Obesity and the Mediterranean diet: a systematic review of observational and intervention studies

Buckland, Genevieve; Bach, Anna Sofie; Serra-Majem, Lluís

doi:10.1111/j.1467-789x.2008.00503.x

Cited by 293 publications

(197 citation statements)

References 42 publications

(157 reference statements)

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“…28,29 In our study however, we found a gender-specific association that is difficult to explain. It has been hypothesized that lignan metabolism in humans could affect that of endogenous estradiol through competition to the estrogen receptors found on the major carriers, such as sex-hormonebinding globulin.…”

Section: Discussioncontrasting

confidence: 46%

Determinants of dietary lignan intake in a representative sample of young Spaniards: association with lower obesity prevalence among boys but not girls

et al. 2012

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BACKGROUND/OBJECTIVES: Lignan-rich diets have been associated with favorable health effects through improved metabolic profile. In this study, we hypothesized that dietary lignan intake could be also associated with childhood obesity. SUBJECTS/METHODS: We studied prevalent obesity in relation to lignan intake within the enKid study that involved 3438 children, adolescents and young adults (2-24 years old). Participant's dietary records were used to calculate lignan dietary intake using a lignan composition database adapted to the Spanish diet. RESULTS: The mean intake of the dietary lignans was calculated as B1 mg/day, corresponding mainly (37%) to pinoresinol. No gender differences were found, but lignan intake was positively associated with age, physical activity level and dietary fiber intake, and negatively with the intake of polyunsaturated and saturated fatty acids. The main sources of dietary lignans were refined wheat, olive oil and whole-wheat bread. A strong association between dietary lignan intake and prevalent obesity was found only for boys, with odds ratio (highest versus lowest quartile of lignan intake) of 0.34 (95% confidence interval, 0.17-0.70) after adjusting for main confounders, including dietary fiber. CONCLUSIONS: Boys with the highest lignan-rich products including cereals, whole-grain products and olive oil, presented less cases of obesity in this representative sample of Spanish children and adolescents. It is unknown whether this association implies an active role of dietary lignans on obesity development, or is merely an indicator of a healthier lifestyle. INTRODUCTIONChildhood obesity has become a major public health issue, both for its increased prevalence worldwide, and its progression to major cardiovascular events later in life that further increases morbidity and mortality. As a disorder of energy balance, obesity is associated with insulin resistance and dyslipidemia. Different bioactive compounds in the diet are currently acknowledged to have favorable effects in these processes. 1 Lignans are fiberrelated phenolic compounds widely distributed in the diet 2 as part of the dietary fiber complex. 3 Lignans are especially abundant in grains, oilseeds, legumes and cruciferous vegetables. [4][5][6] Six different lignans, that is, pinoresinol, lariciresinol, syringaresinol, medioresinol, matairesinol and secoisolariciresinol can be found at relevant concentrations in the human diet. 7 These dietary lignans are absorbed, and to a certain extent (17%) excreted, 8 although the major fraction undergoes an extensive metabolism by the gut microflora that results in the formation of the so-called enterolignans, 9 attending to their colonic origin. These metabolites have been inversely associated with lower weight in women, 10 and further with improved cardiovascular risk factors, and lower risks of acute cardiovascular events. [11][12][13][14][15] There is no information on the intake of lignans in children and adolescents. The aim of this study was to determine the lignan intake and it...

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Section: Discussioncontrasting

confidence: 46%

Determinants of dietary lignan intake in a representative sample of young Spaniards: association with lower obesity prevalence among boys but not girls

et al. 2012

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“…They provide key nutrients, fibre and protective substances that contribute to general well-being, satiety and the maintenance of a balanced diet, and thus should be consumed in high proportions and frequency. This MD core, based on plant-origin foods, is responsible for the prevention of many chronic diseases and for weight control (4,15) .…”

Section: Mediterranean Diet Patternmentioning

confidence: 99%

Mediterranean diet pyramid today. Science and cultural updates

Bach-Faig¹,

Berry

Lairon

et al. 2011

Public Health Nutr.

1,296

977

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Objective: To present the Mediterranean diet (MD) pyramid: a lifestyle for today. Design: A new graphic representation has been conceived as a simplified main frame to be adapted to the different nutritional and socio-economic contexts of the Mediterranean region. This review gathers updated recommendations considering the lifestyle, dietary, sociocultural, environmental and health challenges that the current Mediterranean populations are facing. Setting and Subjects: Mediterranean region and its populations. Results: Many innovations have arisen since previous graphical representations of the MD. First, the concept of composition of the 'main meals' is introduced to reinforce the plant-based core of the dietary pattern. Second, frugality and moderation is emphasised because of the major public health challenge of obesity. Third, qualitative cultural and lifestyle elements are taken into account, such as conviviality, culinary activities, physical activity and adequate rest, along with proportion and frequency recommendations of food consumption. These innovations are made without omitting other items associated with the production, selection, processing and consumption of foods, such as seasonality, biodiversity, and traditional, local and eco-friendly products. Conclusions: Adopting a healthy lifestyle and preserving cultural elements should be considered in order to acquire all the benefits from the MD and preserve this cultural heritage. Considering the acknowledgment of the MD as an Intangible Cultural Heritage of Humanity by UNESCO (2010), and taking into account its contribution to health and general well-being, we hope to contribute to a much better adherence to this healthy dietary pattern and its way of life with this new graphic representation.

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“…Computer-assisted modelling of individual diets identified that the most important foods that enable people to fulfil nutritional requirements (except for vitamin D) are those characteristic of the MDP (63) . Surveys have repeatedly shown that adherence to an MDP is also associated with a healthier body weight (64,65) , reduced waist circumference as a marker of central obesity (66) , and lower incidence of the metabolic syndrome (67) and type 2 diabetes (68,69) . The Mediterranean diet may positively influence the ageing process (70) by delaying the evolution of cognitive decline linked to Alzheimer's disease (71) and vascular dementia, which is often documented a long time before the clinical diagnosis of dementia (72) .…”

Section: Development Of the Med Diet 40 Frameworkmentioning

confidence: 99%

Med Diet 4.0: the Mediterranean diet with four sustainable benefits

Dernini

Berry

Serra-Majem

et al. 2016

Public Health Nutr.

260

175

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Objective: To characterize the multiple dimensions and benefits of the Mediterranean diet as a sustainable diet, in order to revitalize this intangible food heritage at the country level; and to develop a multidimensional framework -the Med Diet 4.0 -in which four sustainability benefits of the Mediterranean diet are presented in parallel: major health and nutrition benefits, low environmental impacts and richness in biodiversity, high sociocultural food values, and positive local economic returns. Design: A narrative review was applied at the country level to highlight the multiple sustainable benefits of the Mediterranean diet into a single multidimensional framework: the Med Diet 4.0. Setting/subjects: We included studies published in English in peer-reviewed journals that contained data on the characterization of sustainable diets and of the Mediterranean diet. The methodological framework approach was finalized through a series of meetings, workshops and conferences where the framework was presented, discussed and ultimately refined. Results: The Med Diet 4.0 provides a conceptual multidimensional framework to characterize the Mediterranean diet as a sustainable diet model, by applying principles of sustainability to the Mediterranean diet. Conclusions: By providing a broader understanding of the many sustainable benefits of the Mediterranean diet, the Med Diet 4.0 can contribute to the revitalization of the Mediterranean diet by improving its current perception not only as a healthy diet but also a sustainable lifestyle model, with country-specific and culturally appropriate variations. It also takes into account the identity and diversity of food cultures and systems, expressed within the notion of the Mediterranean diet, across the Mediterranean region and in other parts of the world. Further multidisciplinary studies are needed for the assessment of the sustainability of the Mediterranean diet to include these new dimensions. Keywords Mediterranean dietSustainable diets Sustainable food systems Public health nutrition Food security and nutrition Sustainability

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Obesity and the Mediterranean diet: a systematic review of observational and intervention studies

Cited by 293 publications

References 42 publications

Determinants of dietary lignan intake in a representative sample of young Spaniards: association with lower obesity prevalence among boys but not girls

Determinants of dietary lignan intake in a representative sample of young Spaniards: association with lower obesity prevalence among boys but not girls

Mediterranean diet pyramid today. Science and cultural updates

Med Diet 4.0: the Mediterranean diet with four sustainable benefits

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