Italian and Middle Eastern adherence to Mediterranean diet in relation to Body Mass Index and non-communicable diseases: nutritional adequacy of simulated weekly food plans.

BACKGROUND: The Mediterranean diet (MD), known to prevent obesity, overweight and the related non communicable diseases (NCD), is based on typical dishes, foods and on a common cultural milieu. Although MD is the basis of dietary guidelines, the prevalence of obesity, overweight and NCD, is increasing both in Western regions, and even more in Middle Eastern regions (MER). This study aimed to analyze (i) the impact of different levels of adherence to the MD, in Italy and MER, on body mass index (BMI) (ii) the bromatological composition of a simulated 7-days food plan (7-DFP) based on Italian or MER typical meals, following MD criteria and the Italian or MER food base dietary guideline; (iii) the optimization of nutrients impacting on NCD. METHODS: The 7-DFPs were implemented using a dietary software. The association between adherence to MD and BMI was evaluated by pooled estimated ORs (with 95% confidence intervals and p-values). Pooled measures were obtained by the methods appropriate for meta-analysis. The different food-based guidelines have been compared. RESULTS: The pooled ORs of obese status comparing medium vs. high adherence to MD were: 1.19 (95% C.I.: 0.99; 1.42, p-value = 0.062) and 1.12 (95% C.I.: 0.90; 1.38, p-value = 0.311) for MER and Italy respectively. For the comparison of low vs. high adherence, the pooled ORs were 1.05 (95% C.I.: 0.88; 1.24, p-value = 0.598) for MER, and 1.20 (95% C.I.: 1.02; 1.41, p-value = 0.031) for Italy when outliers are removed. High adherence to the MD resulted as potential protective factor against obesity. In MER 7-DFP: total fats is higher (34.5 E%) vs. Italian 7-DFP (29.4 E%); EPA (20 mg) and DHA (40 mg) are lower than recommended (200 mg each); sugars (12.6 E%) are higher than recommended (< 10 E%). Calcium, Zinc, and vitamin D do not reach target values in both 7-DFPs. CONCLUSION: This study highlights that, even when 7-DFPs follow MD and refer to nutrient needs, it is necessary to verify nutrient excesses or deficits impacting on NCD. High MD adherence is protective toward NCDs. MD principles, and energy balance should be communicated according to socioeconomic and educational levels.

Dietary intake and adherence to the Mediterranean diet in semi-professional female soccer players: a cross-sectional study.

Background: Adequate energy and nutrient intakes in athletes contribute to optimal performance and recovery, decrease the risk of injury, and help preserve athletes' health. The Mediterranean diet (MD) is considered suitable for covering the nutritional needs of athletes, while contributing to improve eating habits. The aim of the present study was to investigate the energy and nutrient intakes of semi-professional female soccer players and their adherence to the MD, during the competitive season. Methods: A cross-sectional observational study was conducted on twenty-three female soccer players, who were invited to fill in a 3-day food diary twice, one month apart, to assess their energy and nutrient intakes and a validated questionnaire (MEDI-LITE) to evaluate their adherence to MD. Exercise energy expenditure during three training and match-play days was monitored by GPS. Results: On average, the participants consumed 1,981 kcal/day, with 44% of their energy deriving from carbohydrates, 21% from protein, and 34% from fat; the mean MD adherence score was 10.1 ± 1.8, corresponding to a good MD adherence. A substantial percentage of athletes were at risk of insufficient nutrient intakes for vitamin D (100%), iodine (87%), potassium (87%), vitamin E (39%), iron and zinc (17 and 30%, respectively). Conclusion: The evaluation of the dietary intake in female soccer players showed energy deficiency in relation to training level, mainly due to the insufficient intake of carbohydrates, and micronutrient deficiencies. The technical staff should promote adequate consumption of starchy foods in female athletes and emphasize the importance of a proper distribution of energy intake among different eating occasions, including snacks. Periodic monitoring of the nutritional status of micronutrients (vitamin D and some minerals) could help reduce deficiency risk. Over all, nutrition education to improve eating habits of athletes seems worthy of attention, in order to preserve athletes' health and performance.

Exploring the Relationship between Mediterranean Diet Adherence and Subjective Well-Being among Greek and Cypriot Adults.

Associations between subjective well-being (SWB) and dietary habits, employment status, and habitual activities are increasingly capturing the focus of researchers as well as policymakers worldwide. This study aimed to explore these associations in a sample of the population in Greece and Cyprus via an online survey. In total, 936 questionnaires (470: Cyprus, 466: Greece) were analyzed to study the associations between the Mediterranean Diet (MD) (using the 14-item MEDAS score, (14-MEDAS)), subjective well-being (SWB), and several socioeconomic factors. Key remarks of this survey highlight the positive impact of MD adherence on some well-being items. Namely, statistically significant differences were found on the following items: Satisfied with life (p < 0.001), Life worthwhile (p < 0.001), Feeling happy (p < 0.001), worried (p = 0.005), and depressed (p = 0.001), when comparing Low MD adherence (14-MEDAS < 5) to High MD adherence (14-MEDAS > 10). Other lifestyle habits such as spending time with friends and family, spending time in nature, and habitual physical activity were associated with aspects of SWB such as Life satisfaction, Life worthwhile, Feeling happy, and energetic. The findings support adherence to the MD, since it is associated with higher life satisfaction and self-reported happiness in this sample and should be considered when developing health policies on well-being.

Short-Term Effect of a Health Promotion Intervention Based on the Electronic 12-Hour Dietary Recall (e-12HR) Smartphone App on Adherence to the Mediterranean Diet Among Spanish Primary Care Professionals: Randomized Controlled Clinical Trial.

BACKGROUND: The World Health Organization has called for addressing the growing burden of noncommunicable diseases (NCDs) by promoting healthy lifestyles among the population. Regarding patient health, primary care professionals (PCPs) are the first line of care who can positively influence patients' behavior and lifestyle habits. However, a significant percentage of PCPs do not lead a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. The Mediterranean diet has been extensively studied, and there is strong evidence of it being a dietary pattern for the prevention of NCDs, in addition to its significant environmental, sociocultural, and local economics benefits. OBJECTIVE: This study focused only on the dietary aspect of the PCPs' lifestyle. The primary objective was to evaluate the effect of using the Electronic 12-Hour Dietary Recall (e-12HR) smartphone app to improve diet, specifically to promote adherence to the Mediterranean diet (AMD), among PCPs. The secondary objectives were to establish the usability of the e-12HR app and to determine AMD among PCPs. METHODS: An individual-level randomized, controlled, and single-blind clinical trial was conducted with 2 parallel groups: a control group (CG), using the nonfeedback version of the e-12HR app, and an intervention group (IG), using the feedback version of the e-12HR app. The level of human involvement was fully automated through the use of the app. There was a 28-day follow-up period. Participants were PCPs (medicine or nursing) recruited offline at one of the selected primary care centers (Andalusia, Spain, Southern Europe), of both sexes, over 18 years old, possessing a smartphone, and having smartphone literacy. RESULTS: The study response rate was 73% (71 of 97 PCPs), with 27 (38%) women and 44 (62%) men: 40 (56%) PCPs in the CG and 31 (44%) in the IG. At baseline, AMD was medium (mean Mediterranean Diet Serving Score [MDSS] index 9.45, range 0-24), with 47 (66%) PCPs with a medium/high MDSS index. There were significant statistical improvements (CG vs IG, in favor of the IG) at week 4 (no significant statistical differences at baseline): +25.6% for the MDSS index (P=.002) and +213.1% for the percentage with a medium/high MDSS index (P=.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P=.02), vegetables (+352%, P=.001), nuts (+184%, P=.02), and legumes (+75.1%, P=.03). The responses to the usability rating questionnaire were satisfactory. CONCLUSIONS: The results support recommending the use of the e-12HR app as a tool to contribute to improving diet and preventing NCDs among PCPs, while positively influencing patient dietary behavior and preventing diet-related NCDs among patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT05532137; https://clinicaltrials.gov/study/NCT05532137.

Lifestyle Behaviours, Self-Esteem and Academic Performance in Primary Education Students-A Structural Equation Model According to Sex and School Type.

(1) Background: The present study aimed to examine the relationship between physical activity (PA), screen time (ST), maximal oxygen uptake (VO2max), Mediterranean diet (MD) adherence, self-esteem (SE) and academic performance (AP) in primary education students. In order to address this aim, an explanatory model was developed to examine the existing relationships between PA, ST, VO2max, MD adherence, SE and AP. Further, the proposed structural model was examined via multi-group analysis as a function of sex and school type. (2) Methods: A non-experimental, descriptive, comparative and cross-sectional study was designed with a total sample of 269 Spanish students (11.29 ± 0.62). Validated questionnaires were administered to collect data on study variables. (3) Results: Relative to boys, girls reported better academic grades and showed a stronger positive relationship between MD adherence and AP, MD adherence and PA, and VO2max and SE. Likewise, girls showed a stronger negative relationship between ST and VO2max, and ST and MD adherence. At the same time, mixed funding school (MFS) students reported higher PA engagement than state school (SS) students. However, SS students reported better MD adherence, ST and AP than MFS students. Further, a stronger positive relationship was found in SS students between MD adherence or VO2max and SE than in MFS students. Also, within the former group, ST was more negatively related to MD adherence and VO2max. (4) Conclusions: Scientific and educational communities must develop future strategies that consider potential determinants in order to target more desirable outcomes.

Are there differences between Mediterranean diet and the consumption of harmful substances on quality of life?-an explanatory model in secondary education regarding gender.

Background: Adolescence is a key life stage in human development. It is during this stage of development that healthy and physical behaviors are acquired that will last into adulthood. Gender differences in the acquisition of these behaviors have been observed. This research aims to (a) study the levels of Mediterranean diet adherence, quality of life and alcohol and tobacco consumption as regarding the gender of the participants and (b) study the effects of the variable adherence to the Mediterranean diet, alcohol consumption and tobacco consumption on quality of life as a function of the gender of the participants. Methods: A non-experimental, cross-sectional, exploratory study was carried out in a sample of 1,057 Spanish adolescents (Average Age = 14.19; Standard Deviation = 2.87). Results: The comparative analysis shows that the male teenagers shows a higher Mediterranean diet adherence compared to the male adolescents (p ≤ 0.05) and a higher consumption of alcoholic beverages (p ≤ 0.05). On the contrary, adolescent girls show a higher consumption of alcoholic beverages than male participants (p ≤ 0.05). The exploratory analysis indicates that for boys, alcohol consumption has a beneficial effect on the quality of life of adolescents (ß = 0.904; p ≤ 0.001). Conclusion: In this case, participants show differences in the levels of Mediterranean diet adherence, consumption of harmful substances and quality of life according to gender. Likewise, there are different effects between the variables according to gender. Therefore, gender is a key factor to consider during adolescence.

Adherence to Mediterranean diet and dietary changes according to the fear of COVID-19 during the pandemic: a cross-sectional study.

The coronavirus disease 2019 (COVID-19) has led to the implementation of restrictions to reduce transmission worldwide. The restrictions and measures have affected the psychological health and eating habits. The objective of the present study was to evaluate dietary habits, lifestyle changes, adherence to the Mediterranean diet (MD) and fear of COVID-19 in Turkey during the pandemic. A cross-sectional online survey of socio-demographic characteristics, anthropometric measurements, nutrition, physical activity and lifestyle habits was used for data collection. The fear of COVID-19 levels of the participants was determined by the fear of COVID-19 scale (FCV-19S). The Mediterranean Diet Adherence Screener (MEDAS) was used to evaluate participants' adherence to the MD. The differences between the FCV-19S and MEDAS according to gender were compared. Eight hundred and twenty subjects (76⋅6 % women and 28⋅4 % men) were evaluated within the study. The mean of MEDAS (ranged between 0 and 12) was 6⋅4 ± 2⋅1, and almost half of the participants moderately adhered to the MD. The mean of FCV-19S (ranged between 7 and 33) was 16⋅8 ± 5⋅7, while women's FCV-19S and MEDAS were significantly higher than men's (P < 0⋅001). The consumption of sweetened cereals, grains, pasta, homemade bread and pastries of the respondents with high FCV-19S were higher than in those with low FCV-19S. High FCV-19S was also characterized by decreased take-away food and fast food consumption in approximately 40 % of the respondents (P < 0⋅01). Similarly, women's fast food and take-away food consumption decreased more than men's (P < 0⋅05). In conclusion, the respondents' food consumption and eating habits varied according to the fear of COVID-19.

Adherence to Mediterranean Diet: A Population-Based Longitudinal Cohort Study.

Adherence to the Mediterranean diet (MedDiet) is recommended for cardiovascular disease prevention. However, recent epidemiological studies report a shift toward lower adherence to MedDiet. We have conducted a prospective cohort study to evaluate changes in individual determinants of MedDiet adherence over time. Clinical information and MedDiet adherence score (MEDAS) were collected in 711 subjects (mean age 68 ± 10 years; 42% males), enrolled in the PLIC study (Progression of Intimal Atherosclerotic Lesions in Carotid arteries), during two visits conducted, on average, 4.5 years apart. MEDAS score worsening and improvements (absolute change, ΔMEDAS) and the variation in the proportion of subjects reporting to meet each MEDAS criteria were assessed. Overall, 34% of the subjects improved their MedDiet adherence (ΔMEDAS: +1.87 ± 1.13), by consuming more olive oil, legumes and fish and use of dishes seasoned with sofrito and 48% subjects worsened their MedDiet adherence (ΔMEDAS: -2.02 ± 1.14) by consuming less fruit, legumes, fish and nuts, with higher rates of worsening in women and subjects aged 50-65 years. Subjects who improved the score were more obese, had higher plasma glucose levels, and metabolic syndrome at the basal visit. In summary, we report an overall decrease in MedDiet adherence, evaluated during a timeframe heavily affected by the COVID-19 pandemic, underlining the need for better dietary interventions.

Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial.

There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).

Investigating the Dietary Intake Using the CyFFQ Semi-Quantitative Food Frequency Questionnaire in Cypriot Huntington's Disease Patients.

Huntington's disease (HD) is a rare progressive neurodegenerative disease characterised by autosomal dominant inheritance. The past decade saw a growing interest in the associations between the Mediterranean Diet (MD) and HD risk and outcomes. The aim of this case-control study was to assess the dietary intake and habits of Cypriot HD patients, comparing them to gender and age-matched controls, using the Cyprus Food Frequency Questionnaire (CyFFQ) and to assess adherence to the MD by disease outcomes. The method relied on the validated CyFFQ semi-quantitative questionnaire to assess energy, macro- and micronutrient intake over the past year in n = 36 cases and n = 37 controls. The MedDiet Score and the MEDAS score were used to assess adherence to the MD. Patients were grouped based on symptomatology such as movement and cognitive and behavioral impairment. The two-sample Wilcoxon rank-sum (Mann-Whitney) test was used to compare cases vs. controls. Statistically significant results were obtained for energy intake (kcal/day) (median (IQR): 4592 (3376) vs. 2488 (1917); p = 0.002) from cases and controls. Energy intake (kcal/day) (median (IQR): 3751 (1894) vs. 2488 (1917); p = 0.044) was also found to be significantly different between asymptomatic HD patients and controls. Symptomatic patients were also different from controls in terms of energy intake (kcal/day) (median (IQR): 5571 (2907) vs. 2488 (1917); p = 0.001); % energy monounsaturated fatty acids (median (IQR): 13.4 (5.2) vs. 15.5 (5.7); p = 0.0261) and several micronutrients. A significant difference between asymptomatic and symptomatic HD patients was seen in the MedDiet score (median (IQR): 31.1 (6.1) vs. 33.1 (8.1); p = 0.024) and a significant difference was observed between asymptomatic HD patient and controls (median (IQR): 5.5 (3.0) vs. 8.2 (2.0); p = 0.014) in the MEDAS score. This study confirmed previous findings that HD cases have a significantly higher energy intake than controls, revealing differences in macro and micronutrients and adherence to the MD by both patients and controls and by HD symptom severity. These findings are important as they are an effort to guide nutritional education within this population group and further understand diet-disease associations.

Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study.

Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: 'feedback' e-12HR (IG) and 'non-feedback' e-12HR (CG). Only the 'feedback' e-12HR had two specific automatic functions: 1. Evaluation of the user's AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students.

High Adherence to the Mediterranean Diet is Associated with Higher Physical Fitness in Adults: a Systematic Review and Meta-Analysis.

Although prior research has synthesized the relationships between the Mediterranean diet (MD) and components of physical fitness (PF) in adults, they are limited and inconclusive. This study aimed to synthesize the associations between high (compared with low) MD adherence and PF levels with each of its components (cardiorespiratory, motor, and musculoskeletal) in adulthood. We conducted a systematic search in 5 databases from inception to January 2022. Observational studies and randomized controlled trials were included. Pooled odds ratios (ORs) and effect sizes (Cohen d index) with their 95% CIs were calculated via a random effects model. A total of 30 studies were included (19 cross-sectional in young, middle-aged, and older adults; 10 prospective cohort in older adults; and 1 randomized controlled trial in young adults) involving 36,807 individuals (mean age range: 20.9-86.3 y). Pooled effect sizes showed a significant cross-sectional association between higher MD adherence scores (as a continuous variable) and overall PF (d = 0.45; 95% CI: 0.14, 0.75; I2 = 91.0%, n = 6). The pooled ORs from cross-sectional data showed that high adherence to MD was associated with higher cardiorespiratory fitness (OR: 2.26; 95% CI: 2.06, 2.47; I2 = 0%, n = 4), musculoskeletal fitness (OR: 1.26; 95% CI: 1.05, 1.47; I2 = 61.4%, n = 13), and overall PF (OR: 1.44; 95% CI: 1.20, 1.68; I2 = 83.2%, n = 17) than low adherence to MD (reference category: 1). Pooled ORs from prospective cohort studies (3- to 12-y follow-up) showed that high adherence to MD was associated with higher musculoskeletal fitness (OR: 1.20; 95% CI: 1.01, 1.38; I2 = 0%, n = 4) and overall PF (OR: 1.14; 95% CI: 1.02, 1.26; I2 = 9.7%, n = 7) than low adherence to MD (reference category: 1). Conversely, no significant association was observed between MD and motor fitness. High adherence to MD was associated with higher PF levels, a crucial marker of health status throughout adulthood. This trial was registered at PROSPERO as CRD42022308259.

Adherence to the Mediterranean Diet of Pregnant Women in Central South Africa: The NuEMI Study.

Introduction: The Mediterranean diet (MeD) has been shown to have significant health benefits for adults and children. A mother's diet during pregnancy directly impacts the health of her offspring. This study aimed to investigate the adherence to the MeD of pregnant women attending antenatal care at a Regional Hospital in Bloemfontein, South Africa (SA). Methods: A cross-sectional study was conducted on a consecutive sample of 681 pregnant women who attended the antenatal clinic of a Regional Hospital in Bloemfontein. Socio-demographics included: age, highest level of education, household income, employment status, and income stability. Food group intake was assessed with a quantitative food frequency questionnaire. The adapted Mediterranean Diet Adherence Screener (MeDAS) consisted of 13 of the original 14 questions that measured intake of key food groups (score of ⩽7 poor, 8-9 moderate, ⩾10 good) (wine intake was excluded for pregnant women). Results: A total of 681 pregnant women with a median age of 31.8 years (IQR: 26.8-36.5 years) and a median gestational age of 32.0 weeks at the time of the interview participated in the study. The vast majority showed poor adherence to the MeD (99.6%), with only 0.4% (n = 3) having moderate adherence and 0% good adherence. The median adherence score was 5 points and the maximum 8 points. Of those with poor adherence, only 11.5% had tertiary education, 43.2% earned less than R 3000 (<201 USD) per month, 52.5% were unemployed, and 42.0% did not have a stable income in the past 6 months. Of the 3 participants with moderate adherence, all had grade 11 to 12 education, 2 out of the 3 earned more than R3000 (201 USD), one was unemployed, and 2 had a stable income over the past 6 months. Compared to those with an income ⩽ R3000 (⩽201 USD), those with an income above R3000 were significantly more likely to eat nuts (including peanuts) (2.0% vs 4.6%, P = .05), and adhere to sofrito (similar to tomato and onion relish) intake (9.2% vs 15.6%, P = .02). Compared to those who only had a primary education level up to grade 10 (n = 229), those who had a secondary education level or more (grade 11 and higher, n = 452) were significantly more likely to consume enough olive oil per day (1.3% vs 5.0%, P = .01), and to consume sofrito (6.6% vs 18.0%, P = .02). Conclusion: Pregnant participants showed poor adherence to the MeD. Although almost all women fell in the poor adherence group, secondary education contributed to consuming recommended amounts of olive oil and sofrito and higher income was associated with an adequate intake of nuts and sofrito. Based on the findings, we recommend the development of a contextualized MeDAS tool that includes foods that are typically eaten by most South Africans for similar MeD benefits.

Sport motivation, adherence to the mediterranean diet and digital leisure. An explanatory model for gender in education students / Motivación deportiva, adherencia a la dieta mediterránea y ocio digital. Un modelo explicativo en estudiantes de educación en función del sexo

The motivation developed towards sport plays a key role in the adherence to a healthy dietary pattern, however, it also plays an important role towards digital entertainment. Taking this into account, the present study aims to develop an explanatory model of the incidence of sport motivation on adherence to a healthy dietary pattern and adherence to video games and to contrast the structural model by means of a multi-group analysis according to gender. To this end, a cross-sectional descriptive comparative study was carried out with 1112 participants (25.09±6.22). The instruments used were a sociodemographic questionnaire, the Predimed questionnaire, the Perceived Motivational Climate in Sport Questionnaire (PMCSQ-2) and the Video Game Related Experiences Questionnaire (CERV). Finally, the results reveal that the female sex obtains a negative relationship between sport motivation and digital leisure, while the male sex reflects a negative relationship between task climate and adherence to the Mediterranean diet. (AU)

La motivación desarrollada hacia el deporte juega un papel clave en la adherencia a un patrón dietético saludable, sin embargo, también juega un papel importante hacia el ocio digital. El presente estudio pretende desarrollar un modelo explicativo de la incidencia de la motivación hacia el deporte en la adherencia a un patrón dietético saludable y la adicción a los videojuegos y contrastar el modelo estructural mediante un análisis multigrupo en función del sexo de los participantes. Para ello se realizó un estudio descriptivo comparativo transversal con 1112 participantes (25,09±6,22). Los instrumentos utilizados fueron un cuestionario sociodemográfico, el cuestionario Predimed, el Cuestionario de Clima Motivacional Percibido en el Deporte (PMCSQ-2) y el Cuestionario de Experiencias Relacionadas con los Videojuegos (CERV). Finalmente, los resultados revelan que el sexo femenino obtiene una relación negativa entre la motivación deportiva y el ocio digital, mientras que el sexo masculino refleja una relación negativa entre el clima de tarea y la adherencia a la dieta mediterránea. (AU)

Urinary metabolic biomarkers of diet quality in European children are associated with metabolic health.

Urinary metabolic profiling is a promising powerful tool to reflect dietary intake and can help understand metabolic alterations in response to diet quality. Here, we used 1H NMR spectroscopy in a multicountry study in European children (1147 children from 6 different cohorts) and identified a common panel of 4 urinary metabolites (hippurate, N-methylnicotinic acid, urea, and sucrose) that was predictive of Mediterranean diet adherence (KIDMED) and ultra-processed food consumption and also had higher capacity in discriminating children's diet quality than that of established sociodemographic determinants. Further, we showed that the identified metabolite panel also reflected the associations of these diet quality indicators with C-peptide, a stable and accurate marker of insulin resistance and future risk of metabolic disease. This methodology enables objective assessment of dietary patterns in European child populations, complementary to traditional questionary methods, and can be used in future studies to evaluate diet quality. Moreover, this knowledge can provide mechanistic evidence of common biological pathways that characterize healthy and unhealthy dietary patterns, and diet-related molecular alterations that could associate to metabolic disease.

Has COVID-19 Changed the Lifestyle and Dietary Habits in the Spanish Population after Confinement?

Since 2020, the world has been immersed in a change in lifestyle (social, lifestyle, nutri-tion and physical activity patterns), due to the appearance of COVID-19 and the strict mobility measures which were implemented to prevent its spread. All these changes had a nutritional impact on people, modifying their dietary guidelines. This cross-sectional study was carried out to assess whether dietary habits, lifestyle, and adherence to the Mediterranean diet among the Spanish adult population (25-65 years old) during confinement was modified during the post-confinement period, using an e-survey through social networks, involving 510 subjects. A decrease in the intake of ultra-processed products, with a correlation between weekly food delivery orders at home and the consumption of salty snacks, sugary drinks, and processed pastries was also recorded. Most of the subjects performed physical exercise on a regular basis, maintaining the body weight in half of the participants. During the post-confinement period a substantial proportion of the population had healthy lifestyle and dietary habits, including the adequate consumption of fruits, vegetables and legumes; adequate time was spent preparing meals and the population did not regularly order food at home, which in the long term, reduced the risk of several diseases.

Impact of the Level of Adherence to Mediterranean Diet on the Parameters of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies.

High adherence to the Mediterranean diet (MD) has been associated with a lower prevalence of Metabolic Syndrome (MetS). The present study aimed to investigate the impact of MD adherence on parameters of MetS. A systematic literature search was performed in PubMed, Cochrane Central Registry of Clinical Trials (CENTRAL), Scopus, EMBASE, Web of Science and Google Scholar databases. Observational studies that recorded adherence to MD and components/measures of the MetS, such as waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG), high-density lipoprotein (HDL) cholesterol and triglycerides (TG), were included in this study. A total of 58 studies were included in our study. WC and TG were significantly lower in the high adherence MD group (SMD: -0.20, (95%CI: -0.40, -0.01), SMD: -0.27 (95%CI: -0.27, -0.11), respectively), while HDL cholesterol was significantly higher in the same group (SMD: -0.28 (95%CI: 0.07, 0.50). There was no difference in FBG and SBP among the two groups (SMD: -0.21 (95%CI: -0.54, 0.12) & SMD: -0.15 (95%CI: -0.38, 0.07), respectively). MD may have a positive impact on all parameters of MetS. However, further research is needed in this field.

An Italian Survey on Dietary Habits and Changes during the COVID-19 Lockdown.

The World Health Organization has declared the coronavirus outbreak a Public Health Emergency of International Concern; the outbreak has led to lockdowns in several parts of the world, and sudden changes in people's lifestyles. This study explores the impact of the first coronavirus disease 2019 (COVID-19) pandemic period on dietary habits, lifestyle changes, and adherence to the Mediterranean diet among the Italian population, through an online questionnaire, conducted from April to May 2020, involving 1519 participants. The 14-point Mediterranean Diet Adherence Screener (MEDAS) highlighted a medium Mediterranean diet adherence in 73.5% of responders, which principally included the younger population, aged 18-30 years (p < 0.05). In regards to changes in eating habits, 33.5% of responders declared an influence of the pandemic period on nutritional practice. A decrease in alcohol consumption was reported by 81% of responders, while an increase in frozen food consumption was reported by 81.3% of responders. In addition, 58.8% reported positive weight modification (40.8%, +1-3 kg); physical activity reduction was reported for 70.5% of responders. Our study contributes toward amplifying the investigation on the dietary habits and changes of the Italian population during the COVID-19 lockdown, although the pandemic is ongoing. Similar studies should be performed around the world to understand how the emergency has impacted people's habits.

The impact of COVID-19 confinement on the eating habits and lifestyle changes: A cross sectional study.

Novel coronavirus (COVID-19) emerged in December 2019 in the city of Wuhan, China causing severe respiratory infections and resulting in millions admissions to hospital and over a million deaths worldwide. Authorities imposed protective measures including confinement to flatten curves of casualties resulted in sudden lifestyle and eating habit changes. The objectives of this study were to observe the impact of the COVID-19 lockdown on eating behavior and lifestyle of the Kurdish population in Iraqi Kurdistan. A structured cross-sectional study was conducted from 1st to 14th of June when the lockdown finished with three different sections. Section one (6 questions) included socio-demographic information section two (11 questions) composed of dietary behavior information including a) Mediterranean diet (MD) adherence using 14-scaled items with a MD screener tool ranging from 0 to 14 b) and sections three (12 questions) composed of lifestyle habit changes such as physical activity, sleeping behavior, and smoking habit. The total number of included respondents was 2,137. The results showed that 12.0% (256) of participants stated that their lifestyle was improved, whereas 50.9% (1,087) declared their lifestyle deteriorated. In particular, the frequency of physical activity was decreased (McNemar value = 60.53, p <.001) and sleeping hours were significantly increased during lockdown (McNemar value = 447.93, p <.001). Regarding eating habits, it was noticed that 29.3% and 14.3% felt that appetite increased and decreased, respectively. The appetite change during lockdown was significantly associated with age (p =.0001), gender (p =.001), city (p =.007), and BMI (p =.001). Similarly, 32.4% reported weight gain. In conclusion, this study is among the earliest studies showing the effect of COVID-19 on eating behavior and lifestyle changes. COVID-19 confinement had a significant effect on lifestyle particularly reducing physical activity and changing eating habits.

Impact of COVID-19 confinement on eating behaviours across 16 European countries: The COVIDiet cross-national study.

We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0-100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.