline and post-intervention, surveys were used to evaluate anxiety, depression, mood, and well-being, and behavioral tests were used to evaluate cognition. Consumption of the MED diet, with or without mushrooms, increased (improved) self-reported vigor/activity (Time p = 0.026) and both behavioral measures of immediate memory (Time p < 0.05). Mixed effects were observed for other domains of neuropsychological function, and there were no changes in other measured indexes of brain health with the consumption of either MED diet. Adopting a healthy MED-style dietary pattern, with or without consuming white button and oyster mushrooms, may improve vigor/activity and immediate memory among middle-aged and older adults.

Low Adherence to Mediterranean Diet Characterizes Metabolic Patients with Gastrointestinal Cancer.

Background. Gastrointestinal (GI) cancers are one of the most relevant causes of death globally, frequently associated with poor dietary patterns. The Mediterranean Diet (MedDiet) contributes to cancer prevention. To assess adherence to MedDiet, our research group validated a new score, the Chrono Med Diet Score (CMDS), that captures increased visceral adiposity. Methods. We enrolled 401 subjects who underwent an evaluation for metabolic diseases and specific screening procedures according to current guidelines and were asked to answer CMDS. A total of 71 new cancer cases were recorded, including 40 GI and 31 non-gastrointestinal (NON-GI) cancers. Results. We found that CMDS was reduced in subjects who were diagnosed with cancers. Patients who reported a CMDS score of 12 or less had an over three times increased risk of being diagnosed with GI cancers and presented increased waist circumference and triglycerides and reduced HDL cholesterol compared to adherent subjects. Conclusions. Low CMDS values capture the risk for cancer diagnosis, especially for GI cancers. Thus, CMDS, along with waist circumference, can be considered as a bona fide marker for increased risk of cancer, requiring anticipated screening procedures for the detection of premalignant and early stage GI cancers in patients with low adherence to MedDiet.

Nutritional interventions as modulators of the disease activity for idiopathic inflammatory myopathies: a scoping review.

Idiopathic inflammatory myopathies (IIMs) are chronic, autoimmune connective tissue diseases associated with significant morbidity and disability. Nutrients can activate the immune system and contribute to chronic low-grade inflammation (LGI). Chronic muscle inflammation leads to imbalanced pro-inflammatory and anti-inflammatory cytokines, causing inadequate nutrition, weight loss and muscle weakness during a negative cycle. Owing to its potential to modulate LGI in various diseases, the Mediterranean diet (Med Diet) has been extensively studied. This scoping review explores the nutritional implications and recommendations of the Med Diet as a treatment for immune-mediated diseases, focusing on the gaps in IIM nutritional interventions. A comprehensive literature search of the MEDLINE and EBSCO databases between September 2018 and December 2022 was performed. We identified that the Med Diet and its specific components, such as omega-3 (nω3) fatty acids, vitamin D and antioxidants, play a role in the dietary treatment of connective tissue-related autoimmune diseases. Nutritional interventions have demonstrated potential for modulating disease activity and warrant further exploration of IIMs through experimental studies. This review introduces a dietary therapeutic approach using the Med Diet and related compounds to regulate chronic inflammatory processes in IIMs. However, further clinical studies are required to evaluate the efficacy of the Med Diet in patients with IIMs. Emphasising a clinical-nutritional approach, this study encourages future research on the anti-inflammatory effects of the Med Diet on IIMs. This review highlights potential insights for managing and treating these conditions using a holistic approach.

Adherence to the Mediterranean diet and risk of stroke in a Chilean population: a case-control study.

Ñuble is the region of Chile with the highest stroke incidence rates in the country. The aim was to estimate the association between adherence to the MED diet and the first ischemic stroke in adult patients living in the Ñuble region. a case-control hospital-based study. The cases (n = 89) were patients with first ischemic stroke, and controls (n = 178) were admitted to the same hospital during the same month the cases were recruited. We selected two controls for one case and paired them for sex and age (± 5 years). We used the food frequency questionnaire and the adherence Mediterranean diet questionnaire. A descriptive analysis of the variables and a conditional logistic regression to determine the association between variables. 71 % of the sample was ≥ 65 years old and 64 % were male. Cases smoked (11.2 %), consumed at least one drink per month (41.6 %), and had a diagnosis of hypertension (76.4 %) more frequently than controls. In the model adjusted for all variables, it is observed that those who are in quartile 2 of adherence (6-7 points) are 42 % less likely to have a cerebral infarction compared to those who have a lower score (p < 0.005). our findings suggest that moderate adherence to a Mediterranean diet, defined by the PREDIMED score and adjustment for other variables, reduces the probability to first ischemic stroke.

The Mediterranean diet in the treatment of type 2 diabetes and its complications

The incidence of type 2 diabetes mellitus (T2DM) has gone upward sharply for the past few years. Therefore, the efficient way to combat it has set off a new wave of research. Compared with traditional medication, dietary interventions can also control the development of T2DM with fewer side effects or prevent the onset. Among these studies with different methods and views, the Mediterranean diet (Med diet) can be crucial to prevent and treat T2DM in lifestyle. On the basis of the summary and analysis of relevant literature, this paper has introduced the risk factors and pathogenesis of T2DM and the ingredients and function of the Med diet, followed by the research status of this dietary pattern for the aspects such as hormone and inflammation regulation in treating T2DM. At the end of this paper, the treatment of T2DM aims to focus on nutritional interventions based on the Mediterranean diet in the future, in order to provide a reasonable dietary pattern for T2DM patients as soon as possible.

Consuming Mushrooms When Adopting a Healthy Mediterranean-Style Dietary Pattern Does Not Influence Short-Term Changes of Most Cardiometabolic Disease Risk Factors in Healthy Middle-Aged and Older Adults

BackgroundMushrooms are a nutritious food, though knowledge of the effects of mushroom consumption on cardiometabolic risk factors is limited and inconsistent. ObjectiveWe assessed the effects of consuming mushrooms as part of a healthy United States Mediterranean-style dietary pattern (MED) on traditional and emerging cardiometabolic disease (CMD) risk factors. We hypothesized that adopting a MED diet with mushrooms would lead to greater improvements in multiple CMD risk factors. MethodsUsing a randomized, parallel study design, 60 adults (36 females, 24 males; aged 46 ± 12 y; body mass index 28.3 ± 2.84 kg/m2, mean ± standard deviation) without diagnosed CMD morbidities consumed a MED diet (all foods provided) without (control with breadcrumbs) or with 84 g/d of Agaricus bisporus (White Button, 4 d/wk) and Pleurotus ostreatus (Oyster, 3 d/wk) mushrooms for 8 wk. Fasting baseline and postintervention outcome measurements were traditional CMD risk factors, including blood pressure and fasting serum lipids, lipoproteins, glucose, and insulin. Exploratory CMD-related outcomes included lipoprotein particle sizes and indexes of inflammation. ResultsAdopting the MED-mushroom diet compared with the MED-control diet without mushrooms improved fasting serum glucose (change from baseline −2.9 ± 1.18 compared with 0.6 ± 1.10 mg/dL; time × group P = 0.034). Adopting the MED diet, independent of mushroom consumption, reduced serum total cholesterol (−10.2 ± 3.77 mg/dL; time P = 0.0001). Concomitantly, there was a reduction in high-density lipoprotein (HDL) cholesterol, buoyant HDL2b, and apolipoprotein A1, and an increase in lipoprotein(a) concentrations (main effect of time P < 0.05 for all). There were no changes in other measured CMD risk factors. ConclusionsConsuming a Mediterranean-style healthy dietary pattern with 1 serving/d of whole Agaricus bisporus and Pleurotus ostreatus mushrooms improved fasting serum glucose but did not influence other established or emerging CMD risk factors among middle-aged and older adults classified as overweight or obese but with clinically normal cardiometabolic health. Trial registration numberhttps://www.clinicaltrials.gov/study/NCT04259229?term=NCT04259229&rank=1

The Med Diet 4.0 Framework: A Multidimensional Driver for Revitalising the Mediterranean Diet as a Sustainable Diet Model

Abstract Despite being acknowledged as one of the healthiest diets in the world, there has been a shift away from the Mediterranean Diet (MD) pattern observed recently in the Mediterranean countries. This has undesirable consequences for health, but also for social, cultural, economic and environmental domains in the Mediterranean area. The Med Diet 4.0 framework, which is the focus of this case, has been developed as a multidimensional framework to revitalise the MD and to characterise it as a sustainable diet model. It offers four interdependent sustainable benefits, with country-specific variations: (i) nutrition and health advantages; (ii) low environmental impacts and richness in biodiversity; (iii) positive local economic returns; and (iv) high social and cultural food values. All these elements interact and contribute to the holistic well-being of individuals and communities, but Med Diet 4.0 has a broader scope. This is to catalyse multi-stakeholder interest in the MD as a driver towards more sustainable food systems; reconnecting diets, food consumption, food production, food security and sustainability in the region. At the level of the globalised food system, the Med Diet 4.0 model can, therefore, supply useful insights and action points to tackle the challenging policy issue of balancing human and planetary health. Food selection is influenced by exchange, use, and identity values, as well as images, memories, and emotions of people and contexts. It is recommended that MD education programmes should take these values into account and target all age groups with personalised messages. Information © CAB International 2019

Consumption of herbal infusions/decoctions and tea in Greece: a Planeterranean perspective on the results of Hydria survey

BackgroundThe consumption of various herbal infusions was and is common in the traditional Mediterranean diet, and apparently are used in many other regions of the world outside of the Mediterranean region. The present study aimed to investigate the consumption of herbal infusions/decoctions and tea in a nationally representative sample of Greece, considering also their Planetary use.Methods3951 adult participants of the HYDRIA Survey (2013–2014) were included from the 13 regions of Greece. The diet of participants was assessed by two 24-h dietary recalls (24-HDR) and the Food Propensity Questionnaire (FPQ). All food items were analyzed through the HYDRIA Food Composition Tables. Information on socio-demographics, lifestyle, and health characteristics during the baseline was also provided.Results26.9% of herbal infusions and decoctions consumers are ≥ 75 years old, pensioners with a low level of education, and residents of urban areas. However, 22.2% of tea consumers belong to the 18–34-year age group, being employed with an intermediate level of education and living in an urban area. Elderly men and women use more herbal infusions/decoctions (55.4%; 40.6%) compared to tea (41.8%; 25.2%). According to FPQ, 7.1% of men and 9.7% of women use herbal infusions and decoctions four times or more per week, while 7.1 and 10.9% of men and women, respectively, consume tea at the same frequency. Green tea, mountain tea (Sideritis spp.), and black tea are reported most frequently. In addition, mountain tea (61.2%), black tea (60.3%), mixed herbal infusions/decoctions (58.4%), and sage (59.4%) are consumed mostly at breakfast, while chamomile was reported mainly at dinner or during the night (42.4%).ConclusionsBased on the FPQ results, the moderate and high consumption of herbal infusions/decoctions and tea is low in Greece, especially among adults (18–64 years). Thus, our results indicate the existence of a generation gap to the attachment to the traditional Med Diet and the consumption of herbal infusions. The present study could encourage future research to focus on herbal infusions and decoctions consumption by other populations for cross-cultural comparison, as well as on emphasizing the value of consuming locally available herbs in a Planeterranean perspective.Graphical

Metabolic syndrome in systemic lupus erythematosus patients under Mediterranean diet

Background and aimsMetabolic syndrome (MetS) is a chronic proinflammatory and prothrombotic condition that exacerbates insulin resistance, oxidative damage, and cardiovascular risk, being more prevalent in patients with systemic lupus erythematosus (SLE), a chronic multisystemic autoimmune disorder. This study aim was to determine the prevalence of MetS and associations with SLE clinical characteristics, cardiovascular risk and dietary pattern in a population of Spanish SLE patients. Design and methodsCross-sectional study of 293 patients was conducted (90.4% females; mean age 46.8 (12.94)). The diagnosis of MetS was established based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III. SLE Disease Activity Index (SLEDAI-2K) and SDI Damage Index were used to assess disease activity and disease-related damage, respectively. Med Diet adherence was assessed through a 14 items questionnaire on food consumption frequency and habits. ResultsMetS was present in 15% SLE patients. Triglycerides, high-density lipoprotein cholesterol, systolic blood pressure and waist circumference were significantly increased (p<0.001) in the group of MetS patients. Patients with MetS showed significantly increased SDI damage index (1.70 (1.69) vs 0.88 (1.12), p<0.001) and complement C3 level (118.70 (32.67) vs 107.55 (26.82), p=0.011). No significant differences were observed according to Med Diet adherence level. ConclusionWe observed a lower prevalence of MetS in SLE than that reported in previous studies, which may be a result of the good level of adherence to the MedDiet in our study sample. Additionally, MetS was associated with higher SDI and complement C3 levels but no with medication use.

Physical Health-Related Quality of Life in Relation to Mediterranean Diet Adherence in a Sample of Greek Asthma Patients: A Pilot Study.

The role of nutrition in the management of asthma in obese patients is of increasing interest due to their limited response to inhaled corticosteroids. Some studies note that through diet and lifestyle, there can be an improvement in asthma control. The aim of the present study was to investigate the adherence to the Mediterranean Diet and its association with asthma severity and quality of life in patients with bronchial asthma. This is a cross-sectional study of 85 patients (70.6% female), with a mean age of 57 years, from the General University Hospital of Larissa and, more specifically, patients of the outpatient asthma clinic. Data were collected with the use of specific questionnaires. In relation to BMI, 12.9% of participants were of a normal weight, 45.9% were overweight, 25.9% were obese level I, 5.9% were obese level II, and 9.4% were in the morbidly obese range. Based on the Med Diet Score (ranging from 21 to 35), most participants (85.9%) reported moderate adherence to the Mediterranean Diet. Further analysis examined the correlations of the PCS-12 score with the frequency of consumption of each of the 11 food categories, as well as all demographic and health behavior variables. The ranked correlations indicated a significant relationship between PCS-12 score and Med Diet adherence and the consumption of alcoholic beverages (r = 0.437, p < 0.05), in accordance with the Mediterranean Diet suggestions, as well as a negative relationship with BMI score (r = -0.454, p < 0.010). Moreover, significant correlations were also present between the physical quality of life and AQLQ score and work type, as well as gender, age, and marital status. The results of our study showed a high rate of obesity in patients with asthma at the General University Hospital of Larissa and moderate adherence to the Mediterranean Diet. Increased BMI and alcoholic beverage consumption in asthma patients were significant predictors of lower physical health-related quality of life. In conclusion, personal and society-level interventions are required to effectively address obesity and poor diet in patients with asthma.

Exploring the Effects of a Mediterranean Diet and Weight Loss on the Gut Microbiome and Cognitive Performance in Older, African American Obese Adults: A Post Hoc Analysis.

African American adults have a higher prevalence of Alzheimer's dementia (AD) than non-Hispanic Whites. The impact of a Mediterranean Diet (Med Diet) and intentional weight loss (IWL) on the gut microbiome may alter AD risk. A post hoc analysis of the Building Research in Diet and Cognition (BRIDGE) trial was performed to determine whether participation in an 8-month Med Diet lifestyle intervention with (n = 35) or without IWL (n = 31) was associated with changes in gut microbiota structure, abundance, and function and whether these changes were related to changes in cognitive performance. The results showed that family and genus alpha diversity increased significantly in both groups combined (p = 0.0075 and p = 0.024, respectively). However, there were no other significant microbially related within- or between-group changes over time. Also, an increase in Med Diet adherence was significantly associated with a decrease in alpha diversity at the phylum level only (p = 0.049). Increasing alpha diversity was associated with decreasing cognitive performance, but this association was attenuated after controlling for Med Diet adherence. In sum, an 8-month Med Diet lifestyle intervention with or without IWL did not appreciably alter the gut microbiome.

Identification of a Novel Score for Adherence to the Mediterranean Diet That Is Inversely Associated with Visceral Adiposity and Cardiovascular Risk: The Chrono Med Diet Score (CMDS).

Adherence to the Mediterranean diet (MedDiet) leads to reduction of mortality from all causes, especially in subjects with cardiovascular disease, obesity, and diabetes. Numerous scores have been proposed to evaluate the adherence to MedDiet, mainly focused on eating habits. In this study, we verified whether existing validated MedDiet scores, namely, MEDI-LITE and the Mediterranean Diet Score (MDS), could be associated with visceral adiposity. Failing to find a significant association with adiposity, we proposed the validation of a new, easy-to-use adherence questionnaire, the Chrono Med-Diet score (CMDS). CMDS contains eleven food categories, including chronobiology of dietary habits and physical activity. Compared to the MEDI-LITE score and MDS, low values of CMDS are linked to increased waist circumference (WC) and dysmetabolic conditions. CMDS was also inversely correlated with cardiovascular risk (CVR), as well as Fatty Liver Index (FLI). In conclusion, the CMDS is a novel questionnaire to study the adherence to the MedDiet that, focusing on type and timing of carbohydrates intake, has the peculiar capability of capturing subjects with abdominal obesity, thus being an easy-to-use instrument of personalized medicine.

Reader Response: Association Between Dietary Habits in Midlife With Dementia Incidence Over a 20-Year Period.

Like many studies of the Mediterranean diet (Med diet) in non-Mediterranean countries, the study by Glans et al.1 uses a modified Med diet score that does not explicitly measure for extra virgin olive oil (EVOO). This may compromise the evaluation because some studies suggest that EVOO is a crucial component of a Med diet for maintaining cognitive health.

Effect of the Mediterranean Diet on Progression of Dry Form of Age-related Macular Degeneration.

The aim of this study was to investigate the possible effect of the Mediterranean diet (Med Diet) on the progression of age-related macular degeneration (AMD) in patients with early or intermediate stages of dry AMD. The present study included 164 patients with early or intermediate dry AMD. Data collected included demographics, anthropometric data, ophthalmic and medical history. AMD progression was evaluated using patients' optical coherence tomography (OCT) and visual acuity. Using the MedDietScore, sample's attachment to Med Diet was evaluated, and distinguished into high and low. The association of supplement intake and adherence to Med Diet with AMD progression was investigated using logistic regression. Sample's mean age was 73±7.4 years. A positive correlation was found between dietary supplementation and slowing of AMD progression, as well as between high adherence to Med Diet and slowing of AMD progression. In contrast, smokers had 51.4% higher risk of AMD progression (p=0.043). The rate of slowing AMD progression was higher in patients who followed Med Diet and received a dietary supplement, compared to patients who followed one or none of the aforementioned recommendations (p<0.001). Adherence to the Med Diet could have a positive effect on delaying AMD progression in advanced stages, both in patients receiving or not antioxidants. Therefore, our study proposes to strengthen recommendations to AMD patients to follow a Med Diet.

Estimation of the adherence to Mediterranean diet by Greek glaucomatous patients

AbstractPurpose: An estimation of the nutritional profile of patients with primary open angle glaucoma (POAG). We focused on the evaluation of the adherence to Mediterranean diet in Greek population.Methods: An observational study was conducted to assess the adherence to the Mediterranean diet in patients who attended the General Hospital of Athens G. Gennimatas. An experienced dietitian interviewed both healthy and glaucomatous patients and filled the Med Diet Score (range 0–55). The scoring includes food groups close to Mediterranean dietary pattern like non‐refined cereals, fruits, vegetables, legumes, olive oil, fish and potatoes.Results: A total of 132 questionnaires were completed successfully by 64 healthy and 68 patients. Both groups were equally distributed for sex (50/50 males/females) and age (71.9 years ± 10). The overall adhesion to the Mediterranean diet was similar in both groups with the majority of them (around 80%) having moderate adherence. There is no difference between 2 groups for Body Mass Index (BMI), dietary supplements and salt consumption, smoking habits or comorbidities like diabetes type II and hypertension.Conclusions: There is no data concerning adherence to Mediterranean diet in Greek glaucomatous patients. This study indicated that both healthy and glaucomatous patients have moderate adherence to the Mediterranean diet.Reference1. Demosthenes B Panagiotakos et al. Adherence to the Mediterranean food pattern predicts the prevalence of hypertension, hypercholesterolemia, diabetes and obesity, among healthy adults; the accuracy of the MedDietScore. Prev Med. 2007;44(4):335–40. doi: 10.1016/j.ypmed.2006.12.009.

Can Mediterranean Diet Have a Positive Impact on Kidney Health? A Pending Answer to a Long-Time Question.

Dietary studies conducted in chronic kidney disease (CKD) patients were focused on the quantities of single nutrients, however it is possible that the excessive attention put on the restriction of proteins, sodium, potassium and phosphorus may compromise the overall quality of the diet in terms of micronutrients and palatability. Instead, concentrating on the nutritional quality healthy dietary patterns, may provide a better approach to improve nutritional prescriptions in CKD patients. All these dietary regimens share common features as reduced content of red meat, salt and saturated fatty acids, and higher fiber content, but may differ in terms of single nutrients consumption. In particular, Mediterranean Diet (Med Diet) has been associated with reduced incidence of diabetes, cardiovascular diseases and obesity, all conditions that are also strictly related to CKD. Given its low content of animal proteins and high contents of fiber it is possible that Med Diet may exert also positive effects on CKD as well as on its metabolic complications. In this review we summarize the role of Med Diet in primary prevention of CKD and on its progression.

A healthy lifestyle is associated with lower arterial stiffness in a metabolically healthy elderly population with overweight or obesity.

Arterial stiffness is linked with the development of cardiovascular and noncardiovascular diseases. In clinical practice, measurement of carotid-femoral pulse wave velocity (cf-PWV) has become a widely used study for the assessment of cardiovascular risk in elderly population. Our aim was to evaluate whether maintaining a healthy life, based on Mediterranean Diet (MedDiet) and regular practice of physical activity, are associated with arterial stiffness in an elderly, metabolically healthy with overweight or obesity (MHOe) population. A transversal, analytical-descriptive study in MHOe population (aged ≥65 years) with a BMI at least 27 kg/ m 2 who had one or less of the following cardiometabolic disorders: fasting plasma glucose at least 100 mg/dl, blood pressure at least 135/85 mmHg (or the use of blood pressure-lowering agents), low high-density lipoprotein (HDL) cholesterol (≤ 40 mg/dl for men, ≤50 mg/dl for women) or triglycerides at least 150 mg/dl (or the use of lipid-lowering therapies) was conducted. Blood pressure, height, weight, BMI, waist to hip ratio (WHR), practice of physical activity, MedDiet adherence and food intake along with cf-PWV were analysed. One hundred and fifty-eight MHOe individuals (age: 72.2 ± 5.0 years, BMI: 31.6 ± 3.8 kg/m 2 ) were recruited. One hundred and nine of them were younger than 75 years of age (young-old, age: 69.3 ± 2.8 years and BMI: 32.0 ± 3.9 kg/m 2 ) and 49 of them aged 75 years or older (old-old, age: 78.1 ± 2.9 years and BMI: 30.7 ± 3.6 kg/m 2 ). All population showed a strong adherence to the Med Diet due major consumption of homemade meal, olive oil and lean meats. In addition, they presented an important practice of all intensities of physical activity. Young-old individuals had a cf-PWV of 9.7 ± 2.2 m/s and old-old individuals had a cf-PWV of 11.1 ± 4.4 m/s. In all populations, a negative correlation between cf-PWV and BMI ( r = -0.17, P = 0.04) and a positive correlation with WHR in men ( r = 0.18, P = 0.03) was found. WHR shows a significantly positive correlation with the cf-PWV values in old-old women participants ( r = 0.41, P = 0.008). On the other side, only vigorous physical activity showed a negative correlation with cf-PWV in all population and in young-old individuals ( r = -0.20; P = 0.02 and r = -0.22; P = 0.03, respectively). Healthy lifestyle habits based on MedDiet adherence and regular practice of physical activity are associated with lower arterial stiffness in a metabolically healthy population with overweight or obesity older than 65 years compared with data from other elderly populations previously reported in the literature.