Randomized, controlled nutrition education trial promotes a Mediterranean diet and improves anthropometric, dietary, and metabolic parameters in adults.

Servizio di Igiene degli Alimenti e della Nutrizione, Asl Foggia.
Annali di igiene: medicina preventiva e di comunità 01/2011; 23(1):13-25.
Source: PubMed

ABSTRACT Several studies have shown that uptake of a Mediterranean diet could prevent many chronic diseases, such as cancer. However, the effectiveness of Mediterranean diet promotion interventions has not been well researched. The aim of this study was to evaluate the effectiveness of a nutrition education intervention for promoting the Mediterranean diet, by assessing changes in anthropometric, physical activity, dietetic and metabolic parameters in healthy adult subjects, before and after the intervention. Eighty participants, both sexes, aged 51-59 years, were randomly assigned in a 1:1 ratio to the intervention or the control group. The intervention group participated in the Med-Food Anticancer Program (MFAP), designed to promote a Mediterranean diet. This was organized into 15 weeks of intensive training and 10 weeks of consolidation. Participants of the two groups were assessed at baseline (T0) and after 25 weeks (T1) for anthropometric, physical activity, dietetic, and metabolic parameters. The hypothesis was that subjects participating in MFAP would show an improvement in these parameters. The primary endpoint was an improvement of the Mediterranean Adequacy Index (MAI), calculated by dividing the percentage of total energy from typical Mediterranean food groups by the percentage of total energy from non-typical Mediterranean food groups. At T1, the intervention group showed a significant decrease in body weight (-8.3%, P = 0.045), body mass index (-12.4%, P = 0.05), cheese (53.0%, P < 0.0001) and meat (-49.3%, P = 0.005) intake, fasting glycaemia (-9.2%, P = 0.012), and fasting insulin (-32.6%, P = 0.014), C-Reactive Protein (-34.0%, P = 0.005). They showed a significant increase in MAI (+213, P < 0.0001), physical activity (expressed in steps per day, +200.4%, P < 0.0001), fruit (+38.8, P < 0.0001), vegetables (29.3%, P < 0.0001), and dietary fiber (+38.6%, P = 0.04) intake. In contrast, the control group presented non-significant variations in measured parameters, for exception of cheese intake (+18.2%, P < 0.0001). The MFAP was found to promote uptake of the Mediterranean diet, and improve anthropometric, physical activity, dietary, and metabolic parameters in healthy subjects.

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    ABSTRACT: Retirement from work involves significant lifestyle changes and may represent an opportunity to promote healthier eating patterns in later life. However, the effectiveness of dietary interventions during this period has not been evaluated. We undertook a systematic review of dietary interventions among adults of retirement transition age (54 to 70 years). Twelve electronic databases were searched for randomized controlled trials evaluating the promotion of a healthy dietary pattern, or its constituent food groups, with three or more months of follow-up and reporting intake of specific food groups. Random-effects models were used to determine the pooled effect sizes. Subgroup analysis and meta-regression were used to assess sources of heterogeneity. Out of 9,048 publications identified, 67 publications reporting 24 studies fulfilled inclusion criteria. Twenty-two studies, characterized by predominantly overweight and obese participants, were included in the meta-analysis. Overall, interventions increased fruit and vegetable (F&V) intake by 87.8 g/day (P <0.00001), with similar results in the short-to-medium (that is, 4 to 12 months; 85.6 g/day) and long-term (that is, 12 to 58 months; 87.0 g/day) and for body mass index (BMI) category. Interventions produced slightly higher intakes of fruit (mean 53.7 g/day) than of vegetables (mean 41.6 g/day), and significant increases in fish (7 g/day, P = 0.03) and decreases in meat intake (9 g/day, P <0.00001). Increases in F&V intakes were positively associated with the number of participant intervention contacts. Dietary interventions delivered during the retirement transition are therefore effective, sustainable in the longer term and likely to be of public health significance.
    BMC Medicine 04/2014; 12(1):60. DOI:10.1186/1741-7015-12-60 · 7.28 Impact Factor
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    ABSTRACT: Background There is a need for development of more effective interventions to achieve healthy eating, enhance healthy ageing, and to reduce the risk of age-related diseases. The aim of this study was to identify the behaviour change techniques (BCTs) used in complex dietary behaviour change interventions and to explore the association between BCTs utilised and intervention effectiveness. Methods We undertook a secondary analysis of data from a previous systematic review with metaanalysis of the effectiveness of dietary interventions among people of retirement age. BCTs were identified using the reliable CALO-RE taxonomy in studies reporting fruit and vegetable (F and V) consumption as outcomes. The mean difference in F and V intake between active and control arms was compared between studies in which the BCTs were identified versus those not using the BCTs. Random-effects meta-regression models were used to assess the association of interventions BCTs with F and V intakes. Results Twenty-eight of the 40 BCTs listed in the CALO-RE taxonomy were identified in the 22 papers reviewed. Studies using the techniques ‘barrier identification/problem solving’ (93 g, 95% confidence interval (CI) 48 to 137 greater F and V intake), ‘plan social support/social change’ (78 g, 95%CI 24 to 132 greater F and V intake), ‘goal setting (outcome)’ (55 g 95%CI 7 to 103 greater F and V intake), ‘use of follow-up prompts’ (66 g, 95%CI 10 to 123 greater F and V intake) and ‘provide feedback on performance’ (39 g, 95%CI −2 to 81 greater F and V intake) were associated with greater effects of interventions on F and V consumption compared with studies not using these BCTs. The number of BCTs per study ranged from 2 to 16 (median = 6). Meta-regression showed that one additional BCT led to 8.3 g (95%CI 0.006 to 16.6 g) increase in F and V intake. Conclusions Overall, this study has identified BCTs associated with effectiveness suggesting that these might be active ingredients of dietary interventions which will be effective in increasing F and V intake in older adults. For interventions targeting those in the peri-retirement age group, ‘barrier identification/problem solving’ and ‘plan for social support/social change’ may be particularly useful in increasing the effectiveness of dietary interventions.
    BMC Medicine 10/2014; 12(177). DOI:10.1186/s12916-014-0177-3 · 7.28 Impact Factor
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    ABSTRACT: Background High adherence to a Mediterranean diet (MD) is associated with reduced all-cause and cardiovascular mortality risk. To our knowledge, there is no systematic review and meta-analysis of randomized controlled trials that has compared the effects of an MD on outcomes of endothelial function and inflammation. Methods Literature search was performed using the electronic databases MEDLINE, EMBASE, and the Cochrane Trial Register. Inclusion criteria were: randomized controlled trials, 19+ years of age, and minimum intervention period of 12 weeks. Study specific weighted mean differences (WMD) were pooled using a random effect model. Results 17 trials including 2300 subjects met the objectives. MD regimens resulted in a significantly more pronounced increase in flow mediated dilatation [WMD: 1.86%, 95% CI 0.23 to 3.48, p = 0.02; I2 = 43%], and adiponectin [WMD: 1.69 μg/ml, 95% CI 0.27 to 3.11, p = 0.02; I2 = 78%], while high-sensitive C reactive protein [WMD: -0.98 mg/l, 95% CI -1.48 to -0.49, p < 0.0001; I2 = 91%], interleukin-6 [WMD: -0.42 pg/ml, 95% CI -0.73 to -0.11, p = 0.008; I2 = 81%], and intracellular adhesion molecule-1 [WMD: -23.73 ng/ml, 95% CI -41.24 to -6.22 p = 0.008; I2=34%] turned out to be significantly more decreased. Conclusion The results of the present meta-analysis provide evidence that an MD decreases inflammation and improves endothelial function.
    Nutrition, metabolism, and cardiovascular diseases: NMCD 04/2014; DOI:10.1016/j.numecd.2014.03.003 · 3.88 Impact Factor