Mediterranean Style Research Articles

Intake of cooked tomato sauce preserves coronary endothelial function and improves apolipoprotein A-I and apolipoprotein J protein profile in high-density lipoproteins

Intake of tomatoes has been linked with healthy diets (eg, Mediterranean diet). However, it remains unknown whether tomato intake exerts protective effects on the vasculature. The aim of this study was to determine whether medium-term supplementation with cooked tomato sauce (CTS) Mediterranean style (sofrito) attenuates diet-induced coronary endothelial dysfunction in an animal model with clinical impact and explore the mechanisms behind the effects. Pigs (N = 18) were fed a 10-day hypercholesterolemic diet. Half of the animals were given a supplement of 100 g/d of CTS (21.5 mg lycopene per day). Coronary responses to escalating doses of vasoactive drugs (acetylcholine, calcium ionophore, and sodium nitroprusside) and L-NG-monomethylarginine (endothelial nitric oxide synthase [eNOS] inhibitor) were measured using flow Doppler. In the coronary arteries, we investigated eNOS gene expression and activation, monocyte chemoattractant protein 1 (MCP-1) expression, and oxidative DNA damage. In the circulation, we investigated lipoprotein resistance to oxidation and the differential proteomic protein profile. In dyslipidemic animals, CTS intake prevented diet-induced impairment of receptor-operated and nonreceptor-operated endothelial-dependent coronary vasodilation. These beneficial effects were associated with enhanced eNOS transcription and activation and diminished DNA damage in the coronary arteries. CTS-fed animals showed lower lipid peroxidation, higher high-density lipoprotein (HDL) antioxidant potential and plasma lycopene levels of 0.16 mg/L. Interestingly, improved HDL functionality was associated with protein profile changes in apolipoprotein A-I and apolipoprotein J. Lipids levels and MCP-1 expression were not affected by CTS. We report that CTS intake protects against low-density lipoprotein-induced coronary endothelial dysfunction by reducing oxidative damage, enhancing eNOS expression and activity, and improving HDL functionality.

Short-term mediterranean style breakfast is sufficient to improve hdl-cholesterol in a Brazilian sample

Objectives: Most beneficial dietary cardioprotective effects have been attributed to the Mediterranean diet. Changes in Brazilian food intake have been associated with increased obesity rates, an important cardiometabolic risk factor. Healthy components of Mediterranean diet (such as unsaturated fat, fiber and polyphenols) are uncommon in our population. It is not known whether small changes in dietary habits, attempting to approximate Brazilian breakfast to Mediterranean pattern, would induce metabolic benefits. The objective was to investigate the effects of a Brazilian typical breakfast (BB) and a Mediterranean style breakfast (MB) intakes on metabolic profile.

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity.

BackgroundThe beneficial effects of the Mediterranean diet have been amply proven in adults with cardiovascular risk factors. The effects of this diet have not been extensively assessed in pediatric populations with obesity, insulin resistance (IR) and metabolic syndrome (MetS). The aim of this study was to assess the efficacy of the Mediterranean style diet (MSD) to decrease cardiovascular risk factors in children and adolescents with obesity.MethodsParticipants were randomly assigned to a MSD rich in polyunsaturated fatty acids, fiber, flavonoids and antioxidants (60% of energy from carbohydrate, 25% from fat, and 15% from protein, (n = 24); or a standard diet (55% of carbohydrate, 30% from fat and 15% from protein, (n = 25), the caloric ingest was individualized. At baseline and 16-week of intervention, the glucose, triglycerides (TG), total cholesterol (TC), HDL-C, LDL-C were measured as well as the body composition and anthropometric data. The diet compliance was determined by the 24-hour recalls.Paired Student’s t and Macnemar’s test were used to compare effects in biochemical, body composition, anthropometric, and dietary variables.ResultsThe MSD group had a significantly decrease in BMI, lean mass, fat mass, glucose, TC, TG, HDL-C and LDL-C. (p < 0.05); the diet compliance increased consumption of omega 9 fatty acids, zinc, vitamin E, selenium, and decreased consumption of saturated fatty acids (p < 0.05). The standard diet group decrease in glucose levels and frequency of glucose >100 mg/dL (p < 0.05).ConclusionThe MSD improves the BMI, glucose and lipid profile in children and adolescents with obesity and any MetS component.

Design of the back-up system in Patio 2.12 photovoltaic installation

Andalucía team presented in the Solar Decathlon Europe 2012 competition a proposal of a modular, sustainable, self-sufficient housing, Patio 2.12. Inspired by Mediterranean style, Patio 2.12 was composed of four habitable modules around a common space (“patio”). Each habitable module has a photovoltaic system on its roof. Simplicity and modularity determined the design of the photovoltaic system so that, together with a global electrical energy management system, the use of the locally generated electrical energy can be optimized.Amongst others, a remarkable innovation included in Patio 2.12 was the use of an intelligent controlling device, based on an energetic support system that could manage the flows of electrical energy of all elements of the electrical installation integrated in the house. This system allows adapting the electricity availability to the consumption demand, maximizing the amount of photovoltaic energy locally generated and instantaneously consumed.This paper implements the use of a simulation software model to analyze the electrical energy balance of the photovoltaic electrical installation. This model estimates the electrical photovoltaic generation and the electrical exchanges with the grid and the battery bank, under a determined load profile, and for a specific period of time, using environmental data as inputs to the model.

How collision triggers backarc extension: Insight into Mediterranean style of extension from 3-D numerical models

The formation and evolution of a backarc basin are linked to the dynamics of the subduction system. The opening of the central Mediterranean basins is a well-documented example of backarc extension characterized by short-lived episodes of spreading. The underlying reasons for this episodicity are obscured by the complexity of this subduction system, in which multiple continental blocks enter the subduction zone. We present results from three-dimensional numerical models of laterally varying subduction to explain the mechanism of backarc basin opening and the episodic style of spreading. Our results show that efficient backarc extension can be obtained with an along-trench variation in slab buoyancy that produces localized deformation within the overriding plate. We observe peaks in the trench retreating velocity corresponding first to the opening of the backarc basin, and later to the formation of slab windows. We suggest that the observed episodic trench retreat behavior in the central Mediterranean is caused by the formation of slab windows.

Slavery in Medieval and Early Modern Iberia by William D. Phillips (review)

Reviewed by: Slavery in Medieval and Early Modern Iberia by William D. Phillips Heather Dalton Phillips, William D., Jr, Slavery in Medieval and Early Modern Iberia (Middle Ages), Philadelphia, University of Pennsylvania Press, 2014; cloth, pp. 272, R.R.P. US$65.00, £42.50; ISBN 9780812244915. This study encapsulates the complexity of slavery in Spain and Portugal during the medieval and early modern periods. The first recorded slaveholders on the Iberian Peninsula, the Romans and the Visigoths, shared the view that those who were part of the dominant group should not be enslaved. When the Muslims conquered the Peninsula early in the eighth century, citizens of towns that had resisted them were enslaved. Although the situation was reversed during and after the re-conquest, it varied across regions. While most slaves in Castile were Muslim, those in the maritime areas of the Crown of Aragon were generally from the southern and eastern Mediterranean and beyond the Black Sea. Although there were Muslim slaves in Portugal, little is known about slavery here prior to the 1440s, when the trade in Sub-Saharan slaves began. By the end of the fifteenth century, the Portuguese were bringing African slaves to the Iberian Peninsula directly from Africa’s west coast. By the beginning of the sixteenth century, these slaves were joined in Spain by enslaved captives from the war in the Canary Islands. William Phillips points out that although there were often large numbers of slaves in Spain and Portugal, they could not be called slave societies. Indeed, during the sixteenth century slaves probably made up only 10 per cent of the population of the city with the largest number of slaves, namely Seville. Phillips emphasises that the Iberian experience of slavery varied enormously. Christians, Muslims, and Jews alike could be slaves, slave owners, or traders. One could be born into slavery, kidnapped and enslaved, or captured and enslaved as a result of conflict. Moreover, slaves could find themselves ‘at any number of points between full slavery and full freedom’. Phillips brings his survey of slavery to life with examples taken from notarial documents. This means that he is able to provide rather more examples of the Spanish owner/slave relationship than the Portuguese. He does so in the full knowledge that such documents were almost always drawn up at the instigation of the owner rather than the slave. Indeed, when it comes to documents that promise or grant manumission, Phillips rightly points out that the majority of slaves freed in this way actually bought their freedom while others were freed once they became too old and frail to work. In the latter case, manumission was likely to result in destitution and starvation. While the Roman tradition of having domestic slaves continued on the Iberian Peninsula into the early modern period, their practice of maintaining slave gangs did not. By the medieval period, slaves who worked outside the home did so alongside free workers. Even those who manned the galleys toiled with convicts and free labourers. However, things were very different beyond the Peninsula. The trade in African slaves expanded as the demand [End Page 202] for labour grew in the American settlements. During the first two centuries of the colonial period, the medieval Mediterranean style of domestic slavery and plantation slavery coexisted. However, slavery on the Peninsula declined during Portugal’s war with Spain, which lasted until 1668. The death knell came in the 1760s when Carlos III established diplomatic relations with Morocco. Laws were passed in Portugal in 1773, and in the early nineteenth century in Spain, freeing the last slaves. As slavery declined and died out on the Iberian Peninsula, it flourished in the empires, lasting until the late nineteenth century in Brazil. Slavery in Medieval and Early Modern Iberia provides a richly textured overview of the development of slavery in Spain and Portugal. It is aimed at those interested in slavery in the Americas, as well those concerned with the Iberian Peninsula, illustrating why the experience of slavery came to vary so much across South America, North America, and the Caribbean. Heather Dalton The University of Melbourne Copyright © 2014 Heather Dalton

Squalene: a multi-task link in the crossroads of cancer and aging

Since its discovery in the beginning of the XXth century, squalene has been recognized as an important link in metabolic pathways. More recently, it has been further recognized as an intermediate step in the biosynthesis of cholesterol. Its well known antioxidant capability, together with its ability to protect skin, improve the immune system, and modulate the lipid profile, confer a high potential to this natural substance, which is spread all across the body structure, though mainly in the epithelial tissues, and in particular the skin sebum. This review will focus mainly on its major properties, which are related to anticancer properties, the maintenance of the oxidation/antioxidation balance, and its antiaging capabilities. Although the substance was originally obtained from shark liver oil, it is currently possible to obtain useful amounts from vegetable sources like extra virgin olive oil, therefore avoiding the dependence on capturing the aforementioned animal species. Recognized as one of the key components of the Mediterranean dietary style, squalene is necessary to adequately manage oxygen and its derivatives in every cell of the body. Key words: aging, antioxidants, cancer, cholesterol, diet, olive oil, squalene

Effect of using repeated measurements of a Mediterranean style diet on the strength of the association with cardiovascular disease during 12 years: the Doetinchem Cohort Study

In cohort studies, often only one baseline measurement of dietary intake is available. This may underestimate the strength of the association with cardiovascular diseases (CVD). The main objective is to compare the strength of the association of a Mediterranean style diet with CVD using one baseline measurement of diet versus three repeated measurements over a 10-year period. We used dietary and lifestyle data of three rounds of the Doetinchem Cohort Study. At baseline, 7,769 persons aged 20-65 years were examined. Diet was assessed with a 178 item validated food-frequency questionnaire and operationalized with the Mediterranean Diet Score (MDS) ranging from 0 to 9. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). Analyses were adjusted for age, sex, and repeated measurements of smoking, sports, total energy intake, and educational level. Comparing an MDS of ≥5.5-9 to an MDS of 0-<3.5, baseline MDS was associated with a 23% lower risk [HR 0.77 (95% CI 0.53-1.11)] and the updated mean with a 35% lower risk [HR 0.65 (0.43-0.97)] of a composite of fatal CVD, nonfatal myocardial infarction, and stroke (composite CVD). For fatal CVD, baseline MDS was associated with a 13% lower risk [HR 0.87 (0.36-2.07)] and the updated mean with a 56% lower risk [HR 0.44 (0.19-1.05)]. The strength of the association between a Mediterranean style diet and CVD is likely underestimated because most studies so far used only one baseline measurement.

Reprint: 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults.

Reprint: 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults.

The association between carotid intima media thickness and individual dietary components and patterns

AimsTo review: 1) the correlation between individual dietary components and carotid intima media thickness (cIMT); 2) the relationship between dietary patterns and cIMT; 3) the effect of dietary interventions on cIMT progression. Data synthesisAn electronic search for epidemiological and intervention trials investigating the association between dietary components or patterns of intake and cIMT was performed in PUBMED, EMBASE and the Cochrane Library. Epidemiological data shows that a higher intake of fruit, wholegrains and soluble fibre and lower consumption of saturated fat in favour of polyunsaturated fat is associated with lower cIMT. In people at high risk of cardiovascular disease >93 g/day of fruit is associated with lower cIMT. Lower cIMT has also been observed when >0.79 serves/day of wholegrains and >25 g/day of fibre, predominately in the soluble form is consumed. Saturated fat is positively associated with cIMT, for every 10 g/day increase in saturated fat cIMT is 0.03 mm greater. Olive oil is inversely associated with cIMT, with a benefit seen when >34 g/day is consumed. While there are many epidemiological studies exploring the association between dietary intake and cIMT there are few intervention studies. Intervention studies show that a Mediterranean diet may reduce cIMT progression, especially in those with a higher cIMT. ConclusionsA Mediterranean style dietary pattern, which is high in fruits, wholegrains, fibre and olive oil and low in saturated fat, may reduce carotid atherosclerosis development and progression. However further research from randomised controlled trials is required to understand the association between diet and cIMT and the underlying mechanisms.

Lifestyle habits and mortality from all and specific causes of death: 40-year follow-up in the Italian Rural Areas of the Seven Countries Study.

Three lifestyle factors were investigated in a population study to explore their relationships with a long-term mortality. In a cohort of 1564 men aged 45-64 and examined in 1965 within the Italian Rural Areas of the Seven Countries Study, smoking habits, physical activity at work and eating habits (as derived from factor analysis) were determined. During the follow-up 693 men died in 20 years and 1441 in 40 years. In Cox proportional hazards models men smoking cigarettes (versus never smokers), those having a sedentary activity (versus the very active) and those following the Diet Score 1, indexing an unhealthy Diet (versus men with a Diet close to the healthy Mediterranean style) had highly significant hazards ratios (HR) in relations with 20- and 40-year mortality from all causes, coronary heart disease (CHD), cardiovascular disease (CVD) and cancer. HR for all causes in 40 years were 1.44 (95% confidence intervals, CI, 1.27 and 1.64) for smokers, 1.43 (CI 1.23 and 1.67) for sedentary people, and 1.31 (CI 1.15 and 1.50) for men with unhealthy diet. Larger HR were found for CHD, CVD and cancers deaths. Combination of 3 unhealthy risk factors versus their absence was associated with 4.8-year life loss in the 20-year follow-up and 10.7-year in the 40-year follow-up. Lifestyle behavior linked to physical activity and smoking and eating habits is strongly associated with mortality and survival in middle aged men during long-term follow-up.

'Mediterranean' dietary pattern for the primary prevention of cardiovascular disease

The Seven Countries study in the 1960s showed that populations in the Mediterranean region experienced lower cardiovascular disease (CVD) mortality probably as a result of different dietary patterns. Later observational studies have confirmed the benefits of adherence to a Mediterranean dietary pattern on CVD risk factors. Clinical trial evidence is limited, and is mostly in secondary prevention. To determine the effectiveness of a Mediterranean dietary pattern for the primary prevention of CVD. We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 9 of 12, September 2012); MEDLINE (Ovid, 1946 to October week 1 2012); EMBASE (Ovid, 1980 to 2012 week 41); ISI Web of Science (1970 to 16 October 2012); Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database and Health Economics Evaluations Database (Issue 3 of 12, September 2012). We searched trial registers and reference lists of reviews and applied no language restrictions. We selected randomised controlled trials in healthy adults and adults at high risk of CVD. A Mediterranean dietary pattern was defined as comprising at least two of the following components: (1) high monounsaturated/saturated fat ratio, (2) low to moderate red wine consumption, (3) high consumption of legumes, (4) high consumption of grains and cereals, (5) high consumption of fruits and vegetables, (6) low consumption of meat and meat products and increased consumption of fish, and (7) moderate consumption of milk and dairy products. The comparison group received either no intervention or minimal intervention. Outcomes included clinical events and CVD risk factors. Two review authors independently extracted data and contacted chief investigators to request additional relevant information. We included 11 trials (15 papers) (52,044 participants randomised). Trials were heterogeneous in the participants recruited, in the number of dietary components and follow-up periods. Seven trials described the intervention as a Mediterranean diet. Clinical events were reported in only one trial (Women's Health Initiative 48,835 postmenopausal women, intervention not described as a Mediterranean diet but increased fruit and vegetable and cereal intake) where no statistically significant effects of the intervention were seen on fatal and non-fatal endpoints at eight years. Small reductions in total cholesterol (-0.16 mmol/L, 95% confidence interval (CI) -0.26 to -0.06; random-effects model) and low-density lipoprotein (LDL) cholesterol (-0.07 mmol/L, 95% CI -0.13 to -0.01) were seen with the intervention. Subgroup analyses revealed statistically significant greater reductions in total cholesterol in those trials describing the intervention as a Mediterranean diet (-0.23 mmol/L, 95% CI -0.27 to -0.2) compared with control (-0.06 mmol/L, 95% CI -0.13 to 0.01). Heterogeneity precluded meta-analyses for other outcomes. Reductions in blood pressure were seen in three of five trials reporting this outcome. None of the trials reported adverse events. The limited evidence to date suggests some favourable effects on cardiovascular risk factors. More comprehensive interventions describing themselves as the Mediterranean diet may produce more beneficial effects on lipid levels than those interventions with fewer dietary components. More trials are needed to examine the impact of heterogeneity of both participants and the intervention on outcomes.

Relationship between serum bilirubin and uric acid to oxidative stress markers in Italian and Czech populations

Summary Recently, a South-to-North oxidative stress marker gradient has been reported; consistent with known differences in the incidence of coronary heart disease between southern and northern European countries. The aim of the present study was to compare the plasma concentrations of 7-oxocholesterol (7OxCH) and 7β-hydroxycholesterol (7BCH) with systemic antioxidants in healthy Italian and Czech subjects. The study was performed in healthy subjects of Italian (n=131) and Czech (n=84) origins. In all subjects routine biochemistry work-ups were performed; additionally, plasma oxysterols and the peroxyl radicals scavenging activity (PERSA) of the sera were determined. Close relationship of serum bilirubin and uric acid to markers of oxidative stress was observed in both examined populations. Compared to the Czechs, the Italian population showed higher plasma concentrations of both oxysterols (7OxCH: 3.6 vs. 6.0 ng/ml, p −6 ; 7BCH: 5.3 vs. 8.6 ng/ml, p −6 ), lower PERSA (p −6 ), and lower serum concentrations of bilirubin and uric acid (p −6 in both cases). The dietary patterns of the Italian population did not match the Mediterranean style, but was more similar to the Continental type of diet, presumably due to non-adherence to a Mediterranean diet.

Fruit, Mediterranean-style, and high-fat and -sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study

Diet has been suggested to be a potential risk factor for vasomotor menopausal symptoms (VMSs), ie, hot flushes and night sweats. We investigated the associations between dietary patterns and risk of VMSs by using data from middle-aged women born between 1946 and 1951 in the Australian Longitudinal Study on Women's Health. A prospective cohort study of 6040 women with a natural menopause were followed up at 3-y intervals over 9 y. Dietary intake was assessed at baseline in 2001, and the presence of VMSs was assessed at baseline and follow-up. Factor analysis and generalized estimating equation models for binary repeated measures were performed. Six dietary patterns were identified from factor analysis: cooked vegetables, fruit, Mediterranean style, meat and processed meat, dairy, and high fat and sugar. A higher consumption of the fruit or Mediterranean-style diet was inversely associated with VMSs in a comparison of the top with the bottom quintile, with adjusted ORs of 0.81 (95% CI: 0.71, 0.93; P-trend = 0.0009) and 0.80 (95% CI: 0.69, 0.92; P-trend = 0.0004), respectively. The high-fat and -sugar pattern increased the risk of VMSs in a comparison of the top with the bottom quintile, with an adjusted OR of 1.23 (95% CI: 1.05, 1.44; P-trend = 0.02). Consumption of a fruit or Mediterranean-style diet decreased the risk of reporting VMSs, whereas consumption of a high-fat and -sugar diet increased the risk of VMSs. These results may eventually lead to a basis for the development of dietary preventive measures for VMSs.

Increased Gut Microbiome Diversity Following a High Fiber Mediterranean Style Diet

We investigated the effects of a Mediterranean style diet on the composition of the gut microbiome, and on fasting lipids. Nine men and women age 50–65 years with BMIs 25–35 kg/m2 and with impaired fasting glucose collected fecal samples during a 2‐week run‐in period, and after the 2‐week calorically‐neutral diet intervention, and provided blood for the analysis of fasting lipids. Bacterial RNA was extracted from pre and post intervention fecal samples, and 454 pyrosequencing of 16S rRNA transcripts (as cDNA) was performed. We sequenced 391,870 high‐quality 16S reads. There was a mean 14% decrease in triglyceride levels (180.8 mg/dl vs 156.8 mg/dl; SD = ± 57.5, p= 0.25), and a mean 12% decrease in LDL cholesterol levels (157.8 mg/dl vs 139.2 mg/dl; SD = ± 16.4, p= 0.009). We observed clustering of individuals’ microbial profiles; (e.g. each microbiome appears to be unique, and within each individual cluster, pre‐diet datapoints cluster separately from post diet datapoints). The number of species‐level operational taxonomic units increased following the diet intervention (+9.64% on average); richness as calculated by the Chao1 (+8.22%) and Ace estimates (+6.37%) increased, as well as the Simpson diversity index (+34%). Ongoing studies focus on identifying which specific group of microbes is responsible for this increase in diversity and their associations with metabolic and inflammatory markers.Grant Funding Source: P30 DK072488 and the Dry Bean Health Research Program

The associations between personality, diet and body mass index in older people.

Personality traits are related to numerous health outcomes and health-related behaviors. To date, however, little is known about how personality traits are associated with dietary behavior, an important aspect of lifestyle in the current "toxic food environment." The present study investigated the associations of between Five-Factor Model personality traits, dietary patterns, and body mass index (BMI). The sample consisted of 1,091 members of Lothian Birth Cohort 1936 tested at age 70 years. Dietary patterns were measured using a detailed and validated food frequency questionnaire (FFQ). Principal components analysis of the FFQ items identified four dietary dimensions, which were named 'Mediterranean style diet,' 'health aware diet,' 'convenience diet,' and 'sweet foods'. Personality traits were measured with NEO Five-Factor Inventory. The effects of childhood intelligence, education, and sex were controlled. Endorsing the Mediterranean style diet dimension was associated with high Openness and Extraversion, and low Neuroticism. High scores on the health aware diet dimension were associated with high Agreeableness and Conscientiousness. Endorsing the convenience diet dimension was associated with low Openness and high Neuroticism. Preference for sweet foods was associated with low Openness. High BMI was associated with high scores on the convenience diet dimension and low Conscientiousness. Personality traits, especially Openness, are associated with dietary patterns in older age. The pattern of findings may indicate that, in older people, dietary habits may be less related to how controlled they are and more related to their levels of openness and emotional and social adjustment. Policy implications are discussed.

Randomized controlled trial on the promotion of healthy lifestyles among adolescents in the orthodontic setting: study protocol

Many studies have shown that the bad lifestyles are the major factors thought to influence susceptibility to many diseases in our society and often these habits during the adolescence begin. The aim of the study was to evaluate the health promotion intervention effect in an orthodontic adolescent sample, in particular: deterring adolescents from smoking; discourage the use and abuse of alcoholic beverages; encourage the adherence to the Mediterranean style diet. A blinded randomized controlled trial will be performed. The participants will be adolescents aged 10 to 14 years that will receive a medical examination in the Complex Unit of Orthodontics. The sample will be followed for three years. The collected evidence would be a scientific support for decisions in public health, in order to increase the health of the young generations.

The Relationship between a Mediterranean Diet and Circulating Adiponectin Levels is Influenced by Cigarette Smoking

Adherence to a Mediterranean diet has been shown to lower the risk of developing several chronic diseases. The ability to augment circulating adiponectin levels is proposed as an underlying mechanism mediating the beneficial effects of this diet. We aimed to examine whether the positive relationship between the Mediterranean diet and adiponectin is altered by cigarette smoking, taking potential confounders into consideration. Plasma adiponectin levels were enzymatically measured in 45 never smokers, 61 smokers and 34 ex-smokers who adhered to a Mediterranean style diet and in 41 never smokers who did not adhere to the diet. Plasma adiponectin levels increased significantly in nonsmoking diet adherents compared to nonsmoking non-diet adherents. Among the diet adherents adiponectin decreased significantly in both moderate and heavy smokers compared to never smokers and significantly increased in quitters compared to smokers. Multiple regression analysis, controlling for age, obesity, Mediterranean diet and insulin resistance revealed an independent inverse association of smoking with adiponectin. Adiponectin levels remained significant and similar in subjects stratified according to age (</>50 years), BMI (</>25 kg/m(2)) and HOMA-IR (</>1.6). Despite its positive effects on adiponectin, the Mediterranean diet failed to negate the adiponectin-lowering effect of cigarette smoking, demonstrating the profound and independent capacity of cigarette smoke to negatively influence human health.

A Comparison of Mediterranean-Style and MyPyramid Diets on Weight Loss and Inflammatory Biomarkers in Postpartum Breastfeeding Women

Of postpartum women, 15%-20% retain ≥ 5 kg of their gestational weight gain, increasing risk for adult weight gain. Postpartum women are also in a persistent elevated inflammatory state. Both factors could increase the risk of obesity-related chronic disease. We hypothesized that breastfeeding women randomized to a Mediterranean-style (MED) diet for 4 months would demonstrate significantly greater reductions in body weight, body fat, and inflammation than women randomized to the U.S. Department of Agriculture's (USDA) MyPyramid diet for Pregnancy and Breastfeeding (comparison diet). A randomized, controlled dietary intervention trial was conducted in 129 overweight (body mass index [BMI] 27.2 ± 4.9 kg/m(2)), mostly exclusively breastfeeding (73.6%) women who were a mean 17.5 weeks postpartum. Dietary change was assessed using a validated Food Frequency Questionnaire (FFQ) before and after intervention as well as plasma fatty acid measures (gas chromatography/flame ionization detector [GC/FID]). Anthropometric measurements and biomarkers of inflammation, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), also were assessed at baseline and 4 months via enzyme-linked immunosorbent assay (ELISA). Participants in both diet groups demonstrated significant (p<0.001) reductions in body weight (-2.3 ± 3.4 kg and -3.1 ± 3.4 kg for the MED and comparison diets, respectively) and significant (p ≤ 0.002) reductions in all other anthropometric measurements; no significant between-group differences were shown as hypothesized. A significant decrease in TNF-α but not IL-6 was also demonstrated in both diet groups, with no significant between-group difference. Both diets support the promotion of postpartum weight loss and reduction in inflammation (TNF-α) in breastfeeding women.

Health effects of low-carbohydrate diets: where should new research go?

There has been considerable debate about the metabolic effects of restricting carbohydrate intake in weight and diabetes management. However, the American Diabetes Association has noted that weight and metabolic improvements can be achieved with low carbohydrate, low fat (implicitly higher carbohydrate), or a Mediterranean style diet (usually an intermediate level of carbohydrate). Our paper addresses variability in the definition for low or restricted carbohydrate, the effects of carbohydrate restriction on diabetes-related health outcomes, strategies for restricting carbohydrate intake, and potential genetic variability in response to dietary carbohydrate restriction. Issues for future research are also addressed.