Mediterranean Journal of Nutrition and Metabolism - Volume 14, issue 3

Authors: Mirzaei, Asad | Asal, Asma | Seidkhani-Nahal, Ali | Noori-Zadeh, Ali

Article Type: Systematic Review

Abstract: BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) comorbidity with adipose tissue dysfunction is not new and studies have focused on how adipose tissue influences NAFLD pathophysiology. OBJECTIVE: Quantification of nature and magnitude of the association between serum resistin and also insulin resistance, by calculating pooled Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score, with NAFLD pathophysiology was the objective of the current study. METHODS: Using systematic review and meta-analysis and standardized mean difference (SMD) as the effect size, the levels of resistin and HOMA-IR scores have been investigated in NAFLD subjects in comparison with controls in the …case-control studies using random-effects models. RESULTS: This meta-analysis retrieved a total number of 665 and 522 cases and 671 and 555 control subjects until May 2020 for serum levels of resistin and HOMA-IR score until May 2020. The final analyses demonstrated that pooled SMD of resistin and HOMA-IR score was 0.687 (95% confidence interval, 0.070–1.304) and 1.368 (95% confidence interval, 1.080–1.655); respectively. Moreover, the p -value for the test of significance for each pooled SMD was examined by the z-test and calculated as 0.029 and 0.000 for resistin and HOMA-IR score (clearly considered as statistically significant). CONCLUSION: Based on the findings, the HOMA-IR score and the serum levels of resistin in NAFLD subjects are associated with disease pathogenesis. Show more

Keywords: Resistin, HOMA-IR, NAFLD, NASH, simple steatosis

DOI: 10.3233/MNM-210538

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 219-231, 2021

Authors: Kaoutar, K. | Chetoui, A. | El Kardoudi, A. | Boutahar, K. | El Moussaoui, S. | Chigr, F. | Najimi, M.

Article Type: Research Article

Abstract: BACKGROUND: Overweight and obesity among children and adolescents are serious public health issues worldwide. A better understanding of the relationships between obesity and lifestyle factors is necessary for effective prevention and management of obesity in youth. AIMS: This study aimed to assess the prevalence of overweight/obesity and associated factors among schoolchildren aged 12–19 years at Beni Mellal city, Morocco. METHODS: A school based cross sectional study was carried out. A total of 516 children were included in the study. The nutritional status was classified according to the reference curves of WHO (2007). Multivariable logistic regression analysis …was used to identify factors associated with overweight/obesity. The association between dependent and independent variables were assessed using odds ratio with 95% confidence interval and p value < 0.05 was considered statistically significant. RESULTS: The prevalence of overweight was 12.40% and that of obesity was 5.20%. Overweight and obesity were statistically associated with gender (Odds Ratio (OR) = 10.15[95% CI 1.37–3.81], p  = 0.001); skipping breakfast (OR = 9.19 [95% CI 1.42–5.17], p  = 0.002) and eating cake, pastry and biscuit 1 to 3 times per week (OR = 4.14 [95% CI 1.02–3.25], p  = 0.04) and 4 or more times a week (OR = 7.83 [95% CI 1.31–4.66], p  = 0.005). CONCLUSIONS: This study revealed that prevalence of overweight/obesity among school-aged children in Beni Mellal city was high. Thus, promoting healthy dietary practices, particularly improving fruit and vegetable intake is essential to reduce the burden of overweight and obesity. Furthermore, it is important to strengthen nutrition education about avoiding junk food consumption and encouraging regular physical activity. Show more

Keywords: Overweight, obesity, school-aged children, Beni Mellal, Morocco

DOI: 10.3233/MNM-200506

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 233-243, 2021

Authors: Faramarzi, Elnaz | Mohammadzadeh, Mohammad | Sanaie, Sarvin | Andersen, Vibeke | Mahdavi, Reza

Article Type: Research Article

Abstract: BACKGROUND: Inflammation is considered as one of the major factors in chemoradiotherapy toxicity. It has been reported that conjugated linoleic acid (CLA) has anti-inflammatory properties. OBJECTIVE: The aim of this study was to assess the effect of CLA supplementation on serum levels of leptin, interleukin 8 (IL-8), malondialdehyde (MDA), total antioxidant status (TAS), and carcinoembryonic antigen (CEA) in rectal cancer patients treated with chemoradiotherapy. METHODS: In this study, 34 rectal cancer patients were allocated to either the CLA group, who received four 1000 mg capsules (each capsule containing 760 mg CLA; 4 capsules providing 3 g CLA) 3 times/day, …or the placebo group, who received 4 placebo capsules 3 times/day, for 6 weeks. RESULTS: The mean serum leptin level insignificantly increased in both groups; however, this elevation was remarkable in the CLA group. CLA supplementation reduced IL-8 by –0.62 pg/mL while placebo supplementation decreased it by –0.44 pg/mL. CEA levels were decreased by CLA supplementation, while its reduction in the placebo group was negligible compared to the CLA group. The elevation of MDA levels after CLA supplementation was about half of the placebo group in the CLA group. CONCLUSION: Since this study was the first to assess the effect of CLA supplementation on a small number of cancer patients, it is suggested further studies are conducted on larger sample size with various doses of CLA to obtain more clear results. Show more

Keywords: Rectal cancer patients, preoperative chemoradiotherapy, conjugated linoleic acid, oxidative stress, leptin

DOI: 10.3233/MNM-200507

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 245-253, 2021

Authors: Badrasawi, Manal | Hamdan, May | Al Tamimi, Mohammad

Article Type: Research Article

Abstract: BACKGROUND: Diabetes mellitus (DM) is a lifelong metabolic disease with a high rate of mortality and morbidity. Uncontrolled and untreated diabetes results in serious complications that subsequently cause patients’ quality of life (QoL) to deteriorate. Adherence to Mediterranean diet (MD) may relieve the complications of diabetes, thereby improving the quality of life for these patients. OBJECTIVE: The aim of this study was to assess the QoL of DM patients who adhered to MD. METHODS: In this cross-sectional study, we examined the QoL and MD data of 106 DM II patients being treated at a primary health …care clinic in Hebron. We used the SF-36 questionnaire to measure the patients’ QoL and the MEDAS tool to assess their MD adherence. We also recorded their anthropometric measurements, abdominal obesity, lifestyle habits and blood biochemical results. RESULTS: The sample comprised male and female DM II patients between the ages of 35 and 72, with their mean age being 55.8±10.24. Patients’ QoL scores showed a significant relationship with three BMI categories, i.e., total QoL score, physical function, and pain domains (p  < 0.05). In terms of diet, high adherence to MD had a positive impact on all domains and on patients’ total QoL with significant differences in physical functioning, emotional well-being, social functioning and pain domains. CONCLUSION: Patients’ QoL domains were relatively low and highly affected by DM II. Patients with greater MD adherence reported higher scores in all QoL domains. Significantly higher scores were noted for the physical, social and pain domains. Hence, MD is a recommended dietary pattern for DM II patients to achieve a better QoL. Show more

Keywords: Diabetes mellitus, quality of life, Mediterranean diet, SF-36, MEDAS, comorbidities

DOI: 10.3233/MNM-200515

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 255-264, 2021

Authors: El Moussaoui, Soufiane | Kaoutar, Kamal | Chetoui, Ahmed | El Kardoudi, Abdeslam | Chigr, Fatiha | Borrous, Mounir | Najimi, Mohamed

Article Type: Research Article

Abstract: BACKGROUND: Exclusive breastfeeding is the best form of nutrition for infants during the first 6 months of life. Nevertheless, the practice of breastfeeding is currently declining throughout the world. OBJECTIVE: The objective of this study was to assess the prevalence of exclusive breastfeeding (EBF) practice and its associated factors among mothers living in Marrakesh province, Morocco. METHODS: The data were collected using an interviewer administered questionnaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice. RESULTS: Prevalence of exclusive breastfeeding was 50.2%. Mothers with age more …than 30 years, residing in rural area, receiving counseling related breastfeeding during antenatal follow up and having knowledge about duration of breastfeeding were more likely to practice exclusive breastfeeding than their counterparts. CONCLUSION: Although the prevalence of breastfeeding in Marrakesh was higher than the last national survey report but it is still insufficient. These findings have to stress authorities and deciders to sensitize mothers and future mothers to increase exclusive breastfeeding practice notably through the involvement of health professionals. Show more

Keywords: Exclusive breastfeeding practice, prevalence, Marrakesh, Morocco

DOI: 10.3233/MNM-200517

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 265-275, 2021

Authors: Gori, Francesca | Tirelli, Amedea Silvia | Piontini, Alessandra | De Gennaro Colonna, Vito | Bamonti, Fabrizia | Vassalle, Cristina | Vigna, Luisella

Article Type: Research Article

Abstract: BACKGROUND: Uric acid (UA) and homocysteine (HCys) are involved in cardiovascular diseases. Patients with obesity (PwO) are characterized by elevated cardiovascular risk. OBJECTIVE: To evaluate the relationship between HCys and UA concentrations in 1141 overweight patients and PwO with and without metabolic syndrome (MS). METHODS: MS was defined according to IDF criteria (2005). Anthropometric data were recorded and blood biochemical parameters were assessed with routine methods on fasting blood samples. Statistics: Spearman correlation and multiple regression analysis. RESULTS: Gender, obesity and MS influenced both UA and HCys levels, which were increased in males, MS …patients, PwO with MS and positively correlated (p  < 0.001). Patients without MS had normal or slightly high levels. Hypertension, hyperuricemia and hyperhomocysteinemia were found in PwO with MS. UA concentration correlated with systolic blood pressure, triglycerides and HDL (all p  < 0.05). Multivariate analysis showed that HCys concentration was an independent determinant factor affecting UA levels (T value 3.5, p  < 0.001). CONCLUSIONS: HCys and UA levels positively and significantly correlated in PwO, especially in those with MS. The significant correlation between UA and hypertension, triglycerides, HDL suggests the clinical usefulness of monitoring UA together with HCys concentrations as cardiovascular risk marker in these patients. Show more

Keywords: Obesity, homocysteine, uric acid, metabolic syndrome, cardiovascular risk, cardiovascular disease

DOI: 10.3233/MNM-210554

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 277-288, 2021

Authors: Mirashrafi, Shahrzad | Borzoo-Isfahani, Mohammad | Namjoo, Iman | Hojjati Kermani, Mohammad Ali | Moravejolahkami, Amir Reza

Article Type: Research Article

Abstract: BACKGROUND: There is overwhelming scientific evidence that dietary modifications is beneficial in neurodegenerative diseases like Multiple Sclerosis (MS). OBJECTIVE: The goal of this study was to explore the effects of modified Mediterranean Diet (mMeD) on systemic inflammation, anthropometric indices, and relapse rate in MS patients. METHODS: This single-center, randomized controlled trial compared mMeD and traditional Iranian diet (as control) during six months in 180 Relapsing-Remitting MS (RRMS) patients. Serum high sensitivity C Reactive Protein (hs-CRP), body weight, Body Mass Index (BMI), percent body fat, and relapse rate were evaluated at baseline, and 3 and 6 months …later. Multivariate analysis of covariance test (MANCOVA; conducted by SPSS 24) was adjusted for age, gender, family history, duration of MS and education level. RESULTS: Of 261 screened patients (July 2018-February 2019), 180 patients were eligible; 68/90 as mMeD and 79/90 as control group completed the study. Self-reported adherence was excellent (95%). The mean change on the relapse rate was –0.54±0.9 compared to –0.03±0.4 for control group (P  = 0.004). In addition, hs-CRP levels decreased in the mMeD group (–2.9±3.3 mg/L; P  < 0.001) and mean changes were significant between two groups (P  < 0.001). Anthropometric indices were modified in mMeD group, whereas between-group comparisons were not statistically different. CONCLUSIONS: Overall, mMeD improved inflammatory status and relapse rate in RRMS patients. Future trials with larger scale and longer duration should be conducted to confirm the role of diet as a disease-modifier in MS. Show more

Keywords: Mediterranean diet, hs-CRP, inflammation, relapse rate, anthropometric, multiple sclerosis

DOI: 10.3233/MNM-210557

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 289-304, 2021

Authors: Amessis-Ouchemoukh, Nadia | Maouche, Nacera | Otmani, Amar | Terrab, Anass | Madani, Khodir | Ouchemoukh, Salim

Article Type: Research Article

Abstract: BACKGROUND: Honey is a vegetable and animal product which comes from nectar and/or honeydew. It is used in different nutritional and therapeutic fields. OBJECTIVE: Melissopalynology and physicochemical analysis of Algerian honeys, determination of their phenolic compounds and authenticity parameters and the evaluation of their antioxidant properties. METHODS: Twenty Algerians honey were studied for their physicochemical parameters (moisture, pH, proteins, proline, hydroxymethylfurfural, ash, color, electrical conductivity, and optical rotation), floral origin and phenolic compounds contents. Antioxidant activities were tested too. RESULTS: Melissopalynologycal analyses revealed that the studied honeys were twelve multifloral, seven Fabaceae, and one …Myrtaceae. All honeys were acidic (3.65≤pH≤4.35) and most of them were low in moisture content. The electrical conductivity varied between 0.29 mS/cm and 1.78 mS/cm. Ash, protein and proline contents results showed that the majority of honeys were in agreement with the legislation and were authentic. The color varied from mimosa yellow to dark brown. The specific rotation was levorotatory in most honey samples and the hydroxymethylfurfural values (from 1.5 mg/kg to 34.73 mg/kg) agreed with the international requirements. Honeys were rich in total phenolic compounds, 22.41 (Honey11) to 96.16 (Honey15)  mg gallic acid equivalents/100 g, and flavonoids, 8.90 (Honey11) to 80.02 (Honey02) mg quercetin equivalents/100 g. Honey samples 15, 03, 05, 01, and 06 exerted more than 50% reduction of 1,1-diphenyl-2-picrylhydrazyl and 2,2′ -azino-bis(3-ethylbenzothiazoline-6-sulfonate) radicals and were able to reduce iron while honey samples 12, 18, 19, 14, and 11 chelate efficiently iron. High significant correlations between physicochemical parameters and antioxidant activities were found. CONCLUSION: The Algerian honeys analyzed were authentic and variations in their quality parameters and phenolics composition were directly associated with their demonstrated antioxidant properties. Show more

Keywords: Honey, melissopalynologycal analyses, physicochemical quality parameters, bioactive compounds, reducing powers, radical scavenging activities

DOI: 10.3233/MNM-210561

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 305-324, 2021

Authors: Özenoğlu, Aliye | Çevik, Ekin | Çolak, Hatice | Altıntaş, Tuğba | Alakuş, Kamil

Article Type: Research Article

Abstract: BACKGROUND: Social isolation required by the pandemic has led to some changes in individuals’ eating and lifestyle habits. OBJECTIVE: This study aimed to examine the change in nutrition and lifestyle habits of Turkish people during the COVID-19 outbreak and investigate the effects of individuals’ attitudes to healthy eating on this change. METHOD: At the beginning of the pandemic, individuals over the age of 18 participated in this cross-sectional study using an online questionnaire. Demographic information (age, gender, education level, place of residence and occupation), anthropometric data (reported weight and height); nutritional behavior information (number of meals …per day, changes in consumption of various foods, use of nutritional supplements, etc.) and changes in lifestyle habits were requested from the participations. In addition, the Healthy Nutrition Attitude Scale (ASHN) was used to determine the healthy eating attitudes of the participants. RESULTS: A total of 432 volunteers participated in the study. It was revealed that body weight increased in 38.0% of the participants and activity level decreased in 73.1% of them during the initial stage of the pandemic. Nevertheless, 44.7% of participants reported increased sleep time, 77.8% reported increased social media use, and 66.7% reported increased stress and anxiety. It was found that the most commonly used nutritional supplements during this period were vitamin C, vitamin D and multivitamin complex. Women have significantly higher ASHN scores compared to men (p  < 0.001). The total ASHN scores of those whose body weight did not change and those who increased their activity level were found to be significantly higher. It was determined that as the age and education level increased, the healthy eating attitude increased. CONCLUSION: In this study, findings regarding the negative effects of the COVID-19 quarantine on the nutrition and lifestyle of the Turkish people are presented. However, those with a positive attitude toward healthy eating were observed to have better weight control and eating habits and stress management during the pandemic. Therefore, it is thought that the dissemination of healthy eating attitudes in society may contribute to the maintenance of physical and mental health in the event of a pandemic. Show more

Keywords: Nutrition, COVID-19 pandemic, healthy eating attitude, lifestyle habits

DOI: 10.3233/MNM-210562

Citation: Mediterranean Journal of Nutrition and Metabolism, vol. 14, no. 3, pp. 325-341, 2021