Med Diet 4.0: the Mediterranean diet with four sustainable benefits.

OBJECTIVE: To characterize the multiple dimensions and benefits of the Mediterranean diet as a sustainable diet, in order to revitalize this intangible food heritage at the country level; and to develop a multidimensional framework - the Med Diet 4.0 - in which four sustainability benefits of the Mediterranean diet are presented in parallel: major health and nutrition benefits, low environmental impacts and richness in biodiversity, high sociocultural food values, and positive local economic returns. DESIGN: A narrative review was applied at the country level to highlight the multiple sustainable benefits of the Mediterranean diet into a single multidimensional framework: the Med Diet 4.0. Setting/subjects We included studies published in English in peer-reviewed journals that contained data on the characterization of sustainable diets and of the Mediterranean diet. The methodological framework approach was finalized through a series of meetings, workshops and conferences where the framework was presented, discussed and ultimately refined. RESULTS: The Med Diet 4.0 provides a conceptual multidimensional framework to characterize the Mediterranean diet as a sustainable diet model, by applying principles of sustainability to the Mediterranean diet. CONCLUSIONS: By providing a broader understanding of the many sustainable benefits of the Mediterranean diet, the Med Diet 4.0 can contribute to the revitalization of the Mediterranean diet by improving its current perception not only as a healthy diet but also a sustainable lifestyle model, with country-specific and culturally appropriate variations. It also takes into account the identity and diversity of food cultures and systems, expressed within the notion of the Mediterranean diet, across the Mediterranean region and in other parts of the world. Further multidisciplinary studies are needed for the assessment of the sustainability of the Mediterranean diet to include these new dimensions.

Estado nutricional de adolescentes y niños bereberes de las Montañas del Anti Atlas en Marruecos / Nutritional Status of adolescent Berber Children from Anti Atlas Mountains in Morocco

Introducción: La desnutrición tiene consecuencias físicas y mentales para los individuos, hogares y comunidades. Sin embargo, hay una escasez de información sobre el estado nutricional de los adolescentes en Marruecos. Objetivo: Este estudio se realizó para evaluar el estado nutricional y las mediciones de la presión arterial de los escolares rurales bereberes de Lucha contra el Atlas en Marruecos. Métodos: Se midió la altura, peso, circunferencia de la cintura y la cadera, así como la presión arterial (PA)en una muestra de 152 adolescentes de escuelas rurales bereberes de edad 12-18 años de la ciudad de Tafraout en las montañas del Anti Atlas, Marruecos. La delgadez y el sobrepeso se definen, mediante el índice de masa corporal por debajo del percentil 5 y por encima del percentil 85, respectivamente, para la edad y (..) (AU)

Introduction: Malnutrition has physical and mental consequences for individuals, households and communities. However, there is a dearth of information on the nutritional status of adolescents in Morocco. Objective: This study was conducted to evaluate the nutritional status and blood pressure measurements of rural Berber schoolchildren from Anti Atlas Mountains in Morocco. Material and Methods: Height, weight, hip and waist circumference as well as blood pressure (BP) are measured on a sample of 152 rural Berber school adolescent aged 12-18 years from Tafraout city in the Anti Atlas Mountains, Morocco. Thinness and overweight were defined as a body mass index <5th percentile value and >85th percentile value for age-and sex-specific reference data from the WHO 2007 respectively. Stunting (..) (AU)

Prevalence of obesity in Morocco.

Data on measured heights and weights indicate that the prevalence of obesity has increased among Moroccan population over the past 15 years. In 1984/1985, 4.1% of the adult population was obese, and the prevalence increased to 10.3% in 1998/1999. In the most recent survey in the year 2000, 13.3% of individuals aged 20 years and more were obese (22% among women and 8% among men). Excessive weight is more prevalent in urban than in rural areas, varies by geographical residence, positively associated with age and negatively with education level. The increasing prevalence of obesity poses challenges for researchers and policy makers.

Fattening practices among Moroccan Saharawi women.

To study obesity in Moroccan Saharawi culture, 249 women were questioned about their desired body size and diet practices. The majority of women (90.4%) reported wanting to gain weight currently or at some time in the past. To gain weight, women used a fattening period (tablah) of at least 40 days of overeating with a reduction of physical activity and special traditional meals. Appetite enhancers (therapeutic drugs or fenugreek) and traditional suppositories were also used. Some women used corticosteroids to gain weight rapidly. The study highlights the need for health education about the dangers of obesity and steroid use in this culture.

Fattening practices among Moroccan Saharawi women

To study obesity in Moroccan Saharawi culture, 249 women were questioned about their desired body size and diet practices. The majority of women [90.4%] reported wanting to gain weight currently or at some time in the past. To gain weight, women used a fattening period [tablah] of at least 40 days of overeating with a reduction of physical activity and special traditional meals. Appetite enhancers [therapeutic drugs or fenugreek] and traditional suppositories were also used. Some women used corticosteroids to gain weight rapidly. The study highlights the need for health education about the dangers of obesity and steroid use in this culture

Lipoprotein profile and prevalence of cardiovascular risk factors in urban Moroccan women.

OBJECTIVE: The study aimed to characterize the lipid and apolipoprotein profile and the prevalence of cardiovascular risk factors in a population of urban adult women of Morocco. DESIGN: A total of 213 women 25-55 y old were sampled from an agricultural province of Morocco: El Jadida. The following parameters of lipid and apolipoprotein profile were measured: plasma triglycerides (TG), plasma cholesterol (TC), triglyceride-rich lipoprotein triglycerides (TRL-TG), TRL-cholesterol (TRL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoproteins A1, B, B48, CIII and E. Waist circumference (WC), body mass index (BMI) and blood pressure (BP) were also determined. RESULTS: The women studied showed the following pattern: elevated TC, LDL-C levels and TC/HDL-C in 10, 19.4 and in 43.8%, respectively; low HDL-C levels in 45.3% (<0.9 mmol/l) or in 95% (when the cutoff <1.3 mmol/l is used), elevated TG levels in 11.8%. Elevated TRL-C (>0.6 mmol/l) and TRL-TG (>0.8 mmol/l) were observed in 13.4%. Obesity and hypertension were highly prevalent in 23.9 and 16.5%, respectively. Plasma triglyceride concentrations were closely correlated with plasma concentrations of TRL-TG (R = 0.86, P = 0.0001), apoB (R = 0.50, P = 0.0001) and apoCIII (R = 0.52, P = 0.0001) and moderately correlated with HDL-C levels (R = -0.3, P = 0.0001) and BMI (R = 0.4, P = 0.0001). The association between BMI and systolic blood pressure was statistically significant (R = 0.3, P = 0.0001). Obesity, BP, TRL-C, TRL-TG, TG, apoB and apoCIII increased with age. CONCLUSION: There is a high prevalence of some risk factors for cardiovascular disease including altered lipid and lipoprotein profiles in the Moroccan urban women studied, some of these risk factors are associated with age.

Effect of dietary crude proteins on the reproductive function in the postpartum dairy cow.

The study was conducted on 216 dairy cows. Samples of feeds distributed to cows were collected monthly for the purpose of determining their content in dry matter, energy, crude proteins and mineral matter. Milk samples were collected weekly for every cow from newly calved cows until confirmation of pregnancy by rectal palpation at least 2 months after artificial insemination. These samples were used for progesterone assays in skimmed milk, in order to assess the interval between calving and return to ovarian activity [C-ROA], calving and first insemination [C-I1], calving and conception [C-C] and number of inseminations per conception (nI/C). Results have shown a significant negative correlation between the duration of [C-ROA] and [C-C] intervals and the dietary content in crude proteins (r = -0.720, p < 0.05 and r = -0.914, p < 0.01 respectively).

Involvement of insulinemia in the postprandial hypotriacylglycerolemia induced by prazosin in the rat.

The purpose of the present study was to evaluate the role of insulin as a possible mediator of the hypotriacylglycerolemic effect of alpha 1-adrenergic blockade. To this end, determinants of triacylglycerol (TG) metabolism were measured in animals having normal postprandial fluctuations in insulin levels (intact rats) and in others having invariable insulin concentrations (insulin-depleted rats infused long-term with insulin-delivering minipumps). Postprandial changes in plasma TG level, TG secretion rate (TGSR), TG elimination rate (TGER), and lipoprotein lipase (LPL) activity of white (WAT) and brown (BAT) adipose tissues, vastus lateralis muscle (VLM), and heart were measured in animals acutely injected or not with the alpha 1-antagonist prazosin 1 hour before the intake of a high-sucrose, fat-free meal. In intact rats, postprandial increases in glucose and insulin levels were potentiated by administration of prazosin before meal intake. The postmeal increase of plasma TG level was abolished by prazosin in intact animals, whereas this effect was absent in animals with invariable insulin levels. Intact animals treated with prazosin displayed both a lower TGSR (P < .01) and a higher TGER (P < .01) than their saline-injected counterparts. In animals with invariable insulin, both TGSR and TGER remained unaffected by prazosin treatment. Prazosin treatment of intact animals did not affect LPL activity in WAT, but increased enzyme activity in BAT (P < .02). In insulin-infused animals, prazosin increased LPL activity in WAT (P < .02) and BAT (P < .03). alpha 1-Adrenergic blockade had no effect on LPL in VLM and heart. These results confirm that alpha 1-adrenergic blockade prevents the postprandial increase in plasma TG level that follows the ingestion of a high-sucrose meal both by decreasing TGSR and by increasing TGER. The findings also demonstrate that these effects of prazosin are indirect and that their occurrence requires the postprandial increase in circulating insulin levels.

Postprandial plasma triacylglycerols in rats under alpha 1-adrenergic blockade.

The present studies evaluated the effect of prazosin, a selective alpha 1-adrenergic antagonist, on some metabolic determinants of triacylglycerol-rich lipoproteins. Plasma triacylglycerols (TG), TG secretion rate, TG removal rate, plasma insulin, and glucose were evaluated postprandially in animals fed a high-sucrose meal. In the fasted state plasma TG, glucose, and insulin concentrations were minimally affected by prazosin. There was a significant postprandial elevation in plasma TG levels that was larger after ingestion of a meal containing corn oil than after intake of a fat-free meal. Prazosin totally blunted the postprandial elevation in plasma TG independently of the presence (P < 0.004) or absence of dietary fat (P < 0.01). In the postprandial phase after ingestion of a fat-free, high-sucrose meal, prazosin decreased the rate of secretion of TG into the circulation (-54%, P < 0.0003) and accelerated twofold the clearance of an injected fat emulsion (P < 0.02). The postprandial elevations in plasma insulin and glucose were significantly potentiated by administration of prazosin before intake of the fat-free meal. These results indicate that prazosin prevented the postprandial elevation in plasma TG that followed the ingestion of a high-sucrose meal. The results also demonstrate that the alpha 1-blocker exerted its action both by decreasing TG secretion and by increasing the rate of removal of circulating TG.

Alpha-1 adrenergic blockade interacts with dietary carbohydrates on triacylglycerol metabolism in rats.

The purpose of this study was to evaluate the effects of prazosin, an alpha-1 adrenergic antagonist, on determinants of triacylglycerol metabolism in rats fed chronically diets high in starch or sucrose. Hepatic triacylglycerol secretion rate (HTGSR), lipoprotein lipase in white and brown adipose tissues, red vastus lateralis muscle and heart, as well as serum triacylglycerol concentration, were assessed in the post-prandial state, after injection of prazosin or saline. Post-prandial triacylglycerolemia was higher in the sucrose-fed than in the starch-fed rats. After the injection of prazosin, triacylglycerol concentrations were decreased in both dietary groups. This effect was more marked in sucrose-fed than in starch-fed rats (diet x blocker interaction: P < 0.0003). HTGSR was higher in rats fed sucrose than in starch-fed rats (+49%, P < 0.01). Prazosin decreased HTGSR (-45%) in the sucrose-fed rats but not in animals fed starch. Lipoprotein lipase activities in brown adipose tissue, vastus lateralis muscle and heart in rats injected with prazosin were enhanced compared with those of the saline-treated rats, but no change was found in enzyme activity in white adipose tissue. This effect of prazosin was independent of the type of diet. These results suggest that prazosin reduced serum triacylglycerol concentrations after food ingestion at least partly by enhancing lipoprotein lipase activity in several tissues. In addition, the prazosin-induced decrease in HTGSR in sucrose-fed rats, which was absent in starch-fed animals, probably accounted for the greater magnitude of the hypotriacylglycerolemic effect of the blocker in animals given sucrose.

Modulation of lipoprotein lipase activity in the rat by the beta 2-adrenergic agonist clenbuterol.

This study evaluated the effects of beta 2-adrenoceptor stimulation on some determinants of triglyceride metabolism. Male Sprague-Dawley rats were injected twice daily with clenbuterol (30 micrograms.kg-1) for 7 days, or with an equivalent volume of vehicle. Serum triglycerides, hepatic triglyceride secretion rate, and lipoprotein lipase activity in white and brown adipose tissues as well as in red vastus lateralis muscle and heart were evaluated in the fasting state and following a fat-free, high-sucrose meal, 3 h after the last agonist injection. In rats killed in the fasting and postprandial states, clenbuterol reduced the mass of white adipose tissue (-25 and -12%, respectively; p < 0.02), whereas it increased the mass of vastus lateralis muscle (+11 and +7%; p < 0.002) and heart (+13 and %; p < 0.0001). In vehicle-injected animals, the fasting state was associated with lower lipoprotein lipase activity in white and brown adipose tissues, and higher enzyme activity in vastus lateralis and heart, compared with the postprandial state. Postprandially, treatment with clenbuterol reduced lipoprotein lipase activity in white adipose (-24%), whereas it increased enzyme activity in brown adipose (+107%) as well as in vastus lateralis (+35%). In fasted animals, no significant variation of enzyme activity in these tissues was observed following clenbuterol treatment, whereas in the heart, a decrease of lipoprotein lipase activity was observed (-22%). Clenbuterol lowered serum triglycerides significantly (-23%), but not their rate of secretion, whereas the agonist decreased the insulin to glucagon ratio only in the postprandial state.(ABSTRACT TRUNCATED AT 250 WORDS)