Is Extra Virgin Olive Oil the Critical Ingredient Driving the Health Benefits of a Mediterranean Diet? A Narrative Review.

Most chronic diseases are preventable with a healthy diet, although there is debate about the optimal dietary approach. Increasingly more countries are focusing on food-based guidelines rather than the traditional nutrient-based approach. Although there is good agreement on plant foods, controversy remains about the types and amounts of fats and oils. This narrative review aims to systematically summarize and evaluate the latest evidence on the protective effects of extra virgin olive oil (EVOO) on disease risk factors. A systematic search of the relevant literature using PubMed, Cochrane Library, and Embase databases was conducted for the years 2000 through December 2022. A narrative synthesis was then undertaken. Of 281 retrieved articles, 34 articles fulfilled our inclusion criteria and were included. Compared with other dietary fats and low-fat diets, EVOO is superior in the management of clinical biomarkers including lowering blood pressure and LDL-c, increasing protective HDL-c, improving glycemic control, and weight management. The protective effects of EVOO are likely due to its polyphenol content rather than the monounsaturated fat content. It is therefore important to promote the regular use of EVOO in the context of healthy dietary patterns such as the Mediterranean diet for maximal health benefit.

Food Is Medicine: Using a 4-Week Cooking Program of Plant-Based, Olive oil Recipes to Improve Diet and Nutrition Knowledge in Medical Students.

Diet can be used to treat chronic diseases, yet nutrition education is not sufficiently included in most medical school curriculum. Providing practical nutrition information that could lead to improvements in clinical measures could improve patient outcomes and physician clinical skills; it might also improve the diet and eating behavior of the medical student. This study used a 4-week cooking program of plant-based recipes that included extra virgin olive oil to provide medical students with practical cooking skills and nutrition education. The results indicate that the program can improve both the diet and eating behavior of the student and their nutrition knowledge.

Underwater endoscopic mucosal resection of colorectal neoplasia is easily learned, efficacious, and safe.

BACKGROUND: Underwater endoscopic mucosal resection (UEMR) without submucosal injection is a novel endoscopic procedure. It is not known if UEMR can be easily taught and learned, and the efficacy and safety of UEMR has not been demonstrated at multiple medical centers. Our aims were to demonstrate that (1) UEMR is a technique that can be easily learned by an endoscopist trained in traditional EMR, (2) endoscopic ultrasound (EUS) may not be required before UEMR, and (3) UEMR is an efficacious and safe method for resection of large or flat neoplastic colorectal lesions. METHODS: An experienced interventional endoscopist began performing UEMR after observing UEMR procedures. Colorectal UEMR was performed using a pediatric colonoscope with a cap, a waterjet, and a 'duck-bill' snare using blended current. Submucosal injection was not used. Patient data were collected prospectively. RESULTS: A total of 21 patients (17 men, mean age 64.9 years, range 51-83) referred for polypectomy of large colorectal lesions underwent UEMR. A total of 43 colorectal lesions with a mean size of 20 mm (range 8-50) were resected by UEMR. Lesions were found in the right colon (N = 16), transverse colon (N = 5), left colon (N = 19), and rectum (N = 3). Pathology demonstrated tubular adenoma (N = 29), tubulovillous adenoma (N = 5), high-grade dysplasia (N = 3), serrated sessile adenoma without dysplasia (N = 3), and non-neoplastic tissue (N = 3). EUS was used in only two cases of rectal neoplasia (4.7 %). Of the UEMRs, 97.7 % were successful with complete resection of colorectal polyps. The only adverse event was one case (2.3 %) of delayed post-UEMR bleeding. CONCLUSIONS: UEMR was easily learned by an endoscopist already skilled in conventional EMR. EUS may not be required prior to most UEMR procedures. UEMR appears to be an efficacious and safe alternative to traditional EMR or ESD for large or flat colorectal neoplasms.

Risk of renal dysfunction after less invasive multivessel coronary artery bypass grafting.

OBJECTIVE: Several centers have established that off-pump, multivessel coronary artery bypass grafting performed via a small thoracotomy (MVST) is feasible. However, this procedure can be challenging when posterolateral coronary targets need to be grafted. We hypothesized that use of cardiopulmonary bypass via peripheral access (MVST-PA) would improve outcomes compared with a completely off-pump approach (OP-MVST). METHODS: This was a prospective observational study of patients undergoing OP-MVST (n = 46) versus MVST-PA (n = 45) using bilateral internal mammary artery grafts onto the left anterior descending coronary artery and circumflex/right coronary artery distribution. Hemostasis was quantified by measuring platelet function (aggregometry), chest tube output, thrombolysis in myocardial infarction bleeding score (%hematocrit change at 24 hours), and transfusion requirements. The rate of mortality and major morbidity at 30 days was defined according to The Society of Thoracic Surgeons criteria. Estimated glomerular filtration rate (normalized to baseline levels) was determined daily until discharge. RESULTS: The OP-MVST versus MVST-PA groups had similar risk factors at baseline and risks of composite morbidity/mortality at 30 days. However, renal failure was significantly increased after OP-MVST (10.87 vs 0%, P = 0.05), and MVST-PA affected hemostasis as evidenced by inhibition of platelet function (latency to response on aggregometry, 29.9 vs 17.9 seconds; P = 0.04) and higher transfusion requirement (2.31 vs 0.85 units of red blood cells/patient, P = 0.04; 55.6% vs 34.8% transfused; P = 0.059). However, 24-hour chest tube output was similar (645 vs 750 mL; P = 0.53). CONCLUSIONS: In comparison with a completely off-pump strategy, use of cardiopulmonary bypass to assist MVST reduced the risk of renal dysfunction with only modest tradeoffs in other morbidities, for example, altered coagulation and higher transfusion requirements. These data justify further study of the effect of MVST-PA on renal complications.

Comparing an olive oil-enriched diet to a standard lower-fat diet for weight loss in breast cancer survivors: a pilot study.

BACKGROUND: Traditional diets that include moderate to high intakes of extra virgin olive oil have been related to a decrease in breast cancer risk. We hypothesized that an olive oil-enriched diet would lead to greater weight loss and acceptance, compared with a standard diet, in women previously diagnosed with invasive breast cancer. METHODS: Participants consumed a National Cancer Institute (NCI) diet (total fat > 15% and < 30%) and a plant-based olive oil diet (PBOO; > or = 3 tablespoons of olive oil/day) for 8 weeks, each with random assignment to the order. We established a weight loss goal of at least 5% of baseline weight. After completion of the two diet trials, each participant self-selected one of the diets for an additional 6 months of follow-up for weight management. Body measures were done before and after each diet and after follow-up; fasting blood samples were collected after each diet and after follow-up. RESULTS: Forty-four overweight women started and 28 completed the 44-week protocol. Twelve (80%) of the 15 women who started with the PBOO diet achieved a weight loss of > or = 5% compared to 4 (31%) of the 13 who started with the NCI diet (p < 0.01). Nineteen of the 22 women eligible for follow-up chose the PBOO diet, and all completed the study. Of the 3 women who chose the NCI diet for follow-up, 1 completed the study. The PBOO diet resulted in lower triglycerides (NCI 105 +/- 46 mg/dL, PBOO 96 +/- 37 mg/dL, p = 0.06) and higher high-density lipoprotein cholesterol (HDL-C) (NCI 64 +/- 13 mg/dL, PBOO 68 +/- 12 mg/dL, p = 0.001). CONCLUSIONS: An olive oil-enriched diet brought about greater weight loss than a lower-fat diet in an 8-week comparison. Moreover, these women chose, overwhelmingly, the olive oil-enriched diet for 6 months of follow-up. An olive oil-enriched diet may be more efficacious for weight loss in breast cancer survivors than a standard lower-fat diet.