The role of Mediterranean type of diet on the development of cancer and cardiovascular disease,in the elderly: A systematic review

Background

The proportion of elderly worlwide is increasing. This increase in life expectancy, is staggering posing tremendous challenges in disease burden, especially, in chronic diseases such as obesity, diabetes, hypertension, hypercholesterolemia, cancer and cardiovascular disease (CVD). Limited studies investigate the effect of Mediterranean diet on cardiovascular risk and cancer in older populations. In this review, findings from observational studies are summarized to evaluate the effect of Mediterranean diet on cancer and cardiovascular disease risk in elderly people.

Methods

Published results from observational studies that assessed food habits on cancer and cardiovascular disease risk in elderly were retreived and summarized.

Results

In all studies diet had an effect on cardiovascular disease risk. The Mediterranean diet, a high-qulaity diet and increased fruit and vegetable consumption were all found to be cardioprotective.

Conclusion

The systematically reviewed studies reveal that a high adherence to a Mediterranean type of diet or “prudent diet” is associated with reduced risk of CVD and some types of cancer, even in the elderly. Also dietary intervention strategies can prevent morbidity, premature mortality and improve quality of life in older persons worldwide.     

Long-term adherence to the Mediterranean diet reduces the prevalence of hyperuricaemia in elderly individuals, without known cardiovascular disease: the Ikaria study

Background

The purpose of this study was to evaluate the impact of adherence to Mediterranean diet on serum uric acid (UA) levels in elderly individuals, without known cardiovascular disease.

Methods

During 2009, 281 females (75 ± 6 years old) and 257 males (75 ± 7 years old) permanent inhabitants of the island, were voluntarily enrolled. A diet score that assesses the inherent characteristics of the Mediterranean diet (MedDietScore, range 0-55) was applied. Serum levels of UA were determined using an enzymatic colorimetric test through the uricase-peroxidase method. Hyperuricaemia was defined as UA > 7 mg/dL in males and 6 mg/dL in females.

Results

Prevalence of hyperuricaemia was 34% in males and 25% in females (p = 0.02). Mean level of adherence to the Mediterranean diet was 35 ± 2. Linear regression analysis revealed that MedDietScore was inversely associated with UA levels (b ± SE: −1.48 ± 0.17, p < 0.001) in the overall sample, after controlling for hypertension, hypercholesterolemia, diabetes mellitus, creatinine clearance, physical activity, and coffee consumption. When the analysis was stratified by gender, MedDietScore was inversely associated with UA levels in males (b ± SE: −1.10 ± 0.42, p = 0.009), but not in females (b ± SE: 0.04 ± 0.41, p = 0.92).

Conclusion

Another cardioprotective effect of Mediterranean diet was revealed, through the modification of UA levels in elderly individuals. The potential different effect size as regards the relationship between diet and UA levels between genders, deserves further investigation.     

Overweight in classical phenylketonuria children: A retrospective cohort study

PurposeThis cohort study aimed to determine the frequency of overweight and obesity in classical phenylketonuria children and to identify the possible influence of metabolic control on the BMI of the studied patients.Patients and methodsThe study group included 63 classical phenylketonuria patients (40 girls and 23 boys; aged 5–16 years). Their z-score BMI, metabolic control, educational level of parents and socioeconomic status were determined.ResultsTwenty children were overweight or obese and only three were underweight. The percentages of overweight and obese children were 31.7% for the whole group, 21.7% (5 out of 23) for boys and 37.5% (15 out of 40) for girls. Overweight and obesity in these phenylketonuria patients was statistically significantly more frequent when compared to national reference studies (p = 0.0031).The five-year index of dietary control and the percentage of spikes exceeding 6 and 12 mg/dl (Spikes 6 and 12) indicated better metabolic control in the case of normal weight children than those who were overweight and obese (p < 0.049, p < 0.041 and p < 0.011, respectively). The odds ratio of being overweight or obese for those having poorer metabolic control (values higher vs lower than mean) was statistically significantly higher than for the remaining patients (for Spikes 12: 6.926 < 95%CI: 2.011–23.854 > ; p < 0.002). These results strongly suggest a link between overweight and diet non-compliance.ConclusionsChildren with classical phenylketonuria presented higher odds of being overweight or obese as compared with reference national studies, with girls only having a higher frequency of overweight.     

低苯丙氨酸饮食治疗苯丙酮尿症的临床研究

目的总结20年对652例苯丙酮尿症患儿进行低苯丙氨酸饮食治疗经验,探讨有效的饮食控制方案。方法由营养师计算制定食谱,对治疗患儿进行严格饮食控制,并定期测定血中苯丙氨酸浓度,根据血浓度调整饮食,使其维持在理想水平。结果严格随诊早治疗的60例患儿,其体重、身高、头围均在正常儿童相应标准值的±2s之间。<3个月开始治疗的56例智商可达96±10,晚治疗的83例,治疗前为61±23,治疗后为72±26。治疗前后智商比较有显著性差异( P<0．05)。结论合理安排食谱,正确添加辅食是保证患儿正常生长、发育、维持血苯丙氨酸浓度在理想范围的关键,而且一定要在营养师指导下注意患儿的全方位营养。     

Heredity influences the dietary energy density of free-living humans

Dietary energy density has been shown to have large effects on short-term food intake. Little is known, however, about its origins. We investigated the influence of heredity, shared (familial) environment, and individual environment on dietary energy density and its relationship to food intake with 110 identical and 102 fraternal same-sex and 53 fraternal mixed gender adult twin pairs who were paid to maintain 7-day food intake diaries. From the diary reports, the total and meal intakes of food energy, the amounts of the macronutrients ingested, and dietary energy density were estimated. Linear structural modeling was applied to investigate the nature and degree of genetic and environmental influences. The analysis revealed significant genetic and individual environmental, but not shared (familial) environmental, influences on the dietary densities of the reported diets. But, there was no genetic or familial influences on the responsiveness of the individual to dietary density. Dietary energy density appears to be another component in a package of genetically determined physiological, sociocultural, and psychological processes that influence the regulation of energy balance.     

The effect of adherence to high-quality dietary pattern on COVID-19 outcomes: A systematic review and meta-analysis

Dietary quality and patterns may influence SARS-CoV-2 infection and outcomes, but scientific data and evidence to support such a role are lacking. Therefore, this meta-analysis aims to elucidate the effect of prepandemic diet quality on the risk of COVID-19 infection and hospitalization. PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE were systematically searched for articles published up to September 1, 2022. A systematic review and meta-analysis were performed to calculate each outcome's risk ratio (RR) and 95% confidence interval (CI). Five studies including 4 023 663 individuals (3 149 784 high-quality diet individuals and 873 881 controls) were included in the present meta-analysis. The effectiveness of high-quality dietary pattern against SARS-CoV-2 infection and hospitalization was 28% (95% CI 19%–36%) and 62% (95% CI 25%–80%); respectively. Subgroup analysis based on different levels of diet quality showed no difference between middle and high levels of diet quality in reducing the risk of COVID-19 infection. Interestingly, subgroup analysis based on the different types of high-quality diets and the risk of COVID-19 infection revealed that the effectiveness of plant-based diet against SARS-CoV-2 infection was 50% (95% CI 30%–65%); while the effectiveness of Mediterranean diet against SARS-CoV-2 infection was 22% (95% CI 12%–31%). Adherence to a high-quality dietary pattern is associated with a lower risk of COVID-19 infection and hospitalization. More studies are required to confirm these findings, and future studies should determine the biological mechanisms underlying the association between diet quality and risk of COVID-19 infection.     

低强度脉冲超声波治疗高能量胫骨骨折的临床观察

目的评估低强度脉冲超声波(LIPUS)治疗高能量胫骨骨折的临床疗效。方法2004～2005年, 60例采用切开复位内固定或使用外固定器的胫骨骨折患者被随机分为试验组30例和对照组30例。试验组采用LIPUS治疗:术后第一天起,每天治疗20min,持续90天,对照组术后未予以LIPUS治疗。结果术后平均随访10个月。试验组胫骨骨折愈合时间为9～15周(平均12周),无延迟愈合和骨不连发生;对照组为13～36周(平均18周),延迟愈合3例(愈合时间为8～9个月)。按Johner-Wruhs标准评估,术后12周和26周,试验组优良率分别为83%和100%,对照组为47%和87%,两组间有显著性差异(P＜0．01)。结论LIPUS是一种促进骨折愈合的有效方法。     

Follow-up of a web-based tailored intervention promoting the Mediterranean diet in Scotland

Objective

To assess the impact of a 3-month follow-up of a 6-month quasi-experimental study conducted to evaluate a web-based, tailored-feedback intervention promoting four key components of the Mediterranean diet.

Methods

Fifty-three (intervention) and nineteen (control) healthy females, 25–55 years, employed at two Universities in Glasgow, Scotland, between 2003 and 2004 participated. Participants received tailored dietary and psychosocial feedback and Internet education, or minimal dietary feedback and general healthy-eating brochures, respectively. Dietary intake using 7d-estimated food diaries and blood lipids were assessed at baseline, 6 (post-test) and 9 months (follow-up).

Results

Intention-to-treat analyses for between-group comparisons over time showed that the intervention group had increased their vegetable intake over 9 months and had more favourable levels of HDL-cholesterol and ratio of total:HDL-cholesterol over the 9-month assessment, compared with the control group. Within-group comparisons showed that, except for fruit consumption, the intervention group sustained their dietary improvement at 9 months, compared with baseline.

Conclusion

This intervention proved successful at sustaining most of the favourable dietary and blood lipid profile changes achieved over the 6-month intervention at the 3-month follow-up.

Practice implications

This intervention can be effective in promoting a Mediterranean-style diet in work settings.     

低蛋白饲料对雄性大鼠胫骨上段和腰椎的骨计量学研究

目的比较低蛋白饲料对大鼠胫骨上段和腰椎松质骨的影响。方法12只3月龄SD雄性大鼠,随机分成正常对照组、低蛋白组LPD(Pr8%)。实验90d时取胫骨上段和第五腰椎行不脱钙骨制片,骨组织形态计量学测量。结果与对照组比,LPD组胫骨上段骨小梁面积百分率(%Tb.Ar)减少(P<0.01),骨结构变差,骨转换率下降;而腰椎松质骨各项指标的变化均无统计学意义。结论低蛋白饲料诱导大鼠胫骨上段骨丢失,而对腰椎骨丢失无明显影响。     

Meal-taking behavior is related to predisposition to dietary obesity in the rat

The hypothesis that early nutritional experience can determine endogenous patterns of meal-taking behavior and thereby affect predisposition to dietary obesity was tested by raising male Sprague-Dawley rats in litters of 4, 8, and 20, and examining their meal patterns and responsiveness to a high-fat, high-sugar (HFS) diet in adulthood. At 9 months of age, half the rats from each litter size group were given the HFS diet for 16 weeks, while the other half were continued on laboratory chow. As expected, HFS-fed rats gained more weight and developed larger fat depots and more and larger fat cells than did chow-fed controls. Analysis of meal-taking behavior just prior to the introduction of HFS-feeding allowed some of the rats to be classified as "gorgers" or "nibblers" according to their average daily meal size. While on lab chow, gorgers and nibblers showed no differences in body weight gain, but upon being switched to the HFS diet, gorgers gained significantly more weight than did nibblers, and showed a greater degree of fat depot enlargement. These findings suggest that patterns of meal-taking behavior can predict the magnitude of and may contribute to the development of dietary obesity.     

A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study

BackgroundThe proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly.MethodsThe NU-AGE study is a parallel randomized one-year trial in 1250 apparently healthy, independently living European participants aged 65–80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium.C-reactive protein is measured as primary outcome.DiscussionThe NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.     

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations in elderly men and women

The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations were examined in 30 elderly men and women. These subjects were randomly divided into two groups. The training group [n=15; 7 men and 8 women; mean age 75.5 (SD 5.6) years] agreed to take part in physical training using a treadmill with an exercise intensity at the blood lactate concentration threshold for 30 min 3–6 times a week for 9 months. The other group [n=15; 7 men and 8 women; mean age 73.7 (SD 4.4) years] did not perform any particular physical training and was followed as the control. Following this training period the high density lipoprotein-cholesterol (HDL-C) had increased significantly (P<0.01) while the total cholesterol (TC) : HDL-C ratio had decreased significantly (P<0.01) in the training group after 9 months but had not changed in the control group. The TC, triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) had not changed significantly in either group. No significant difference was seen between the groups throughout the period for TC, LDLC or TG. There was, however, a significant correlation between the initial TC:HDL-C ratio and the change in the TC:HDL-C ratio following 3 months of training (P <0.05). After 1 month of detraining in 5 patients, the HDL-C had decreased significantly (P < 0.05) while the TC:HDL-C had increased significantly in the training group (P<0.01). These results suggested that long-term low intensity aerobic training improved the profile of serum lipid and lipoprotein concentrations, while detraining returned the profile to that of the pretraining levels in elderly persons.     

低钙饮食对雄性大鼠松质骨和密质骨影响的比较

目的　比较低钙饮食对大鼠胫骨上段松质骨和胫骨中段密质骨的影响。方法　实验用 3月龄SD雄性大鼠 2 0只 ,随机分为正常年龄对照组 (control)、极低钙组 (VLCD)、低钙组 (LDC)。Control组饲养正常饲料 ,VLCD组饲养 0 0 1%含钙饲料 ,LCD组饲养 0 3%含钙饲料。 3个月后取各组大鼠左侧胫骨近心端和中段 ,行不脱钙骨制片 ,进行骨组织形态计量学测量。结果　松质骨 :与对照组相比 ,VLCD组和LCD组的大鼠骨量减少 ,骨小粱面积百分率 (%Tb .Ar)分别减少 5 7% (P <0 0 1)和4 0 % (P <0 0 5 ) ,骨结构参数变差 ,代表骨形成指标荧光周长百分数 (L .Pm % )、矿化沉积率 (MAR)、骨形成率 (BFR/BV)有增加的趋势。VLCD组骨吸收参数骨小粱周长破骨细胞数量 (N .OC/Tb .Pm)有显著增加 ,呈现骨高转化的改变。密质骨 :与对照组相比 ,VLCD组和LCD组的骨量有减少的趋势 ,骨外膜面代表骨形成的参数增加 ,骨内膜代表骨形成的参数变化不大 ,骨内膜骨吸收增加。结论　低钙饮食使骨量减少 ,但不同的部位有不同的骨丢失速度     

Regeneration in denervated toad (bufo viridis) gastrocnemius muscle and the promotion of the process by low energy laser irradiation

Background: It is known that while denervated skeletal muscles have the ability to regenerate, maturation of regenerated myofibres does not take place under these conditions. Denervation also causes elevation of “invasive” and satellite cells, but the role of these cells in the regeneration process after injury to the denervated muscle is still unknown. Low energy lasers have recently been found to modulate and accelerate physiological processes in cells. The aim of the present study was to compare regeneration in denervated and innervated amphibian muscles and to investigate whether this process in denervated muscles can be stimulated by low energy laser irradiation prior to injury in these muscles. Methods: Denervated gastrocnemius muscles of toads were irradiated with He-Ne laser (6.0 mW, 31.2 J/cm²) 7 days postdenervation (control muscle received red light irradiation at the same wavelength). Nine days after denervation cold injury was performed on the site of irradiation of both groups of muscles. At 14 days postinjury all muscles were removed and processed for histology and histomorphometric analysis of mononucleated cells, myotubes, and young myofibres in the regenerated zone. Results: The volume fraction (percent of total injured zone) of the various histological structures in the injured zones 14 days after cold injury in the denervated (9 days prior to injury) muscles did not differ from innervated injured muscles at the same time interval postinjury. The mononucleated cells and myotubes in the laser irradiated muscles comprised 49 ± 4% and 6 plusmn; 1% of the injured area, respectively, which was significantly lower than their volume fraction (67 plusmn; 2% and 11 plusmn; 2%, respectively) in the control muscles. The young myofibres populated 34 plusmn; 4% of the total injured area in the denervated and laser irradiated muscles which was significantly higher than their volume fraction (12 ± 2%) in control denervated muscles. Conclusions: It is concluded that initial stages of regeneration can also take place in skeletal denervated and injured muscles of amphibians. The kinetics of the regeneration process are identical in denervated and innervated muscles. The process of regeneration in denervated muscles can be markedly enhanced if the muscle is irradiated by low energy laser prior to injury, probably by activation (stimulation of proliferation and/or differentiation) cells in the muscles that are “recruited” and participate in the process of regeneration. © 1995 Wiley-Liss, Inc.     

Direct observation of physical activity and dietary behaviors in a structured environment: Effects of a family-based health promotion program

The effects of cardiovascular risk reduction are typically assessed by self-reported behavior change and physiological outcomes. There is a need to enhance evaluation protocols by including direct observation measures of targeted health behaviors. To improve the evaluation of a family-based diet and physical activity change program, families were observed during a planned visit to the San Diego Zoo. This standardized environment afforded many options for dietary intake and physical activity. Thirty families who had participated in a 1-year intervention program and 30 control families were observed. Caucasian and Mexican-American families were equally represented. Observations in this standard environment discriminated between intervention and control families, and the findings indicated that intervention effects generalized to this novel setting. Intervention families consumed fewer calories, ate less sodium, and walked further than did control families. Ethnic differences were noted.This work was supported by NHLBI Grant HL-30872 to Philip R. Nader.     

Effect of low potassium-diet on Na−K-ATPase in rat nephron segments

Na–K-ATPase activity was determined in 10 segments of the rat nephron using a fluorometric microassay method [4]. The enzyme activity showed three peaks (>200 pmol ADP min^–1 mm^–1) along the nephron of normal rats. These peaks were in the S₁ portion of the proximal tubule, the medullary thick ascending limb from the inner stripe and the distal convoluted tubule. Feeding the rats a low potassium diet for 8 weeks produced a significant decrease in Na–K-ATPase activity in the cortical collecting duct, but no significant change in this enzyme in any other segment. The low potassium diet did not produce a significant change in Mg-ATPase in any nephron segments. We conclude that Na–K-ATPase activity along the rat nephron shows a pattern that is qualitatively similar to that seen in the rabbit nephron [4]. However, quantitatively the Na–K-ATPase activity in the rat nephron is greater than in the corresponding segments of the rabbit nephron. The results are consistent with the greater rate of glomerular filtration and Na⁺ reabsorption per rat nephron. Furthermore, our results suggest that the decrease in potassium excretion during potassium deficiency is modulated, at leat in part, by the level of Na–K-ATPase activity in the cortical collecting duct.     

The influence of migration on dietary practices of Ghanaians living in the United Kingdom: a qualitative study

Abstract

Background: Previous studies have identified a process of dietary acculturation when migrant groups adopt the food patterns of the host country.

Aim: The aim of this study was to explore the influence of migration on dietary practices and the process of dietary acculturation amongst Ghanaians living in the UK.

Subject and methods: A qualitative study of adults aged ≥25 years (n?=?31) of Ghanaian ancestry living in Greater Manchester using face-to-face interviews. Participants varied in socioeconomic status, gender and migration status. Interviews were transcribed verbatim and analysed thematically.

Results: Three distinct dietary practice typologies were discernible that differed in terms of typical meal formats, meal contexts, structure and patterning of meals, food preparation and purchasing behaviours: (i) continuity practices; (ii) flexible practices; and (iii) changed practices. The identified practices were shaped by interrelating factors that fell into four main clusters: social and cultural environment; accessibility of foods; migration context; and food beliefs/perceptions.

Conclusion: Participants retained, to a varying degree, some aspects of Ghanaian dietary practices, whilst adopting key features of UK food culture. This study demonstrates the complexity of dietary change, indicating that it is not a linear process and it is dependent on several factors.