Promotion of the mediterranean diet incancer long-survivors by means of the Med-Food Anticancer Program: a pilot study.

BACKGROUND: The intervention "Med-Anticancer Food Program" has proven to be effective in promoting the Mediterranean Diet, significantly increasing the Mediterranean Adequacy Index in healthy subjects. There are no studies that have investigated the effectiveness of this intervention in individuals who have had a diagnosis of cancer. OBJECTIVE: To perform a pilot study to assess the opportunity of employing the methodology of the Med-Anticancer Food Program in order to encourage "long-term cancer survivors" to adhere to the Mediterranean Diet, as well as healthy people, and this in order to apply the program to larger groups. METHODS: From the residents' register of Foggia, a city in southern Italy, forty adults of both sexes, over 25 years of age, were recruited at random and assigned (1:1) as follows: - Twenty healthy subjects to the intervention-1 group - Twenty long-term cancer survivors to the intervention-2 group. The Med-Anticancer Food Program was applied to both groups with an articulated intervention 11 weeks long, followed by a 52-week period of follow up. By means of a food diary of the last 3 days, the Mediterranean Adequacy Index values were calculated before intervention (T0), after a period of 11 weeks of interventions (T1) and at the end of the 52 weeks of follow-up period (T2). The H0 hypothesis of the study was that there are no differences between the two interventions in reaching by T1, and maintaining at T2, values of Mediterranean Adequacy Index around 7, considered the optimum for adherence to the Mediterranean diet. RESULTS: Out of the subjects assigned to the intervention-1 group (n = 20), 11 subjects have completed the 52-months follow-up (55.0% ); for intervention-2, 16 (80%) out of 20 have completed it. The average age of subjects was 52.1 years. The Mediterranean Adequacy Index, of intervention-1 group significantly increased from 2.8 (T0) to 9.2 (T1) and to 9.0 (T2) (p <0.0001); whereas, in the intervention-2 group, Mediterranean Adequacy Index moved from 2.4 (T0) to 10.2 (T1) and to 9.3 (T2) (p <0.0001). The difference of Mediterranean Adequacy Index between the two study groups at T1 and T2 was not significant. Such non-significance persists also after the stratification by sex and age obtained with Mantel-Haenszel procedure. The performance of the values of the laboratory parameters considered (folic acid, total cholesterol, alkyl resorcinol) was similar in the subjects of both intervention 1 and 2, without any difference, while considered at a basal level T0, at T1 and at the end of the follow-up period (T2). CONCLUSIONS: The results of our work suggest the feasibility of conducting the Med-Anticancer Food Program in long-term cancer survivors. The results of the pilot study show that such intervention, carried on a small number of long term cancer survivors, is adequate to assess its feasibility but, due to the limited size of our study, a confirmation is required through larger nutritional prevention intervention studies.

Training the teachers for improving primary schoolchildren's fruit and vegetables intake: a randomized controlled trial.

Effectiveness comparison of different school-based nutrition education interventions to improve fruit and vegetable (F&V) consumption in schoolchildren not yet well researched. We evaluated the effectiveness of two school-based interventions promoting fruit and vegetable intake among Italian schoolchildren. In this randomized intervention trials, the first intervention was conducted by schoolteachers who attended a nutritionist-led training course (group-1), the second intervention conducted by schoolteachers who performed a self-training course (group-2). Thirty-two second to fifth-grade elementary classes enrolling 96 schoolteachers and 813 schoolchildren were randomized, and assigned to the two different nutrition education interventions. 804 students completed the study. By the end of the study, the group-1 (n = 409) followed by the teachers who attended a nutritionist-led course successfully increased the consumption of fruit and vegetables: in 183 (44.7%) and 157 (38.3%) schoolchildren respectively; the group-2 (n = 395) with teachers who performed a self-training course reported an increased consumption of fruit and vegetables in 81 (20.5%) and 76 (19.2%), respectively. This study indicates that a school-based nutrition education conducted by teachers who attended a nutritionist-led training course has a significant impact on primary school-age children's F&V intake.

Randomized, controlled nutrition education trial promotes a Mediterranean diet and improves anthropometric, dietary, and metabolic parameters in adults.

Several studies have shown that uptake of a Mediterranean diet could prevent many chronic diseases, such as cancer. However, the effectiveness of Mediterranean diet promotion interventions has not been well researched. The aim of this study was to evaluate the effectiveness of a nutrition education intervention for promoting the Mediterranean diet, by assessing changes in anthropometric, physical activity, dietetic and metabolic parameters in healthy adult subjects, before and after the intervention. Eighty participants, both sexes, aged 51-59 years, were randomly assigned in a 1:1 ratio to the intervention or the control group. The intervention group participated in the Med-Food Anticancer Program (MFAP), designed to promote a Mediterranean diet. This was organized into 15 weeks of intensive training and 10 weeks of consolidation. Participants of the two groups were assessed at baseline (T0) and after 25 weeks (T1) for anthropometric, physical activity, dietetic, and metabolic parameters. The hypothesis was that subjects participating in MFAP would show an improvement in these parameters. The primary endpoint was an improvement of the Mediterranean Adequacy Index (MAI), calculated by dividing the percentage of total energy from typical Mediterranean food groups by the percentage of total energy from non-typical Mediterranean food groups. At T1, the intervention group showed a significant decrease in body weight (-8.3%, P = 0.045), body mass index (-12.4%, P = 0.05), cheese (53.0%, P < 0.0001) and meat (-49.3%, P = 0.005) intake, fasting glycaemia (-9.2%, P = 0.012), and fasting insulin (-32.6%, P = 0.014), C-Reactive Protein (-34.0%, P = 0.005). They showed a significant increase in MAI (+213, P < 0.0001), physical activity (expressed in steps per day, +200.4%, P < 0.0001), fruit (+38.8, P < 0.0001), vegetables (29.3%, P < 0.0001), and dietary fiber (+38.6%, P = 0.04) intake. In contrast, the control group presented non-significant variations in measured parameters, for exception of cheese intake (+18.2%, P < 0.0001). The MFAP was found to promote uptake of the Mediterranean diet, and improve anthropometric, physical activity, dietary, and metabolic parameters in healthy subjects.

[Nutrition prevention intervention for cancers: "Med-Food Anticancer Program"]. / L'intervento di prevenzione nutrizionale dei tumori: "Med-Food Anticancer Program".

Several studies recommend the Mediterranean diet and daily physical activity to prevent cancer development. These recommendations, however must be transformed into public health structured programmes, so that they assume operational effectiveness. The aim of the diet and lifestyle intervention called Med-Food Anticancer Program (MFAP) is to promote the Mediterranean diet and physical activity in the adult population. In particular; the target for participants in the intervention is the increased consumption of legumes, fish, whole grain bread and cereals, fruits and vegetables, and the decreased consumption of meat, cheese and foods of animal origin. At the same time, it is recommended to make at least ten thousand steps a day. Two studies have shown the effectiveness of MFAP.

15-week long school-based nutritional education program to promote Italian primary schoolchildren's fruit and vegetable intake.

A short-version (15-week long) of school-based nutrition education program called "Bring Fruit to School" to enhance primary schoolchildren's fruit and vegetable (F&V) intake was evaluated. We recruited 199 primary schoolchildren from 8 classes (grade 2-5). The primary end-point was an increase in the children's F&V intake. The intervention period lasted 15 weeks, and was divided into three phases: weeks 1-5, weeks 6-10 and weeks 11-15. The F&V intake of the schoolchildren was also monitored in a subsequent follow-up period (16th-32nd week). By week 15, 92 (46.2%, P < .001) schoolchildren increase fruit intake and 91 (45.7%, P < .001) increase vegetable intake. The F&V intake increased during the intervention period and was constant in follow-up. The BFtS program is an effective means to promote primary schoolchildren's F&V intake, and was implemented in Italy by the Food and Nutrition Service of Foggia's Local Health Authority. It could be extended to many other countries by local nutrition agencies, such as associations for nutrition.

[Bring fruit at school: promotion of healthy food habit in primary school-children]. / Porta la frutta a scuola: promozione delle corrette abitu- dini alimentari negli alunni della scuola primaria.

The many nutrition education guidelines formulated by different organizations and institutions are the frames for the program actions targeting nutrition awareness in the school-age population. But while the guidelines represent a solid starting block they still need to be backed up by programs giving concrete form to the guiding principles, a program whose efficacy is demonstrated by specific applications studies. The aim of the "Bring Fruit at School" nutrition education program is to encourage elementary school children to change their eating habits for the better. And in particular to eat more fruit, vegetables, legumes, and fish and to cut down on junk-food and sugar-sweetened drink.