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Potential molecular mechanisms of MD on mitochondrial dysfunction in MetS. The dotted red line represents inhibitory pathways. Abbreviations: AMPK: AMP-activated protein kinase; BAX: bcl2-like protein 4; Bcl−2: B-cell lymphoma 2; NRF−1: nuclear respiratory factor 1; PPARs: peroxisome proliferator-activated receptors; PGC−1α: peroxisome proliferator-activated receptorgamma coactivator-1α; SIRT−1: sirtuin 1; TFAM: transcription factor A, mitochondrial.
Source publication
The abnormal expansion of body fat paves the way for several metabolic abnormalities including overweight, obesity, and diabetes, which ultimately cluster under the umbrella of metabolic syndrome (MetS). Patients with MetS are at an increased risk of cardiovascular disease, morbidity, and mortality. The coexistence of distinct metabolic abnormaliti...
Contexts in source publication
Context 1
... studies (in vitro cellular and in vivo animal studies) show that the nutrients and polyphenols present in the MD, such as chlorogenic acid, resveratrol, hydroxytyrosol, and apigenin, exert a vast range of beneficial effects on mitochondrial dysfunction. Figure 3 summarizes the possible mechanisms, including the effects on key regulators of mitochondrial function and biogenesis such as SIRT-1, AMPK, and PGC-1α. In addition, the antioxidant properties of the polyphenols present in the MD reduced mtROS production and ameliorated mitochondrial damage and apoptosis in different experimental studies. ...
Context 2
... studies (in vitro cellular and in vivo animal studies) show that the nutrients and polyphenols present in the MD, such as chlorogenic acid, resveratrol, hydroxytyrosol, and apigenin, exert a vast range of beneficial effects on mitochondrial dysfunction. Figure 3 summarizes the possible mechanisms, including the effects on key regulators of mitochondrial function and biogenesis such as SIRT-1, AMPK, and PGC-1α. In addition, the antioxidant properties of the polyphenols present in the MD reduced mtROS production and ameliorated mitochondrial damage and apoptosis in different experimental studies. ...
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Introduction
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Citations
... In contrast, the Mediterranean diet, renowned for its abundance of n-3 fatty acids, MUFAs, fiber, and essential nutrients, has been associated with enhanced longevity, cardiometabolic health benefits, and potent anti-inflammatory and antioxidant properties. 55,56 Moreover, SFAs have been implicated in compromising mitochondrial function, whereas PUFAs appear to counteract the detrimental effects of SFAs ( Figure 2B). 23,57 ...
Adipose tissue serves as a dynamic endocrine organ that is pivotal in metabolic regulation. Augmenting mitochondrial activity within this tissue holds promise in combating obesity. Mitochondrial function is intricately modulated by diverse fatty acid compositions. This comprehensive review aimed to elucidate the molecular mechanisms underlying mitochondrial dysfunction induced by various fatty acid profiles. While saturated fatty acids (SFAs) pose a threat to mitochondrial integrity, polyunsaturated fatty acids (PUFAs), notably n-3, mitigate SFA-induced damage, concurrently regulating thermogenic gene expression. With regard to monounsaturated fatty acids (MUFAs), their impact on mitochondrial function in adipose tissue remains relatively unexplored. Although human studies are imperative for comprehensive insights, prioritizing the consumption of n-3 fatty acids and MUFAs has emerged as a strategic approach, potentially enhancing mitochondrial biogenesis and metabolic pathways. This synthesis underscores the critical need for further investigation of the differential effects of fatty acid types on adipose tissue mitochondria, offering potential avenues for obesity intervention.
... This correlation between the DII and a healthy diet was also detected in a research by Vahid et al. [50], which supports our findings related to food groups such as vegetables, fruits, and non-caloric beverages. Therefore, a high compliance to DII, which involves consuming a high amount of vegetables and fruits, ensures a high intake of vitamins C, E, and fiber [56]. Additionally, consuming nuts leads to an increased intake of potassium, magnesium, calcium, MUFA, PUFA, and vitamin E [57,58]. ...
Background
The metabolic syndrome (MetS) comprises metabolic irregularities, including hypertension and central obesity, which are influenced by genetic, metabolic, environmental, and dietary factors. As diet and lifestyle are risk factors for MetS, it is important to know which diet quality index better predicts MetS. The aim of this study is to compare the ability of different diet quality indices in predicting MetS and to identify the most effective one.
Methods
This cross-sectional study involved 5,206 participants aged 35 to 70 engaged in the Prospective Epidemiological Research Study in Iran (PERSIAN) cohort. Assessment of one year’s food intake via a validated 134-item semi-quantitative food frequency questionnaire (FFQ) facilitated the calculation of adherence to five diet quality indices: Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Dietary Inflammatory Index (DII), and Diet Quality Indices (DQI). While bivariate Pearson correlation and binary logistic regression aided in identifying the strongest correlation and predictor for MetS among the indices.
Results
This study showed a significant association between adhering to the DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, and the odds of developing MetS (OR: 0.94, (95% CI: 0.93–0.95), OR: 0.85, (95% CI: 0.81–0.89), OR: 0.84, (95% CI: 0.80–0.89), OR: 1.22, (95%CI: 1.11–1.34), OR: 0.95, (95%CI 0.94–0.96) respectively). Therefore, with each unit increase in DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, the odds of MetS was reduced by 5.4%, 14.5%, 15.6%, 22%, 5%, respectively. All the indices were correlated with the intake of most of the micronutrients, with the strongest correlations being observed in the DII. DASH diet score aligned with the most favourable MetS biomarker risk, while DII score primarily associated with MetS and could be considered as a predictor for MetS.
Conclusion
The present study’s findings reveal that between all these five diet quality indices, the DASH diet score correlates strongly with a favourable biomarker risk profile, while the DII score is predominantly linked to MetS.
... On the other hand, the impairment of the antioxidative capacity of the vascular endothelium is an established aggravating factor for the development of endothelial dysfunction and future major cardiovascular events [18,19]. On that basis, a considerable number of previous studies [20][21][22][23] have suggested that the MD is strongly associated with favorable effects on oxidative status, implying a potential pathway for exerting its well-established cardiovascular benefits. However, the results on COF as a vital subset of the MD and its effects on oxidative status, particularly compared to other healthy nutritional patterns widely adopted by the general population, remain scarce. ...
Background/Objectives: The Mediterranean diet has been widely suggested to exert significant beneficial effects on endothelial oxidative status and cardiometabolic health. Greek Orthodox monasteries, due to their specific nutritional and sartorial habits, comprise a population thatstrictly adheres to nutritional patterns with restricted eating and a plant-based subset of the Mediterranean diet, often accompanied by profound hypovitaminosis D. Time-restricted eating (TRE) is also adopted bya large part of the general lay Greek population for health-promoting reasons, without restrictions on animal product consumption, as imposed by Orthodox religious fasting. However, the comparative effects of these nutritional patterns on oxidative stress markers remain scarce. Methods: The present study attempted to evaluate the effects of Christian Orthodox fasting (COF) in a group of vitamin D-deficient and overweight Orthodox nuns from Central and Northern Greece compared to the implementation of TRE, a 16:8 dietary regimen (16 h of food abstinence and 8 h of feeding) in a cohort of adult women from the general population from the same region with regard to markers of endothelial oxidative status. A group of 50 women from two Orthodox monasteries in Northern Greece and one group of 50 healthy lay women were included. During the enrollment, a detailed recording of their dietary habits was performed, along with a scientific registry of their demographic and anthropometric characteristics (via bioimpedance). The Orthodox nuns followed a typical Orthodox fasting regimen [daily feeding window (8 a.m.–4 p.m.)], whereas the lay women followed a TRE 16:8 regimen with the same feeding time-window with a recommendation to follow a low-fat diet, without characteristics of the Mediterranean diet. We included a complete biochemical analysis, as well as calciotropic profiles [calcium—Ca, albumin, parathyroid hormone—PTH, and 25-hydroxyvitamin D—25(OH)D] and markers of TAC (total antioxidant capacity), GSH (glutathione),and thiobarbituric acid reactive substances (TBARSs) concentrations as markers of oxidative status. Results: All the groups were compared at the baseline regarding their calcium, PTH, and 25(OH)D concentrations, with no statistically significant differences between the groups apart from higher PTH levels in the nuns due to lower 25(OH)D levels. The Orthodox nuns manifested a lower median GSH compared to the controls (6.0 vs. 7.2, p 0.04) and a higher median TAC (0.92 vs. 0.77, p < 0.001). The TBARS comparisons showed no significant difference between the two groups. No significant associations of oxidative status with 25(OH)D, PTH, and the markers of glucose homeostasis were evident. Conclusions: The results of this small pilot study indicate that both dietary regimens have advantages over the oxidative markers compared to each other, with increased TAC in the group of Orthodox nuns after a 16-week period of COF compared to a 16:8 TRE and increased GSH concentrations in the lay women group. Future randomized trials are required to investigate the superiority or non-inferiority between these dietary patterns in the daily clinical setting.
... On the other hand, impairment of antioxidative capacity of vascular endothelium is an established aggravating factor for development of endothelial dysfunction and future cardiovascular major events [19,20]. On that basis, a considerable number of previous studies [21][22][23][24] have suggested that MD is strongly associated with favorable effects on oxidative status, implying a potential pathway for exerting its well-established cardiovascular benefits. However, results on COF as a vital subset of MD and its effects on oxidative status, particularly compared to other healthy nutritional patterns widely adopted by the general population, remain scarce. ...
Mediterranean diet has been widely suggested to exert significant beneficial effects on endothelial oxida-tive status and cardiometabolic health. Greek Orthodox monasteries, due to their specific nutritionaland sartorial habits, comprise a population which strictly adheres to nutritional patterns with restricted eating and a plant-based subset of the Mediter-ranean diet, often accompanied by profound hypovitaminosis D. Time –restricted eating is also adopted from a large part of general lay Greek population for health promoting reasons, without restrictions on an-imal product consumption, as imposed by Orthodox religious fasting. However, comparative effects of these nutritional patterns on oxidative stress markers remain scarce. The present study attempted to evaluate the effects of Christian Orthodox fasting (COF) in a group of vitamin D –deficient and overweight Orthodox nuns from Central and Northern Greece, compared to the implementation of TRE, 16:8 dietary regimen in a cohort of adult women from the general population from the same region, with regard to markers of endothelial oxidative status. A group of 50 women from two Orthodox monasteries in Northern Greece and one group of 50 healthy lay women were included. During enrollment a detailed recording of dietary habits was performed, along with a scientific registry of demographic and anthropometric characteristics (via bioimped-ance).Orthodox nuns followed a typical Orthodox fasting regimen[daily feeding window (8 am–4 pm)] whereas lay women followed a TRE 16:8 regimen with the same feeding time-window with recommenda-tion to follow a low-fat diet, without characteristics of the Mediterranean diet. We included a complete biochemical analysis, as well as calciotropic profiles [Calcium-Ca, Albumin, Parathyroid hormone-PTH, 25-hydroxyvitamin D- 25(OH)D] as well as and markers of TAC (trichloroacetic acid), (glutathione) GSH and thiobarbituric acid reactive substances (TBARS) concentrations, as markers of oxidative status. All groups were comparable at baseline for calcium, PTH and 25(OH)D concentrations, with no significant differences between groups. Orthodox nuns manifested a lower median GSH compared to con-trols (6.0 vs. 7.2, p 0.04) and a higher median TAC (0.92 vs. 0.77, p <0.001). TBARS comparisons showed no significant difference between the two groups. No significant associations of oxidative status with 25(OH)D, PTH and markers of glucose homeostasis were evident. Results of this small pilot study indicate that both dietary regimens have advantages over oxidative markers compared to each other, with increased TAC in the groups of Orthodox Nuns after a 16th week period of COF compared to a 16:8 TRE and increased GSH concentrations in the lay women group. Future randomized trials are required to investigate superiority or non-inferiority between these dietary patterns, in the daily clinical setting.
... Studies have shown that a Mediterranean diet, characterized by the consumption of PBDs such as vegetables, fruits, and nuts, which are rich in polyphenols (isoflavones, phytoestrogens) and other phytochemicals (phytosterols, carotenoids, luteolin, organosulfur, terpenes, saponins) as well as polyunsaturated fatty acids from flaxseeds and sunflower seeds, can enhance mitochondrial function [68]. Polyphenols have been demonstrated to inhibit the activity of PARP-1, a critical component in the pathogenesis of atherosclerosis [69]. Enhancing mitochondrial function can accelerate the reversal of atherosclerosis, as depicted in Figure 4. ...
Atherosclerosis, a chronic systemic inflammatory process, is the leading cause of disease, disability, and mortality worldwide. While current management approaches can temporarily alleviate the problem, they do not address the root cause. This paper presents a novel approach, demonstrating that adopting a whole food plant-based diet (PBD) can reduce the risk of atherosclerosis-related conditions and cause atherosclerosis to regress. We will delve into the mechanisms by which PBDs can cause regression of atherosclerosis plaque, a crucial aspect in managing coronary artery disease (CAD) patients. Despite the significant role of PBDs in managing CAD, the medical community has been slow to embrace this approach. By providing more information on the mechanism of action of PBDs, we aim to bridge the gap in knowledge and promote wider acceptance and implementation of PBDs by medical professionals.
... Recent investigations have demonstrated that a Mediterranean diet, characterized by the consumption of plant-derived compounds such as vegetables, fruits, and nuts, which are rich in polyphenols (isoflavones, phytoestrogens) and other phytochemicals (phytosterols, carotenoids, luteolin, organosulfur, terpenes, saponins) as well as polyunsaturated fatty acids from flaxseeds and sunflower seeds and can enhance mitochondrial function [73]. Polyphenols have been demonstrated to hinder the activity of PARP-1, a crucial component in the pathogenesis of atherosclerosis [74]. ...
Despite the advances in stent design, coating drugs, polymers, the use of intravascular imaging, special devices (such as intravascular lithotripsy, ultra-high-pressure non-compliant balloons, and drug-coated balloons), and improved operator skills and techniques, the problem of in-stent restenosis (ISR) and stent thrombosis (ST) remains a challenge for interventional cardiologists. Atherosclerotic lesions, ISR, and ST, are systemic metabolic chronic inflammatory illnesses with a local manifestation in the coronary vessels. Therefore, we propose managing these systemic illnesses systemically through plant-based diet (PBD) intervention. We explain how PBD intervention can help mitigate atherosclerosis, ISR, and ST. Thus, PBD intervention can overcome biological and epigenetic problems in managing ISR and ST similarly to reversing atherosclerosis. Our team is pioneering the implementation of PBD for cardiology patients who have undergone coronary intervention. So far, the results have been very promising. We hope that in the future, many research studies will be performed to investigate further the role of PBD in decreasing the incidence of ISR and ST.
... Recent investigations have demonstrated that a Mediterranean diet, characterized by the consumption of plant-derived compounds such as vegetables, fruits, and nuts, which are rich in polyphenols (isoflavones, phytoestrogens) and other phytochemicals (phytosterols, carotenoids, luteolin, organosulfur, terpenes, saponins) as well as polyunsaturated fatty acids from flaxseeds and sunflower seeds and can enhance mitochondrial function [73]. Polyphenols have been demonstrated to hinder the activity of PARP-1, a crucial component in the pathogenesis of atherosclerosis [74]. ...
The persistent problem of in-stent restenosis (ISR) and stent thrombosis (ST) remains a significant challenge for interventional cardiologists, despite the progress made in stent design, coating drugs, polymers, the use of intravascular imaging, special devices (such as intravascular lithotripsy, ultra-high-pressure non-compliant balloons, and drug-coated balloons), and enhanced operator skills and techniques. Atherosclerotic lesions, ISR, and ST are systemic metabolic chronic inflammatory diseases with a local manifestation in the coronary vessels (coronary stenosis). Therefore, we propose addressing these systemic illnesses systemically through plant-based diet (PBD) intervention. We explain how PBD intervention can mitigate ISR, and ST. Consequently, PBD intervention can overcome biological and epigenetic issues in managing ISR and ST, similar to the mechanism in reversing atherosclerosis. Our team is at the forefront of implementing PBD for cardiology patients undergoing coronary intervention. So far, the outcomes have been highly promising. We hope that the knowledge behind the mechanisms in which PBDs help reduce the incidence of ISR and ST will lead to many future research studies, ultimately resulting in the widely accepted adoption of PBDs for patients who have received coronary interventions.
... Recent investigations have demonstrated that a Mediterranean diet, characterized by the consumption of plant-derived compounds such as vegetables, fruits, and nuts, which are rich in polyphenols (isoflavones, phytoestrogens) and other phytochemicals (phytosterols, carotenoids, luteolin, organosulfur, terpenes, saponins) as well as polyunsaturated fatty acids from flaxseeds and sunflower seeds and can enhance mitochondrial function [73]. Polyphenols have been demonstrated to hinder the activity of PARP-1, a crucial component in the pathogenesis of atherosclerosis [74]. ...
Despite the advances in stent design, coating drugs, polymers, the use of intravascular imaging, special devices (such as intravascular lithotripsy, ultra-high-pressure non-compliant balloons, and drug-coated balloons), and improved operator skills and techniques, the problem of in-stent restenosis (ISR) and stent thrombosis (ST) remains a challenge for interventional cardiologists. Atherosclerotic lesions, ISR, and ST, are systemic metabolic chronic inflammatory illnesses with a local manifestation in the coronary vessels. Therefore, we propose managing these systemic illnesses systemically through plant-based diet (PBD) intervention. We explain how PBD intervention can help mitigate atherosclerosis, ISR, and ST. Thus, PBD intervention can overcome biological and epigenetic problems in managing ISR and ST similarly to reversing atherosclerosis. Our team is pioneering the implementation of PBD for cardiology patients who have undergone coronary intervention. So far, the results have been very promising. We hope that in the future, many research studies will be performed to investigate further the role of PBD in decreasing the incidence of ISR and ST.
... These lifestyle choices contribute to maintaining healthy mitochondria. Mitochondrial function can be improved by consuming PBD foods, specific natural products, caloric restriction, intermittent fasting, and exercise [63][64][65]. Our elderly coronavirus cardiology patients have been living a Blue Zone lifestyle for many years, leading us to hypothesize that this has resulted in less severe symptoms and zero mortality due to their healthy mitochondria. ...
The potential advantages of plant-based interventions in decreasing the incidence and lessening the morbidity and mortality of COVID-19 are yet to be widely acknowledged. Nevertheless, recent publications propose that these interventions could be effective. Our cardiology center conducted an interventional study in which we incorporated plant-based foods and provided supplementation to 3470 elderly COVID-19 patients with multiple comorbidities. We pay close attention to the precise selection of food items, the application of appropriate processing methods, and the provision of nourishing meals to our patients. Our outcome was highly successful as we achieved a zero mortality rate, and none of our patients experienced worsening conditions or required hospitalization. In this review article we present the mechanisms how plant-based and supplement interventions can mitigate COVID-19 disease severity and mortality. And experts have validated our hypotheses very recently. The measures and methods used to address the ongoing SARS-CoV-2 pandemic through plant-based interventions and supplements are effective and may help prevent or manage future pandemics.
... These lifestyle choices contribute to maintaining healthy mitochondria. Mitochondrial function can be improved by consuming plant-based foods, specific natural products, caloric restriction, intermittent fasting, and exercise [63][64][65]. Our elderly patients have been living a Blue Zone lifestyle for many years, leading us to hypothesize that this has resulted in less severe symptoms and zero mortality due to their healthy mitochondria. ...
The potential advantages of plant-based interventions in decreasing the incidence and lessening the severity and mortality of COVID-19 are yet to be widely acknowledged. Nevertheless, recent investigations propose that these interventions could be effective. Our recent publication (part one) features an interventional study in which we incorporated plant-based foods and provided supplementation to 3470 elderly COVID-19 patients with multiple comorbidities. We pay close attention to the precise selection of food items, the application of appropriate processing methods, and the provision of nourishing meals to our patients. Our outcome was highly successful as we achieved a zero mortality rate, and none of our patients experienced worsening conditions or required hospitalization. This second paper presents our theoretical framework on the mechanisms through which plant-based and supplement interventions can mitigate disease severity and mortality. However, only very recently have experts validated our hypotheses. The measures and methods used to address the ongoing SARS-CoV-2 pandemic through plant-based interventions and supplements are effective and may help prevent or manage future pandemics.
