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Dietary Patterns and Clinical Health Outcomes

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 September 2024) | Viewed by 20353

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Special Issue Editors

Prof. Dr. Silvio Buscemi

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Guest Editor

1. Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90100 Palermo, Italy
2. Center of Sustainability and Ecological Transition (CSTE), University of Palermo, 90100 Palermo, Italy
3. Unit of Clinical Nutrition, Obesity and Metabolic Diseases–University Hospital Policlinico “P. Giaccone”, 90127 Palermo, Italy
Interests: obesity; diabetes; diet; clinical nutrition; longevity; lipodistrophy; cardiovascular prevention; endothelial function; indirect calorimetry; body composition
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Dr. Carola Buscemi

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Guest Editor

1. Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy
2. Unit of Internal Medicine, Villa Sofia-Cervello Hospital, 90100 Palermo, Italy
Interests: obesity; diabetes; diet; clinical nutrition; cardiovascular prevention; geriatrics and longevity

Dr. Cristiana Randazzo

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Co-Guest Editor

1. Department of Health Promotion, Maternal and Child Health, Internal and Specialty Medicine of Excellence (PROMISE), University of Palermo, 90127 Palermo, Italy
2. Unit of Clinical Nutrition, Obesity and Metabolic Diseases–University Hospital Policlinico “P. Giaccone”, 90127 Palermo, Italy
Interests: obesity; diabetes; diet; clinical nutrition; lipodistrophy; cardiovascular prevention

Special Issue Information

Dear Colleagues,

Health and dietary patterns are in a strict and complicated connection that is still far from fully understood. Diet is, at the same time, a protecting and causal factor of diseases; it is also an important treatment for many clinical conditions. Nevertheless, this is an open and continuously changing matter. Classical influences on the health of dietary patterns have been identified as Mediterranean, vegetarian, low-fat, Western, junk-food, ketogenic, low/high glycemic index diets, etc., the quality of food and chemical contaminants per se that result from both environmental factors and the industrial procedures of production in food may independently have an impact on health outcomes. Dietary patterns also need rethinking regarding new social-economic changes in actual societies, with particular reference to the evolution of globalized and multiethnic societies. Another important question concerns whether dietary patterns have always had an independent effect on clinical health outcomes per se or if this is mediated by other conditions, such as obesity or changes in gut microbiota. Considering traditional outcome measures linking health and diet, such as blood pressure or blood concentrations of glucose, lipids or other molecules and hormones, today, other powerful and promising outcome measures, such as genetics, including nutrigenomic, endothelial function, AGEs and glycemic variability, are available. Finally, different methods of investigation, ranging from clinical epidemiology to clinical trials of intervention, are now well-defined methods of research even in the field of modern clinical nutrition. This Special Issue welcomes scientific contributions that consider all these aspects when investigating the clinical health outcomes of dietary factors and patterns that are probably the most important determinants of health.

Prof. Dr. Silvio Buscemi
Dr. Carola Buscemi
Guest Editors

Dr. Cristiana Randazzo
Co-Guest Editor

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Keywords

diet
health
non-communicable diseases
food
clinical nutrition
longevity
obesity
diabetes

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Published Papers (8 papers)

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Research

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13 pages, 412 KiB

Open AccessArticle

Dietary Patterns Associated with Body-Composition Phenotype in a Middle-Aged and Elderly Population: A Population-Based Cross-Sectional Study

by Jong Eun Park, Narae Yang and Kirang Kim

Nutrients 2024, 16(21), 3583; https://doi.org/10.3390/nu16213583 - 22 Oct 2024

Viewed by 693

Abstract

Background/Objectives: There is currently limited understanding of the intricate dynamics between fat and muscle mass and the potential effect of dietary patterns. This study aimed to investigate the effects of overall dietary patterns on four body composition phenotypes associated with central obesity and low muscle mass in the middle-aged and elderly population of Korea. Methods: We examined data from 6120 adults aged ≥ 50 years, collected during the 4th (2008–2009) and 5th (2010–2011) Korea National Health and Nutrition Examination Survey. Participants were classified into four groups according to their combined status of central obesity and low muscle mass: healthy control, central obesity, low muscle mass, and sarcopenic obesity. Using factor analysis on the twenty-two pre-defined food groups, we identified three distinct dietary patterns: the “Healthy dietary pattern”, “Convenience-based dietary pattern”, and “Alcohol and side dish pattern”. Multivariate analysis included potential confounders such as age, sex, place of residence, marital status, educational level, occupation, household income, and physical activity level. Results: Higher scores in the “Healthy dietary pattern” were associated with lower odds of sarcopenic obesity (OR = 0.61, 95% CI = 0.40–0.92, p for trend = 0.018). For the “Convenience-based dietary pattern”, individuals in the third tertile of the dietary pattern score showed a marginal association with low muscle mass (OR = 1.18, 95% CI = 0.99–1.41, p for trend = 0.056). The “Alcohol and side dish pattern” was linked to higher odds of central obesity (OR = 1.22, 95% CI = 1.03–1.44, p for trend = 0.016) and low muscle mass (OR = 1.21, 95% CI = 1.01–1.45, p for trend = 0.043). Conclusions: The drinking practice of consuming foods high in saturated fats and salt alongside alcoholic drinks may negatively affect fat accumulation and muscle composition among older adults. Adopting a healthy eating pattern characterized by grains, vegetables, legumes, fruits, fish, and seaweed could be notably advantageous for promoting and maintaining healthy body composition and optimal skeletal muscle health. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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21 pages, 2208 KiB

Open AccessArticle

Locally Prepared Therapeutic Food for Treatment of Severely Underweight Children in Rural India: An Interventional Prospective Controlled Community-Based Study with Long Follow-Up:—‘SAMMAN’ Trial

by Ashish Rambhau Satav, Vibhawari S. Dani, Jayashri S. Pendharkar, Kavita Ashish Satav, Dhananjay Raje, Dipty Jain, Shubhada S. Khirwadkar and Eric A. F. Simões

Nutrients 2024, 16(17), 2872; https://doi.org/10.3390/nu16172872 - 27 Aug 2024

Viewed by 1056

Abstract

Background: Severely underweight (SUW) children contribute significantly to under-five mortality and morbidity. There are WHO guidelines for the management of severe acute malnutrition but no specific guidelines for SUW management. Objective: The objectives were to achieve a recovery rate of 30% at 90 days of treatment for severe underweight (SUW) children aged 6–60 months, compare changes in weight-for-age Z (WAZ) scores, growth patterns, and case fatality rates between intervention and reference arms (RA), and reduce the prevalence of SUW in the intervention arm (IA). The target of a 30% recovery rate was achievable and significant based on our past research conducted in similar settings. Methods: Design: A prospective controlled community-based, longitudinal, two arms (IA, RA), intervention study with long follow-up was conducted between January 2011 and October 2023. Setting: Primary care for participants from 14 villages in rural Melghat, India. Participants: The study participants included SUW children aged 6–60 months and age-matched (±2 weeks) normal controls. The SAMMAN (Acronym for SAM-Management) intervention was comprised of local therapeutic food-micronutrient (LTF-MN) therapy for 90 days, intensive behavior change communication, infection treatment, and quarterly anthropometric records. SUW recovery, growth patterns, case fatality rate, prevalence at 90 days of therapy and at 60 months of age, and survival until early adolescence were assessed. ANCOVA analysis was used to obtain changes in Z-scores. Results: In the IA, the recovery rate was 36.8% at 90 days and 78.2% at 60 months of age. The mean difference in change in WAZ scores between the intervention arm and the reference arm was statistically significant (p < 0.0001). Growth patterns were similar between the two arms up to early adolescence. The SUW case fatality rate was significantly lower in the IA (0.9%) as compared to 4.62% in the RA at 60 months (p = 0.022). The reduction in SUW prevalence in intervention villages was higher than in the control villages (p < 0.001). The cost of management per SUW child was 3888 INR (47 USD) less than RUTF. Conclusion: The SAMMAN intervention is safe and cost-effective for significantly improving WAZ scores, sustainable, and hence replicable in resource-limited areas. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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22 pages, 2275 KiB

Open AccessArticle

Online Questionnaire with Fibromyalgia Patients Shows Negative Correlations between Disease Severity and Adherence to Mediterranean Diet

by Elisa Proietti, Fabio Rapallo, Elena Molinari, Viviana Mucci, Lucio Marinelli, Consuelo Borgarelli, Bruno Burlando, Livia Pisciotta and Ilaria Demori

Nutrients 2024, 16(7), 1078; https://doi.org/10.3390/nu16071078 - 6 Apr 2024

Viewed by 1587

Abstract

Fibromyalgia (FM) is a multidimensional disorder in which intense chronic pain is accompanied by a variety of psychophysical symptoms that impose a burden on the patients’ quality of life. Despite the efforts and the recent advancement in research, FM pathogenesis and effective treatment remain unknown. Recently, the possible role of dietary patterns and/or components has been gaining attention. The current study aimed to investigate a potential correlation between adherence to the Mediterranean diet (MedDiet) and FM severity in a sample of Italian FM patients. An online survey was designed, composed of customized questions and validated questionnaires with the aim of investigating the intensity and type of pain, the presence of other psychophysical symptoms, the overall impact of FM, general food and lifestyle habits, and adherence to the MedDiet. The collected responses were analyzed for descriptive statistics, linear regression, and propensity score analyses. The results show that, despite considerable use of pharmaceuticals and supplements, FM participants suffered from a high-severity grade disease. However, those with good adherence to the MedDiet experienced a lower pain intensity and overall FM impact. A propensity score analysis indicates a positive influence of the MedDiet against FM severity, thus unveiling the need for well-designed intervention studies to evaluate the therapeutic potential of different dietary patterns. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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11 pages, 818 KiB

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Higher-Level Steatosis Is Associated with a Greater Decrease in Metabolic Dysfunction-Associated Steatoic Liver Disease after Eight Weeks of a Very Low-Calorie Ketogenic Diet (VLCKD) in Subjects Affected by Overweight and Obesity

by Annamaria Sila, Sara De Nucci, Caterina Bonfiglio, Vincenza Di Stasi, Nicole Cerabino, Martina Di Chito, Roberta Rinaldi, Paola Cantalice, Endrit Shahini, Vito Giannuzzi, Pasqua Letizia Pesole, Sergio Coletta, Nicoletta Maria Tutino, Giuseppina Piazzolla, Raffaele Cozzolongo, Gianluigi Giannelli and Giovanni De Pergola

Nutrients 2024, 16(6), 874; https://doi.org/10.3390/nu16060874 - 18 Mar 2024

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Abstract

The most common form of chronic liver disease, recently defined as MASLD, is strongly linked to obesity and metabolic syndrome. Lifestyle changes are part of MASLD prevention. The very low-calorie ketogenic diet (VLCKD) is a useful option for treating MASLD and reducing liver steatosis in patients with obesity. We assessed whether a greater degree of steatosis could have a positive or negative impact on how well 8 weeks of using the VLCKD improve steatosis and fibrosis in a patient population of overweight and obese individuals. Anthropometric parameters, along with changes in hormone and metabolic biomarkers, were also assessed both before and after the dietary change. The study population included 111 overweight (14.41%) or obese subjects (85.59%) aged between 18 and 64 years; the 75 women and 36 men involved were not taking any medicine. In both the raw (0.37 95% CI 0.21; 0.52) and the multivariate models (model a: 0.439 95% CI 0.26; 0.62; model b: 0.437 95% CI 0.25; 0.63), there was a positive and statistically significant correlation between the CAP delta value and the CAP before using the VLCKD. Additionally, the liver stiffness delta was found to be positively and statistically significantly correlated with liver stiffness before the use of the VLCKD in both models: the multivariate model (model a: 0.560 95% CI 0.40; 0.71; model b: 0.498 95% CI 0.34; 0.65) and the raw model (0.52 95% CI 0.39; 0.65). Systolic and diastolic blood pressure, insulin resistance (measured by HOMA-IR), insulin, HbA1c, fasting blood glucose, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, BMI, waist circumference, and fat mass, were all decreased (p < 0.001) following the use of the VLCKD. However, following the use of the VLCKD, there was an increase in vitamin D levels. (p < 0.001). We found that using the VLCKD for 8 weeks has a greater effect on improving steatosis and fibrosis in subjects who initially have more severe forms of these conditions. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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14 pages, 743 KiB

Open AccessArticle

Comparative Evaluation of a Low-Carbohydrate Diet and a Mediterranean Diet in Overweight/Obese Patients with Type 2 Diabetes Mellitus: A 16-Week Intervention Study

by Walter Currenti, Francesca Losavio, Stefano Quiete, Amer M. Alanazi, Giovanni Messina, Rita Polito, Fabiana Ciolli, Raffaela Simona Zappalà, Fabio Galvano and Raffaele Ivan Cincione

Nutrients 2024, 16(1), 95; https://doi.org/10.3390/nu16010095 - 27 Dec 2023

Cited by 4 | Viewed by 6274

Abstract

Introduction: The worldwide prevalence of type 2 diabetes mellitus (T2DM) and obesity has been steadily increasing over the past four decades, with projections indicating a significant rise in the number of affected individuals by 2045. Therapeutic interventions in T2DM aim to control blood glucose levels and reduce the risk of complications. Dietary and lifestyle modifications play a crucial role in the management of T2DM and obesity. While conventional medical nutritional therapy (MNT) often promotes a high-carbohydrate, low-fat Mediterranean diet as an elective treatment, low-carbohydrate diets (LCDs), specifically those restricting carbohydrate intake to less than 130 g/day, have gained popularity due to their multifaceted benefits. Scientific research supports the efficacy of LCDs in improving glycemic control, weight loss, blood pressure, lipid profiles, and overall quality of life. However, sustaining these benefits over the long term remains challenging. This trial aimed to compare the effects of a Mediterranean diet vs. a low-carbohydrate diet (carbohydrate intake < 130 g/day) on overweight/obese patients with T2DM over a 16-week period. The study will evaluate the differential effects of these diets on glycemic regulation, weight reduction, lipid profile, and cardiovascular risk factors. Methods: The study population comprises 100 overweight/obese patients with poorly controlled T2DM. Anthropometric measurements, bioimpedance analysis, and blood chemistry assessments will be conducted at baseline and after the 16-week intervention period. Both dietary interventions were hypocaloric, with a focus on maintaining a 500 kcal/day energy deficit. Results: After 16 weeks, both diets had positive effects on various parameters, including weight loss, blood pressure, glucose control, lipid profile, and renal function. However, the low-carbohydrate diet appears to result in a greater reduction in BMI, blood pressure, waist circumference, glucose levels, lipid profiles, cardiovascular risk, renal markers, and overall metabolic parameters compared to the Mediterranean diet at the 16-week follow up. Conclusions: These findings suggest that a low-carbohydrate diet may be more effective than a Mediterranean diet in promoting weight loss and improving various metabolic and cardiovascular risk factors in overweight/obese patients with T2DM. However, it is important to note that further research is needed to understand the clinical implications and long-term sustainability of these findings. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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13 pages, 1641 KiB

Open AccessArticle

The Association between Dietary Habits and Rapid Postoperative Recovery of Rotator Cuff Repair

by Jiaxin Liu, Wei Wang, Zhifeng Wang, Qingyun Wu, Yunli Zhu, Weicheng Wu and Qi Zhou

Nutrients 2023, 15(21), 4587; https://doi.org/10.3390/nu15214587 - 28 Oct 2023

Viewed by 1712

Abstract

Some nutritional factors have been suggested to improve postoperative outcomes in rotator cuff (RC) repair, but dietary effects on the recovery speed after the surgery remain undefined. To investigate the potential roles of dietary habits in this context, we analyzed the 12-month follow-up data of 55 patients with RC repair and found that these patients could be categorized into a rapid recovery group (n = 35) and slow recovery group (n = 20) according to their postoperative recovery patterns. Group-based logistic analysis revealed that habitual intakes of meat (OR = 1.84, 95%CI, 1.22–2.76, p = 0.003), fruits (OR = 2.33, 95%CI, 1.26–5.67, p = 0.01), and wheat-flour foods (OR = 1.62, 95%CI, 1.2–2.25, p = 0.002) were significantly associated with rapid recovery. Moreover, among all intakes of wheat-flour foods, intakes of steamed and boiled flour products were also associated with rapid recovery. Further mediation analysis showed that eosinophilic granulocytes (EOs) significantly mediated the association between rapid RC recovery and the habitual intakes of meat (mediation proportion = 17.5%, P-mediation < 0.0001), fruits (17.9%, p < 0.0001), and wheat-flour foods (11.4%, p < 0.0001). Thus, our study suggests that certain dietary habits play beneficial roles in the context of postoperative recovery for RC repair. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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24 pages, 367 KiB

Open AccessArticle

Analysis of the Diet Quality and Nutritional State of Children, Youth, and Young Adults with Prader–Willi Syndrome: A Polish Multiple Case Study

by Michał Skrzypek, Katarzyna Kowal, Paweł Glibowski, Grzegorz Dzida, Karolina Nowosad, Renata Krzyszycha, Klaudia Soczyńska and Olga Przybysz

Nutrients 2023, 15(17), 3811; https://doi.org/10.3390/nu15173811 - 31 Aug 2023

Cited by 1 | Viewed by 1638

Abstract

Given the lack of data on dietary quality in young individuals with Prader–Willi syndrome (PWS) in Poland, a multiple case study was conducted in which anthropometric measurements and 7-day dietary records were collected from 20 subjects with PWS. The study group consisted of 8 females and 12 males with a mean age of 14.8 years and a mean BMI of 21.6. Based on BMI analysis, five subjects were overweight, including two subjects who were obese. The study showed that 35% of the subjects had energy intakes above the recommended levels. Protein deficiency was found in one subject in the analyzed diets. However, fat intake was excessive in four subjects, and the majority exceeded the recommended intake of saturated fatty acids. Vitamin E and B₁₂ deficiencies were found in 40% and 85% of the subjects, respectively. All subjects had inadequate intakes of vitamin D and iodine, while the majority had deficiencies in sodium and copper intakes. Calcium intake was deficient in 35% of the subjects. However, most subjects met recommendations for the intakes of other minerals, vitamins, and fiber. These findings confirm the suboptimal dietary patterns of Polish individuals with PWS, with deficits observed in the intake of certain vitamins and minerals. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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13 pages, 598 KiB

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Is There an Ideal Diet? Some Insights from the POUNDS Lost Study

by George A. Bray, Lu Qi and Frank M. Sacks

Nutrients 2024, 16(14), 2358; https://doi.org/10.3390/nu16142358 - 20 Jul 2024

Cited by 2 | Viewed by 3776

Abstract

Diets for weight loss have a long history but an ideal one has not yet been clearly identified. To compare low-fat and lower carbohydrate diets, we designed The Preventing Overweight by Novel Dietary Strategies (POUNDS) Lost study. This is a 2 × 2 factorial study with diets of 20% or 40% fat and 15% or 25% protein with a graded carbohydrate intake of 35, 45, 55 and 65%. Weight loss, overall, was modest at nearly 6% with all four diets, and no significant dietary difference. The variability in weight loss in each diet group was significant, ranging from greater than 20% to a small weight gain. Studies of genetic variations in relation to weight loss showed that the diet that was selected could significantly affect weight loss, emphasizing that there is no ideal diet and more than one diet can be used to treat obesity. Weight loss was also influenced by the level of baseline triiodothyronine or thyroxine, and baseline carbohydrate and insulin resistance. Achieving a stable Health Eating Food Diversity Index, eating more protein, eating more fiber, engaging in more physical activity, sleeping better and eating less ultra-processed foods were beneficial strategies for weight loss in this trial. Although there is no “ideal diet”, both the DASH diet and the Mediterranean diet have clinical trials showing their significant benefit for cardiovascular risk factors. Finally, the lesson of the “Last Chance Diet”, which recommended a diet with protein from gelatin, proved that some diets could be hazardous. Full article

(This article belongs to the Special Issue Dietary Patterns and Clinical Health Outcomes)

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