Costas A Anastasiou

• PhD
• Professor (Assistant) at Harokopio University of Athens

It has been suggested that intramyocellular diglycerides may be associated with insulin resistance and thus may be linked to the pathophysiology of diabetes. We aimed to investigate intramyocellular diglyceride as well as triglyceride levels in diabetic subjects and to explore a possible association with glycemic control. The participants of the st...

Intramyocellular diglycerides have been implicated in the development of insulin resistance. We aimed to evaluate the effect of weight loss, a well-known means for the improvement of insulin resistance, on intramyocellular diglycerides and triglycerides in type II diabetes. Participants were five obese women with type II diabetes (body mass index 3...

A direct link has been established between insulin resistance and obesity; however, the influence of body fat content on insulin sensitivity in normal-weight individuals has not been explored. The aim of this cross-sectional study was to examine differences in insulin sensitivity, glycemic control, and blood lipid levels in normal-weight, healthy p...

We aimed to evaluate the relationship of physical activity and obesity with glycemic control and insulin resistance. A randomized, population-based, cross-sectional health and nutrition survey was conducted in the province of Athens, Greece. Subjects included 1514 men and 1528 women without evidence of cardiovascular or other chronic disease. Parti...

We sought to evaluate the association between physical activity levels and the clinical outcome at presentation, as well as the 30-day prognosis of hospitalized patients with acute coronary syndromes (ACS). Regular physical activity has been associated with decreased risk of coronary heart disease. However, less is known about the effects of life-l...

Background/Objectives: Early-life factors and maternal education interact with childhood overweight/obesity through pathways that remain unclear. Our aim was to investigate the predominant perinatal correlates of childhood overweight/obesity and their mediating effects on the association between maternal education and children's overweight/obesity....

The high worldwide prevalence of asthma, obesity and anaemia in the paediatric population is a matter of great concern since it is associated with adverse consequences for physical and mental development. This study aimed to investigate the association between iron status, body mass index (BMI) and asthma in pre‐adolescence. Secondary data analysis...

Aim Study the influence of a variety of perinatal factors on the presence of metabolic syndrome and its parameters in prepubertal age, considering socio‐demographic factors, sex, Tanner stage and weight status of the preadolescent. Methods Data collected from the cross‐sectional Healthy Growth Study (2007) in students from four prefectures of Gree...

Background: The long-term effects of breakfast on childhood z-BMI remain inconclusive. Objective: To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries. Methods: Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Fee...

Background Although the genetic interplay with the environment has a major impact on obesity development, little is known on whether breastfeeding could modulate the genetic predisposition to obesity. Objectives To investigate whether breastfeeding attenuates the effect of an obesity genetic risk score (GRS) on adiposity in European adolescents....

Digital screening programs and tools provide the potential for early detection of chronic diseases such as diabetes in the general population. The main purpose of the current paper is to present the findings of a multi-country study conducted with implementers (i.e., health professionals) and citizens (i.e., patients) to assess the usability and ac...

Background Common mental disorders often emerge during childhood and adolescence, and their prevalence is disproportionately elevated among those affected by obesity. Early life growth patterns may provide a useful target for primordial prevention; however, research is lacking. Therefore, this study aimed to identify distinct body mass index (BMI)...

Background The long-term effects of breakfast on childhood z-BMI remain inconclusive. Objective To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries. Methods Data of 6,528 children (8.2 ± 1.0 years, 48.9% male) from the Feel4Diab...

Aim To examine physical activity levels in association with metabolic health and estimate the stability of metabolically healthy obese (MHO) phenotypes over a 2‐year period. Methods In total, 2848 men and women from families at risk of the development of diabetes were recruited. Participants were classified as obese or non‐obese and metabolic heal...

Screen time among children in most European countries is notably high and is influenced by various sociodemographic and other factors. Our study aimed to explore the associations between parents’ sociodemographic characteristics, socioeconomic status, body mass index (BMI), physical activity, risk status for type 2 diabetes, and their children’s BM...

Early-life onset of high blood pressure is associated with the development of cardiovascular diseases in adulthood. In adolescents, limited evidence exists regarding the association between adherence to the Mediterranean Diet (MedDiet) and normal blood pressure (BP) levels, as well as its potential to modulate genetic predisposition to HTN. This st...

Maternal weight-status at various time-points may influence child obesity development, however the most critical time-point remains unidentified. We used data from the Healthy Growth Study, a cross-sectional study of 2666 Greek schoolchildren aged 9–13 years, exploring associations between childhood obesity and maternal weight-status at pre-pregnan...

This systematic review aimed to assess the level and time-trends of adherence to Mediterranean-type diets (MTD) among the general population, globally. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a comprehensive literature search of the MEDLINE and Scopus databases was carried out, until 04/09/2023, based on spe...

Background: Meat consumption has shown from detrimental to beneficial effects against cardiovascular disease (CVD) incidence, mainly depending on the type of meat studied (i.e., red/white, processed/unprocessed) and quantity consumed. Objective: To examine the associations between meat type consumption patterns and incident CVD among apparently...

Individual lifestyle targets have been associated with weight loss outcomes, yet few studies have examined associations of one's total lifestyle with weight loss maintenance. We aimed to examine the relationship between lifestyle patterns and weight loss outcomes, in weight loss maintainers and regainers. We hypothesized that higher adherence to a...

The aim of the current study was to investigate whether a Total Lifestyle Index (TLI), including adherence to the Mediterranean diet, sleep duration, physical activity and engagement in activities of daily living, is associated with cognitive health over time and dementia risk, in a representative cohort of older people. A total of 1018 non-demente...

Background Previous frailty studies found higher prevalence of frailty in female than in male participants. This was mainly attributed to the fact that compared to men, women show increased longevity. Recent studies have reported that the observed difference between sexes applies irrespectively of the age of older people.Objectives To provide data...

The Feel4Diabetes study recruited 12,193 children (age: 8.20 ±1.01 years) and their parents from six European countries as part of the broader attempt to prevent type 2 diabetes. The current work collected data pre-intervention to identify the prevalence of childhood obesity by country and describe its association with socio-demographic characteris...

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 ris...

Studies exploring the accuracy of equations calculating Resting Energy Expenditure (REE) in patients with Crohn’s disease are lacking. The aim of this study was to investigate the accuracy of REE predictive equations against indirect calorimetry in Crohn’s disease patients. REE was measured using indirect calorimetry (mREE) after an overnight fasti...

Introduction: Though consistent evidence suggests that physical activity may delay dementia onset, the duration and amount of activity required remains unclear. Methods: We harmonized longitudinal data of 11,988 participants from 10 cohorts in eight countries to examine the dose-response relationship between late-life physical activity and incid...

Aim The aim of the present study was to investigate the association of the inflammatory potential of diet with prodromal Parkinson's disease (pPD) probability and incidence among community-dwelling older individuals without clinical features of parkinsonism at baseline. Methods The sample consisted of 1,030 participants 65 years old or older, draw...

Background and aims Several studies have reported the positive cardio-metabolic effects of yogurt consumption. The addition of olive oil’s bioactive extracts into yogurt can result to a functional food with pleiotropic properties against cardiovascular diseases. A polar lipid extract of olive pomace (OOPLE) that contains platelet activating factor...

Very few data are available regarding the association of adherence to the Mediterranean Diet (MeDi) with Subjective Cognitive Decline (SCD) evolution over time. A cohort of 939 cognitively normal individuals reporting self-experienced, persistent cognitive decline not attributed to neurological, psychiatric or medical disorders from the Hellenic Ep...

Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study res...

Background and objectives Aging is characterized by a functional shift of the immune system towards a proinflammatory phenotype. This derangement has been associated with cognitive decline and has been implicated in the pathogenesis of dementia. Diet can modulate systemic inflammation; thus, it may be a valuable tool to counteract the associated ri...

Background There are no published data on Mild Cognitive Impairment (MCI) incidence in people over 65 years of age in Greece, relevant literature is scarce for Southern Europe, and reported rates worldwide show great variability.AimsTo investigate the incidence and risk factors of MCI and its subtypes in the elderly population in Greece.Methods The...

Background: A decrease in glutathione (GSH) levels is considered one of the earliest biochemical changes in Parkinson's disease (PD). Objective: The authors explored the potential role of plasma GSH as a risk/susceptibility biomarker for prodromal PD (pPD) by examining its longitudinal associations with pPD probability trajectories. Methods: A...

Background: Current evidence suggests that nutrition in general and specific dietary patterns in particular, such as the Mediterranean type diet (MeDi), can be employed as potential preventive strategies against the development of dementia and cognitive decline. However, longitudinal data exploring the applicability of these findings in population...

Background The relationship of weight loss motives with long‐term outcomes is equivocal. We aimed to examine differences in weight loss motives of maintainers and regainers, as well as explore associations between motives and successful maintenance. Methods The study sample includes 607 adults, with a history of overweight/obesity and self‐reporte...

Objectives: Recently a declining trend in dementia incidence rates has been reported in high-income countries. We investigated dementia incidence in a representative sample of the Greek population in the age group of 65 years and above. Methods: This research is part of the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (H...

Background Potential links between oxidative stress and the pathophysiology of Alzheimer's disease (AD) have been reported in the existing literature. Biological markers of oxidative stress, such as the reduced form of glutathione (GSH), may have a potential role as predictive biomarkers for AD development. The aim of the present study was to explo...

Objective: To explore the association between both self-reported quality and quantity sleep characteristics and frailty status in a large non-sex-specific population of older individuals in Greece. Design: Cross-sectional study. Setting and participants: In total, 1984 older individuals (≥65 years old) were drawn from the Hellenic Longitudinal...

Introduction Life expectancy has increased leading to a concomitant increase in the population of older people. Malnutrition, a major problem in this age group, deteriorates their health and quality of life. The association between risk of malnutrition and dietary intake has not been investigated sufficiently. The aim of this study was to examine p...

Introduction Adherence to the Mediterranean dietary pattern has been associated with numerous health benefits in non-communicable diseases, including obesity management. However, the associations of the Mediterranean Diet with weight loss maintenance remain to be evaluated. Methods We analyzed data from 500 participants (61% women) of the MedWeigh...

Objective The objective of this study was to validate the recently updated research criteria for prodromal Parkinson's disease (pPD) proposed by the International Parkinson's Disease and Movement Disorders Society. Methods A total of 16 of 21 markers of pPD were ascertained in the Hellenic Longitudinal Investigation of Aging and Diet cohort compos...

Weight loss maintenance is crucial for obesity management, yet optimal dietary patterns for this period are not established. We aimed to explore the relationship between adherence to the Mediterranean Diet and weight loss maintenance. Sample includes 565 adults (62% women) of the MedWeight study. Eligible volunteers were those reporting intentional...

Research on hyponatremia during mountain marathons is scarce. The present study aimed to investigate the prevalence of exercise-associated hyponatremia during a 44-km trail running race that reached an altitude of 2780 m (Olympus Marathon). Sixty-two runners (five women) who completed the race participated in the study (age: 34.4 ± 8.6 years; heigh...

Background: Assessment of diet and physical activity and their determinants still remains a demanding task, especially when the objective is to evaluate the efficacy of lifestyle interventions. In the context of the Feel4Diabetes study (a European community based intervention study in families with school aged children and at high risk of developi...

Background: Feel4Diabetes was a large-scale, multicenter lifestyle intervention aiming to prevent type 2 diabetes among families from vulnerable population groups in six European countries (Belgium, Bulgaria, Finland, Greece, Hungary and Spain). The current study aimed to describe the process that was followed to harmonize and standardize the meas...

Objective: To estimate the prevalence of frailty using five different instruments in a cohort of older adults and explore the association between frailty and various risk factors. Method: 1,867 participants aged 65 years and above were included in the current retrospective cross-sectional study. Frailty was operationalized according to the Fried de...

Background Short sleep duration and low sleep quality are negatively associated with obesity in young adults, but in older people the results are inconsistent. Aims The aim of the present study was to examine the associations between sleep duration and quality with both body mass index (BMI) and waist circumference (WC) and to investigate sex- and...

Background: The number of older adults is increasing rapidly. Malnutrition is a major problem in this age group, which may adversely affect health and quality of life. Several physiological, socioeconomic, and neuropsychological factors can lead to malnutrition. Objectives: The aim of this study was to evaluate the nutritional status of communit...

Purpose: The purpose of this observational study was to examine the incidence of exercise-associated hyponatremia (EAH) in a 246-km continuous ultra-marathon. Methods: Over 2 years, 63 male finishers of the annual Spartathlon ultra-marathon foot race from Athens to Sparta, Greece were included in the data analysis. A blood sample was drawn from an...

Objective The present study aimed to explore the associations between social life and adherence to a healthy dietary pattern, the Mediterranean diet (MD), in a population-representative cohort of older people. Design Cross-sectional study. Adherence to the MD was evaluated by an a priori score; tertiles of the score, indicating low, medium and hig...

Apolipoprotein (APOE) ε4 allele has been associated with a number of age-related diseases but previous studies failed to identify any link with Frailty syndrome. The aim of the present study is to investigate the association between APOE ε4 allele and frailty syndrome. We operationalised Frailty according to the Fried definition, and we determined...

Objective: Given the limited information on cognitive function before Parkinson disease (PD) clinical onset in the general population, we sought to assess prodromal PD (pPD) probability and relate it to detailed cognitive performance in a community cohort. Methods: In a population-based cohort of 1,629 dementia-free and PD-free participants ≥65...

Worldwide obesity rates remain at a rise, and to treat obesity is at the top of the global public health agenda. In 2013, the AHA/ACC/TOS obesity management guidelines were published, in essence suggesting that any dietary scheme seems to be effective for weight loss, as long as it can induce a sustainable energy deficit. In the present review, we...

Objectives We studied the prevalence of subjective cognitive decline (SCD) and its determinants in a sample of 1456 cognitively normal Greek adults ≥65 years old. Methods/Design Subjects were evaluated by a multi‐disciplinary team on their neurological, medical, neuropsychological and lifestyle profile to reach consensus diagnoses. We investigated...

Introduction: Study of the epidemiology of dementia to gain insight into putative predisposing and prophylactic factors is the first step toward establishing effective preventive and therapeutic strategies for this ever-growing public health problem. Relevant data in Greece are scattered and outdated. Methods: We investigated dementia prevalence...

Background: Although plenty of evidence indicates that weight loss maintainers are highly physically active, studies focusing on the sex-specific differences in activity levels between maintainers and regainers are scarce. The authors aimed to investigate sex-specific differences in activity patterns in a cohort of Mediterranean maintainers and re...

Many lifestyle factors have been linked to cognitive function but little is known about their combined effect. An overall lifestyle pattern for people living in the Mediterranean basin has been proposed, including diet, but also physical activity, sleep and daily living activities with social/intellectual aspects. We aimed to examine the associatio...

Background: The International Parkinson and Movement Disorder Society recently introduced a methodology for probability score calculation for prodromal PD. Objectives: To assess the probability of prodromal PD in an older population and investigate its possible association with Mediterranean diet adherence. Methods: Data from a population‐based coh...

Even though obese individuals often succeed with weight loss, long-term weight loss maintenance remains elusive. Dietary, lifestyle and psychosocial correlates of weight loss maintenance have been researched, yet the nature of maintenance is still poorly understood. Studying the neural processing of weight loss maintainers may provide a much-needed...

Aim Although there is some evidence of the relationships between sleep duration/quality and nutrient and/or food intake, the associations between sleep and dietary patterns have been poorly explored. The aim of the present study was to evaluate sleep duration and quality in relation to adherence to the Mediterranean diet (MeDi), and to investigate...

Nutrition is an important lifestyle factor that can modify the risk of future cognitive impairment and dementia. Some, but not conclusive, evidence (mostly from observational studies and infrequently from clinical trials) exists of a protective association between certain nutrients (eg, folate, flavonoids, vitamin D, and certain lipids) or food gro...

Nutrition is a modifiable factor affecting the quality of life and independence of older people. The physiological, psychological and social changes during aging affect their dietary choices. Many older adults have inadequate energy and protein intake. Carbohydrate intake and intake of total lipids, in terms of contribution to total energy intake,...

Purpose: Women are almost twice as likely as men to develop frailty and early-traumatic experiences related to reproduction may have a role to play. The purpose of this study was to investigate the association between a history of induced abortions and risk of frailty. Methods: 1062 women aged ≥ 65 years from the HELIAD study were included in th...

Aim: To examine the validity of published resting energy expenditure (REE) equations in Greek adults, and if indicated, develop new cohort-specific predictive REE equations. Methods: Indirect calorimetry and anthropometric data were obtained from 226 adult volunteers of diverse age groups and body mass index ranges (18-60 years, 16.6-67.7 kg·m-2...

Smart Communities understand the potential of Internet technology, and make a conscious decision to adopt this technology to transform life and work in significant and positive ways. Smart communities could be effectively supported by social network solutions, though specific issues should be explored to efficiently model the behaviour of community...

Objective: Το investigate associations between adherence to the Mediterranean diet and frailty in a Greek population of older adults. Design: Cross-sectional study. Setting: Data were drawn from the Hellenic longitudinal Investigation of Aging and Diet (HELIAD), a population-based, multidisciplinary study designed to estimate the prevalence an...

The effect of smoking on energy balance and the underlying mechanisms are not fully understood. The aim of the present study is to examine the acute effect of smoking and its abstinence on energy intake, subjective feelings of appetite and related hormones. Fourteen healthy smokers participated in a randomized, crossover study consisting of two tri...

Background The Mediterranean dietary pattern has been associated with a decreased risk of many degenerative diseases and cognitive function in particular; however, relevant information from Mediterranean regions, where the prototype Mediterranean diet is typically adhered to, have been very limited. Additionally, predefined Mediterranean diet (MeDi...

Sleep duration and quality have been associated with many health outcomes, including weight management. We aimed to investigate the effect of self-reported sleep duration and quality on weight loss maintenance in participants of the MedWeight study, a registry of individuals that lost at least 10% of body weight in the past and either maintained th...

Purpose: The dietary habits contributing to weight loss maintenance are not sufficiently understood. We studied weight loss maintainers in comparison with regainers, to identify the differentiating behaviors. Methods: The MedWeight study is a Greek registry of weight loss maintainers and regainers. Participants had intentionally lost ≥10 % of th...

Frailty is a geriatric condition characterized by unintentional weight loss, low muscle strength, feeling of exhaustion, reduced physical activity capacity and slow walking speed. Theoretically, nutrition is a factor closely related to the frailty syndrome: all frailty criteria are more or less affected by poor eating habits, whereas frailty itself...

Introduction: Smoking and its cessation are related to weight change. Those who manage to stop smoking increase their weight, while current smokers are less likely to be obese than non-smokers. Aims and objectives: The aim of this study was to examine the acute effect of smoking and its abstinence on dietary intake, subjective feelings and hormones...

The role of social support in weight management is not fully understood, as more support has been linked to both favorable and unfavorable outcomes. We examined social support in relation to weight loss maintenance, comparing between maintainers and regainers of weight loss. The MedWeight study is a Greek registry of people who have intentionally l...

Daily breakfast consumption is a common eating behaviour among people who have maintained their weight loss after weight-loss management. However, there is not a precise definition for breakfast in the literature. The purpose of this study was to investigate potential associations between breakfast consumption (based on several definitions) and wei...

Social networks have been established as a prominent model for communication and interaction between individuals, as well as among members of communities or organizations. However, as the need to support on-line vibrant communities constituting of different individuals, having different roles, privileges and capabilities, is constantly increasing,...

Achieving maintenance of weight loss is crucial to combat obesity. However, most individuals tend to regain weight. Data from successful maintainers show that they remain vigilant and constantly apply techniques to oppose the course of regaining. On the other hand, current advances in obesity research show that the reduced obese state is a state of...

Rationale: Weight loss maintenance remains a public health challenge. It is not clear whether the weight loss method affects maintenance results. Hence, we aimed to explore whether weight loss methods and motives differ between weight loss maintainers and regainers. Methods: Present analysis is part of the MedWeight, an observational study. Partici...

Locus of control, i.e. the degree of an individual's belief on the control of his/her life, has been related to many health outcomes, including weight loss in overweight/obese individuals. No information is available on the impact of locus of control in maintaining weight loss. We aimed to investigate the effect of locus of control in weight loss m...

Intramyocellular diglycerides have been implicated in the development of insulin resistance in skeletal muscle. In the myocardium, excess lipid storage may also contribute to the appearance of diabetic cardiomyopathy, while diglycerides may have certain cardio-protective functions. However, little is known on intracellular diglyceride accumulation...

The aim of the present analysis was to evaluate the association of the Mediterranean diet (MeDi), smoking habits and physical activity with all-cause mortality in an Italian population during a 20-year follow-up study. A total of 1693 subjects aged 40-74 who enrolled in the study in 1991-5 were asked about dietary and other lifestyle information at...

The active form vitamin D is a seco-steroid with multiple neurotrophic and neuroprotective functions in the central nervous system. Robust evidence from studies in animals suggests that vitamin D deficiency may impair brain physiological functioning causing anatomical and behavioral adverse effects. On the other hand, vitamin D has been found to be...

BAGKGROUND: Weight loss maintenance contributing behaviors have not been adequately studied in Mediterranean populations. OBJECTIVE: The MedWeight study created a registry of weight loss maintainers and regainers, to assess and compare their features and lifestyle habits. METHODS: Participants had intentionally lost ≥10% of their starting weight; m...

Purpose To determine fat and fatty acid (FA) profile of Greek mother's milk during the first 6 months of exclusive breastfeeding and to examine their correlation with dietary and other maternal characteristics. Methods Milk samples and dietary records were obtained by mothers at 1st (n = 64), 3rd (n = 39), and 6th (n = 24) month postpartum. Fatty a...

Purpose: To determine fat and fatty acid (FA) profile of Greek mother's milk during the first 6 months of exclusive breastfeeding and to examine their correlation with dietary and other maternal characteristics. Methods: Milk samples and dietary records were obtained by mothers at 1st (n = 64), 3rd (n = 39), and 6th (n = 24) month postpartum. Fa...

Water is the most abundant molecule in the human body that undergoes continuous recycling. Numerous functions have been recognized for body water, including its function as a solvent, as a means to remove metabolic heat, and as a regulator of cell volume and overall function. Tight control mechanisms have evolved for precise control of fluid balanc...

Obesity is associated with impaired postprandial triacylglycerolemia, an independent risk factor for cardiovascular disease. Given that obesity is hard to treat, efforts should focus on treating its comorbidities. We aimed to investigate whether moderate weight loss normalizes postprandial triacylglycerol (TAG) concentrations, in the absence of the...

Monocyte chemoattractant protein‐1 (MCP‐1) and Interleukin‐8 (IL‐8) have important roles in the pathogenesis of many chronic inflammatory disorders. Our aim is to determine the association between MCP‐1 and IL‐8 levels and the degree of inflammation in athletes that participated in an ultradistance foot race. In 15 male athletes participating in th...