Evaluation of the degree of adherence to the Mediterranean diet in patients with heart failure: DIME-EAHFE study

Relationship between diabetic peripheral neuropathy and adherence to the Mediterranean diet in patients with type 2 diabetes mellitus: an observational study

PURPOSE

The main study goal is to assess the relationship between adherence to the mediterranean diet (MD) and the presence of diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM).

METHODS

Observational pilot study of 174 patients diagnosed with T2DM. Sociodemographic and anthropometric variables, physical activity, smoking habits, blood biochemical parameters and comorbidities were recorded. The presence of alterations in sensitivity to pressure, pain, thermal and vibration was explored. Good MD adherence was a score  ≥  9 the 14-point MD adherence questionnaire (MEDAS-14).

RESULTS

The study population consisted of 174 patients (61.5% men and 38.5% women), with a mean age of 69.56 ± 8.86 years; 19% of these patients adhered to the MD. The score obtained in the MEDAS-14 was higher in patients who did not present alterations in sensitivity to pressure (p = 0.047) or vibration (p = 0.021). The patients without diabetic peripheral neuropathy were more likely to comply with the MD and had a higher score on the MEDAS-14 (p = 0.047). However, multivariate analysis showed that only altered sensitivity to pressure was associated with adherence to the MD (altered sensitivity OR = 2.9; 95%CI 1.02-8.22; p = 0.045).

CONCLUSIONS

Although the patients with DPN had lower scores on the MEDAS questionnaire and therefore poorer adherence to the mediterranean diet, the only parameter significantly associated with the MD was that of sensitivity to pressure (monofilament test).

Adherence to Mediterranean diet and its association with multiple colonic polyps of unknown origin: a case-control study

Introduction

Multiple colonic polyps do not have a genetic origin in most patients, and the cause of this phenotype remains elusive. Environmental factors, such as diet, could be related to this phenotype. Our aim was to investigate the relationship between the adherence to Mediterranean diet and multiple colonic polyps of unknown origin.

Methods

A case-control pilot study was carried out with a sample of 38 individuals, including 23 cases with more than 10 adenomatous or serrated polyps from the national multicenter project EPIPOLIP and 15 healthy controls with normal colonoscopy. A validated Spanish version of the MEDAS questionnaire was administered to cases and controls.

Results

Adherence to Mediterranean diet was higher in controls than in patients with multiple colonic polyps (MEDAS score: 8.6 ± 1.4 vs. 7.0 ± 1.6; p = 0.01). Optimal overall adherence to the Mediterranean diet pattern was significantly higher among the controls than among cases (MEDAS score >9: 46% vs. 13%; OR 0.17; 95% CI 0.03-0.83). Non-optimal adherence to the Mediterranean diet acts as a risk factor for developing colorectal cancer derived from colorectal polyps.

Conclusion

Our results suggest that environmental factors play a role in the pathogenesis of this phenotype.

Dietary Intervention on Overweight and Obesity after Confinement by COVID-19

BACKGROUND

Obesity has become a public health problem in our society and is associated with many diseases, including type 2 diabetes mellitus, cardiovascular diseases, dyslipidemia, respiratory diseases, and cancer. Several studies relate weight loss in obese patients to improved anthropometric measurements and cardiometabolic risk. The objective of our study was to evaluate anthropometric changes, analytical parameters, insulin resistance, fatty liver, and metabolic scales, after a personalized weight loss program, through dietary advice to increase adherence to the Mediterranean diet and a motivational booster via mobile SMS messaging.

METHODS

Intervention study on a sample of 1964 workers, in which different anthropometric parameters were evaluated before and after dietary intervention: the metabolic score of insulin resistance; non-alcoholic fatty liver disease using different scales; metabolic syndrome; atherogenic dyslipidemia; and the cardiometabolic index. A descriptive analysis of the categorical variables was performed, by calculating the frequency and distribution of the responses for each one. For quantitative variables, the mean and standard deviation were calculated, since they followed a normal distribution. Bivariate association analysis was performed by applying the chi-squared test (corrected by Fisher's exact statistic when conditions required it) and Student's t-test for independent samples (for comparison of means).

RESULTS

The population subjected to the Mediterranean diet improved in all the variables evaluated at 12 months of follow-up and compliance with the diet.

CONCLUSIONS

Dietary advice on a Mediterranean diet and its reinforcement with reminder messages through the use of mobile phones may be useful to improve the parameters evaluated in this study and reduce the cardiometabolic risk of patients.

[Analysis of eating habits among the main health care agents in health promotion (physicians and nurses) of emergency services in times of COVID-19]

Objetivo

Determinación de hábitos nutricionales de profesionales sanitarios de servicios de urgencias hospitalarios durante la pandemia de la COVID-19.

Material y métodos

Estudio descriptivo longitudinal (periodo de seguimiento: 28 días), fundamentado en la utilización de una aplicación de Smartphone (e-12HR), realizado en un hospital de tercer nivel de Andalucía (España).

Resultados

Cuarenta y cuatro profesionales sanitarios de servicios de urgencias hospitalarios completaron el estudio: edad media = 47,7 años, predominio de mujeres (52,3%); IMC promedio = 25,2 kg/m²; mayoría de no fumadores (86,4%); elevado porcentaje de participantes con actividades físicas moderadas/intensas ≥ 150 minutos/semana (84,1%); el 54,5% era personal de enfermería y el 45,5% personal médico. El valor medio del indicador de adherencia a la dieta mediterránea fue 5,98 puntos (máximo 15), con un 20,5% de los participantes con valor del indicador ≥ 8. Según los estratos la adherencia a la dieta mediterránea en el personal de enfermería fue significativamente mayor que en el personal médico.

Conclusiones

La dieta de los profesionales sanitarios de servicios de urgencias hospitalarios se caracterizó, en el global de la muestra, por una baja adherencia al patrón de dieta mediterránea y, según los estratos, especialmente entre los profesionales médicos. La caracterización de la dieta en los profesionales sanitarios de servicios de urgencias hospitalarios puede proporcionar a las autoridades de salud pública un punto de partida para el diseño y la aplicación de intervenciones de promoción de la salud destinadas a fomentar unos hábitos alimenticios saludables durante las sucesivas olas por COVID-19 que se prevén a corto y medio plazo.

Adherence Of Spanish Primary Physicians And Clinical Practise To The Mediterranean Diet

BACKGROUND/OBJECTIVES

The primary objective of this study was to explore physicians' adherence to the dietary pattern known as the Mediterranean diet (MD). As a secondary objective we assessed physicians' awareness on the benefits of the MD and of the possibility of prescribing it.

SUBJECTS/METHODS

Physicians' adherence to the MD was evaluated through the Spanish associations SEMERGEN and CAMFIC, who sent the validated PREDIMED screener to their affiliates. The results reflected a high, medium, low or very low level of adherence depending on total score. The sample was drawn between 2014 and 2016. The second questionnaire evaluated the physicians' knowledge of the MD and their opinion about recommending it.

RESULTS

The PREDIMED test was answered by 422 Spanish physicians. In 8 out of 14 questions, more than 50% of the individuals scored only 1 point. However, 3 questions resulted in 1 point being scored by almost all physicians. Thus, on average, 55% of questions obtained 1-point scoring. The second questionnaire was answered by 212 physicians; 70% of them considered themselves to be aware of the benefits of the MD. More than 60% said they could invest 5 min of their time to recommend the MD.

CONCLUSIONS

Primary care physicians do not show a high level of adherence to the MD and emphasize the need for creating tools to evaluate it in their patients. This research can be useful as both a database and a justification for the creation of a new protocol to help physicians increase their own and their patients' MD adherence.

Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure: Results of the MEDIT-AHF Study

OBJECTIVES

The authors sought to evaluate clinical outcomes of patients after an episode of acute heart failure (AHF) according to their adherence to the Mediterranean diet (MedDiet).

BACKGROUND

It has been proved that MedDiet is a useful tool in primary prevention of cardiovascular diseases. However, it is unknown whether adherence to MedDiet is associated with better outcomes in patients who have already experienced an episode of AHF.

METHODS

We designed a prospective study that included consecutive patients diagnosed with AHF in 7 Spanish emergency departments (EDs). Patients were included if they or their relatives were able to answer a 14-point score of adherence to the MedDiet, which classified patients as adherents (≥9 points) or nonadherents (≤8 points). The primary endpoint was all-cause mortality at the end of follow-up, and secondary endpoints were 1-year ED revisit without hospitalization, rehospitalization, death, and a combined endpoint of all these variables for patients discharged after the index episode. Unadjusted and adjusted hazard ratios (HRs) were calculated.

RESULTS

We included 991 patients (mean age of 80 ± 10 years, 57.8% women); 523 (52.9%) of whom were adherent to the MedDiet. After a mean follow-up period of 2.1 ± 1.3 years, no differences were observed in survival between adherent and nonadherent patients (HR of adherents [HR_adh] = 0.86; 95% confidence interval [CI]: 0.73 to 1.02). The 1-year cumulative ED revisit for the whole cohort was 24.5% (HR_adh = 1.10; 95% CI: 0.84 to 1.42), hospitalization 43.7% (HR_adh = 0.74; 95% CI: 0.61 to 0.90), death 22.7% (HR_adh = 1.05; 95% CI: 0.8 to 1.38), and combined endpoint 66.8% (HR_adh = 0.89; 95% CI: 0.76 to 1.04). Adjustment by age, hypertension, peripheral arterial disease, previous episodes of AHF, treatment with statins, air-room pulsioxymetry, and need for ventilation support in the ED rendered similar results, with no statistically significant differences in mortality (HR_adh = 0.94; 95% CI: 0.80 to 1.13) and persistence of lower 1-year hospitalization for adherents (HR_adh = 0.76; 95% CI: 0.62 to 0.93).

CONCLUSIONS

Adherence to the MedDiet did not influence long-term mortality after an episode of AHF, but it was associated with decreased rates of rehospitalization during the next year.