Popular Diets and Skin Effects: A Narrative Review. / Dietas populares y su impacto en la piel. Una revisión narrativa.

Numerous diets for losing weight, building strength, and managing a range of cardiovascular, neurologic, and skin diseases have become popular in recent years. The ketogenic diet and intermittent fasting in particular have shown promising results in clinical and sports medicine. The Mediterranean diet, in turn, is widely recognized for its numerous health benefits. Also popular are the paleo diet and vegan and gluten-free diets. Positive effects on inflammatory conditions, such as psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne, have been observed in patients who practice intermittent fasting or follow ketogenic or Mediterranean diets. This last choice may also protect against certain skin cancers. We review the role of several popular diets in the management of skin disorders.

Effect of the Mediterranean diet on histological indicators and imaging tests in non-alcoholic fatty liver disease. / Efecto de la dieta mediterránea sobre indicadores histológicos y pruebas de imagen en enfermedad de hígado graso no alcohólico.

AIM: To analyze the scientific evidence regarding to the effect of the Mediterranean diet on the imaging tests and biopsy characteristics in subjects with non-alcoholic fatty liver disease (NAFLD). METHODS: A bibliographic search was carried out in this narrative review in Pubmed and Web of Science databases, considering studies published between 2011 and 2020, in English or Spanish, randomized clinical trials and observational studies in patients with a diagnosis of NAFLD, in subjects over 18years of age of both sexes. RESULTS: In the observational studies found, an inverse association between adherence to a Mediterranean diet and liver damage stands out, while in the intervention studies with measurement of liver biopsy a 4.4% reduction in intrahepatic lipids and with magnetic resonance a reduction between 4.2 and 10.2% was found. In experimental studies with ultrasound measurement, the proportion of people with moderate (6-16%) and severe (25%) degree decreased and the studies with transient elastography showed a decrease in liver stiffness between 0.5 and 2.1kPa. CONCLUSIONS: The Mediterranean diet contributes to the treatment of NAFLD, which is manifested in the liver and histological imaging tests characteristics.

Dietary patterns and components to prevent and treat heart failure: a comprehensive review of human studies.

Growing evidence has emerged about the role of dietary patterns and components in heart failure (HF) incidence and severity. The objective here is to provide a comprehensive summary of the current evidence regarding dietary patterns/components and HF. A comprehensive search of online databases was conducted using multiple relevant keywords to identify relevant human studies. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets have consistently been associated with decreased HF incidence and severity. Regarding specific dietary components, fruit, vegetables, legumes and whole grains appear beneficial. Current evidence suggests that red/processed meats, eggs and refined carbohydrates are harmful, while fish, dairy products and poultry remain controversial. However, there is a notable lack of human intervention trials. The existing but limited observational and interventional evidence from human studies suggests that a plant-based dietary pattern high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans-fat and Na may decrease HF incidence/severity. Potential mechanisms include decreased oxidative stress, homocysteine and inflammation but higher antioxidant defence and NO bioavailability and gut microbiome modulation. Randomised, controlled trials are urgently required.

May the Mediterranean diet attenuate the risk of type 2 diabetes associated with obesity: the Seguimiento Universidad de Navarra (SUN) cohort.

It is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0-9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25-29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25-30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.

Current and future strategies for the nutritional management of cardiometabolic complications of androgen deprivation therapy for prostate cancer.

Androgen deprivation therapy (ADT) is used widely as part of a combined modality for the treatment of prostate cancer. However, ADT has also been associated with the development of cardiometabolic complications that can increase mortality from cardiovascular events. There is emerging evidence to suggest that ADT-related cardiometabolic risk can be mitigated by diet and lifestyle modification. While the clinical focus for a nutritional approach for achieving this effect is unclear, it may depend upon the timely assessment and targeting of dietary changes to the specific risk phenotype of the patient. The present review aims to address the metabolic origins of ADT-related cardiometabolic risk, existing evidence for the effects of dietary intervention in modifying this risk, and the priorities for future dietary strategies.

Association between dietary fibre intake and fruit, vegetable or whole-grain consumption and the risk of CVD: results from the PREvención con DIeta MEDiterránea (PREDIMED) trial.

Prospective studies assessing the association between fibre intake or fibre-rich food consumption and the risk of CVD have often been limited by baseline assessment of diet. Thus far, no study has used yearly repeated measurements of dietary changes during follow-up. Moreover, previous studies included healthy and selected participants who did not represent subjects at high cardiovascular risk. We used yearly repeated measurements of diet to investigate the association between fibre intake and CVD in a Mediterranean cohort of elderly adults at high cardiovascular risk. We followed-up 7216 men (55-80 years) and women (60-80 years) initially free of CVD for up to 7 years in the PREvención con DIeta MEDiterránea study (registered as ISRCTN35739639). A 137-item validated FFQ was repeated yearly to assess diet. The primary end point, confirmed by a blinded ad hoc Event Adjudication Committee, was a composite of cardiovascular death, myocardial infarction and stroke. Time-dependent Cox's regression models were used to estimate the risk of CVD according to baseline dietary exposures and to their yearly updated changes. We found a significant inverse association for fibre (P for trend=0·020) and fruits (P for trend=0·024) in age-sex adjusted models, but the statistical significance was lost in fully adjusted models. However, we found a significant inverse association with CVD incidence for the sum of fruit and vegetable consumption. Participants who consumed in total nine or more servings/d of fruits plus vegetables had a hazard ratio 0·60 (95 % CI 0·40, 0·96) of CVD in comparison with those consuming <5 servings/d.

[Impact of the Mediterranean diet and the consumption of fermented beverages on subjective well-being in different contexts in Spain]. / Impacto de la dieta mediterránea y del consumo de bebidas fermentadas en el bienestar subjetivo en diferentes contextos en España.

Introduction: The relationship between the Mediterranean diet, the consumption of fermented beverages (beer and wine), and subjective well-being in Spain was investigated. Using a cross-sectional study with 2,752 participants, dietary patterns and emotional well-being were evaluated in contexts such as work, the gym, and bars/restaurants. The results showed that context significantly impacts dietary habits and well-being. Participants at the gym adhered more to the Mediterranean diet and reported fewer negative emotions compared to other contexts. Correlation maps indicated that beer consumption was associated with a higher intake of red meat, while wine was related to a higher consumption of fish and seafood. Additionally, the study found that participants following the Mediterranean diet experienced higher levels of emotional well-being, with less frequent negative emotions such as anxiety and anger, and higher levels of life satisfaction, especially in contexts like the gym. These findings suggest that public health interventions should consider contextual factors to promote healthy eating habits and improve emotional well-being, highlighting the importance of the Mediterranean diet in health and the prevention of psychological problems.

Introducción: Se investigó la relación entre la dieta mediterránea, el consumo de bebidas fermentadas (cerveza y vino) y el bienestar subjetivo en España. Utilizando un estudio transversal con 2752 participantes, se evaluaron los patrones dietéticos y el bienestar emocional en contextos como el trabajo, el gimnasio y bares o restaurantes. Los resultados mostraron que el contexto tiene un impacto significativo en los hábitos dietéticos y el bienestar. Los participantes del gimnasio siguieron más la dieta mediterránea y reportaron menos emociones negativas en comparación a los de otros contextos. Los mapas de correlación indicaron que el consumo de cerveza se asociaba con una mayor ingesta de carne roja, mientras que el vino se relacionaba con un mayor consumo de pescado y mariscos. Además, el estudio encontró que los participantes que seguían la dieta mediterránea experimentaban mayores niveles de bienestar emocional, con menor frecuencia de emociones negativas, como la ansiedad y la ira, y mayores niveles de satisfacción con la vida, especialmente en contextos como el gimnasio. Estos hallazgos sugieren que las intervenciones de salud pública deberían considerar los factores contextuales para fomentar hábitos alimenticios saludables y mejorar el bienestar emocional, resaltando la importancia de la dieta mediterránea en la salud y en la prevención de problemas psicológicos.

[Nutritional status and adherence to the Mediterranean diet in the school population of the city of Mataró (Catalonia, Spain)]. / Estado nutricional y adherencia a la dieta mediterránea en la población escolar de la ciudad de Mataró (Cataluña, España).

Introduction: Background: there is a decrease in adherence to the Mediterranean diet (MD) and an increase in the prevalence of excess weight among the Spanish child and adolescent population. Objectives: the objective of the present study was to determine the degree of adherence to MD and the nutritional status of the school population of Mataró (Spain) in order to obtain useful information for the design and application of future interventions. Material and methods: a cross-sectional descriptive study was carried out in a sample of 1177 schoolchildren between 6 and 18 years of age. The KIDMED index was used to assess adherence to MD, and the body mass index (BMI) to assess nutritional status. Questions were related to the students' perception of access to unhealthy foods, availability of money and parental interest in receiving nutrition education. Results: the percentage of children and adolescents with optimal adherence to MD does not reach 50 %, with secondary school youths presenting a lower percentage (30 %). Regarding the nutritional status of the sample, more than 70 % had a normal nutritional status according to their BMI, and 20.7 % of primary school students and 13.8 % of secondary school students were classified as overweight. Conclusions: the data confirm the interest of designing and implementing educational actions involving both students and parents, with the aim of improving the eating habits of the population. The results suggest that availability of money may facilitate access to unhealthy foods and, therefore, the promotion of healthy environments that increase the supply of healthy foods should be considered.

Introducción: Introducción: existe una disminución de la adherencia a la dieta mediterránea (DM) y un aumento de la prevalencia del exceso de peso entre la población infantil y juvenil española. Objetivos: el objetivo del presente estudio fue conocer el grado de adherencia a la DM y el estado nutricional de la población escolar de Mataró (España) a fin de obtener información útil para el diseño y aplicación de futuras intervenciones. Material y métodos: se realizó un estudio descriptivo de tipo transversal en una muestra de 1177 escolares de entre 6 y 18 años. Se utilizó el índice KIDMED para evaluar la adherencia a la DM y el índice de masa corporal (IMC) para valorar el estado nutricional. Se incluyeron preguntas relacionadas con la percepción de los estudiantes del acceso a alimentos no saludables, la disponibilidad de dinero y el interés de los padres en recibir educación sobre alimentación. Resultados: el porcentaje de niños y adolescentes con óptima adherencia a la DM no alcanza el 50 %, siendo los jóvenes de secundaria quienes presentan un porcentaje menor (30 %). En relación con el estado nutricional de la muestra, más del 70 % presentaron un estado nutricional normal según el IMC, y un 20,7 % de los alumnos de primaria y un 13,8 % de los de secundaria se clasificaron con exceso de peso. Conclusiones: los datos confirman el interés de diseñar e implementar acciones educativas que involucren tanto a los estudiantes como a los padres, con el objetivo de mejorar los hábitos alimentarios de la población. Los resultados sugieren que la disponibilidad de dinero puede facilitar el acceso a alimentos no saludables y, por consiguiente, se debe considerar la promoción de entornos saludables que aumenten la oferta de alimentos saludables.

[Limitations and opportunities for the appropriation of the Mediterranean diet in Chilean adults with diagnostic elements of metabolic syndrome]. / Limitaciones y oportunidades para la adopción de la dieta mediterránea en adultos chilenos con elementos diagnósticos del síndrome metabólico.

Introduction: Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65-year-old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.

Introducción: Antecedentes: un estilo de alimentación saludable, específicamente la dieta mediterránea (DMed), es un factor asociado a bajo riesgo, menor prevalencia y mejor manejo de las enfermedades crónicas. Sin embargo, existe información limitada respecto a cómo los pacientes incorporan propuestas de este patrón alimentario en su vida cotidiana. Objetivo: identificar factores y condiciones que pueden influir en la adherencia a la DMed en Chile. Métodos: estudio cualitativo exploratorio en 17 pacientes de ambos sexos de entre 35 y 65 años que presentaban algún criterio diagnóstico de síndrome metabólico (SMet). Mediante entrevistas en profundidad y grupos focales se indagaron el conocimiento, la valoración, las actitudes y las prácticas asociadas a cambios y mantenimiento de alimentación con énfasis en la DMed. El análisis de la información se realizó bajo el enfoque de teoría fundada usando el software ATLAS.ti. Resultados: los participantes reconocieron el valor de una alimentación saludable tipo DMed, pero declararon bajo conocimiento (identificación de algunos alimentos aislados, dinámica familiar) de ella, junto con facilitadores (variedad de ingredientes) y limitantes (sabor, disponibilidad/costo de algunos alimentos) para su adopción rutinaria. Además, el cambio de hábitos alimentarios genera alta carga cognitiva y emocional inicial que requiere esfuerzo no solo individual sino también relacional, pues implica modificaciones de prácticas familiares y colectivas. Conclusiones: la información obtenida sobre barreras y oportunidades para adherir a una alimentación saludable como la DMed resulta clave para diseñar e implementar intervenciones nutricionales basadas en este patrón alimentario y que puedan ser sostenibles en el tiempo para el enfrentamiento de las enfermedades crónicas en Chile.

[Improvement in adherence to Mediterranean diet in children attending preschool centers]. / Mejoría de la adherencia a la dieta mediterránea en preescolares asistentes al jardín infantil.

Introduction: Background: the Mediterranean diet has been associated with a lower prevalence of obesity and metabolic syndrome, and with healthier lifestyles in adults and children, but data is scarce in younger ages. The Mediterranean-type ecosystem of the central region of Chile as well as its traditional gastronomy would facilitate the adoption of this dietary pattern. Objectives: to assess the adherence to Mediterranean diet in preschoolers and their parents, and to evaluate the impact of a nutrition education intervention and diet implementation. Methods: prospective cohort study. The KidMed index was applied to children older than 18 months, and the Mediterranean Dietary Index in Chile (Chilean-MDI) to their parents, before and after a remote educational intervention. Results: one hundred and thirty-nine families participated, with 95 preschoolers; 56 % were girls, aged 26.2 ± 8.7 months. The basal mean KidMed score was 7.4 ± 1.9 and increased to 7.9 ± 1.9 after the intervention (p = 0.1). The Chilean-MDI score was 6.9 ± 1.8 and 7.1 ± 1.7, respectively (p = 0.09). When separated by categories, there was improvement from low and moderate adherence to optimal adherence in both children and their parents (Chi2, p = 0.009 y p = 0.04). In 58 dyads, there was a positive correlation between the KidMed and the Chilean-MDI index, pre- and post-intervention (Pearson R = 0.3 y 0.34; p = 0.004 y 0.003, respectively). Conclusions: most of these sample of preschoolers and their parents had a moderate adherence to Mediterranean diet, with an improvement after an educational intervention.

Introducción: Introducción: la dieta mediterránea se ha asociado a menor prevalencia de obesidad y síndrome metabólico y a estilos de vida saludable en adultos y escolares, siendo escasa la información en edades menores. La región central de Chile tiene un ecosistema de tipo mediterráneo, lo que, junto con su gastronomía tradicional, facilitaría la adopción de este estilo de alimentación. Objetivos: determinar la adherencia a la dieta mediterránea en preescolares y sus padres y evaluar el impacto de una intervención educativa y su implementación. Métodos: estudio de cohorte prospectiva. Se aplicaron los índices KidMed en niños/as mayores de 18 meses y el Índice Chileno de Dieta Mediterránea (IDM-Chile) en los padres, antes y después de una intervención educativa remota. Resultados: participaron 139 familias, con 95 preescolares, 56 % mujeres, con edad de 26,2 ± 8,7 meses. Inicialmente, el KidMed en los niños fue de 7,4 ± 1,9 puntos y aumentó hasta 7,9 ± 1,9 puntos postintervención (p = 0,1). El IDM-Chile en los padres fue de 6,9 ± 1,8 y 7,1 ± 1,7 puntos, respectivamente (p = 0,09). Al separar por categorías, hubo mejoría desde una adherencia baja o moderada hacia una óptima en los niños y adultos (Chi2, p = 0,009 y p = 0,04). En 58 diadas hubo una correlación positiva entre los índices KidMed e IDM-Chile preintervención y postintervención (R Pearson: 0,3 y 0,34; p = 0,004 y 0,003, respectivamente). Conclusiones: la mayoría de esta muestra de preescolares y sus padres presentaron una adherencia moderada a dieta mediterránea, con una mejoría posterior a la intervención educativa.

[Dietary patterns associated with obesity and its comorbidities]. / Patrones dietéticos asociados a la obesidad y a sus comorbilidades.

Introduction: Obesity is a major public health challenge. In Spain the prevalence of excess of weight and obesity and is 56 % and 19 %, respectively, and it is linked to numerous preventable chronic diseases. Nutritional epidemiology focused on nutrients has evolved towards the study of dietary patterns that consider synergistic interactions between foods and nutrients. This study aims to investigate the relationship between obesity and its treatment by healthy dietary patterns. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), based on plant products, whole grains and low levels of salt, sugars and red meat, have been shown to promote weight loss and reduce comorbidities associated with obesity. Although vegetarian and vegan diets are adequate options for disease management and prevention, they require planning to avoid nutritional deficiencies. In conclusion, healthy dietary patterns such as the Mediterranean diet, DASH and vegetarian options are effective in both the prevention and treatment of obesity, highlighting the importance of considering the synergy between foods and nutrients in the management of this health condition.

Introducción: La obesidad es un importante desafío de salud pública. En España, la prevalencia de exceso de peso y obesidad es del 56 % y del 19 %, respectivamente. Además, se vincula con numerosas enfermedades crónicas prevenibles. La epidemiología nutricional centrada en nutrientes ha evolucionado hacia el estudio de patrones dietéticos que consideran las interacciones sinérgicas entre alimentos y nutrientes. Este estudio tiene como objetivo investigar la relación entre la obesidad y su tratamiento mediante patrones dietéticos saludables. La dieta mediterránea y la dieta para detener la hipertensión (o dieta DASH), basadas en productos vegetales, cereales integrales y bajos niveles de sal, azúcares y carnes rojas, han demostrado favorecer la pérdida de peso y reducir comorbilidades asociadas a la obesidad. Aunque las dietas vegetarianas y veganas son opciones adecuadas en el manejo y en la prevención de la enfermedad, requieren planificación para evitar deficiencias nutricionales. En conclusión, patrones dietéticos saludables como la dieta mediterránea, la DASH y las opciones vegetarianas son efectivas tanto en la prevención como en el tratamiento de la obesidad. Destaca la importancia de considerar la sinergia entre alimentos y nutrientes en la gestión de esta condición de salud.

[Results of the eating habits program for children from 3 to 12 years based on Nutriplato®]. / Resultados del programa de hábitos alimentarios para niños de 3 a 12 años basado en el Nutriplato®.

Introduction: Introduction: poor dietary habits and lack of physical activity are associated with non-communicable diseases. A healthy diet during childhood is important for the prevention of these diseases in the short and long term. Objectives: improve eating habits, promote the Mediterranean diet (MD) and prevent and/or reverse overweight and obesity in children aged 3 to 12 years. Methods: the program includes 3 to 5 visits with dietitian-nutritionists, 1 telephone control and 1 practical workshop, with a follow-up of 1 year. Anthropometric, body composition and eating habits data are collected, and nutritional education is provided. Results: the program included 1018 participants (51.5 % boys; median age 8.5 ± 2.7 years). At baseline, 31 % were overweight or obese and 33.9 % had optimal MD. 696 participants completed the 12-month follow-up, and an increase in the percentage of participants following optimal MD was observed (38.1 % vs. 53.4 %; p < 0.001). Statistically significant improvements were also observed in relation to the consumption of fruits (except for 3 servings/day), vegetables, legumes, nuts and wholegrains cereals. In participants who were overweight or obese, a slight decrease in the mean BMI z-score was observed at the 12-month follow-up (p = 0.039). Conclusions: the results highlight the need for nutritional education in children and show that the Nutriplato® Program is effective in improving eating habits.

Introducción: Introducción: los malos hábitos alimentarios y la falta de actividad física se asocian a enfermedades no transmisibles. Una alimentación saludable durante la infancia es importante para la prevención de estas enfermedades a corto y a largo plazo. Objetivos: mejorar los hábitos alimentarios, promocionar la dieta mediterránea (DM) y prevenir o revertir el sobrepeso y la obesidad en niños de 3 a 12 años. Métodos: el programa incluye de 3 a 5 visitas con dietistas­nutricionistas, 1 control telefónico y 1 taller práctico, con seguimiento de 1 año. Se recogen datos antropométricos, de composición corporal y de hábitos alimentarios y se realiza educación nutricional. Resultados: en el programa se han incluido 1018 participantes (51,5 % niños; edad media: 8,5 ± 2,7 años). Al inicio, el 31 % presentaba sobrepeso u obesidad y el 33,9 % seguían una DM óptima. 696 participantes completaron los 12 meses de seguimiento y se observó un aumento en el porcentaje de participantes que seguía una DM óptima (38,1 % frente al 53,4 %; p < 0,001). También se observaron mejoras estadísticamente significativas en relación con el consumo de frutas (excepto en 3 raciones/día), verduras, legumbres, frutos secos y cereales integrales. En los participantes con sobrepeso u obesidad, se observó una ligera disminución en la media del z-score del índice de masa corporal (IMC) a los 12 meses de seguimiento (p = 0,039). Conclusiones: los resultados muestran la necesidad de realizar educación nutricional en los niños y muestran que el programa Nutriplato® es efectivo en la mejora de hábitos alimentarios.

[Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren]. / Adhesión a la dieta mediterránea y conducta alimentaria en escolares españoles.

Introduction: Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children and adolescents. Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren. Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED questionnaire for adherence to the Mediterranean diet and the Children's Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior. Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and 27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoyment of food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables, nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played an important role in food choices. Conclusions: eating behaviors may play an essential role in the quality of school children's diets highlighting the enjoyment and acceptance or rejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis for future research with the aim of a better nutritional approach from the earliest ages.

Introducción: Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterránea de niños y adolescentes. Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles. Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluado mediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children's Eating Behaviour Questionnaire (CEBQ) para evaluar el comportamiento alimentario. Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %, adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menos exigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secos o pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingesta también tuvieron un papel importante en las elecciones alimentarias. Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y la aceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, el análisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.

Metabolic syndrome in systemic lupus erythematosus patients under Mediterranean diet.

BACKGROUND AND AIMS: Metabolic 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 METHODS: Cross-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. RESULTS: MetS 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. CONCLUSION: We 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.

Effect of the Mediterranean diet in cardiovascular prevention.

The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.

Impact of Mediterranean diet in lowering risk of gestational diabetes mellitus: A cross-sectional study.

INTRODUCTION AND OBJECTIVES: The prevalence of gestational diabetes is increasing, and the Mediterranean diet is highly recommended for health. The objective of this study is to determine the relationship between adherence to the Mediterranean diet and gestational diabetes mellitus (GDM). MATERIALS AND METHODS: In this cross-sectional study the presence of GDM is the dependent variable, and socio-demographic and anthropometric characteristics and adherence to the Mediterranean diet are the independent variables in this study, which was carried out in pregnant women who were 24-28 weeks pregnant and had Oral Glucose Tolerance Test (OGTT). Adherence to the Mediterranean diet was evaluated with the Mediterranean Diet Adherence Scale (MEDAS). Data were collected through face-to-face interviews, weight and height measurements of the pregnant women were made, and the diagnosis of GDM was made with OGTT. RESULTS: Two hundred and seven pregnant women participated in the study and 85 of them (41.1%) were diagnosed as GDM. According to Logistic Regression models, age (OR: 1.088, 95% CI: 1.031-1.149) and infertility treatment (OR: 4.570, 95% CI: 1.443-14.474) significantly increased the occurrence of GDM, while adherence to the Mediterranean diet (OR: 0.683, 95% CI: 0.568-0.820) significantly reduced the risk. CONCLUSIONS: Nearly two-fifths of pregnant women were diagnosed with GDM while only one-fourth complied with a Mediterranean diet. The increase in the frequency of GDM should be carefully monitored. It may be useful to detect risky pregnant women at the time of the first diagnosis, to measure their glucose levels, and to give suggestions about the Mediterranean diet in the early period.

Recent advances in precision nutrition and cardiometabolic diseases.

A growing body of research on nutrition omics has led to recent advances in cardiovascular disease epidemiology and prevention. Within the PREDIMED trial, significant associations between diet-related metabolites and cardiovascular disease were identified, which were subsequently replicated in independent cohorts. Some notable metabolites identified include plasma levels of ceramides, acyl-carnitines, branched-chain amino acids, tryptophan, urea cycle pathways, and the lipidome. These metabolites and their associated pathways have been associated with incidence of both cardiovascular disease and type 2 diabetes. Future directions in precision nutrition research include: a) developing more robust multimetabolomic scores to predict long-term risk of cardiovascular disease and mortality; b) incorporating more diverse populations and a broader range of dietary patterns; and c) conducting more translational research to bridge the gap between precision nutrition studies and clinical applications.

Nutritional habits in patients with peripheral arterial disease: Adherence to the mediterranean diet. / Hábitos nutricionales en los pacientes con enfermedad arterial periférica: adherencia a la dieta mediterránea.

INTRODUCTION: Adherence to the Mediterranean diet (Dietmed) exerts protective effects on cardiovascular disease (CVD). In the Lower Extremity Peripheral Arterial Disease (PAD) there are fewer studies that analyze these data. OBJECTIVE: To determine adherence to Dietmed and dietary habits in patients with PAD, according to a history of CVD (coronary and/or cerebral ischaemic pathology) and according to the ankle-brachial index (ABI ≥ or <0,5). MATERIAL AND METHODS: Cross-sectional analytical study carried out in a tertiary hospital. The sample was collected consecutively. Sociodemographic and clinical history, ankle-brachial index (ABI) and a 14-point Dietmed adherence dietary questionnaire were included. The analysis of categorical variables was carried out using the Pearson's Chi-Square test, the T-Student's statistic test for independent samples was used for parametric variables and the U. Mann-Whitney test for non-parametric variables. RESULTS: Of the 97 patients, 87,6% had low adherence to Dietmed, with no differences according to the severity of PAD. However, when we analysed the data according to whether or not they had a history of CVD, we observed a high adherence to some items included in Dietmed, specifically, in the CVD group, the consumption of lean meat (95,5% vs 64%; P=.004). In addition, we observed a significant difference in the consumption in the group without a history of CVD (32% vs 9,1%; P=.033). CONCLUSION: In our population, patients with PAD, regardless of the stage of the disease and whether they had associated coronary or cerebral ischaemic pathology, had low adherence to Dietmed. Therefore, it is important to implement nutritional education programmes in patients with PAD in all stages, as well as in those patients who have already suffered a vascular event, so that they maintain adherence to healthy dietary habits in the long term.

Mediterranean diet and non enzymatic antioxidant capacity in the PREDIMED study: evidence for a mechanism of antioxidant tuning.

BACKGROUND AND AIMS: The intake of antioxidant-rich foods may increase the blood levels of non enzymatic antioxidant capacity (NEAC). NEAC takes into account all antioxidants from food and synergistic effects between them. We examined the effect of a 1-year intervention with Mediterranean diet on plasma NEAC and assessed whether it was related to baseline NEAC levels. METHODS AND RESULTS: Five hundred sixty-four participants at high cardiovascular risk were randomly selected from the PREDIMED (Prevención con DIeta MEDiterránea) Study, a large 3-arm randomized clinical trial. Blood NEAC levels were measured at baseline and after 1-year of dietary intervention with 1) a Mediterranean diet supplemented with virgin olive oil (MED + VOO); 2) a Mediterranean diet supplemented with nuts (MED + nuts), or 3) a control low-fat diet. Plasma NEAC was analyzed using FRAP (ferric reducing antioxidant potential) and TRAP (total radical-trapping antioxidant parameter) assays. Plasma FRAP levels increased after 1-year of intervention with MED + VOO [72.0 µmol/L (95% CI, 34.2-109.9)] and MED + nuts [48.9 µmol/L (24.3-73.5)], but not after the control low-fat diet [13.9 µmol/L (-11.9 to 39.8)]. Participants in the lowest quartile of plasma FRAP at baseline significantly increased their levels after any intervention, while those in the highest quartile decreased. Similar results occurred with TRAP levels. CONCLUSIONS: This study shows that a 1-year of MED diet intervention increases plasma TAC level in subjects at high risk for cardiovascular disease. Moreover, the effectiveness of dietary supplementation with antioxidants may be related to baseline levels of plasma NEAC.