Epidemiology, Nutrition and Metabolism

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: closed (30 March 2024) | Viewed by 25854

Special Issue Editors


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Guest Editor
Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
Interests: public health; nutrition; dietetics; epidemiology; metabolism; body composition; anthropometrics; aging; frailty; obesity
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Guest Editor
Department of Interdisciplinary Medicine, University "Aldo Moro", Piazza Giulio Cesare 11, 70100 Bari, Italy
Interests: epidemiology; computer engineering; data mining; artificial intelligence algorithms; clinical trials; machine learning; supervised learning; neural networks and artificial intelligence

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Guest Editor
Department of Geriatric and Orthopedic Sciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Interests: human nutrition; nutrition education; malnutrition; nutritional epidemiology body composition; anthropometry; abdominal obesity; non-communicable diseases; clinical nutrition, dietetics; body composition; diet; obesity; nutritional therapy

Special Issue Information

Dear Colleagues,

Nutritional epidemiology has long been defined as exploring the relationship between food and human health and disease at the community level. Food consumption is a significant source of exposure of interest. Recently, nutritional epidemiology has moved from a black box to a systems approach, whereby metabolic indicators give new insights into the relationship between food and health. Indeed, metabolomics is emerging as a new focus in nutritional epidemiology in this context. However, key challenges such as robust validation of biomarkers and novel methods for identifying novel metabolites, including prediction algorithms obtained with innovative machine learning approaches, must be addressed to fully appreciate the potential of metabolomics in nutritional epidemiology. A deeper understanding of metabolic pathways will enhance disease monitoring and management, especially relevant in preventive medicine settings. As a result, the burden of multimorbidity and healthcare burden will be lessened. The purpose of this Special Issue is to explore the metabolic paths of epidemiological nutrition in public health. Original articles, systematic reviews, reviews, mini-reviews, and clinical trial articles providing additional
knowledge on the topic of “Epidemiology, Nutrition, and Metabolism” will be welcome.

Dr. Roberta Zupo
Prof. Fabio Castellana
Dr. Hélio José Coelho-júnior
Guest Editors

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Keywords

  • nutrition
  • epidemiology
  • dietary intake
  • foods
  • micronutrients
  • biomarkers
  • metabolism

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Related Special Issue

Published Papers (9 papers)

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Research

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15 pages, 489 KiB  
Article
Adipose Dysfunction Indices as a Key to Cardiometabolic Risk Assessment—A Population-Based Study of Post-Myocardial Infarction Patients
by Elżbieta Szczepańska, Małgorzata Słoma-Krześlak, Agnieszka Białek-Dratwa, Izabela Dudzik and Oskar Kowalski
Metabolites 2024, 14(6), 299; https://doi.org/10.3390/metabo14060299 - 24 May 2024
Viewed by 787
Abstract
Anthropometric indices, such as the BMI (body mass index), WC (waist circumference), and WHR (waist–hip ratio) are commonly used for cardiometabolic risk assessment. Consequently, in the context of evaluating cardiometabolic risk in the post-MI population, it is worthwhile to consider indices such as [...] Read more.
Anthropometric indices, such as the BMI (body mass index), WC (waist circumference), and WHR (waist–hip ratio) are commonly used for cardiometabolic risk assessment. Consequently, in the context of evaluating cardiometabolic risk in the post-MI population, it is worthwhile to consider indices such as the Visceral Adiposity Index (VAI) and Body Adiposity Index (BAI), which have emerged as valuable risk assessment tools in clinical trials. The aim of this study was to provide a more comprehensive understanding of the importance of anthropometric indices and body composition analysis in evaluating the cardiometabolic risk among post-myocardial infarction patients. In the pursuit of this objective, this study involved assessing the BMI, WC, WHR, WHtR, VAI, BAI, and body composition in a population of patients. This study enrolled a total of 120 patients hospitalised at the Silesian Centre for Heart Diseases (SCCS) due to MI, and body composition analysis evaluated various parameters including the percentage of adipose tissue (FatP) [%], total adipose tissue (FatM) [kg], fat-free mass (FFM) [kg], muscle mass (PMM) [kg], total body water (TBW) [kg], and visceral adipose tissue (VFAT). The mean BMI for the entire group was 27.76 ± 4.08, with women exhibiting a significantly lower value compared with men (26.66 ± 3.33 vs. 28.16 ± 4.27). The mean values obtained for the WHR, WHtR, BAI, and VAI were 0.97 ± 0.08, 0.59 ± 0.07, 28.37 ± 5.03, and 3.08 ± 3.50, respectively. Based on the visceral adiposity index (VAI), in 47.5% patients, there was no adipose tissue dysfunction, with a higher proportion among women (71.88%) compared with men (38.64%). What raises concern is that 32.50% of patients had acute ATD, with a significantly higher prevalence among men (38.64%) compared with women (15.63%). Conclusion: The study results suggest that the BMI, WC, and WHR have their limitations, whereas the WHtR, VAI, and BAI provide a more comprehensive view of cardiometabolic risk, especially in the context of adipose tissue distribution and its metabolic consequences. Incorporating the WHtR, VAI, and BAI into routine clinical practice may enhance the management of cardiometabolic risk, especially among post-MI patients. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
15 pages, 5351 KiB  
Article
Biomarker Candidates of Habitual Food Intake in a Swedish Cohort of Pregnant and Lactating Women and Their Infants
by Mia Stråvik, Olle Hartvigsson, Stefania Noerman, Anna Sandin, Agnes E. Wold, Malin Barman and Ann-Sofie Sandberg
Metabolites 2024, 14(5), 256; https://doi.org/10.3390/metabo14050256 - 29 Apr 2024
Cited by 1 | Viewed by 1380
Abstract
Circulating food metabolites could improve dietary assessments by complementing traditional methods. Here, biomarker candidates of food intake were identified in plasma samples from pregnancy (gestational week 29, N = 579), delivery (mothers, N = 532; infants, N = 348), and four months postpartum [...] Read more.
Circulating food metabolites could improve dietary assessments by complementing traditional methods. Here, biomarker candidates of food intake were identified in plasma samples from pregnancy (gestational week 29, N = 579), delivery (mothers, N = 532; infants, N = 348), and four months postpartum (mothers, N = 477; breastfed infants, N = 193) and associated to food intake assessed with semi-quantitative food frequency questionnaires. Families from the Swedish birth cohort Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE) were included. Samples were analyzed using untargeted liquid chromatography–mass spectrometry (LC-MS)-based metabolomics. Both exposure and outcome were standardized, and relationships were investigated using a linear regression analysis. The intake of fruits and berries and fruit juice were both positively related to proline betaine levels during pregnancy (fruits and berries, β = 0.23, FDR < 0.001; fruit juice, β = 0.27, FDR < 0.001), at delivery (fruit juice, infants: β = 0.19, FDR = 0.028), and postpartum (fruits and berries, mothers: β = 0.27, FDR < 0.001, infants: β = 0.29, FDR < 0.001; fruit juice, mothers: β = 0.37, FDR < 0.001). Lutein levels were positively related to vegetable intake during pregnancy (β = 0.23, FDR < 0.001) and delivery (mothers: β = 0.24, FDR < 0.001; newborns: β = 0.18, FDR = 0.014) and CMPF with fatty fish intake postpartum (mothers: β = 0.20, FDR < 0.001). No clear relationships were observed with the expected food sources of the remaining metabolites (acetylcarnitine, choline, indole-3-lactic acid, pipecolic acid). Our study suggests that plasma lutein could be useful as a more general food group intake biomarker for vegetables and fruits during pregnancy and delivery. Also, our results suggest the application of proline betaine as an intake biomarker of citrus fruit during gestation and lactation. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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14 pages, 2568 KiB  
Article
Development of New Predictive Equations for the Resting Metabolic Rate (RMR) of Women with Lipedema
by Małgorzata Jeziorek, Jakub Wronowicz, Łucja Janek, Krzysztof Kujawa and Andrzej Szuba
Metabolites 2024, 14(4), 235; https://doi.org/10.3390/metabo14040235 - 19 Apr 2024
Viewed by 1281
Abstract
This study aimed to develop a novel predictive equation for calculating resting metabolic rate (RMR) in women with lipedema. We recruited 119 women diagnosed with lipedema from the Angiology Outpatient Clinic at Wroclaw Medical University, Poland. RMR was assessed using indirect calorimetry, while [...] Read more.
This study aimed to develop a novel predictive equation for calculating resting metabolic rate (RMR) in women with lipedema. We recruited 119 women diagnosed with lipedema from the Angiology Outpatient Clinic at Wroclaw Medical University, Poland. RMR was assessed using indirect calorimetry, while body composition and anthropometric measurements were conducted using standardized protocols. Due to multicollinearity among predictors, classical multiple regression was deemed inadequate for developing the new equation. Therefore, we employed machine learning techniques, utilizing principal component analysis (PCA) for dimensionality reduction and predictor selection. Regression models, including support vector regression (SVR), random forest regression (RFR), and k-nearest neighbor (kNN) were evaluated in Python’s scikit-learn framework, with hyperparameter tuning via GridSearchCV. Model performance was assessed through mean absolute percentage error (MAPE) and cross-validation, complemented by Bland–Altman plots for method comparison. A novel equation incorporating body composition parameters was developed, addressing a gap in accurate RMR prediction methods. By incorporating measurements of body circumference and body composition parameters alongside traditional predictors, the model’s accuracy was improved. The segmented regression model outperformed others, achieving an MAPE of 10.78%. The proposed predictive equation for RMR offers a practical tool for personalized treatment planning in patients with lipedema. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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11 pages, 1084 KiB  
Article
Impact of Immuno-Nutrition on the Nutritional Status, Inflammatory Response and Clinical Outcome of Clinic-Admitted Mild-Intensity-COVID-19 Patients: A Pilot, Perspective-Concluding Study
by Martina Basilico, Marialaura Scarcella, Emanuele Rinninella, Nena Giostra, Stefano Marcelli, Carlo Rasetti, Jan Tack, Ludovico Abenavoli and Emidio Scarpellini
Metabolites 2023, 13(10), 1070; https://doi.org/10.3390/metabo13101070 - 12 Oct 2023
Viewed by 1515
Abstract
The SARS-CoV-2 pandemic has impacted our lives since early 2020. Both malnutrition and an overweight status significantly correlate with worse patient outcomes and mortality. Immuno-nutrition (IN) has shown promising results in the inflammatory bowel disease (IBD) clinical course and the extubation time and [...] Read more.
The SARS-CoV-2 pandemic has impacted our lives since early 2020. Both malnutrition and an overweight status significantly correlate with worse patient outcomes and mortality. Immuno-nutrition (IN) has shown promising results in the inflammatory bowel disease (IBD) clinical course and the extubation time and mortality of patients admitted to intensive care units (ICUs). Thus, we wanted to assess the impact of a standardized IN oral formula on COVID-19 patients admitted to our mild-intensity clinic in late 2021. We prospectively enrolled patients admitted to the Internal Medicine COVID-19 Unit of San Benedetto General Hospital. All patients had biochemical, anthropometric, HRCT chest scan, and nutritional assessments at the time of admission and, after oral immuno-nutrition formula administration, at 15 days of the interval follow up. We enrolled 52 consecutive patients (mean age of 60.9 ± 5.4 years, 17 F, and BMI of 23.5 Kg/m2). The main comorbidities were diabetes (20%, type 2: 90%), hyperuricemia (15%), hypertension (38%), chronic ischemic heart disease (12%), COPD (13%), anxiety (10%), and depression (8%). Upon informed consent, 14 patients (mean age of 67.9 ± 5.4 years, 7 F, and BMI of 26.7 Kg/m2) were accepted to be administered IN. A moderate to severe overweight status was present in 59% of the patients; MNA test (4.4 ± 0.7) and phase angle (PA) values, suggestive of malnutrition, were present in 13% of the patients. After 15 days of admission, we recorded three deaths (mean age of 68.9 ± 4.1 years, 3 F, and BMI of 27.5 Kg/m2). An overweight status significantly correlated with the exitus occurrence (r = 0.65). One death was reported among the IN-treated patients. IN administration was followed by a significant decrease in inflammatory markers with a tendency to be higher than those of non-treated patients. IN prevented the worsening of BMI and PA vs. non-treated patients. In this overweight COVID-19 population, immuno-nutrition prevented malnutrition development with a significant decrease in inflammatory markers. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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16 pages, 1156 KiB  
Article
A Machine-Learning Approach to Target Clinical and Biological Features Associated with Sarcopenia: Findings from Northern and Southern Italian Aging Populations
by Roberta Zupo, Alessia Moroni, Fabio Castellana, Clara Gasparri, Feliciana Catino, Luisa Lampignano, Simone Perna, Maria Lisa Clodoveo, Rodolfo Sardone and Mariangela Rondanelli
Metabolites 2023, 13(4), 565; https://doi.org/10.3390/metabo13040565 - 17 Apr 2023
Cited by 11 | Viewed by 2535
Abstract
Epidemiological and public health resonance of sarcopenia in late life requires further research to identify better clinical markers useful for seeking proper care strategies in preventive medicine settings. Using a machine-learning approach, a search for clinical and fluid markers most associated with sarcopenia [...] Read more.
Epidemiological and public health resonance of sarcopenia in late life requires further research to identify better clinical markers useful for seeking proper care strategies in preventive medicine settings. Using a machine-learning approach, a search for clinical and fluid markers most associated with sarcopenia was carried out across older populations from northern and southern Italy. A dataset of adults >65 years of age (n = 1971) made up of clinical records and fluid markers from either a clinical-based subset from northern Italy (Pavia) and a population-based subset from southern Italy (Apulia) was employed (n = 1312 and n = 659, respectively). Body composition data obtained by dual-energy X-ray absorptiometry (DXA) were used for the diagnosis of sarcopenia, given by the presence of either low muscle mass (i.e., an SMI < 7.0 kg/m2 for males or <5.5 kg/m2 for females) and of low muscle strength (i.e., an HGS < 27 kg for males or <16 kg for females) or low physical performance (i.e., an SPPB ≤ 8), according to the EWGSOP2 panel guidelines. A machine-learning feature-selection approach, the random forest (RF), was used to identify the most predictive features of sarcopenia in the whole dataset, considering every possible interaction among variables and taking into account nonlinear relationships that classical models could not evaluate. Then, a logistic regression was performed for comparative purposes. Leading variables of association to sarcopenia overlapped in the two population subsets and included SMI, HGS, FFM of legs and arms, and sex. Using parametric and nonparametric whole-sample analysis to investigate the clinical variables and biological markers most associated with sarcopenia, we found that albumin, CRP, folate, and age ranked high according to RF selection, while sex, folate, and vitamin D were the most relevant according to logistics. Albumin, CRP, vitamin D, and serum folate should not be neglected in screening for sarcopenia in the aging population. Better preventive medicine settings in geriatrics are urgently needed to lessen the impact of sarcopenia on the general health, quality of life, and medical care delivery of the aging population. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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15 pages, 2495 KiB  
Article
Amino Acid Profiles in Older Adults with Frailty: Secondary Analysis from MetaboFrail and BIOSPHERE Studies
by Riccardo Calvani, Anna Picca, Leocadio Rodriguez-Mañas, Matteo Tosato, Hélio José Coelho-Júnior, Alessandra Biancolillo, Olga Laosa, Jacopo Gervasoni, Aniello Primiano, Lavinia Santucci, Ottavia Giampaoli, Isabelle Bourdel-Marchasson, Sophie C. Regueme, Alan J. Sinclair, Andrea Urbani, Francesco Landi, Giovanni Gambassi, Federico Marini and Emanuele Marzetti
Metabolites 2023, 13(4), 542; https://doi.org/10.3390/metabo13040542 - 10 Apr 2023
Cited by 6 | Viewed by 2399
Abstract
An altered amino acid metabolism has been described in frail older adults which may contribute to muscle loss and functional decline associated with frailty. In the present investigation, we compared circulating amino acid profiles of older adults with physical frailty and sarcopenia (PF&S, [...] Read more.
An altered amino acid metabolism has been described in frail older adults which may contribute to muscle loss and functional decline associated with frailty. In the present investigation, we compared circulating amino acid profiles of older adults with physical frailty and sarcopenia (PF&S, n = 94), frail/pre-frail older adults with type 2 diabetes mellitus (F-T2DM, n = 66), and robust non-diabetic controls (n = 40). Partial least squares discriminant analysis (PLS–DA) models were built to define the amino acid signatures associated with the different frailty phenotypes. PLS–DA allowed correct classification of participants with 78.2 ± 1.9% accuracy. Older adults with F-T2DM showed an amino acid profile characterized by higher levels of 3-methylhistidine, alanine, arginine, ethanolamine, and glutamic acid. PF&S and control participants were discriminated based on serum concentrations of aminoadipic acid, aspartate, citrulline, cystine, taurine, and tryptophan. These findings suggest that different types of frailty may be characterized by distinct metabolic perturbations. Amino acid profiling may therefore serve as a valuable tool for frailty biomarker discovery. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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17 pages, 6480 KiB  
Article
Study the Effect of Relative Energy Deficiency on Physiological and Physical Variables in Professional Women Athletes: A Randomized Controlled Trial
by Laura Miralles-Amorós, Nuria Asencio-Mas, María Martínez-Olcina, Manuel Vicente-Martínez, José Manuel García-De Frutos, Marcelo Peñaranda-Moraga, Lucía Gonzálvez-Alvarado, Rodrigo Yáñez-Sepúlveda, Guillermo Cortés-Roco and Alejandro Martínez-Rodríguez
Metabolites 2023, 13(2), 168; https://doi.org/10.3390/metabo13020168 - 23 Jan 2023
Cited by 7 | Viewed by 3175
Abstract
Energy deficits are often observed in athletes, especially in female athletes, due to the high expenditure of sport and strict diets. Low energy availability can cause serious health problems and affect sport performance. The aim of this study was to evaluate the effects [...] Read more.
Energy deficits are often observed in athletes, especially in female athletes, due to the high expenditure of sport and strict diets. Low energy availability can cause serious health problems and affect sport performance. The aim of this study was to evaluate the effects of different personalized dietary plans on physiological and physical factors related to energy deficit syndrome in female professional handball players. Twenty-one professional female handball players, aged 22 ± 4 years, 172.0 ± 5.4 cm and 68.4 ± 6.7 kg, divided into three groups (FD: free diet; MD: Mediterranean diet; and AD: high antioxidant diet), participated in this 12-week randomized controlled trial. Energy expenditure through indirect calorimetry, energy availability, 7 day dietary intake analysis, blood pressure, cholesterol, menstrual function, body composition by both anthropometry and bioelectrical impedance, and strength performance were assessed. All participants showed low energy availability (<30 kcal/lean mass per day); despite this, all had eumenorrhea. Significant improvements were found after the intervention in all components of body composition (p < 0.05). In the remaining variables, despite slight improvements, none were significant neither over time nor between the different groups. Low energy availability has been observed in all professional female handball players, which may lead to serious consequences. A longer period of intervention is required to assess the differences between diets and improvements in other parameters. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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Review

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13 pages, 434 KiB  
Review
Clinical Evidence of Low-Carbohydrate Diets against Obesity and Diabetes Mellitus
by Eleni Pavlidou, Sousana K. Papadopoulou, Aristeidis Fasoulas, Maria Mantzorou and Constantinos Giaginis
Metabolites 2023, 13(2), 240; https://doi.org/10.3390/metabo13020240 - 6 Feb 2023
Cited by 8 | Viewed by 7716
Abstract
The popularity of low-carbohydrate diets (LCDs) in the last few decades has motivated several research studies on their role in a variety of metabolic and non-morbid conditions. The available data of the results of these studies are put under the research perspective of [...] Read more.
The popularity of low-carbohydrate diets (LCDs) in the last few decades has motivated several research studies on their role in a variety of metabolic and non-morbid conditions. The available data of the results of these studies are put under the research perspective of the present literature review of clinical studies in search of the effects of LCDs on Obesity and Diabetes Mellitus. The electronic literature search was performed in the databases PubMed, Cochrane, and Embase. The literature search found seven studies that met the review’s inclusion and exclusion criteria out of a total of 2637 studies. The included studies involved randomized controlled trials of at least 12 weeks’ duration, in subjects with BMI ≥ 25 kg/m2, with dietary interventions. The results of the study on the effects of LCDs on obesity showed their effectiveness in reducing Body Mass Index and total body fat mass. In addition, LCDs appear to cause drops in blood pressure, low-density lipoprotein (LDL), and triglycerides, and seem to improve high-density lipoprotein (HDL) values. Regarding the effectiveness of LCDs in Diabetes Mellitus, their effect on reducing insulin resistance and fasting blood glucose and HbA1c values are supported. In conclusion, the results suggest the critical role of LCDs to improve the health of people affected by obesity or diabetes. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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Other

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16 pages, 3922 KiB  
Systematic Review
Olive Oil Polyphenols Improve HDL Cholesterol and Promote Maintenance of Lipid Metabolism: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Roberta Zupo, Fabio Castellana, Pasquale Crupi, Addolorata Desantis, Mariangela Rondanelli, Filomena Corbo and Maria Lisa Clodoveo
Metabolites 2023, 13(12), 1187; https://doi.org/10.3390/metabo13121187 - 6 Dec 2023
Cited by 7 | Viewed by 3542
Abstract
In 2011, the European Food Safety Authority (EFSA) accorded a health claim to olive oil polyphenols in that they protected LDL particles from oxidative damage. However, limited scientific evidence has so far failed to confer any claim of function on the maintenance of [...] Read more.
In 2011, the European Food Safety Authority (EFSA) accorded a health claim to olive oil polyphenols in that they protected LDL particles from oxidative damage. However, limited scientific evidence has so far failed to confer any claim of function on the maintenance of normal lipid metabolism. We performed a systematic review and meta-analysis of human RCTs, evaluating the effect of olive oil polyphenol administration on lipid profiles. Previous literature was acquired from six electronic databases until June 2023. A total of 75 articles were retrieved and screened for inclusion criteria, which resulted in the selection of 10 RCTs that evaluated the effect of daily exposure to olive oil polyphenols on serum lipids in adults. Meta-analyses were built by tertiles of outcomes, as follows: low (0–68 mg/kg), medium (68–320 mg/kg), and high (320–600 mg/kg) polyphenols for HDL and LDL cholesterol (HDL-C and LDL-C, respectively), and low (0–59.3 mg/kg), medium (59.3–268 mg/kg), and high (268–600 mg/kg) polyphenols for total cholesterol (TC). The study protocol was registered on PROSPERO (registration code: CRD42023403383). The study design was predominantly cross-over (n = 8 of 10) but also included parallel (n = 2 of 10). The study population was predominantly European and healthy. Daily consumption of olive oil polyphenols did not affect TC levels and only slightly significantly reduced LDL-C, with WMD statistically significant only for high daily consumption of olive oil polyphenols (WMD −4.28, 95%CI −5.78 to −2.77). Instead, our data found a statistically significant HDL-C enhancing effect (WMD pooled effect model: 1.13, 95%CI 0.45; 1.80, heterogeneity 38%, p = 0.04) with WMD by daily exposure level showing a statistically significant improvement effect for low (WMD 0.66, 95%CI 0.10–1.23), medium (WMD 1.36, 95%CI 0.76–1.95), and high (WMD 1.13, 95%CI 0.45–1.80) olive oil polyphenol consumptions. Olive oil polyphenols contribute toward maintaining lipid metabolism. Thus, food labeling regulations should stress this health feature of olive oil, whereby a declaration of the olive oil polyphenol content should be added to products on the market. Consumers need to be aware of the quality and possible health effects of any products they consume, and enforcement of nutrition labels offers the best way of providing this information. Full article
(This article belongs to the Special Issue Epidemiology, Nutrition and Metabolism)
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