The Mediterranean diet originates in the food cultures of ancient civilizations which developed around the Mediterranean Basin and is based on the regular consumption of olive oil (as the main source of added fat), plant foods (cereals, fruits, vegetables, legumes, tree nuts, and seeds), the moderate consumption of fish, seafood, and dairy, and low-to-moderate alcohol (mostly red wine) intake, balanced by a comparatively limited use of red meat and other meat products. A few decades ago, the Mediterranean diet drew the attention of medical professionals by proving extended health benefits. The first reports ascertained cardiovascular protection, as multiple large-scale clinical studies, starting with Ancel Keys’ Seven Countries Study, showed a marked reduction of atherosclerotic clinical events in populations with a Mediterranean dietary pattern. Ensuing trials confirmed favorable influences on the risk for metabolic syndrome, obesity, type 2 diabetes mellitus, cancer, and neurodegenerative diseases. While its health benefits are universally recognized today by medical professionals, the present state of the Mediterranean diet is challenged by major difficulties in implementing this protective dietary pattern in other geographical and cultural areas and keeping it alive in traditional Mediterranean territories, also tainted by the unhealthy eating habits brought by worldwide acculturation.

The PREDATORR study shows a high prevalence of impaired glucose regulation in the adult Romanian population, providing data on the prevalence of DM and prediabetes and their association with several risk factors.

PREDATORR study showed a high prevalence of obesity/overweight, abdominal obesity and MetS in the adult Romanian population, and their association with kidney function and several cardiometabolic factors.

Gastric emptying and glycemic control pathways are closely interrelated processes. Gastric chyme is transferred into the duodenum with velocities depending on its solid or liquid state, as well as on its caloric and nutritional composition. Once nutrients enter the intestine, the secretion of incretins (hormonal products of intestinal cells) is stimulated. Among incretins, glucagon-like peptide-1 (GLP-1) has multiple glycemic-regulatory effects that include delayed gastric emptying, thus triggering a feedback loop lowering postprandial serum glucose levels. Glycemic values also influence gastric emptying; hyperglycemia slows it down, and hypoglycemia accelerates it, both limiting glycemic fluctuations. Disordered gastric emptying in diabetes mellitus is understood today as a complex pathophysiological condition, with both irreversible and reversible components and high intra- and interindividual variability of time span and clinical features. While limited delays may be useful for reducing postprandial hyperglycemias, severely hindered gastric emptying may be associated with higher glycemic variability and worsened long-term glycemic control. Therapeutic approaches for both gastric emptying and glycemic control include dietary modifications of meal structure or content and drugs acting as GLP-1 receptor agonists. In the foreseeable future, we will probably witness a wider range of dietary interventions and more incretin-based medications used for restoring both gastric emptying and glycemic levels to nearly physiological levels.

The PREDATORR study showed a high prevalence of chronic kidney disease in the adult Romanian population providing data on its prognosis and association with several cardio-metabolic risk factors.

Non-alcoholic fatty liver disease (NAFLD) represents the hepatic expression of the metabolic syndrome and is the most prevalent liver disease. NAFLD is associated with liver-related and extrahepatic morbi-mortality. Among extrahepatic complications, cardiovascular disease (CVD) is the primary cause of mortality in patients with NAFLD. The most frequent clinical expression of CVD is the coronary artery disease (CAD). Epidemiological data support a link between CAD and NAFLD, underlain by pathogenic factors, such as the exacerbation of insulin resistance, genetic phenotype, oxidative stress, atherogenic dyslipidemia, pro-inflammatory mediators, and gut microbiota. A thorough assessment of cardiovascular risk and identification of all forms of CVD, especially CAD, are needed in all patients with NAFLD regardless of their metabolic status. Therefore, this narrative review aims to examine the available data on CAD seen in patients with NAFLD, to outline the main directions undertaken by the CVD risk assessment and the multiple putative underlying mechanisms implicated in the relationship between CAD and NAFLD, and to raise awareness about this underestimated association between two major, frequent and severe diseases.

Childhood obesity is a leading public health concern because it represents a risk factor for many comorbid conditions in youth, such as cardiovascular disease, metabolic syndrome and sleep apnea. The purposes of the study were to evaluate the effect of the program at 6 months after the first visit and determine the predictive factors. We realised a retrospective study that included 69 obese children and adolescent, boys and girls, followed-up at Saint Mary Children�s Hospital and Regional Center of Diagnosis, Counselling and Monitoring of Overweight and Obese Children from �Grigore T. Popa� University of Medicine and Pharmacy Iasi, Romania, aged 12 to 18 years. The patients were included in two groups: group 1 included 38 patients receveived a hypocaloric diet only and group 2 included 31 patients received a hypocaloric diet associated with kinetotherapy and psychoterapy. We evaluated the body mass index, total cholesterol and tryglicerides before and after treatment. Our results confirm that diet and physical activity affects significantly the serum lipid profile. In this context, decreasing obesity in children through diet and exercise should be an important strategy for preventing cardio-metabolical disease in adult.

There is an increasing interest in non-invasive methods to assess gut inflammation. The data regarding the correlations between inflammatory markers and activity of inflammatory bowel disease (IBD) are still controversial. In the last years faecal calprotectin became the most widely used biomarker in diagnosis and monitoring the IBD activity. We prospectively studied the correlation between the serological inflammatory markers (platelets, erythrocyte sedimentation rate - ESR, fibrinogen, C Reactive Protein -CRP, ferritin, albumin), faecal calprotectin and severity of IBD in a tertiary referral centre in North-East Romania. Our study demonstrated that is a good correlation between serologic inflammatory markers (platelets, fibrinogen and ferritin, not ESR and albumin) and severity of IBD. CRP is a good marker in Crohn�s disease (CD) but not in ulcerative colitis (UC). Faecal calprotectin (FC) is the best inflammatory biomarker which correlates with activity both in UC and CD. Inflammatory biomarkers, especially FC are an important tool to evaluate patients with IBD.