Mediterranean Journal of Nutrition and Metabolism - Volume 12, issue 1
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Mediterranean Journal of Nutrition and Metabolism publishes original scientific papers on metabolism, including diabesity and eating disorders; nutrition (epidemiological, basic, clinical and artificial); dietary and nutritional practices and management and their impact on health from prevention to treatment.
The journal hosts the proceedings of relevant congresses and presents shorter notices focused on the original character of the Mediterranean nutritional civilisation. In addition, this journal is intended as a platform for scientific debate and knowledge-sharing among students and clinical practitioners, and between them and the broader scientific community, and finally as a tool for promoting and enhancing scientific cooperation.
Abstract: BACKGROUND: People who engage in regular sport activities in commercial gyms usually consume dietary supplements without proper advice from health care professionals. Little is known about use of specific type of dietary supplements and factors associated with their use among people who exercise in gyms. OBJECTIVES: The objectives of this research work were to assess the prevalence of dietary supplement intake among people exercising in gyms and its influencing factors, to evaluate the use of specific type of dietary supplements and its association with sex and age. METHODS: A cross-sectional study was carried…out in 22 gyms. Data were collected form 367 exercisers. Chi-square was used to study relationship between intake of dietary supplement and factors related to its use. RESULTS: The intake of dietary supplements was reported by 49% of the participants. The most frequent used supplements were: vitamin D (42%), protein powder (33.1%), vitamin B12 (30.4%), omega-3 (26.5%), vitamin C (26.0%), calcium (21.5%), iron (21.0%), branched chain amino acids (17.1%), vitamin E (16.1%), and multi- vitamins and minerals (16.0%). Age and self-perception of overall diet (P = 0.026) were associated with the overall use of dietary supplements. Type of used supplements differed by sex and age groups. Males took protein powder (P < 0.001), branched chain amino acids (P < 0. 001), energy drinks (P = 0.001), and Brewer’s yeast (P = 0.02). Whereas, females consumed more antioxidants (P = 0.036), vitamin D (P < 0.001), calcium (P = 0.001), and iron (P = 0.002). Participants older than 40 years consumed more (P < 0.05) vitamin C, vitamin E, vitamin D, B-complex, vitamin B12, folic acid and calcium, and less protein powder (P = 0.024) in comparison to youngers. CONCLUSION: More than 40% of people exercising in gyms reported using dietary supplements. The use of specific dietary supplements was associated with sex and age.
Abstract: BACKGROUND: Methylglyoxal (MG) is a highly reactive compound derived from sugar metabolism, precursor of cytotoxic products named Advanced Glycation End products (AGEs). Increased MG levels and MG-related AGEs have been long associated with diabetes and its complications. The association between MG and hypercholesterolemia – induced by high-fat diets- has not been studied previously, neither the effect of olive oil addition to this diets. OBJECTIVE: To analyze the variations of MG and cholesterol levels under the effect of high-fat and olive oil-enriched diets. METHODS: Sixteen healthy male adult (New Zealand White, 6 months old)…rabbits were fed with commercial pellets (control, four rabbits), or with 14% of bovine grease added to the pellets (high-fat diet, twelve rabbits). After six months, bovine grease was reduced to 7% (half fat diet, eight rabbits). Then, 7% of olive oil was added to the pellets (protective diet, four rabbits). Glycaemia, cholesterolemia, HDL-cholesterolemia, triglyceridemia, fructosamine and MG-H1 levels were assessed in all experimental conditions (n = 4). RESULTS: The high-fat diet promoted a hypercholesterolemia associated with increased MG-H1 levels (p < 0.05) in non-diabetic and non-obese rabbits. Replacement of the high-fat diet with olive oil decreased significantly the cholesterolemia and MG-H1 levels (p < 0.05). CONCLUSIONS: Our data indicates that the replacement of a high-fat diet with olive oil can recover normal blood cholesterol values and can decrease MG-H1 levels.
Abstract: BACKGROUND: The Metabolic syndrome (MetS) is a disorder characterized by a cluster of symptoms, which increases risk of developing cardiovascular disease and diabetes. OBJECTIVE: To estimate the prevalence rate of the MetS and identify its predisposing risk factors in Lebanese university students. METHODS: Using two-stage sampling, 266 students were recruited to participate in a cross-sectional study at a local University. Anthropometric measurements, biochemical data and blood pressure were collected. Students filled out the following questionnaires: demographics, lifestyle habits, beverage consumption, International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index and the Perceived Stress Questionnaire. MetS…was diagnosed based on the criteria of the International Diabetes Federation. RESULTS: The prevalence of MetS in the sample population was found to be 6.4%. Furthermore, 65% of the sample had low HDL-C levels (53.10±13.06 mg/dl) and approximately 52% had a high waist circumference (85.67±11.45 cm). Neither lifestyle habits, beverage consumption, physical activity level, sleep quality nor increased stress were associated with increased risk of developing MetS. Age was significantly associated with higher odds of developing the MetS (aOR = 1.15, 95% CI: 1.03– 1.29). CONCLUSION: Metabolic syndrome is a cause of concern among Lebanese students, which highlights the need for prevention programs to decrease future health risks.
Abstract: The present investigation was conducted to evaluate the effect of Citrus maxima fruit peel supplementation in alloxan-induced diabetic rats. Diabetes was induced in male Long Evans rats by intraperitoneal injection of alloxan monohydrate (90 mg/kg body weight). Blood glucose level, oral glucose tolerance, and liver enzyme markers were evaluated. Moreover, histopathological examinations were also conducted using in liver sections to examine inflammation and fibrosis in the liver. Alloxan administered animals showed significant body weight loss and poor glucose tolerance. Alloxan administration also increased the liver marker enzymes’ activities and increased oxidative stress parameters compared to control rats. Citrus maxima…fruit peel supplementation for 21 days significantly (p < 0.05) reverted the glucose intolerance and liver enzymes activities to near normal levels. Moreover, Citrus maxima fruit peel supplementation prevented oxidative stress in liver of alloxan-induced diabetic rats. Our investigation also showed that alloxan administration in rats causes inflammatory cells’ infiltration and fibrosis in the liver which is ameliorated by Citrus maxima fruit peel supplementation. Our investigation suggests that Citrus maxima fruit peel supplementation can ameliorate alloxan-induced diabetes and its complications. The antioxidant properties of the fruit probably play a major role in the observed effects.
Keywords: Alloxan, inflammation, fibrosis, oxidative stress, Citrus maxima
Abstract: BACKGROUND: Type 2 diabetes is a common chronic disease in developing countries. It has widespread effects on many aspects of the lives of patients and their families, so health care systems should prioritize the management of diabetes. Blood glucose control and prevention of complications are the primary goals of diabetes care. Achievement is possible when the patients adhere to the treatment regimen, although several factors are known to affect the adherence. OBJECTIVE: The aim of this study was to evaluate the adherence to treatment and identify a number of its predictive factors in patients with diabetes in northern…Iran. METHODS: In this cross-sectional analytical study, 266 patients with type 2 diabetes were selected through convenience sampling. The data-gathering tool was a self-administered questionnaire containing questions about personal and social characteristics of patients, as well as a 40-item questionnaire to measure patients’ adherence to treatment. The questionnaire consisted of seven domains: (i) making the effort for treatment, (ii) intention to take the treatment, (iii) adaptability, (iv) integrating illness into life, (v) sticking to the treatment, (vi) commitment to treatment, and (vii) indecisiveness about applying treatment. Data collection lasted from first week of November 2017 to the first week of January 2018. RESULTS: Most subjects were adherent to treatment. The highest adherence was in “commitment to treatment,” subdomain and the lowest adherence was in “adaptability.” In univariate analysis age, educational achievement, occupation, Body Mass Index (BMI), duration of diabetes, searching information about diabetes, and comorbidities were significantly related to adherence to treatment. The results of multivariate analysis also showed that patients who had normal BMI, academic education, searching behaviour for information, longer history of diabetes, and more comorbidities were more likely to be adherent. CONCLUSION: This study revealed a number of predictive factors of adherence to treatment in patients with diabetes. This may inform the health policy makers to take appropriate actions for promoting treatment adherence among patients.
Keywords: Type 2 diabetes, adherence to treatment, predictive factors
Abstract: BACKGROUND: Nutrition literacy seems to be positively correlated with a healthy and balanced diet. OBJECTIVE: The purpose of the study was to develop and validate the Greek version of Nutrition Literacy Scale (NLS). METHODS: The NLS, initially developed by Diamond in 2007 in the USA, was translated to the Greek language forward and backward twice and subsequently was administered to 50 healthy adult individuals living in Greece. The participants had to complete the tool twice, within a period of 15 days, followed by a specifically designed structured interview, coupled with the New Vital…Sign (NVS), for comparison purposes. All anthropometric data were self-reported. RESULTS: There was a strong positive correlation between the Greek NLS (NLS-Gr) and the structured interview (r = 0.503, p < 0.001) and the Greek NLS and the NVS (r = 0.451, p = 0.001). Obese participants scored lower than normal weight participants. CONCLUSIONS: The NLS-Gr can be considered as a useful tool for assessing NL.
Abstract: OBJECTIVE: The consumption of fruits and vegetables is important for a healthy lifestyle. The intake of fruits and vegetables is recommended to be at least 5 portions/per day, but currently, less than 15% of children between the ages of 4–8 years reach that consumption level. How to promote and increase fruit consumption in children is still an open issue. This study aimed to experimentally assess the efficacy of intense pro-fruit advertising on actual consumption in children during snacking. STUDY DESIGN: The study was conducted on 12 children (ages 6–10 years) exposed to a 9-minute movie containing a total…of 3.30 minutes of advertising (25% of the total time). Advertising was classified as healthy if the message focused on fruit and vegetable consumption and as unhealthy if it focused on hypercaloric foods. Children were randomized to have equicaloric snacks of apples in slices (packaging of 80 grams) or chips (25 grams) in four groups of three children each: fruit-healthy ads, fruit-unhealthy ads, chips-healthy ads, and chips-unhealthy ads. RESULTS: No significant differences (p = 0.762) were found regarding kcal intake deriving from fruit consumption among the group exposed to chip advertising (20.20 kcal mean difference, 95% C.I. 1.01–32.93). Overall, children had a higher consumption of chips (11.35 grams, 0–22.86) than fruit (0 grams, 0.00–44.91). CONCLUSIONS: Even an intense exposure to TV advertising for fruits and vegetables did not increase the consumption of fruit during snack time. More innovative approaches may be necessary to stimulate the intake of fruits and vegetables in children.
Abstract: INTRODUCTION: The impressive growth in the incidence of metabolic syndrome (MetS) as well as the risk of its complications implies the need to focus on finding new ways to control such conditions. The present study was conducted to examine the effect of L-arginine supplementation on the lipid profile, glycemic status, and insulin resistance in patients with the MetS. METHODS: In this randomized double-blind, placebo-controlled trial, 60 patients with MetS were randomly divided into a placebo group (PG) and an arginine group (AG). The AG members received 5 g/d of L-arginine. The triglyceride (TG) levels, high-density lipoprotein cholesterol…(HDL-c) and low-density lipoprotein cholesterol (LDL-c) values, total cholesterol (TC), hemoglobin A1c(HbA1c), fasting blood glucose (FBG), insulin, homeostasis model assessment of insulin resistance(HOMA-IR), quantitative insulin sensitivity check index(QUICKI), ß-cell function (β %), and insulin sensitivity were measured at baseline and after 3 months of intervention. RESULTS: The results showed that the change in the AG in the TG levels (–20.92±22.2 mg/dl) was significantly greater than in the PG (–3.57±15.6 mg/dl; P = 0.001).The change in the ratio of cholesterol/HDL-c (–0.20±0.37) in the AG was also significantly greater than in the PG (0.12±0.69; P = 0.03). There was a significantly greater decrease (P = 0.001) in the FBG in the AG (–11.32±9.36 mg/dl) compared with the FBG in the PG (–1.57±7.96 mg/dl). CONCLUSIONS: The study showed that the daily supplementation of 5 g/d L-arginine for 12 weeks in patients with MetS significantly decreased the levels of FBG and TG, and the ratio of cholesterol/HDL-c. Thus, L-arginine can be useful in these patients.
Abstract: Epidemiological evidence has linked the consumption of milk and dairy products to an increased risk of developing Parkinson’s disease (PD). However, the potential pathogenetic mechanisms remain to date yet to be ascertained. Galactose (D-Gal) is a hexose sugar which, when given orally and by other routes of administration, is picked up by the brain after a few hours. For doses above 100 mg/kg, it appears that galactose can cause biochemical and neuropathological alterations in neurons and astrocytes, similar to those observed in PD. These quantities can be reached and surpassed with the simple daily consumption of two glasses of milk,…the main dietary source of D-Gal in humans. It is likely that, relative to other neurons, dopaminergic neurons are more vulnerable to D-Gal induced damage, because of their greater vulnerability to oxidative stress. Mitochondrial dysfunction plays a critical role in both PD and D-Gal toxicity, and mutations of the genes commonly involved in PD and in mitochondrial homeostasis could enhance this mechanism. If this hypothesis were to be confirmed, dietary interventions, such as reducing the sources of galactose in the diet, and/or increasing the intake of protective molecules, could help reduce the occurrence of this disease in the aging population.
Abstract: OBJECTIVE: Parental eating behavior and feeding practices have an important influence on child eating style and weight status. The aim of this study is to explore the association of parental feeding practices with later body mass index(BMI) in children and adolescents. METHODS: This cross-sectional nationwide study was conducted on 23183 Iranian students aged 6–18 years,living in 30 provinces of Iran. They were selected randomly through cluster sampling method.Trained interviewers gathered data on demographic, anthropometric and dietary behaviors related to weight disorders. The questions were about anorexia,overeating and parental pressure to eat, family history of chronic diseases, student’s history…on birth weight and breastfeeding duration, as well as the children and parents’ body image. RESULTS: The mean (standard deviation, SD) of age was 12.53(3.31) years. Of 22841 participants, 50.7% were boys and 73.48% were from urban areas. We found significant association between gender, living area, birth weight, parental BMI, parental education, socio-economic status (SES), screen time,and student’s weight in the one-way analysis. Students who had usually experienced forced eating were more underweight than other students (OR = 1.7, CI = 1.01–1.36, P = 0.03); moreover, they were significantly less obese (OR = 0.82,CI = 0.68–0.99, P = 0.04). Students who rarely had anorexia, were more overweight than those who never had anorexia(OR = 1.16,CI = 1.02–1.32, P = 0.02). The odds of being obese was lower among students who usually were forced to eat in recent months compared to those who had never experienced forced eating (OR = 0.76,CI = 0.61–0.96, P = 0.01). CONCLUSION: We found that parental feeding practices and parental perception of child weight might affect child weight status later in life.These results underscore the importance of focusing on the behaviors of both children and parents to prevent and/or treat unhealthy child weight.
Keywords: Parental feeding practices, eating behavior, body mass index, weight