The CASSIOPEA Study (Economic Crisis and Adherence to the Mediterranean diet: poSSIble impact on biOmarkers of inflammation and metabolic PhEnotypes in the cohort of the Moli-sAni Study): Rationale, design and characteristics of participants

Adherence to the Mediterranean Diet in Preventing Major Cardiovascular Events in Patients with Ischemic Heart Disease: The EVA Study

BACKGROUND

Adherence to healthy dietary patterns, such as the Mediterranean diet (Med-diet), is recommended for the maintenance of cardiovascular health. The determinants for adherence to Med-diet and its importance in secondary cardiovascular disease prevention are still unclear. The aim of the study was to evaluate the influence of sex- and psycho-socio-cultural (i.e., gender-related) factors on Med-diet adherence and its role in preventing major cardiovascular events (MACEs) in patients with ischemic heart disease (IHD).

METHODS

Med-diet adherence was evaluated among 503 consecutive adults with IHD. MACEs were collected during a long-term follow-up.

RESULTS

Male Bem Sex-Role Inventory score (i.e., male personality traits) and physical functional capacity were associated with higher adherence, while cohabitation with a smoker and physical inactivity with poorer adherence. During a median follow-up of 22 months, 48 participants experienced MACEs (17.5%, 8.1%, and 3.9% of patients with low, medium, and high adherence, respectively; p = 0.016). At multivariate Cox--regression analysis, a greater adherence remained inversely associated with MACEs (HR: 0.49; 95% CI: 0.29-0.82; p = 0.006) after adjusting for confounding factors.

CONCLUSION

The study suggests that gender-related factors have a role in maintaining a healthy dietary pattern. Improving Med-diet adherence may lower the risk of recurring cardiovascular events.

Maintaining, Managing, and Tele-Monitoring a Nutritionally Adequate Mediterranean Gluten-Free Diet and Proper Lifestyle in Adult Patients

The gluten-free diet (GFD) is a restrictive diet. In many cases, it must be permanent and strict, and it may be associated with both nutritional deficiencies and excesses, which can be prevented by following a healthy, natural Mediterranean GFD (Med-GFD). In this paper, we describe the importance of the Mediterranean diet, the correct intake of vitamins and minerals, and how they may play an important protective role against chronic or degenerative conditions. Herewith, we analyze different aspects that influence the ability to maintain a correct and balanced Med-GFD, which may contribute to the health status of patients, including a conscious use of gluten-free products to maintain a healthy lifestyle. Monitoring the Med-GFD remains a pivotal issue: to evaluate the presence of gluten peptides in urine, it could be important to introduce point-of-care testing, an efficient method for GFD self-monitoring (immunochromatographic technique), together with online nutritional questionnaires. Indeed, medical care via telemedicine can provide practical indications aimed at supporting patients and doctors. A natural Med-GFD can ensure the correct intake of nutrients and could be important for patients affected by gluten-related disorders, helping them to maintain a correct and healthy lifestyle.

The tenth anniversary as a UNESCO world cultural heritage: an unmissable opportunity to get back to the cultural roots of the Mediterranean diet

In 2010, the Mediterranean diet was awarded the recognition of UNESCO as an Intangible Heritage of Humanity because of its complex interplay between several factors, including skills, knowledge, processing, cooking, and particularly the sharing and consumption of food. Also, the Mediterranean way of eating emphasizes local food, seasonality and biodiversity. Actually, all these aspects are almost completely neglected by the current nutrition research, which rather focuses on amount of food consumed by an individual or a given population but rarely simultaneously considers how foods are matched, whether they are locally-grown or consumed convivially. Basically, nutritional epidemiology usually ends up with classifying populations as highly or poorly adhering to a Mediterranean diet on the basis of the quantity of food consumed with poor or little knowledge on other features of this eating model. As such, this approach is likely to miss important information that could turn out to be as crucial for health as the traditional analysis of food intake. Since a global industrial food system has emerged, traditional diets are facing a global food challenge threating their own survival in the next decades. To transmit the Mediterranean heritage to future generations, it is important to get back to its roots by disentangling the complexity of this diet, which is not merely a healthful model to defeat chronic diseases and improve survival. The Mediterranean diet is a cultural heritage strictly tied to its people and territories. Nutritional epidemiology is now challenged to account for all these aspects in future health research.