Analysis of the Gut Microbiome and Dietary Habits in Metastatic Melanoma Patients with a Complete and Sustained Response to Immunotherapy.

Immunotherapy has improved the prognosis of metastatic melanoma patients, although most patients do not achieve a complete response. While specific gut microbiome and dietary habits might influence treatment success, there is a lack of concordance between the studies, potentially due to dichotomizing patients only into responders and non-responders. The aim of this study was to elucidate whether metastatic melanoma patients with complete and sustained response to immunotherapy exhibit differences in gut microbiome composition among themselves, and whether those differences were associated with specific dietary habits. Shotgun metagenomic sequencing revealed that patients who exhibited a complete response after more than 9 months of treatment (late responders) exhibited a significantly higher beta-diversity (p = 0.02), with a higher abundance of Coprococcus comes (LDA 3.548, p = 0.010), Bifidobacterium pseudocatenulatum (LDA 3.392, p = 0.024), and lower abundance of Prevotellaceae (p = 0.04) compared to early responders. Furthermore, late responders exhibited a different diet profile, with a significantly lower intake of proteins and sweets and a higher intake of flavones (p < 0.05). The research showed that metastatic melanoma patients with a complete and sustained response to immunotherapy were a heterogeneous group. Patients with a late complete response exhibited microbiome and dietary habits which were previously associated with an improved response to immunotherapy.

The Outcome of COVID-19 Lockdown on Changes in Body Mass Index and Lifestyle among Croatian Schoolchildren: A Cross-Sectional Study.

Globally, the COVID-19 pandemic altered adults' and children's lifestyles and habits, causing an increase in body weight. Adolescents are sensitive to habit changes and, because of their insufficient capacity to deal with the unexpected COVID-19 changes, were at greater risk of noncommunicable disease development due to the consequences of adopting unhealthy habits. The survey aimed to reveal the changes in nutritional status and lifestyle habits of school children in Croatia and to assess their nutrition knowledge and emotional state and feelings about COVID-19 lockdown. Self-reported data from 1370 school children aged 10 to 15 years were obtained to examine the influence of the lockdown on their nutritional status, lifestyle and emotional status, and to assess their nutrition knowledge. The study revealed that the COVID-19 lockdown has caused an increase in the proportion of overweight and obesity among Croatian school children who changed their lifestyle habits towards being less physically active, spending more time using screen-based media and revealing potential psychological distress. However, the schoolchildren had a high adherence to the Mediterranean diet assessed with the Mediterranean Diet Quality Index for children and adolescents KIDMED index and had good nutrition knowledge. Public health programs promoting a healthy lifestyle and involving the whole family, in a school environment, could provide children with a healthy adulthood.

Metabolic and Hepatic Effects of Energy-Reduced Anti-Inflammatory Diet in Younger Adults with Obesity.

Background: Associated with epidemics of obesity, nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide. The cornerstone of therapy for NAFLD is lifestyle intervention, mainly focused on weight loss. Significant weight loss results from energy-restricted diets, regardless of macronutrient distribution. An anti-inflammatory diet was related to lower odds of NAFLD among daily alcohol drinkers and individuals with metabolic syndrome. This study aims to evaluate the effect of an energy-reduced anti-inflammatory diet on liver status in younger adults with obesity after a 6-month follow-up. Methods: A two-arm randomized controlled trial surveyed 81 participants' (mean age, 43 years) anthropometric and body composition changes. Metabolic status was determined with glycaemic and lipid status, inflammatory status with hs-CRP, IL-6, and TNF-α, and liver status with liver enzymes, NAFLD-FLS, FLI, and FIB-4 indices. The inflammatory potential of the diet was assessed by the Dietary Inflammatory Index, DII®. Results: Energy-restricted anti-inflammatory diet resulted in significant weight loss (-7.1%, p < 0.001), in reducing the visceral adiposity (-22.3%, p < 0.001), metabolic (HOMA-IR, -15.5%; total cholesterol, -5.3%; LDL-C, -4.6%; triglycerides, -12.2%), and inflammatory biomarkers (hs-CRP, -29.5%; IL-6, -18.2%; TNF-α, -34.2%), with significant improvement of liver parameters (NAFLD-FLS, -143.4%; FLI, -14.3%; FIB-4, -2.5%). Conclusion: The study showed the effectiveness of the anti-inflammatory diet with significant improvement of liver parameters in younger adults with obesity, which may reinforce the effectiveness of nutrition-based lifestyle programs, with an anti-inflammatory dietary approach for the treatment and resolution of NAFLD.

The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults.

There is growing evidence of the dietary impact on obesity-induced low-grade chronic inflammation and the associated chronic non-communicable diseases modification. We determined changes in body composition and cardiometabolic and inflammatory status of participants with obesity after 24 weeks of a dietary intervention based on an energy-reduced anti-inflammatory diet and examined the relationship of these changes with changes in the inflammatory potential of the diet. The anthropometric and body composition parameters of 81 participants (average age of 43 years, 74 women) were assessed. Metabolic status was determined using the glycemic and lipid statuses, and the cardiometabolic index and inflammatory status were determined using the concentration of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α). The inflammatory potential of the diet was assessed using the Dietary Inflammatory Index (DII®). Intervention with an anti-inflammatory diet resulted in a significant reduction in body weight and visceral adipose tissue and caused improvements in the participants' cardiometabolic and inflammatory statuses. The anti-inflammatory diet was shown to be effective regarding obesity management. The study data could advance current scientific knowledge in the field of inflammation and diet, provide guidelines for obesity management, and find its application in routine clinical practice.

The association between the Mediterranean diet and high physical activity among the working population in Croatia.

BACKGROUND: Unhealthy eating habits and physical inactivity constitute an emerging public health problem. The working population is of special interest for public health monitoring and evaluation because workers' unhealthy lifestyles may lead to reduced work ability. The aim of this study was to determine diet quality and adherence to the Mediterranean diet (MD), according to the level of physical activity, and to detect variables associated with the working population's being highly physically active. MATERIAL AND METHODS: At the Institute for Occupational Medicine 400 full-time workers were examined for obesity factors, filled in the short version of International Physical Activity Questionnaire (IPAQ-short) and a validated food frequency questionnaire for adherence to the Mediterranean diet using Mediterranean Diet Score (MDS). The workers were divided into low, moderate and high physical activity groups according to the IPAQ-short scoring protocol. Hierarchical linear regression was performed to determine the variables associated with being highly active. RESULTS: One-third of the participants were highly physically active and their diet adhered to the MD (MeMDS = 7). Significant variables associated with a high level of physical activity were gender (p < 0.001), age (p = 0.02), waist-to-hip ratio (WHR) (p < 0.001), sitting level (p = 0.044) and occupational type (p < 0.001). CONCLUSIONS: It was found that the participants displaying a high level of physical activity had a better quality diet that adhered to the Mediterranean diet but not to a significant degree. The variables associated with a high level of physical activity were male gender, younger age, normal WHR, non-sedentary occupation and reduced sitting time. The study findings could serve the purpose of improving future public health promotion of physical activity and the Mediterranean diet. Med Pr. 2019;70(2):169-76.

Associations between Adherence to the Mediterranean Diet and Lifestyle Assessed with the MEDLIFE Index among the Working Population.

The adherence to the Mediterranean diet is beneficial for cardiovascular diseases prevention. The study aim is to use Mediterranean lifestyle (MEDLIFE) questionnaire for estimation of Mediterranean lifestyle habits among the working population and to establish MEDLIFE score correlation with the risk factors for cardiovascular diseases. In the study has participated 366 workers from Croatia, which fulfilled MEDLIFE and validated food frequency questionnaire (FFQ) questionnaire. The multivariate logistic regression was performed to evaluate the association between MEDLIFE index, workers' obesity and cardiovascular diseases risk. The lowest adherence to Mediterranean lifestyle was associated to younger, low education, body fat above acceptable ranges and unfavorable lipid profile. Significant association to Mediterranean lifestyle was more among women (p = 0.002), middle aged (p = 0.02), highly physically active (p = 0.009) and those who play collective sports >2 h/w (p = 0.001), having body fat within acceptable range (p = 0.003), total cholesterol less (p = 0.03) and high-density lipoproteins (HDL-C) (p = 0.04) more than recommended. Inverse significant association was for high educational level (p = 0.02). The Mediterranean lifestyle adherence is associated to lower risk factors for cardiovascular diseases among studied working population. MEDLIFE index revealed that physical activity and conviviality are better ingrained among younger population but not the Mediterranean diet.

The effect of nutrition knowledge on dietary intake among Croatian university students.

The aim of this study was to examine the relationship between nutrition knowledge and dietary intakes among university students. The students (264 males and 741 females) were asked to answer a validated General Nutrition Knowledge Questionnaire and to fulfil a Food Frequency Questionnaire. Gender, university status (freshmen, juniors, seniors) and eating arrangements (home, restaurants, self-cooking) were used as predictors of the relationship between nutrition knowledge and dietary intake. The findings indicated that women (p = 0.008), senior students (p < 0.001) and those who prepare food for themselves (p = 0.038) have higher nutrition knowledge scores. The assessment of nutrition knowledge had parallels in dietary intake, and adherence to the dietary recommendations was significantly associated with nutrition knowledge scores (p < 0.001). Regression analysis showed differences in daily intakes of grains (p < 0.001), meat and beans group (p < 0.001), vegetables (p < 0.001), fruits (p = 0.002) and oils (p < 0.001) in relation to all predictors. However nutrition knowledge acted as a modifier of the influence of eating arrangements. Logistic regression has shown that students with the highest nutrition knowledge are twelve times more likely to have a diet in accordance to recommendations compared to students with the lowest level of knowledge ([OR] = 12.03, 95% [CI] = 6.64-21.79, p < 0.001). The results support the value of including nutrition knowledge in health education campaigns targeting the student population with the aim of improving their dietary intake.