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Background: The impact of a healthy diet on the secondary prevention of ischemic stroke (IS) remains uncertain. Levels of low-density lipoprotein cholesterol (LDL-C) are inversely associated with the risk of IS recurrence. A Mediterranean diet (MeDi), consisting of a preference for fish/poultry, monosaturated fats from olive oil, fruit, vegetables, whole grains, legumes/nuts and limited red meats, animal fats and sweetened beverages, reduces metabolic syndrome, LDL-C levels and stroke risk. Avocados also reduce metabolic syndrome and LDL-C levels but are not part of the traditional MeDi diet. The effects of an avocado-based Mediterranean diet on LDL-C were investigated and compared to those of a low-fat diet in patients with previous IS., Methods: The Avocado-Based Mediterranean Diet on Serum Lipids for Secondary Prevention after Ischemic Stroke (ADD-SPISE) was a prospective, randomized, open-label, blinded outcome assessment, phase 2, clinical trial. The participants were adults with an IS in the previous month who were randomly assigned at a 1:1 ratio to a MeDi or a low-fat diet for three months. Outcome assessors of laboratory results and data analysts were masked. The primary outcome was the mean difference in LDL-C between groups at 90 days, adjusted by statin use. Safety, feasibility and acceptability (assessed through a 14-item questionnaire administered to all patients who completed the follow-up) were also evaluated., Results: From August 2018 to October 2022, 200 participants were enrolled (97 randomized to the low-fat diet and 103 to the MeDi), with 189 (94.5%) completing the study. There were no significant differences in LDL-C levels between the MeDi group and the low-fat group at 90 days: 66.5 mg/dL (95% confidence interval [CI] 59.6, 73.4) in the MeDi group and 69.9 mg/dL (62.6, 77.2) in the low-fat group at the end of follow-up. The adjusted difference was - 3.4 mg/dL (-13.4, -6.62); P = 0.50. The intervention group showed significant improvements in Mediterranean diet adherence (P < 0.01). Moreover, no significant differences in adverse events were observed between the groups., Conclusion: Compared with a low-fat diet, the avocado-based MeDi did not significantly lower LDL-C in IS patients after three months. The intervention was safe, feasible, and well accepted. Larger trials should establish whether longer dietary interventions could yield clinically significant benefits in these patients. The study is registered under ADD-SPISE at www., Clinicaltrials: gov . Identifier: NCT03524742., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics approval was obtained from Universidad del Desarrollo, Clínica Alemana de Santiago Scientific Ethics Committee (ID 2018–43) for the first protocol and its amendments. All patients or their next of kin provided written informed consent to participate in the trial. Consent for publication: Not applicable. Competing interests: VO reports receiving research funding from Clínica Alemana de Santiago and ANID-Fondecyt Regular 1181333 during the conduct of the study and a research grant from Boehringer Ingelheim for the RECCA registry outside the submitted work.PL reports research support from Clínica Alemana and Boehringer Ingelheim. Research grants from Clínica Alemana de Santiago during the conduct of the study, personal fees from Boehringer Ingelheim, and a Chilean Government research grant (ANID) for the ÑANDU project outside the submitted work. VN reports receiving an educational grant from Boehringer Ingelheim. PC, VV, PvG, CV, PP, BV, PD, AG, GC, EM, MG, and PB report no conflicts of interest., (© 2025. The Author(s).)

Epigenetic mechanisms, which can be modulated by dietary factors, have been proposed as a possible factor in understanding interindividual differences in disease susceptibility. We aimed to determine the relationships between DNA methylation (DNAm), diet quality, and metabolic health in Spanish individuals. This is a transversal study encompassing 337 male and female participants in the Obekit study. Diet quality was assessed using a validated semiquantitative food frequency questionnaire and seven previously established scores: overall, healthy and unhealthy Plant-Based Diet Index (PDI, hPDI and uPDI, respectively), dietary diversity score (DDS), unprocessed/minimally processed foods (MPF) and ultra-processed foods (UPF) consumption and Mediterranean diet (MD) score. DNAm was analyzed in white blood cells using the Infinium MethylationEPIC v1.0 BeadChip kit. After filtering by a variance >0.36, we have worked with 5,261 CpG sites. We found four false discovery rate (FDR)-significant correlations between nutrients and CpGs sites: cg00167275 (GLUD1) correlated with alcohol, cg05218090 with folic acid, cg16682935 (PAPSS2) with selenium, and cg09821790 (SLC7A6) with fish food. One differentially methylated region (DMR) located at zinc finger protein gene 57 (ZFP57) was closely related to obesity and specific nutrients, food groups, and diet quality indices. The regression models of diet quality based on DNAm demonstrated that the most predictive values were when UPF and hPDI were considered. Also, UPF and hPDI were the best indices for predicting the main cardiometabolic risk factors. Our finding suggests that specific nutrients and diet quality indices may influence the degree of DNAm and putatively, the metabolic health in Spanish individuals., Competing Interests: Declaration of competing interest This work (1) has not been published previously; (2) is not under consideration for publication elsewhere; (3) is approved by all authors; (4) if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright-holder; (5) the study protocol was approved by the Research Ethics Committee of the University of Navarra (ref. 132/2015)., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

This Bayesian network meta-analysis method was used to assess the effect of novel treatments on global cognition in patients with Parkinson's disease (PD). We searched randomized controlled trials from PubMed, Cochrane Library, Web of Science and Embase to investigate novel treatments for global PD cognition until April 10, 2024. Effect size measures were standardized mean differences with 95% confidence intervals. We included 13 studies investigating traditional paper-and-pencil cognitive training, modified cognitive training (MCT), repetitive transcranial magnetic stimulation (rTMS), rTMS plus MCT, Mediterranean diet, speech therapy, transcranial direct current stimulation (tDCS) and tDCS plus MCT. Comparisons between novel treatments and the control group revealed the following findings: Mediterranean diet (1.25, 0.74-1.76), rTMS plus MCT (0.82, 0.13-1.52), rTMS (0.42, 0.08-0.76) and MCT (0.34, 0.03-0.66) exhibited statistically significant improvements in global cognition in patients with PD, while the remaining treatments did not reveal significant differences. To conclude, the Mediterranean diet, rTMS, MCTs and rTMS plus MCT could effectively improve global cognition in patients with PD., (© 2025 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Background: Mindful eating (ME) is a promising approach for promoting healthy eating. Although an association between ME and healthier eating habits has been indicated in the literature, data remain limited. The aim of this cross-sectional study was to investigate the association between ME and several nutritional indicators, including overall diet quality, consumption of ultra-processed foods (UPF), organic foods, food groups, and intake of energy and nutrients in a large population sample., Methods: In 2023, 13,759 participants of the NutriNet-Santé cohort study completed the Mind-Eat Scale, assessing total ME (range: 1-5), and its six sub-dimensions, and at least three 24-h dietary records. Multivariable linear regressions were performed to analyze the association between ME (independent variable) and various indices reflecting the nutritional quality of the diet: two scores reflecting the adherence to the French dietary guidelines (sPNNS-GS2) and the Mediterranean diet (MEDI-LITE score), the consumption of UPF (using the NOVA classification), organic foods and food groups, and energy and nutrient intake (dependent variables), adjusted for socio-demographic and lifestyle characteristics., Results: ME was positively associated with French dietary guideline (β = 0.33; 95%CI: 0.30, 0.45) and Mediterranean diet (β = 0.37; 95%CI: 0.30, 0.45) scores and with organic food consumption (β = 9.72; 95%CI: 8.84, 10.60). Furthermore, ME was negatively associated with energy intake (β = -36.79; 95%CI: 50.92, -22.67) and UPF consumption (β = -1.55; 95%CI: 1.81, -1.29). ME was also associated with the intake of several food groups and nutrients., Conclusion: Overall, ME was associated with a healthier diet. These results suggest that ME could be an interesting lever for promoting healthy eating habits. Further studies are required to better understand the relationships between ME, dietary intake, and health, particularly through the use of longitudinal studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Advancing age and estrogen deficiency increases susceptibility of post-menopausal women (PMW) to abdominal obesity and manifestation of cardiometabolic disease. There is limited evidence on the effect of lifestyle interventions on adiposity markers within at-risk PMW. Therefore, this study aims to evaluates an 8-weeks of home-based, equipment-free, interval training (HEFIT) with or without Mediterranean-style diet (MD) on adiposity markers in physically inactive, postmenopausal women with overweight/obesity. Thirty PMW (56.7 ± 3.9 years, BMI: 30.5 ± 5.2 kg/m 2 ) were randomly assigned to three groups: (i) Ex; HEFIT thrice weekly/week, (ii) EX + MD, or (iii) CTL; control. Visceral Adiposity Index (VAI), body weight, BMI, waist and hip circumference (WC; HC), visceral adipose tissue (VAT), total body fat percentage, leptin, and adiponectin were determined pre- and post-8-week intervention. There was no significant between group effect on VAI. Compared to CTL, a significant between group reduction was seen in weight, BMI, and WC in both EX and EX+D (p < 0.05). Leptin and adiponectin remained unchanged in all groups (p > 0.05). Adherence rates were 85% and 96% for EX and EX+MD, respectively, and 80% of EX+D of participants had optimal adherence to diet. Concluding HEFIT with or without dietary changes could improve adiposity in overweight/obese postmenopausal women., (© 2025 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Background: Tomatoes are a significant product of the Mediterranean region and a crucial component of the Mediterranean diet. The formulation of dried tomato products enriched with proteins and bioactive compounds could be a strategic approach to promote adherence to the Mediterranean diet. Six different novel tomato products were analyzed using different protein enrichment sources (pea proteins and leaf proteins) and drying technologies (hot-air dryer, microwave vacuum dryer, and conventional dryer). The novelty of this approach lies in combining product-specific criteria with global societal factors across their life cycles. Using 21 criteria and an analytic hierarchy process (AHP) survey of experts, the social sustainability score for each product was determined through a multi-criteria assessment., Results: The tomato product's life cycles have minimal regional impacts on unemployment, access to drinking water, sanitation, or excessive working hours. However, they affect discrimination, migrant labor, children's education, and access to hospital beds significantly. The study identified nutritional quality as the top criterion, with the most sustainable design being a tomato bar enriched with pea protein and processed using microwave vacuum drying., Conclusion: The study revealed that integrating sensory and nutrient compounds into social sustainability assessments improves food sustainability and provides a practical roadmap for social life cycle assessments of food products. It emphasized the importance of considering global social issues when reformulating Mediterranean products to ensure long-term adherence to the Mediterranean diet. Incorporating social factors into sustainability scores can also enhance the effectiveness of product information for conscious customers. © 2024 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2024 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Aim: Low-carbohydrate (LC) diets have gained popularity. We compared glycaemic and metabolic parameters following an LC versus a Mediterranean (MED) diet in adolescents and youths with type 1 diabetes., Methods: In a six-month, open-label, randomised trial, 40 individuals were assigned to either diet. Glycaemic outcomes, based on continuous glucose monitoring, included per cent time of blood glucose in the range [3.9-10.0 mmol/L (70-180 mg/dL)] and haemoglobin A1c (HbA1c)., Results: Twenty-eight (70%) were females. The median age was 18 years. After 6 months, the median time in range increased from 47% to 58% in the LC and from 52% to 64% in the MED diet group (p = 0.98). The delta values for the time in range were 16% and 7% for the respective groups (p = 0.09). The percentage of time >13.9 mmol/L (>250 mg/dL) improved more in the LC diet than in the MED diet group: -10% vs. -2% (p = 0.005). The percentage of time <3.0 mmol/L (<54 mg/dL) was comparable. The delta HbA1c improved in both groups: -0.7% vs. -0.1% (p = 0.02). Changes in BMI Z-score and lipid levels were similar., Conclusion: Both diets improved glycaemic outcomes in adolescents and youths with type 1 diabetes, without increasing hypoglycaemia or cardiovascular risk factors, indicating comparable safety and efficacy., (© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Purpose of Review: The COVID-19 pandemic, caused by SARS-CoV-2, has highlighted the potential role of nutrition in modifying disease susceptibility and severity. This review aims to systematically evaluate the current evidence on associations between dietary patterns, assessed using diet quality scores (DQS), and COVID-19 severity and outcomes., Recent Findings: A comprehensive literature search identified 15 studies across diverse populations. Prospective cohort studies generally found higher diet quality associated with lower COVID-19 infection rates. Case-control studies consistently showed reduced odds of COVID-19 infection and severe illness with adherence to anti-inflammatory dietary patterns, particularly the Mediterranean diet. Cross-sectional data revealed associations between higher DQS and reduced COVID-19 symptom burden and improved prognostic biomarkers. An ecological study demonstrated inverse relationships between national-level diet quality and COVID-19 caseloads. Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and plant-based diet scores were notably predictive of favourable outcomes, even after adjusting for confounders. Conversely, consumption of processed foods high in saturated fats, sugars, and additives was linked to increased COVID-19 complications. Despite these findings, research gaps remain, including the impacts of specific dietary components, effect modifiers across populations, and establishing causality through interventional trials. This review highlights the observational evidence supporting the potential integration of optimal nutrition into pandemic preparedness strategies. Further research is needed to strengthen these findings and inform evidence-based dietary recommendations for COVID-19 prevention and management., Competing Interests: Compliance with Ethical Standards. Conflict of Interest: The authors declare no competing interests. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors., (© 2025. The Author(s).)

Background: Only a few studies have investigated the role of diet on the risk of chronic kidney disease (CKD) in European populations and have mainly focused on the Mediterranean diet. This is the first study to evaluate the association between various diet quality indices and CKD incidence in British adults., Objective: To study the relationship between a set of 6 different diet quality indices and CKD incidence among British adults., Methods: A prospective cohort with 106,870 participants from the UK Biobank, followed from 2009 to 2012 through 2021. Food consumption was obtained from ≥2 24-h dietary assessments. Dietary patterns were assessed using previously established indices: Alternate Mediterranean Index (aMED), Alternative Healthy Eating Index 2010, dietary approaches to stop hypertension (DASH), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), and dietary inflammatory index (DII). Incident CKD was obtained from clinical records, death registries, and self-reports. Analyses were performed with Cox regression models and adjusted for the main confounders., Results: After a median follow-up of 9.27 y, 2934 cases of CKD were ascertained. Hazard ratios (95% confidence interval) of CKD for the highest compared with lowest tertile of adherence to each diet score were 0.84 (0.76, 0.93) for aMED, 0.94 (0.85, 1.03) for alternative healthy eating index 2010, 0.77 (0.70, 0.85) for DASH, 0.79 (0.72, 0.87) for hPDI, 1.27 (1.16, 1.40) for uPDI, and 1.20 (1.18, 1.33) for DII. The results were robust in sensitivity analyses., Conclusions: In British adults, higher adherence to the aMED, DASH, and hPDI patterns was associated with lower risk of CKD, whereas greater adherence to the uPDI and DII patterns was associated with greater risk., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Aim: Lifestyle factors significantly influence the development of inflammatory diseases, and emerging evidence suggests they may also impact oral health. However, no studies have explored their role in apical periodontitis (AP) amongst adults. This study aimed to assess the association between adherence to the Mediterranean diet (MD), physical activity, perceived stress, and sleep quality with the periapical and caries status in a university-based cohort., Methodology: A total of 149 periodontally healthy patients were included in the study. Clinical assessments and radiographic examinations [Orthopantomography (opt) and periapical radiographs] were conducted to evaluate the periapical status. Data on their periapical index (PAI) score and the decayed, missing and filled teeth (DMFT) index were recorded. Validated questionnaires were used to investigate patient's lifestyles. A final logistic regression model was performed for the multivariable analysis to evaluate the predictive ability of adherence to Mediterranean lifestyle on the presence of AP; other local, systemic and environmental factors were included as independent factors in the model., Results: Significant associations were observed between AP and high/low adherence to the MD (p = .00), high/low-moderate physical activity (p = .00), high/low sleep quality (p = .00) and high/low perceived stress (p = .00). The final multivariable regression model showed that low adherence to MD (OR = 3.68; 95% confidence interval [CI]: 1.24-10.83; p = . 01) and reduced sleep quality (OR = 3.04; 95% CI: 1.42-6.50; p = .00) were identified as potential risk factors for AP development. On the other hand, the DMFT index showed no significant association with lifestyle factors (OR = 1.0; CI: 1.01-1.14; p = .02) but was correlated with the development of AP (OR = 1.07; CI: 1.01-1.14; p = .02)., Conclusion: Results from the present study suggest a potential association between low adherence to MD and reduced sleep quality with the development of AP. Individuals with low adherence to MD and inadequate sleep quality faced respectively 4-fold and 3-fold increased odds of developing periapical lesions. Further research is essential to elucidate the causal mechanisms underlying these associations and to determine whether lifestyle adjustments could improve endodontic success rate., (© 2024 The Author(s). International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

Objective: The Metformin and Dietary Restriction to Prevent Age-Related Morbid Events in People With Metabolic Syndrome (MeMeMe) trial tested whether 1,700 mg/day metformin (MET) with or without a Mediterranean diet (MedDiet) intervention could reduce the cumulative incidence of major noncommunicable diseases in people with metabolic syndrome., Research Design and Methods: A total of 1,442 participants were randomly assigned to one of four interventions: 1) MET (1,700 mg/day) plus MedDiet intervention (MET+MedDiet); 2) placebo plus MedDiet intervention; 3) MET (1,700 mg/day) alone; and 4) placebo alone. Participants were followed up for 3 years on average. The primary outcome was the cumulative incidence of major noncommunicable diseases (including type 2 diabetes, cardiovascular diseases, and cancer). Secondary outcomes were the incidence of type 2 diabetes and the changing prevalence of metabolic syndrome., Results: The crude incidence of the major noncommunicable diseases was 6.7 cases per 100 person-years in the MET+MedDiet group, 6.9 in the MET alone group, 13.3 in the placebo plus MedDiet group, and 11.3 in the placebo group. The differences were fully explained by the reduction of type 2 diabetes, which was 80% and 92% lower in the MET and MET+MedDiet groups, respectively, compared with placebo., Conclusions: The use of 1,700 mg/day MET is effective to prevent diabetes in people selected on the basis of metabolic syndrome., (© 2024 by the American Diabetes Association.)

Context: Childhood and adolescence are periods of critical importance in the development of mental health disorders. The Mediterranean diet (MD) has been linked to multiple positive health outcomes, including reduced incidence of mental health disorders and fewer psychiatric symptoms., Objective: This study aimed to investigate the association between adherence to an MD and mental health outcomes in children and adolescents., Methods: A systematic literature review was conducted of original research that explored the relationship between psychiatric symptoms or disorders and adherence to an MD. The literature search was conducted on PubMed, Scopus, Web of Science, MEDES, Dialnet, and Latindex from inception to November 2022, and the Newcastle-Ottawa Scale was used to evaluate the quality of studies., Results: A total of 13 studies (6 cross-sectional, 4 case-control, 2 randomized clinical trials, and 1 longitudinal cohort) out of 450 met the inclusion criteria. A total of 3058 children or adolescents with a mean age range from 8.6 to 16.2 years were included. Among the reviewed studies, 5 (71.42%) of those looking at attention-deficit/hyperactivity disorder, 4 (80%) examining depression, and 2 (50%) assessing anxiety found a significant protective association. Seven articles (53.84%) were found to be of high quality and 6 (46.15%) of moderate quality., Conclusion: Adherence to an MD could be a protective factor for mental health in child and adolescent populations. This suggests that promoting an MD could help prevent the onset of clinical psychiatric symptoms, reduce symptom severity, and improve prognosis in young patients., Systematic Review Registration: PROSPERO registration no. CRD42021276316., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Gut microbiota generates a series of bioactive metabolites that can be converted into uremic toxins such as trimethylamine-N-oxide (TMAO), p-cresyl sulfate (pCS), and indoxyl sulfate (IS). The aim of the study was to examine the association between diet and the concentrations of the mentioned gut microbiota-derived uremic toxins., Methods: An observational cross-sectional study was conducted involving 210 participants: 84 hemodialysis (HD) patients, 44 peritoneal dialysis (PD) patients, 52 kidney transplant recipients (KTR), and 30 healthy controls. Dietary intake was assessed using a 3-day food diary and a food frequency questionnaire with 6 answers (FFQ-6). The alternate Mediterranean diet (aMED) score was calculated based on data obtained from the 3-day food diary and FFQ-6. Blood samples were analyzed for TMAO, pCS, and IS concentrations using liquid chromatography-mass spectrometry (LC-MS/MS)., Results: Significant differences in TMAO, pCS, and IS concentrations were observed among the study groups. HD and PD patients exhibited higher levels of these metabolites compared to KTR and healthy controls. The median aMED score was 4 (3-5) points in the HD group, 4.5 (4-6) points in the PD group, 5 (4-6) points in the KTRs, and 6 (5-7) points in the control group. Higher adherence to the Mediterranean diet (aMED score) was associated with lower pCS levels in dialysis patients. Vegetable intake several times a day was found to mitigate the effects of phenylalanine and tyrosine intake on pCS concentration among dialysis patients., Conclusions: The diet of patients undergoing kidney replacement therapy (KRT) significantly affects the concentrations of gut microbiota-derived uremic toxins. These findings highlight the importance of dietary management in mitigating the adverse effects of these toxins in patients with chronic kidney disease (CKD)., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Life expectancy and obesity prevalence are increasing worldwide, leading to an increase in the prevalence of cardiovascular disease. High-density lipoprotein (HDL) functionality and immunosenescence play key roles in cardiovascular disease, longevity, and quality of aging. Both molecular hallmarks of aging are impacted by obesity and metabolic syndrome and can be modulated by lifestyle. We aimed to evaluate the effect of a lifestyle intervention focused on an energy-reduced Mediterranean diet (erMedDiet), physical activity (PA), and behavioral support on HDL cholesterol efflux capacity (CEC) and immunosenescence., Method: CEC and immunosenescent T cells were determined in 60 participants from the control group (CG) and 56 from the intervention group (IG) of the PREDIMED-Plus trial at baseline and after 1 and 3 years of follow-up. PREDIMED-Plus is a randomized, controlled, parallel-group trial with an IG of erMedDiet, PA promotion, and behavioral support for weight loss and a CG of usual primary care advice. The sample included 116 volunteers from the PREDIMED-Plus-IMDEA subsample of the PREDIMED-Plus trial. Men aged 55 to 75 years and women aged 60 to 75 years with a body mass index between 27 and 40 kg/m 2 and metabolic syndrome were included., Results: Participants within the IG had significantly improved CEC (2.42% and 10.69% after 1 and 3 years of follow-up) and a decreased in senescent T cell profile (-3.32% ± 12.54% and -6.74% ± 11.2%, p  < 0.001, after 1 and 3 years of follow-up). Baseline obesity status impacted the response to the intervention., Conclusions: A weight loss intervention program with erMedDiet and PA ameliorated senescence markers.

Diet quality is closely related to the occurrence of gastrointestinal (GI) cancers; however, few studies have investigated the association between the Healthy Eating Index (HEI-2020) and the alternative Mediterranean diet (aMED) scores and GI (GI) cancers. This study aims to assess the association between HEI-2020, aMED scores and GI cancers. Information from a total of 26,320 participants was included in the National Health and Nutrition Examination Survey (NHANES). In our sub-analysis, we focused on participants with complete dietary and health data, specifically assessing the relationship between diet quality and GI cancers outcomes. The 24-hour recall questionnaire was used to collect and assess the participants' average dietary intake. Diagnoses of GI cancers were based on self-reported medical history confirmed through physician interviews or linked cancer registry data, ensuring diagnostic reliability. Logistic regression models, restricted cubic splines (RCS), subgroup analysis, and interaction methods were employed to fully evaluate the associations between HEI-2020, aMED scores, and GI cancers. Mediation analysis was also conducted to identify potential mediators of this relationship. Even after fully adjusting for potential confounders, participants with high adherence to the HEI-2020-2020 and aMED scores were significantly associated with a reduced risk of GI cancers. Compared to the lowest tertile of HEI-2020, participants in the highest tertile had a 30% reduced risk of GI cancers (OR 0.70, 95% CI 0.50 to 0.98, p = 0.037). Compared to the lowest tertile of aMED scores, participants in the highest tertile had a 37% reduced risk of GI cancers (OR 0.63, 95% CI 0.44 to 0.92, p = 0.014). RCS analysis indicated that both HEI-2020 and aMED scores were significantly associated with GI cancers; however, no significant non-linear relationship was observed. The primary findings confirm that higher adherence to HEI-2020 and aMED scores is associated with a lower risk of GI cancers. These results suggest that maintaining a high-quality diet may play a crucial role in the prevention and management of these cancers. Further research is needed to elucidate the mechanisms and effects of healthy diet management and high-quality diets in the prevention of GI cancers., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The National Health and Nutrition Examination Survey involving human participants was reviewed and approved by the National Center for Health Statistics Ethics Review Board. The patients/participants provided their written informed consent. This study involved secondary data analysis of the National Health and Nutrition Examination Survey, and this study we conducted was exempt from institutional review for this reason., (© 2025. The Author(s).)

Context: Consumption of the Mediterranean diet (MedDiet) has beneficial effects on cardiometabolic health and aging., Objective: This systematic review aimed to critically investigate the effect of the MedDiet on glycation markers in healthy or overweight individuals with type 2 diabetes or cardiovascular disease., Data Sources: MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched, using the terms "Mediterranean diet" AND "glycation end products, advanced"., Data Extraction: Three randomized and 3 nonrandomized clinical trials, containing data on 2935 adult and elderly individuals with normal weight or overweight, were included. All extracted data were compiled, compared, and critically analyzed., Data Analysis: The authors of most of the studies demonstrated a reduction in serum concentrations of advanced glycation end products (AGEs), such as εN-carboxymethyllysine and methylglyoxal, and in skin autofluorescence levels after at least 4 weeks of adherence to the MedDiet. The MedDiet also led to positive effects on gene expression of receptors for AGEs, as RAGE and AGER1, and an enzyme involved in detoxification (glyoxalase I). There is no evidence that short-term adherence affects glycation markers., Conclusions: Glycation markers improved in response to the MedDiet. The possible mechanisms involved may be related to the low AGE and refined sugars content of the diet, as well as its high monounsaturated fatty acid, phenolic compound, and dietary fiber contents., Systematic Review Registration: PROSPERO registration no. CRD42021284006., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: A comparison of commonly used diet quality indexes (DQIs) and their association with multiple indicators of sustainability has not been performed, which limits policy action., Objectives: To evaluate the associations between 8 DQIs and 7 sustainability indicators in a nationally representative sample in the United States., Methods: In this cross-sectional analysis, dietary data from the National Health and Nutrition Examination Survey (2011-2018, n = 18,522 ≥20 y) were merged with data on greenhouse gas emissions (GHGE), cumulative energy demand (CED), water scarcity footprint (WSF), land, fertilizer nutrients, pesticides, and food prices from multiple publicly available databases. Diet quality was measured using the Healthy Eating Index-2020 (HEI-2020), Alternate Healthy Eating Index-2010 (aHEI-2010), Mediterranean Diet Score (Med), Alternate Mediterranean Diet Score (aMed), Healthful Plant-Based Diet Index (hPDI), Planetary Health Diet Index (PHDI) for the United States, Dietary Approaches to Stop Hypertension Index (DASH), and Nutrient-Rich Foods Index 9.3 (NRF9.3). The relationship between each DQI and sustainability indicator was assessed using linear regression., Results: Greater scores on most or all DQIs were associated with lower daily per capita GHGE (β = -0.908 to -0.250 carbon dioxide equivalents per 1 unit increment in diet quality z-score), CED (β = -2.699 to 0.202 MJ), land (β = -0.002 to <-0.001 ha), and fertilizer nutrients (β= -0.026 to 0.007 kg). By contrast, greater scores on most or all DQIs were associated with greater WSF (β = 343-649 L equivalents) and diet cost (β = 0.037-1.125 US$), and had mixed associations with pesticide use (β = -0.001 to <-0.001 kg). Greater scores on aHEI-2010 and hPDI were associated with the greatest ratio of favorable-to-unfavorable sustainability outcomes (5:2 each), followed by PHDI (4:1), Med and aMed (4:2 each), HEI-2020 and DASH (3:2 each), and NRF9.3 (3:4)., Conclusions: All DQIs had sustainability trade-offs, but those that emphasized plant-based foods, rather than nutrients or animal-based foods, were associated with more favorable sustainability outcomes., Competing Interests: Conflict of interest ZC has research awards for diet sustainability projects from the United States Department of Agriculture, Jeffress Trust Awards Program for Research Advancing Health Equity, and National Pork Board., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Aims: This study aimed to review meta-analyses of randomised controlled trials that evaluated the effectiveness of the Mediterranean Diet for the primary and secondary prevention of cardiovascular disease., Methods: Five databases (Medline, Embase, Cochrane, CINAHL and ProQuest) were searched from inception to November 2022. Inclusion criteria were: (i) systematic review of randomised controlled studies with metanalysis; (ii) adults ≥18 years from the general population with (secondary prevention) and without (primary prevention) established cardiovascular disease; (iii) Mediterranean Diet compared with another dietary intervention or usual care. Review selection and quality assessment using AMSTAR-2 were completed in duplicate. GRADE was extracted from each review, and results were synthesised narratively., Results: Eighteen meta-analyses of 238 randomised controlled trials were included, with an 8% overlap of primary studies. Compared to usual care, the Mediterranean Diet was associated with reduced cardiovascular disease mortality (n = 4 reviews, GRADE low certainty; risk ratio range: 0.35 [95% confidence interval: 0.15-0.82] to 0.90 [95% confidence interval: 0.72-1.11]). Non-fatal myocardial infarctions were reduced (n = 4 reviews, risk ratio range: 0.47 [95% confidence interval: 0.28-0.79] to 0.60 [95% confidence interval: 0.44-0.82]) when compared with another active intervention. The methodological quality of most reviews (n = 16/18; 84%) was low or critically low and strength of evidence was generally weak., Conclusions: This review showed that the Mediterranean Diet can reduce fatal cardiovascular disease outcome risk by 10%-67% and non-fatal cardiovascular disease outcome risk by 21%-70%. This preventive effect was more significant in studies that included populations with established cardiovascular disease. Better quality reviews are needed., (© 2024 The Author(s). Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Australia.)

Background: Large-scale trials evaluating a multicomponent lifestyle intervention aimed at weight loss on kidney function are lacking., Methods: This was a post hoc analysis of the "PREvención con DIeta MEDiterránea-Plus" (PREDIMED-Plus) randomized controlled trial, including patients with overweight/obesity and metabolic syndrome, measured cystatin C and creatinine. Participants were randomly assigned (1:1) to an intensive weight loss lifestyle intervention (intervention group [IG]) consisting of an energy-restricted Mediterranean diet (MedDiet), physical activity promotion and behavioral support, or a control group (CG) receiving ad libitum MedDiet recommendations. The primary outcome was between-group differences in cystatin C-based kidney function (cystatin C-based estimated glomerular filtration rate-eGFRcys-and combined cystatin C-creatinine-based eGFR-eGFRcr-cys) change from baseline to 12 and 36 months. Secondary outcomes included between-group differences in creatinine-based eGFR (eGFRcr) and urinary albumin-to-creatinine ratio (UACR) change and the predictive capacity of these formulas at baseline for new-onset chronic kidney disease (CKD)., Results: A total of 1909 participants (65 ± 5 years, 54% men) were included. Twelve-month decline in eGFRcys, eGFRcr-cys, and eGFRcr was greater in the CG compared to the IG, with between-group differences of -1.77 mL/min/1.73 m 2 [95% confidence interval -2.92 to -0.63], -1.37 [-2.22 to -0.53], and -0.91 [-1.74 to -0.71], respectively. At 36 months, the decline in eGFRcr-cys and eGFRcr was greater in the CG. No between-group differences in UACR were found. Significant adjusted areas under the curve for baseline eGFRcys and eGFRcr-cys were observed for incident CKD at 36 months, which were similar to those for eGFRcr and UACR., Conclusions: In older adults with overweight/obesity and metabolic syndrome, the PREDIMED-Plus intervention may be an optimal approach to preserve kidney function., (© 2025 The Author(s). Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.)

Background: Psoriasis is an inflammatory disease primarily treated through molecular-targeted therapies. However, emerging evidence suggests that dietary interventions may also play a role in managing inflammation associated with this condition. The Mediterranean diet (MedDiet), prevalent in southern European countries, has been widely recognized for its ability to reduce cardiovascular mortality, largely due to its anti-inflammatory properties. This anti-inflammatory potential has prompted interest in exploring the MedDiet's role in immune-mediated diseases, including psoriasis. Observational studies have indicated potential benefits, such as reductions in the Psoriasis Area and Severity Index. However, there is a need for well-designed clinical trials to address the methodological limitations of these studies and to establish specific dietary recommendations for psoriasis., Objective: This study aims to evaluate the impact of an intensive dietary intervention based on the MedDiet in patients with psoriasis. The study will assess the effects of this intervention on skin involvement, metabolic parameters, and inflammatory cytokines. In addition, the emotional well-being and quality of life of participants will be evaluated using validated questionnaires. A methodological analysis will also be conducted to enhance the design of future large-scale clinical trials., Methods: An open-label, single-blinded (evaluator) randomized controlled trial was designed to assess the impact of a high-intensity MedDiet intervention in patients with mild-to-moderate psoriasis. A total of 38 patients will be randomly assigned into 2 groups-an intervention group receiving the MedDiet intervention and a control group receiving standard care. The intervention group will participate in dietary education sessions aimed at adopting the MedDiet over 4 months, with monthly monitoring by experienced nutritionists. Participants will receive 500 mL of extra virgin olive oil per week, along with informative materials, recipes, and weekly menus. In contrast, the control group will receive standard low-fat diet recommendations without nutritionist monitoring. All participants will undergo a baseline visit, a 2-month follow-up visit, and a final visit at 4 months. Blood tests will be conducted at the beginning and end of the study. This study protocol was approved by the Institutional Review Board of the Hospital Ramón y Cajal (Madrid) in July 2023., Results: Enrollment concluded in October 2024, with data collection set to finish by February 2025. The findings will be presented at national and international conferences and published in peer-reviewed journals., Conclusions: This protocol outlines the design of a clinical trial that implements the MedDiet in patients with psoriasis to evaluate its benefits on skin involvement, systemic inflammation, and quality of life., Trial Registration: ClinicalTrials.gov NCT06257641; https://clinicaltrials.gov/study/NCT06257641., International Registered Report Identifier (irrid): DERR1-10.2196/64277., (©Javier Perez-Bootello, Emilio Berna-Rico, Carlota Abbad-Jaime de Aragon, Ruth Cova-Martin, Leticia Goni, Asuncion Ballester-Martinez, Pedro Jaen-Olasolo, Nehal Mehta, Joel M Gelfand, Miguel Angel Martinez-Gonzalez, Alvaro Gonzalez-Cantero. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 29.01.2025.)

Purpose of Review: This review aims to summarise recent evidence on the effects of dietary patterns on the risk of bone fractures and sarcopenia., Recent Findings: Several dietary patterns have been investigated in relation to musculoskeletal health, including Mediterranean Dietary Patterns (MDP), Dietary Inflammatory Indices, vegetarian and vegan diets. Adherence to 'healthier' dietary patterns appears to be protective against fractures and sarcopenia, with the strongest protective associations found between the MDP and fractures. Individuals following vegan or vegetarian eating patterns need to be aware of calcium and vitamin D requirements to maintain musculoskeletal health. Although more healthy dietary patterns may be protective for musculoskeletal health the current evidence base is limited by variation in the construction of dietary pattern scores and reported outcome measures. Future research should fully report scoring methods, intakes of dietary components across scoring groups or categories, and consider outcome measures that allow for better comparison between studies., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s).)

Metabolic syndrome is a cluster of risk factors, including abdominal obesity, insulin resistance, hypertension, dyslipidemia (intended as an increase in triglyceride levels and a reduction in HDL cholesterol levels), and elevated fasting glucose, that increase the risk of cardiovascular disease and type 2 diabetes. With the rising prevalence of metabolic syndrome, effective dietary interventions are essential in reducing these health risks. The Mediterranean diet, rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil and moderate in fish and poultry, has shown promise in addressing metabolic syndrome and its associated components. This diet's anti-inflammatory and antioxidant properties, primarily due to its unsaturated fats, polyphenols, and fiber, have improved blood pressure, lipid levels, and insulin sensitivity. Adherence to the Mediterranean diet has been linked to reductions in central obesity and insulin resistance, both key elements in managing metabolic syndrome. Regarding lipid management, the Mediterranean diet lowers triglyceride levels and low-density lipoprotein (LDL) cholesterol while raising high-density lipoprotein (HDL) cholesterol, enhancing lipid profiles. It also helps regulate blood glucose levels, reducing the likelihood of developing type 2 diabetes. Additionally, the diet promotes weight loss and improves body composition, particularly by decreasing visceral fat, a primary driver of metabolic syndrome according to IDF classification. The Mediterranean diet offers a holistic approach to managing metabolic syndrome and reducing the risk of related chronic diseases. Its positive impact on metabolic health, combined with lifestyle changes like increased physical activity, provides a sustainable method for addressing the global burden of this syndrome. This review aimed to summarize the positive effects of the Mediterranean diet on the component of the metabolic syndrome with subsequent positive effects on cardiometabolic risk profile.

Background: The Mediterranean diet (MedD) exerts anti-inflammatory and anti-oxidant effects that are beneficial in autoimmune thyroid diseases (ATD). Recently, a gluten-free diet (GFD) has been proposed for non-celiac patients with Hashimoto's thyroiditis (HT), but its usefulness is under debate. The present pilot study evaluates the effects of these two dietary regimes, with a focus on redox homeostasis, in HT., Patients and Methods: 45 euthyroid HT patients (30 F; median age 42 years) were randomly assigned to different dietary regimes: MedD ( n = 15), GFD ( n = 15) and free diet (FD, n = 15). Thyroid function tests, autoantibodies, and oxidative stress markers (Advanced glycation end products, AGEs; glutathione peroxidase (GPx), thioredoxin reductase (TRxR), and total plasma antioxidant activity (TEAA) were measured at baseline and after 12 weeks., Results: In the MedD group, significantly lower values of AGEs and higher values of GPX, TRX and TEAA with anti-oxidant action were detected ( p < 0.05) at 12 weeks compared to baseline, and compared to the GFD and FD groups, in which the oxidative stress parameters did not change significantly ( p > 0.05). No significant differences in serum levels of TSH, FT4, Ab-Tg, Ab-TPO compared to baseline were found in any group., Conclusions: This pilot study confirms the protective effect of the MedD against oxidative stress, while a GFD does not significantly influence markers of oxidative stress and/or thyroid autoimmunity/function parameters.

Background: Gender differences in metabolic response to lifestyle interventions remain poorly explored. This study aimed to evaluate the impact of a six-month Mediterranean diet (MD) intervention combined with regular physical activity on metabolic parameters in overweight adults., Methods: A prospective cohort study was conducted in an obesity clinic in Rome, Italy, involving overweight adults (BMI ≥ 25 kg/m 2 ) motivated to improve their lifestyle. Participants ( n = 205; 107 men and 98 women) self-selected into physical activity groups (aerobic, anaerobic, combined or no activity). Gender-specific metabolic changes were assessed, including lipid profiles, liver markers and fasting glucose., Results: Significant gender differences in metabolic results were observed. Men showed greater reductions in total cholesterol (TC) and LDL, as well as significant reductions in alanine aminotransferase (ALT). Women showed a significant increase in HDL cholesterol. Fasting blood glucose decreased significantly in both sexes, with no differences between the sexes. Activity-specific analysis revealed that anaerobic activity significantly improved lipid metabolism in men, while aerobic activity produced the greatest benefits in women, including increased HDL and improved liver marker profiles., Conclusions: Therapeutic strategies combining MD and physical activity must take into account gender-specific physiological differences and the type of sport activity to optimise metabolic benefits. Personalised approaches may improve the management of cardiovascular risk factors in overweight individuals., Study Registration: This study is registered on ClinicalTrials.gov (NCT06661330).

Background/objectives: Diet composition is important for health, especially during critical periods such as pre-gestation (P), gestation (G), or lactation (S), due to its potential impact not only on the mother but on the offspring. The Mediterranean diet includes many healthy foods rich in fiber and/or polyphenols, such as whole grains, fruits, vegetables, beans, and nuts. The present preclinical study assesses the impact of a diet rich in fiber and polyphenols (HFP diet) during one of those three periods (P, G, or S, three weeks each) on the rat gene expression of the small intestine obtained at the end of the lactation period., Methods: This analysis was performed by the mRNA two step PCR amplification by random primers and poly-T, followed by library generation and HiSeq X-Ten Illumina sequencing (Seqplexing), and further confirmed by Real time PCR and ELISA., Results: The results showed a broad number of genes significantly modulated after the HFP diet compared to the reference diet, with a higher number of genes modulated when the supplementing period was closer to the analysis day (S > G > P). Notably, genes involved in immune signaling, intestinal absorption, and cell growth were among those more significantly affected by the HFP dietary intervention. The HFP diet influenced the expression of key genes such as ferritin, fatty acid synthase, apelin, and complement proteins, among others. There was a unique gene modified in all the intervention periods (Family with Sequence Similarity 117 Member A, Fam117A , which codifies a protein with unknown function), indicating that this molecule may participate critically in the effects induced by fiber and polyphenols during these periods., Conclusions: Overall, in rats, the influence of diet for a three-week period around birth is able to modulate the intestinal gene expression, and consequently, maternal health, which can eventually have an indirect impact on the offspring.

Background/objectives: recent studies have suggested that components typical of the Mediterranean diet (MedDiet) are associated with depression and anxiety prevention. In this sense, the main objective of this study was to analyse the associations between adherence to the MedDiet and depression and anxiety symptoms and to examine whether this relationship is mediated by lean mass and the muscle strength index (MSI)., Methods: a cross-sectional study (based on data obtained from the Nuts4Brain-Z study) was conducted from 2023-2024, involving 428 university students, aged 18-30 years, from a Spanish public university. Depression was assessed using the Beck Depression Inventory (BDI-II), and anxiety was assessed via the General Anxiety Disorder-7 (GAD-7) tool. Adherence to the MedDiet was assessed using the MEDAS questionnaire. Lean mass was assessed via bioimpedance, and MSI was measured via a dynamometer. ANCOVA models were used to test the mean differences in depression and anxiety scores using MEDAS categories (low adherence < 9 points vs high adherence ≥ 9 points). Serial multiple mediation models, adjusted for the main confounders, were used to explore the role of lean mass and MSI in the relationships between adherence to the MedDiet and depression and anxiety symptoms., Results: university students with high adherence to the MedDiet exhibited lower scores for depression and anxiety symptoms ( p < 0.05) than did students with low adherence to the MedDiet. The mediation analysis preliminarily revealed that both lean mass and MSI acted as mediators of the relationships between adherence to the MedDiet and depression and anxiety., Conclusion: adherence to the MedDiet in university students per se does not appear to have a direct effect on depression and anxiety symptoms because these associations are partially (for depression) or entirely (for anxiety) explained by lean mass and MSI.

Background/objectives: Dementia is not a single disease but an umbrella term that encompasses a range of symptoms, such as memory loss and cognitive impairments, which are severe enough to disrupt daily life. One of the most common forms of dementia is Alzheimer's Disease (AD), a complex neurodegenerative condition influenced by both genetic and environmental factors. Recent research has highlighted diet as a potential modifiable risk factor for AD. Decades of research have explored the role of dietary patterns, including the Mediterranean Diet (MD) and its components, in neuroprotection and cognitive health. Systematic review examines studies investigating the impact of the Mediterranean Diet, Mediterranean-like diets, the Nordic Diet (ND), dietary intake patterns, and specific components such as extra virgin olive oil and rapeseed oil on cognitive function, disease onset, and progression in AD and dementia., Methods: A comprehensive search of PubMed, the Directory of Open Access Journals, and the Social Science Research Network was conducted independently by two reviewers using predefined search terms. The search period included studies from 2006 to 2024. Eligible studies meeting the inclusion criteria were systematically reviewed, yielding 88 studies: 85 focused on the MD and its relationship to AD and dementia, while only 3 investigated the ND., Results: The findings suggest that adherence to the Mediterranean and Nordic diets is generally associated with improved cognitive function and delayed cognitive decline and that adherence to both these diets can improve cognitive function. Some studies identified that higher legume consumption decreased dementia incidence, while fruits and vegetables, carbohydrates, and eggs lowered dementia prevalence. Most studies demonstrated that high MD or ND adherence was associated with better cognitive function and a lower risk of poor cognition in comparison to individuals with lower MD or ND adherence. However, some studies reported no significant benefits of the MD on cognitive outcomes, while two studies indicated that higher red meat consumption was linked to better cognitive function., Conclusion: Despite promising trends, the evidence remains varying across studies, underscoring the need for further research to establish definitive associations between diet and cognitive function. These findings highlight the essential role of dietary interventions in the prevention and management of dementia and AD, therefore offering critical insights into the underlying mechanisms by which the diet may impact brain health.

Background: Physical Activity (PA) provides numerous biological and psychological benefits, especially for cancer patients. PA mitigates treatment side effects, influences hormones, inflammation, adiposity, and immune function, and reduces symptoms of anxiety, depression, and fatigue. This study evaluates the impact of PA on these positive outcomes. Materials and Methods: An observational retrospective study enrolled 81 patients: 31 with CKD stages II-V and 50 with CKD and urological malignancies. Baseline and 6-month follow-up visits included clinical (Iohexol, Creatinine, Cystatin C) and anthropometric parameters (Bioimpedance Analysis, body circumferences). Physical activity levels were assessed using the Rapid Assessment of Physical Activity (RAPA) test. Patients followed a Mediterranean-like diet with controlled protein intake (MCPD) and received PA improvement advice. Statistical analysis was performed using linear regression and Pearson's Chi-Squared test with R programming. Results: Significant reductions in total adiposity and abdominal fat and improved body fluid distribution were observed. Post intervention, there was a 25.4% reduction in inactive individuals and an 88% increase in active lifestyles. Patients aged 75+ were more likely to be sedentary, indicating a need for increased professional attention. No correlation was found between increased PA and creatinine, cystatin, and eGFR values, but a positive correlation with GFR measured by iohexol clearance remained significant in multivariate analysis. Post intervention, regular PA engagement increased from 12.3% to 48% ( p < 0.002). Conclusions: Incorporating PA and nutritional assessments into standard clinical care, supported by a collaborative nephrologist-nutritionist approach, can enhance the quality of life of CKD patients.

Dietitians are uniquely positioned to promote the Mediterranean Diet (MedDiet), a diet recognized for its health benefits and sustainability. This study aimed to assess the knowledge and attitudes regarding the MedDiet among dietitians in the United Arab Emirates (UAE), and to examine the frequency and correlates of using this diet in clinical practice. Practicing dietitians (n = 220) completed a 44-item web-based questionnaire, verified for face, content and construct validity, as well as internal and parallel form reliability. Total scores were computed as sum of items for knowledge and attitudes. The mean knowledge score was 6.48 ± 1.85 out of 10, with gaps related to MedDiet's benefits and nutrient composition. Despite positive attitudes, many dietitians did not agree that it is easy to encourage patients to decrease red meat (68%) and increase fruits/vegetables intake (70%). In clinical practice, 35% of dietitians rarely/never used the MedDiet. Dietitians were more likely to recommend the MedDiet if they had a Mediterranean country of origin (p = 0.037), higher knowledge (p = 0.022) and attitude (p = 0.013) scores, and acquired information about the MedDiet through university education (p = < 0.001) or conferences/seminars/workshops (p = 0.002). Using the findings of this study, evidence-based interventions can be developed to support the role of dietitians in promoting adherence to the MedDiet., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Recent research emphasizes the importance of integrating psychological-emotional factors with nutrition and body composition in athletes. This study investigates the correlations between these aspects in 36 professional rugby players, aiming to identify relationships that could optimize sports performance and overall well-being., Methods: The study sample included 36 male athletes (mean age: 24.4 ± 2.1 years, weight: 86.5 ± 7.1 kg, and height: 181.8 ± 5.7 cm). Four assessment tools were used: the Short Form Health Survey Questionnaire (SF-36) to evaluate quality of life, the Mediterranean diet adherence (MEDI-LITE), the International Physical Activity Questionnaire (IPAQ), and body composition measurements (stadiometer and BIVA). Statistical analyses, including the Shapiro-Wilk test, Pearson, and Spearman correlations, were conducted to explore relationships between the variables., Results: The athletes' mental and physical health was comparable to the general population (mean MCS = 50.5 ± 7.4, PCS = 49.6 ± 9.6). Mediterranean diet adherence was low (mean MEDI-LITE = 8.6 ± 2.6), while physical activity levels were high (mean IPAQ = 2560.5 ± 950.1). Body composition indicated overweight status (mean BMI = 26.15 ± 1.62 kg/m 2 , body fat = 22 ± 4.3%). Positive correlations were observed between mental health, diet adherence, and physical activity, with a stronger link between physical activity and body composition., Conclusions: This study confirms a relationship between psychological-emotional factors, nutrition, and body composition in athletes, suggesting an integrated approach to optimize performance. However, causality remains unconfirmed, and the small sample size limits generalizability. Future research should include larger, more diverse samples to expand these findings.

Background: Increased burden of socially determined vulnerabilities (SDV), which include nonmedical conditions that contribute to patient health, is associated with incident heart failure (HF). Mediators of this association have not been examined. We aimed to determine if a healthy lifestyle mediates the association between SDV and HF., Methods: We included adults aged 45 to 64 years old across the United States from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke) without evidence of HF at baseline. The primary exposure was a count of SDV based on the Healthy People 2030 framework. The primary outcome was incident HF. We assessed the role of a healthy behavior score (HBS range, 0-8) and its components (adherence to a Mediterranean diet, physical activity, lack of sedentary lifestyle, and smoking abstinence) as potential mediators of the association between SDV and incident HF., Results: We included 13 on 525 participants. The median HBS was 4, with 16% with low HBS (0-2), 55% with moderate HBS (3-5), and 29% with high HBS (6-8). Increasing burden of SDV was associated with a stepwise increase in incident HF (adjusted hazard ratio, 1.84 [95% CI, 1.32-2.52] for 1 SDV, 2.59 [95% CI, 1.87-3.60] for 2 SDV, and 4.20 [95% CI, 3.08-5.73] for ≥3 SDV). There was no statistically significant mediation of HBS for the association of SDV count of 1 and incident HF. HBS score mediated 10.6% of the association between SDV count of 2 and incident HF and 11.1% of the association for those with ≥3 SDV. This increased to 10.8% and 18.3%, respectively, in the complete case analysis. Regarding individual components of HBS as mediators, only avoidance of a sedentary lifestyle was statistically significant (8.6% mediation) for the association of SDV count of 2 and incident HF., Conclusions: A healthy lifestyle plays a small role in mediating the association between high SDV count and incident HF.

Background: The research on orthorexia nervosa (ON) has thoroughly outlined the connection between it and various mental disorders, including obsessive-compulsive disorders and eating disorders, in addition to stress. However, research has not considered psychophysical stress and other measures of psychophysical health, such as adherence to the Mediterranean diet. Methods: This cross-sectional and case-control research involved 63 students from the University of Parma, aged between 18 and 49 years. The ORTO-15 questionnaire was utilized to categorize the entire sample into two groups: one without orthorexia (score > 35) and another with orthorexia (score < 35). All subjects were assessed with the Psychophysiological Stress Profile (PSP) and completed the Eating Disorder Inventory-3 (EDI-3) and the Symptom Checklist-90-Revised (SCL-90-R). In addition, they were interviewed using the PREDIMED questionnaire to assess adherence to the Mediterranean Diet, and their body mass index (BMI) was calculated. Results: Subjects with orthorexia represented 38.10% of the total sample and reported a higher BMI than controls, although the PREDIMED score did not show a difference in adherence to the Mediterranean diet. The EDI-3 highlighted emotional dysregulation and hypercontrol in students with orthorexia, and a dissociation between subjective and objective measures of stress emerged. Particularly, the psychophysiological parameters of skin conductance, heart rate, and heart rate variability showed greater reactivity to stressful stimuli, but no difference was noted in psychological symptoms. Conclusions: These findings confirmed the presence of alterations in eating behavior in people with orthorexia as well as a higher BMI. It was hypothesized that hypercontrol might favor the perception of psychological well-being at a subjective level, although inadequate management of stress emerged at an objective psychophysiological level. Further studies are needed to highlight the causality between ON, hypercontrol, diet, and psychophysical stress, given that students with orthorexia present a dysregulation of emotions associated with greater autonomic arousal.

Background: Dementia is a growing public health concern with limited effective treatments. Diet may be a modifiable factor that significantly impacts brain health. Mediterranean diet (MeDi) has been suggested to be associated with brain Magnetic Resonance Imaging (MRI) markers related to dementia, but the existing evidence is inconsistent., Objectives: This systematic review and meta-analysis aimed to quantify the association between MeDi and dementia-related MRI markers., Methods: A systematic search was conducted on PubMed, Embase, and Web of Science up to September 2024. Two reviewers worked in parallel to select studies and extract data. We considered epidemiologic studies that reported beta coefficients (β) with 95% confidence intervals (CIs) for MRI markers related to MeDi. Separate meta-analyses were performed for cross-sectional and longitudinal studies., Results: A total of 20 relevant studies involving 44,893 individuals were included in the analysis. Thirteen cross-sectional studies included a total of 42,955 participants. A meta-analysis of cross-sectional studies revealed significant associations between MeDi and white matter hyperintensity (WMH) (β = - 0.03, 95% CI = - 0.05- - 0.01, P = 0.02). However, there were no significant associations found between MeDi and total brain volume (TBV) (β = - 0.03, 95% CI = - 0.20-0.13, P = 0.71), gray matter volume (GMV) (β = 0.26, 95% CI = - 0.19-0.71, P = 0.26), white matter volume (WMV) (β = - 0.09, 95% CI = - 0.40-0.22, P = 0.58), or hippocampal volume (HCV) (β = - 1.02, 95% CI = - 7.74-9.79, P = 0.82). In the longitudinal analysis, seven prospective studies with an average follow-up period ranging from 1.5 to 9 years and involving 1,938 participants. The combined effect size of MeDi showed no significant association with TBV or GMV., Conclusion: Adherence to MeDi may be associated with reduced WMH in older adults. This suggests that MeDi may affect brain health and highlights the need for further research into its role as a modifiable lifestyle factor that might potentially modify the risk of dementia., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Human and animal rights and informed consent: This article does not contain any studies with human or animal subjects., (© 2025. The Author(s).)

The loss of skeletal muscle mass and strength, known as sarcopenia, is prevalent in older adults and linked to an increased risk of disability, frailty, and early mortality. Muscle health is crucial for the functionality and independence of older adults. As the aging population continuously grows, finding cost-effective strategies for preventing and treating sarcopenia is an important public health priority. While nutrition is recognized as a key factor in the development of sarcopenia, its role in preventing and treating the condition is still under investigation. In recent decades, nutritional research has shifted from a focus on individual nutrients or healthy foods to examining the combination of nutrients and foods in dietary patterns, along with their potential synergistic and antagonistic effects. A balanced diet and regular participation in physical activity are essential for maintaining musculoskeletal health. One of the healthy eating patterns with the greatest evidence of multiple health benefits is the Mediterranean diet, which has also been linked to positive effects on muscle function in observational studies. However, there is a lack of intervention studies. This review explores the updated evidence from longitudinal prospective studies on associations between adherence to the Mediterranean diet and sarcopenia in order to promote preventive and intervention strategies for healthy muscle aging.

Background: Food neophobia, characterized by the fear of unfamiliar foods, can be influenced by environmental, cultural, and genetic factors, leading to decreased consumption of novel or diverse foods. Understanding the impact of Mediterranean diet adherence and eating disorders on dietary behaviors is crucial, particularly for young adults who are developing lifelong eating patterns., Methods: The aim of this study was to investigate the relationships among food neophobia, Mediterranean diet adherence, and eating disorders in university students aged 18-24 years. A cross-sectional study was conducted with 1277 students (67.2% female) via an online questionnaire to assess sociodemographic characteristics, food neophobia (Food Neophobia Scale, FNS), Mediterranean diet adherence (KIDMED), and eating disorder risk (Eating Disorder Examination Questionnaire, EDE-Q)., Results: Most participants (67.7%) had a normal body mass index (BMI), 19.3% were classified as overweight, and 3.7% were classified as obese. Compared with male students, female students had significantly higher FNS scores (40.8 ± 9.21) (38.5 ± 10.97, p < 0.05), indicating greater food neophobia among women. Similarly, men's EDE-Q scores (3.5 ± 3.32) were significantly lower than those of women (4.4 ± 4.05, p < 0.05). Most participants (69.5%) did not experience food neophobia, and underweight individuals (11.0%) were more neophobic than obese individuals (4.4%). No significant differences were observed according to BMI (p > 0.05). A positive correlation was found between age and KIDMED adherence, whereas a negative correlation was observed between BMI and EDE-Q scores regarding food neophobia. The effects of BMI on food neophobia and the risk of eating disorders were found to vary by sex., Conclusions: These findings suggest that food neophobia may harm Mediterranean diet adherence and increase the risk of eating disorders among university students. Targeted interventions addressing food neophobia could promote healthier eating habits, such as the Mediterranean diet, thereby reducing disordered eating behaviors and associated risks. Further research is needed to confirm these findings, improve population nutritional habits and mental health outcomes, and develop effective public health strategies., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of Social Sciences and Humanities of Erciyes University (No. 449). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Approximately 35% of long-term cancer survivors experience ongoing cancer-related cognitive impairment (CRCI). Yet, few efficacious interventions exist to prevent or ameliorate CRCI. The underlying biological processes driving CRCI are complex and are reported to include changes in brain structure and function, increased oxidative stress and inflammation, and alterations in gut microbiome composition. Some of the mechanisms promoting CRCI have the potential to be modified through behavioral changes, such as dietary changes. Compelling evidence from randomized controlled trials and observational research supports the positive impacts of the Mediterranean-DASH Intervention for Neurodegenerative Delay diet on cognition outside of the context of cancer, but studies investigating the Mediterranean-DASH Intervention for Neurodegenerative Delay diet as an intervention for people who experience CRCI are lacking. This review examines the current state of the science for cognitive outcomes of dietary interventions in aging populations and discusses future opportunities to adapt these interventions to cancer populations., (©2024 American Association for Cancer Research.)

Purpose of Review: This narrative review explores the role of Medical Nutritional Therapy (MNT) in managing Metabolic-Associated Steatotic Liver Disease (MASLD), previously known as nonalcoholic fatty liver disease. It aims to examine the effectiveness of specific nutritional strategies in preventing and treating this obesity-linked liver disease., Recent Findings: Emerging evidence underscores the benefits of the Mediterranean diet, low-carbohydrate diets, and intermittent fasting in reducing liver fat, improving insulin sensitivity, and mitigating inflammation. Supplementing with vitamin E, omega-3 fatty acids, and silymarin can potentially reduce liver fibrosis and promote liver health. MNT is a key intervention for MASLD management, emphasizing dietary patterns, caloric restriction, and nutraceutical supplementation. Integrating these strategies with lifestyle modifications, including regular physical activity, offers a comprehensive approach to improving metabolic and liver outcomes in patients with MASLD. Further research is needed to refine and personalize these therapeutic interventions., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors., (© 2024. The Author(s).)

Background: Metabolic syndrome (MS) is a combination of comorbidities that increase pro-inflammatory cytokines (PIC) production, with subsequent body composition (BC) abnormalities and high cardiovascular risk. Treatment with diet and exercise has been suggested as possible non-pharmacological adjuvant treatment., Objective: To determine changes in BC and PIC in patients with MS after a Mediterranean-type diet (MedDiet) and/or isokinetic exercise (IE)., Methods: A controlled randomized clinical trial was conducted at a third-level hospital in Mexico City. Intervention groups: G1: MedDiet + IE; G2: IE; G3: MedDiet; G4: control. Anthropometry, BC, and PIC were collected from the baseline and at 12 weeks post-intervention. MedDiet was estimated from a 24-h recall record. IE consisted of a standard high-intensity anaerobic exercise program., Results: Forty-two patients with MS aged 18-65 years old were included. The most frequent comorbidities were obesity, insulin resistance, and dyslipidemia. After 6 months of intervention, a significant reduction of resistin was observed within the IE group and MedDiet + IE, whereas the former group also showed an increase in adiponectin. Interventions of MedDiet and MedDiet + IE showed a decrease in IL-10. Regarding BC, all groups increased the resistance values in relation to the baseline but were lower than the control group., Conclusions: The results suggest that MedDiet and IE have a selective impact on pro-inflammatory mediators, while the combination of MedDiet and IE may induce only minor changes in BC.

Background/objectives: There is current scientific interest pertaining to the therapeutic effects of olive-derived polyphenols (ODPs), in particular their associated anti-inflammatory properties, following the wealth of research surrounding the physiological impact of the Mediterranean Diet (MD). Despite this association, the majority of the current literature investigates ODPs in conjunction with metabolic diseases. There is limited research focusing on ODPs and acute inflammation following exercise, regardless of the knowledge surrounding the elevated inflammatory response during this time. Therefore, the aim of this scoping review is to understand the impact ODPs may have on exercise-induced inflammation., Methods: This scoping review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScRs). The literature searches were conducted in PubMed and EBSCOhost and considered for review if records reported original data, examined olives, olive-derived nutrients, food sources, or ODPs in conjunction with exercise-induced inflammation (including known causes, associations, and proxy measures)., Results: Seven studies investigated ODPs and exercise-induced inflammation, providing commentary on reduced oxidative stress, inflammatory biomarkers, and immune biomarkers, enhanced antioxidant defenses and modulations in mitochondrial function, albeit in low numbers. An average of 100.9 mg∙d -1 ODPs were supplemented for an average of 40 days, with hydroxytyrosol (HT) being the primary ODP investigated. Six studies employed individual aerobic exercise as their stimulus, whilst one study investigated the impact of an acute dose of ODP., Conclusions: There is a limited consensus on the direction of isolated HT in human models, whereas animal models suggest a reduced inflammatory response following ≥2 weeks HT supplementation in conjunction with chronic exercise. Future research should initially investigate the inflammatory response of ODP, with particular focus on HT, and aim to identify an optimum dose and time course for supplementation surrounding exercise to support acute recovery and exercise adaptations.

Background: A healthy lifestyle, including good adherence to a Mediterranean diet (MD) and regular physical exercise, may be an important factor during the course of inflammatory bowel disease (IBD). Our aim is to determine whether adherence to MD, physical activity, and the combination of both can impact on IBD course., Methods: This prospective cohort study includes 693 IBD outpatients who were in remission with a median follow-up time of 27 months (interquartile range 22-29 months). Each patient completed a survey to assess their adherence to the MD and physical activity. Healthy lifestyle was considered to be a proper adherence to both MD and an active lifestyle. Relapse during follow-up, severity of relapses, need for systemic steroids, and therapy changes were recorded., Results: During the follow-up period, 188 patients (27.1%) experienced relapse, of which 56.1% were moderate or severe. Among patients with relapse, 85 (45%) required treatment with corticosteroids, and 15 (7.9%) were hospitalized. Patients with ulcerative colitis (CU) were more adherent to healthy lifestyle than patients with Crohn's disease (P = .011). Healthy lifestyle was associated with lower risk of moderate and severe relapses (adjusted Hazard ratio [aHR], 0.250; 95% confidence interval [CI], 0.093-0.670) and steroids use (aHR 0.292; 95% CI, 0.103-0.828) in IBD patients and with lower risk of moderate and severe relapses (aHR 0.270; 95% CI, 0.093-0.789) in UC patients., Conclusions: Healthy lifestyle has a favorable influence on promoting a milder disease course, and thus should be a crucial part of clinical management of patients with IBD., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background and Objectives: Regular physical activity (PA) and Mediterranean diet (MeDi) adherence independently improve glycemic control and clinical outcomes in type 2 diabetes mellitus (T2DM). This study examined the associations between PA, body composition (BC), MeDi adherence, and glycemic control in Dalmatian T2DM patients., Materials and Methods: A cross-sectional study was conducted at the University Hospital of Split (November-December 2023) during an open call for T2DM patients. Data collected included blood/urine samples, blood pressure, BC, and anthropometrics. MeDi adherence and PA were assessed via the Mediterranean Diet Service Score and the International PA Questionnaire-Short Form., Results: Among 252 participants (median age: 67 years, IQR: 60-73; 51.6% women; median T2DM duration: 10 years, IQR: 6-20), PA levels were low (31.4%, N = 79), moderate (45.2%, N = 114), and high (23.4%, N = 59), with uniformly low MeDi adherence across groups. Low PA was associated with higher body mass index (BMI) and lower phase angle (PhA). PA negatively correlated with fat mass (FM; %) and visceral adiposity. Positive BMI predictors included FM (kg), total body water, visceral fat level, and PhA, while fat-free mass, intracellular water, and FM (%) were negative predictors. The estimated glomerular filtration rate was the only positive predictor of the total metabolic equivalent of the task score., Conclusions: PA enhances BC and metabolic health, but inadequate MeDi adherence limits these benefits in the T2DM population. To optimize glucose control and health outcomes, public health initiatives must emphasize MeDi adherence and a combination of aerobic and resistance training.

Purpose of Review: This review examines the long-term efficacy and safety of various nutritional and pharmacological strategies for managing obesity. The focus is on the Mediterranean diet (MedDiet), very low-energy ketogenic therapy (VLEKT), and pharmacological interventions such as naltrexone/bupropion and liraglutide. Given the chronic nature of obesity, understanding the sustainability and impact of these treatments over time is critical., Recent Findings: The MedDiet has shown significant benefits for cardiovascular health and moderate long-term weight loss, though it does not always outperform other diets in terms of weight reduction. VLEKT is highly effective for rapid weight loss, but concerns remain about its long-term sustainability. Pharmacological treatments, including naltrexone/bupropion and liraglutide, have shown promise in promoting significant weight loss and improving metabolic markers. However, issues related to long-term adherence and potential side effects need further exploration. Both nutritional and pharmacological strategies offer valuable tools in obesity management. While treatments like VLEKT and pharmacological options provide significant short-term benefits, the MedDiet remains a sustainable long-term approach. The long-term efficacy and safety of naltrexone/bupropion and liraglutide require more investigation to address challenges in weight maintenance and side effects. Further studies are needed to establish the optimal duration and combination of these therapies for sustained obesity management., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Aims: We demonstrated in the randomized 18-month DIRECT PLUS trial (n = 294) that a Mediterranean (MED) diet, supplemented with polyphenol-rich Mankai duckweed, green tea, and walnuts and restricted in red/processed meat, caused substantial intrahepatic fat (IHF%) loss compared with 2 other healthy diets, reducing NAFLD by half, regardless of similar weight loss. Here, we investigated the baseline proteomic profile associated with IHF% and the changes in proteomics associated with IHF% changes induced by lifestyle intervention., Approach and Results: We calculated IHF% by proton magnetic resonance spectroscopy (normal IHF% <5% and abnormal IHF% ≥5%). We assayed baseline and 18-month samples for 95 proteomic biomarkers.Participants (age = 51.3 ± 10.8 y; 89% men; and body mass index = 31.3 ± 3.9 kg/m 2 ) had an 89.8% 18-month retention rate; 83% had eligible follow-up proteomics measurements, and 78% had follow-up proton magnetic resonance spectroscopy. At baseline, 39 candidate proteins were significantly associated with IHF% (false discovery rate <0.05), mostly related to immune function pathways (eg, hydroxyacid oxidase 1). An IHF% prediction based on the DIRECT PLUS by combined model ( R2 = 0.47, root mean square error = 1.05) successfully predicted IHF% ( R2 = 0.53) during testing and was stronger than separately inputting proteins/traditional markers ( R2 = 0.43/0.44). The 18-month lifestyle intervention induced changes in 18 of the 39 candidate proteins, which were significantly associated with IHF% change, with proteins related to metabolism, extracellular matrix remodeling, and immune function pathways. Thrombospondin-2 protein change was higher in the green-MED compared to the MED group, beyond weight and IHF% loss ( p = 0.01). Protein principal component analysis revealed differences in the third principal component time distinct interactions across abnormal/normal IHF% trajectory combinations; p < 0.05 for all)., Conclusions: Our findings suggest novel proteomic signatures that may indicate MRI-assessed IHF state and changes during lifestyle intervention. Specifically, carbonic anhydrase 5A, hydroxyacid oxidase 1, and thrombospondin-2 protein changes are independently associated with IHF% change, and thrombospondin-2 protein change is greater in the green-MED/high polyphenols diet., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Aims: To test if a New Zealand food-based Mediterranean diet (NZMedDiet) with behavioural intervention improves cardiometabolic health and wellbeing., Methods: A randomised controlled trial comparing 12 weeks of the NZMedDiet to usual diet in participants with increased cardiometabolic risk (metabolic syndrome severity score [MetSSS] > 0.35). The intervention group was provided with food and recipes to meet 75% of their energy requirements, supported by a behavioural intervention to improve adherence. The primary outcome measure was (MetSSS) after 12 weeks., Results: Two hundred individuals with mean (SD) age 49.9 (10.9) years of which 62% women were enrolled with their household/whānau. After 12 weeks, the mean (SD) MetSSS was 1.0 (0.7) in the control (n = 98) and 0.8 (0.5) in the intervention (n = 102) group; estimated difference (95% confidence interval [CI]) of -0.05 (-0.16 to 0.06), p = 0.35. The Mediterranean diet score (PyrMDS) was greater in the intervention group 1.6 (1.1-2.1), p < 0.001, consistent with a change to a more Mediterranean dietary pattern. Weight reduced in the NZMedDiet group compared with control (-1.9 kg [-2.0 to -0.34]), p = 0.006 and wellbeing, assessed by the SF-36 quality of life questionnaire, and improved across all domains. For example, the physical component summary score difference (95% CI) was 4.0 (2.4-5.7), p < 0.001, and the mental component summary score difference was 3.0 (0.7-5.2), p = 0.01., Conclusion: In participants with increased cardiometabolic risk, food provision with a Mediterranean dietary pattern and a behavioural intervention did not improve metabolic risk scores but was associated with reduced weight and improved quality of life., (© 2024 John Wiley & Sons Ltd.)

Introduction: We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12 months old., Methods: This was a secondary analysis of a randomized clinical trial (2017-2020), including 1,221 singleton pregnancies at high risk for small-for-gestational age. Participants were randomized into three groups at 19-23 weeks' gestation: Mediterranean diet intervention, stress reduction program, or usual care. A detailed neurosonography was performed on 881 participants at mean (SD) 33.4 (1.1) weeks' gestation. Neurosonographic measurements were done offline. ASQ was performed on 276 infants at 1 year of corrected age., Results: Biparietal diameter was similar among study groups. Mediterranean diet group fetuses had deeper insula (26.80 [1.68] versus 26.63 [1.75], mm, p = 0.02) and longer corpus callosum (42.98 [2.44] versus 42.62 [2.27], mm, p = 0.04), with a lower rate of suboptimal score infants in ASQ problem-solving domain (6.2 vs. 16.3%, p = 0.03). Stress reduction group fetuses had deeper insula (26.90 [1.75] versus 26.63 [1.75], mm, p = 0.04) and lower rates of suboptimal score infants in ASQ fine motor domain (4.3 vs. 12.8%, p = 0.04), compared to usual care group fetuses., Conclusion: Maternal structured intervention during pregnancy of the trial has the potential to modify offspring's neurodevelopment., (© 2024 S. Karger AG, Basel.)

Context: High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain., Objective: This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression., Data Sources: PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms., Data Extraction: Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration's Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively., Data Analysis: In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of "some concerns" to "high," while the certainty of evidence was low., Conclusion: MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs., Systematic Review Registration: PROSPERO registration no. CRD42022341895., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

In recent times, there has been growing interest in understanding the factors contributing to prolonged and healthy lifespans observed in specific populations, tribes, or countries. Factors such as environmental and dietary play significant roles in shaping the ageing process and are often the focus of inquiries seeking to unravel the secrets behind longevity. Among these factors, diet emerges as a primary determinant, capable of either promoting or mitigating the onset of age-related diseases that impact the ageing trajectory. This review examines the impact of various diet types on ageing and age-related conditions, including cardiovascular disease, cancer, neurodegenerative disorders, and metabolic syndrome. Different dietary patterns, such as the Mediterranean diet, the Japanese diet, vegetarian and vegan diets, as well as low-carbohydrate and ketogenic diets, are evaluated for their potential effects on longevity and health span. Each diet type is characterized by distinct nutritional profiles, emphasizing specific food groups, macronutrient compositions, and bioactive components, which may exert diverse effects on ageing processes and disease risk. Additionally, dietary factors such as calorie restriction, intermittent fasting, and dietary supplementation are explored for their potential anti-ageing and disease-modifying effects. Understanding the influence of various diet types on ageing and age-related diseases can inform personalized dietary recommendations and lifestyle interventions aimed at promoting healthy aging and mitigating age-associated morbidities., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This systematic review appraised previous findings of non-pharmacological interventions on gut microbiota and/ or intestinal permeability in older adults. A literature search was performed using PubMed, Scopus, ScienceDirect and the Cochrane Library. Relevant studies were shortlisted based on the inclusion and exclusion criteria, and evaluated for risks of bias using the "Cochrane Collaboration's Risk of Bias 2" and the "NIH Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group". The primary outcomes were the effects of non-pharmacological interventions on gut microbiota diversity and composition, and intestinal permeability in older adults. Out of 85,114 studies, 38 were shortlisted. Generally, the non-pharmacological interventions were beneficial against dysbiosis and the leaky gut in older adults. Considering specific interventions with two or more studies that reported consistent outcomes, a pattern was observed amongst the Mediterranean diet (MD), polyphenol-rich (PR) diet and supplements (i.e., probiotics, prebiotics and synbiotics). As for the other interventions, the very few studies that have been conducted did not allow a strong conclusion to be made just yet. The MD (single and multidomain interventions) restored gut microbiota by increasing species richness (alpha diversity) and reduced intestinal permeability (zonulin) and inflammation (CRP). The PR diet only showed slight changes in the gut microbiota but improved the gut barrier by reducing zonulin, CRP and IL-6. Probiotics, prebiotics and synbiotics increased the genus Bifidobacterium spp. which are considered beneficial bacteria. This review has uncovered insights into the relationship between gut microbiota and intestinal epithelial barriers of specific non-pharmacological interventions in older adults., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Retinal sublayer thickness is associated with both ophthalmic and neurodegenerative diseases, serving as a valuable biomarker. Despite the established role of diet in chronic disease prevention, the relationship between healthy dietary patterns and retinal sublayer thickness remains underexplored., Objective: This study aims to investigate the associations between four commonly used diet assessment scores and retinal sublayer thickness in a large-scale population., Methods: This study utilized data from the UK Biobank, including 13,993 participants with complete optical coherence tomography (OCT) measurements and dietary assessments. The dietary patterns analyzed were the Alternate Mediterranean Diet (AMED), Anti-Empirical Dietary Inflammatory Index (AEDII), Alternate Healthy Eating Index-2010 (AHEI-2010), and Healthful Plant-Based Diet Index (HPDI). Retinal sublayers measured included macular retinal nerve fiber layer (mRNFL), macular ganglion cell-inner plexiform layer (mGCIPL), macular ganglion cell complex (mGCC), retinal pigment epithelium (mRPE), the outer nuclear layer of the central subfield (ONL), photoreceptor inner segment of the central subfield (IS) and total macular thickness. Multivariable linear regression models adjusted for demographics, ophthalmic measurements, and lifestyle factors were employed to examine associations. Mediation analysis was applied to explore the potential mediation effect of several blood biochemical indicators in simple mediation models., Results: Higher HPDI scores were significantly associated with increased central retinal macular thickness (β = 0.106, p = 0.001), mGCIPL thickness (β = 0.017, p = 0.033), mRPE (β = -0.012, p = 0.161), ONL (β = 0.044, p = 0.003), IS (β = 0.003, p = 0.005) and mGCC thickness (β = 0.027, p = 0.025). In contrast, the AMED, AEDII, and AHEI-2010 scores did not show consistent associations with retinal sublayer thickness except ONL and IS. The mediation analysis revealed that cholesterol acted as a suppressor variable, partially mediating the relationship between HPDI and retinal sublayer thickness. Sensitivity analyses indicated that the associations between HPDI and retinal sublayer thickness were more pronounced in younger individuals and females. Additionally, the variability in associations across different age and sex subgroups highlighted the potential influence of demographic factors on dietary impacts., Conclusion: The study findings suggest that adherence to a healthful plant-based diet may confer neuroprotective benefits, particularly for retinal ganglion cell health. This large-scale population-based study underscores the potential role of diet in mitigating early neurodegenerative changes detectable through non-invasive retinal imaging. Further longitudinal research is needed to establish causal relationships and elucidate the underlying mechanisms between diet and retinal health., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

This review analyzed existing literature regarding the relationship between different diets and chemotherapy toxicities, as well as the quality of life (QOL) among patients undergoing treatment. It aims to identify the most advantageous diet for cancer patients. PubMed, CINAHL, and Embase were used to select randomized control trials (RCTs) assessing the relationship between a specific diet and chemotherapy toxicities and/or QOL in patients as of October 2023. Out of 1,419 records, 11 RCTs were included. Analyses were stratified by diet type. Pooled odds ratios and 95% confidence intervals (CI) were obtained from the random-effect model using STATA. We included 7 studies testing fasting variations; 1 testing a ketogenic diet; 1 testing a Mediterranean diet; 1 testing a plant-based, high-protein diet; and 1 testing an anti-inflammatory diet. Four fasting studies were in the meta-analysis. The random-effects meta-analysis showed no significant difference in the incidence of chemotherapy toxicities between fasting and non-fasting patients. There is insufficient evidence to determine which dietary intervention is the most advantageous, however, there is evidence that all the diets examined may complement conventional cancer therapy by helping to reduce chemotherapy toxicities. No intervention can be ruled out. More research is needed in this field.