The aim of this study was to evaluate whether dietary behaviours of the Spanish adult population were changed during the COVID-19 outbreak confinement. For that purpose, an online questionnaire, ...based on 44 items including socio-demographic data, Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, processed foods intake, changes in their usual food choices and weight gain was distributed using social media and snowball sampling. A total of 7514 participants (37% aged below 35 years, 70.6% female, 77.9% university-level education or higher) from all the Spanish territory completed the questionnaire. Results outlined healthier dietary behaviours during the confinement when compared to previous habits. Overall, the MEDAS score (ranging from 0 to 14, whereby higher a scoring reflects greater adherence to the MedDiet) increased significantly from 6.53 ± 2 to 7.34 ± 1.93 during the confinement. Multivariate logistic regression models, adjusted for age, gender, region and other variables, showed a statistically significant higher likelihood of changing the adherence to the MedDiet (towards an increase in adherence) in those persons who decreased the intake of fried foods, snacks, fast foods, red meat, pastries or sweet beverages, but increased MedDiet-related foods such as olive oil, vegetables, fruits or legumes during the confinement. COVID-19 confinement in Spain has led to the adoption of healthier dietary habits/behaviours in the studied population, as reflected by a higher adherence to the MedDiet. This improvement, if sustained in the long-term, could have a positive impact on the prevention of chronic diseases and COVID-19-related complications.
Abstract
Background
Multiple sclerosis is an inflammatory and neurodegenerative disease. People with multiple sclerosis (pwMS) experience chronic fatigue which is difficult to deal with ...therapeutically and greatly affects health-related quality of life (QOL).
PwMS are aware of the lack of generalized dietary advice related to their disease, leading to self-experimentation with diet.
It is necessary to provide objective information about dietary interventions for pwMS. We aim to provide an objective synthesis of the evidence for efficacy and safety of specific diets in pwMS through a rapid review and meta-analyses of randomized controlled trials (RCTs), examining symptomatic fatigue (MFIS), QOL, Expanded-Disability-Status-Scale (EDSS), and severe adverse events.
Methods
We have carried out a rapid review (MEDLINE and EMBASE) up to December 2021, with PRISMA methodology, and meta-analyses, of (RCTs). All statistical analyses were performed using the comprehensive meta-analysis (CMA) -RStudio 4.1.3. The analysis used weighted mean differences (WMD) and a 95% confidence interval (CI) using a random-effects model to compare the effects of the dietary intervention with the control.
Results
Eight studies met the inclusion criteria. Of these eight studies, five analyzed EDSS, three MFIS, and three QOL. A total of 515 patients were analyzed. These meta-analyses cumulative evidence support that dietary intervention is associated with a trend of reduction in fatigue (308 patients studied) -the difference between means (SMD) of the control group and intervention group was -2,033, 95%-IC (-3,195, -0,152), a
p
-value of 0.0341)-, an increase in QOL (77 patients studied), no significant effect on EDSS (337 patients studied), and no severe adverse events.
Conclusions
It is difficult to reach a high level of evidence in dietary studies. Our findings show that dietary intervention is associated with a trend of reduction in fatigue in MS. Taking into account the potential of dietary interventions and the benefit/risk ratio in their favor, neurologists must be aware of the great importance of making interventions on diet in MS if necessary. There are dietary interventions with some evidence of benefit for patients with MS, which could be chosen based on adherence, patient preferences, and individual outcomes. Large prospective clinical trials are needed to shed further light on this topic.
Perceived health in caregivers is related to caregiver burden, psychological well‐being and social support. Women perceive poorer health and are more likely than men to experience caregiver overload. ...The objectives of this study were to analyse perceived health, perceived social support and caregiver overload in family caregivers of patients with Alzheimer's disease, as well as to study the effect of the perceived social support as a mediating variable between perceived health and caregiver overload was also analysed, taking into account the caregivers’ gender. A cross‐sectional descriptive design was used. The sample consisted of 255 family caregivers of individuals with Alzheimer's disease in the Almería Health District (Spain). This study was conducted from January to December 2015. The caregivers’ mean age was 55.35 years (SD = 12.35), with 85.5% (n = 218) being women and 14.5% (n = 37) being men. The following questionnaires were administered: Goldberg's General Health Questionnaire‐28; the Caregiver Strain Index, measuring caregiver overload; and the Duke‐UNC‐11 functional social support questionnaire. Poor perceived health, high caregiver overload and high perceived social support were found. Differences in perceived health and perceived social support were significantly higher in women than in men. In women, perceived social support was a mediating variable between perceived health and family caregiver overload. This mediation was not observed in men. This study suggests that perceived social support influences the emotional well‐being and the caregiver overload of family caregivers of patients with Alzheimer's. However, its effect differs according to gender. It would, therefore, be necessary to have an in‐depth understanding of the variables determining these differences in family caregivers.
Monthly samplings carried out in 2016–2019 and satellite color images from 2002 to 2019 have been combined to determine the onset and causative species of the ecosystem disruptive algal bloom (EDAB) ...that affects the Mar Menor coastal lagoon (Western Mediterranean Sea) since 2015. Substantial changes in satellite spectral reflectance attributable to increasing abundance of Synechococcus were registered in 2014. Furthermore, cell abundances of this species in 2016 were the largest ever obtained in the lagoon (6 106 cells mL−1), with values similar to those reported for other Mediterranean hypertrophic estuaries and coastal lagoons. These results suggest that the early changes leading to the EDAB started in 2014 and that Synechococcus played a relevant role in its development. Moreover, diatom and dinoflagellate abundances changed substantially in 2016–2019, ranging from 102 to more than 104 cells mL−1. Some of these changes were linked to flood, suggesting that EDAB has modified substantially the homeostatic capacity of the lagoon.
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•Eutrophication has produced a significant alteration of the lagoon phytoplankton.•Synechococcus had a key role in the onset of the ecosystem disruptive algal bloom in the coastal lagoon.•Self-regulation of the Mar Menor in response to environmental changes has been reduced.
Diet in the first years of life is an important factor in growth and development. Dietary protein is a critical macronutrient that provides both essential and nonessential amino acids required for ...sustaining all body functions and procedures, providing the structural basis to maintain life and healthy development and growth in children. In this study, our aim was to describe the total protein intake, type and food sources of protein, the adequacy to the Population Reference Intake (PRI) for protein by the European Food Safety Authority (EFSA), and the Recommended Dietary Allowance (RDA) by the Institute of Medicine (IoM). Furthermore, we analyzed whether the consumption of dairy products (including regular milk, dairy products, or adapted milk formulas) is associated with nutrient adequacy and the contribution of protein to diet and whole dietary profile in the two cohorts of the EsNuPI (in English, Nutritional Study in the Spanish Pediatric Population) study; one cohort was representative of the Spanish population from one to <10 years old (
= 707) (Spanish reference cohort, SRS) who reported consuming all kinds of milk and one was a cohort of the same age who reported consuming adapted milk over the last year (including follow-on formula, growing up milk, toddler's milk, and enriched and fortified milks) (
= 741) (adapted milk consumers cohort, AMS). The children of both cohorts had a high contribution from protein to total energy intake (16.79% SRS and 15.63% AMS) and a high total protein intake (60.89 g/day SRS and 53.43 g/day AMS). We observed that protein intake in Spanish children aged one to <10 years old was above the European and international recommendations, as well as the recommended percentages for energy intakes. The main protein sources were milk and dairy products (28% SRS and 29% AMS) and meat and meat products (27% SRS and 26% AMS), followed by cereals (16% SRS and 15% AMS), fish and shellfish (8% in both cohorts), eggs (5% SRS and 6% AMS), and legumes (4% in both cohorts). In our study population, protein intake was mainly from an animal origin (meat and meat products, milk and dairy products, fish and shellfish, and eggs) rather than from a plant origin (cereals and legumes). Future studies should investigate the long-term effect of dietary protein in early childhood on growth and body composition, and whether high protein intake affects health later in life.
The primary aims of this study were to evaluate the changes in dietary behavior among the Croatian adult population during the COVID-19 outbreak and to explore the impact of confinement on cooking ...habits.
The study was based on results from COVIDiet_Int cross-sectional study-a part of COVIDiet project (NCT04449731). A self-administered online questionnaire was used to assess the frequency of food consumption, eating habits, and sociodemographic information. A total number of 4,281 participants (80.5% females and 19.4% males) completed the questionnaire.
The Mediterranean Diet Adherence Screener (MEDAS) score before the confinement was 5.02 ± 1.97, while during the confinement, the MEDAS score increased to 5.85 ± 2.04. Participants who had higher adherence to the Mediterranean diet (MedDiet) during the confinement were mostly females (88.8%), aged between 20 and 50 years, with the highest level of education (66.3%) and normal BMI (70.6%). The majority of participants maintained their dietary behavior as it was before COVID-19 confinement, while 36.9% decreased their physical activity. Participants with higher MEDAS score were more eager to increase their physical activity. Additionally, higher median values of MEDAS score were noted for participants with body mass index values below 24.9 kg/m
(6.0 vs. 5.0 for participants with BMI above 25 kg/m
). Participants in all residence places increased their cooking frequency during the confinement (53.8%), which was associated with an increase in vegetables, legumes, as well as fish and seafood consumption.
According to our findings, Croatian adults exhibited medium adherence to the MedDiet during the COVID-19 confinement. The results suggest that cooking frequency could be positively associated with overall dietary quality, which is of utmost importance in these demanding times.
Sarcopenia is an important risk factor for hip fracture in older people. Nevertheless, this condition is overlooked in clinical practice. This study aimed to explore the factors associated with ...sarcopenia among older patients hospitalized for hip fracture, to identify a predictive model of sarcopenia based on variables related to this condition, and to evaluate the performance of screening tools in order to choose the most suitable to be adopted in routine care of older people with hip fracture. A cross-sectional study was undertaken with 90 patients (mean age 83.4 ± 7.2 years), by assessing sociodemographic and clinical characteristics, anthropometric measures, such as body mass index (BMI) and calf circumference (CC), the functional status (Barthel Index), the nutritional status (MNA-SF), and the adherence to the Mediterranean Diet (MEDAS). Diagnosis of sarcopenia was established according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). The analysis of variables associated with sarcopenia was performed using multivariate logistic regression models. Clusters of sarcopenia were explored with heatmaps and predictive risk models were estimated. Sarcopenia was confirmed in 30% of hip fracture patients. Variables with the strongest association with sarcopenia were BMI (OR = 0.79 0.68−0.91, p < 0.05) and CC (OR = 0.64 0.51−0.81, p < 0.01). CC showed a relatively high predictive capacity of sarcopenia (area under the curve: AUC = 0.82). Furthermore, CC could be a valuable tool to predict sarcopenia risk compared with the currently used screening tools, SARC-F and SARC-CalF (AUC, 0.819 vs. 0.734 and 0.576, respectively). More studies are needed to validate these findings in external study populations.
Lactobacillus plantarum C4, previously isolated from kefir and characterized as a potential probiotic strain, was tested for its protective and immunomodulatory capacity in a murine model of ...yersiniosis. The inoculation of BALB/c mice with a low pathogenicity serotype O9 strain of Yersinia enterocolitica results in a prolonged intestinal infection with colonization of Peyer's patches. Pretreatment with C4 was without effect on fecal excretion of yersiniae, but shortened the colonization of Peyer's patches. This protective effect was associated with pro-inflammatory status in the intestinal mucosa (TNF-α production in infected mice was increased by C4) and an increase in total IgA secretion. At a systemic level, C4 did not promote a pro-inflammatory response, although production of the immunoregulatory cytokine IFN-γ was enhanced. These findings suggest that L. plantarum C4 can increase resistance to intestinal infections through its immunomodulatory activity.
Diet is a key modifiable factor in the management of malnutrition and age-related diseases such as sarcopenia, an important issue in long-term care homes. The objectives of this study were to ...evaluate the dietary intake of residents, define dietary patterns, and analyze their association with sex, diet texture, nutritional status, and the presence of sarcopenia. Intake was assessed by the precise weighing method, dietary patterns were defined a posteriori by cluster analysis, and nutritional status and sarcopenia were evaluated by applying the MNA-SF test and EWGSOP algorithm, respectively. A regular diet was consumed by 63% of participants; 56% were at risk of malnutrition and 63% were diagnosed with sarcopenia. Intake of potassium, magnesium, zinc, iodine, vitamin D, E, folic acid, and fiber was low in >80% of participants. Protein intake was <1 g/kg/day in 56% of participants and <25 g/meal in 100%. Two dietary patterns were identified, but neither fully met recommendations. The risk of a poorer diet was higher in females and residents with sarcopenia and was lower in those consuming regular diets. In conclusion, action is required to improve the inadequate nutritional intake of long-term care residents.
Abstract
Genetic determinants of BK polyomavirus infection after kidney transplantation remain poorly investigated. We assessed the potential impact of 13 different single nucleotide polymorphisms ...within genes mainly involved in innate immune responses on the risk of BKPyV viremia in 204 KT recipients. After a median follow-up of 1121.5 days, the cumulative incidence of any-level BKPyV viremia was 24.5% (50/204). There was a significant association between the minor T allele of
TLR3
(rs3775291) SNP and the development of BKPyV viremia (adjusted hazard ratio aHR: 2.16; 95% confidence interval CI: 1.08–4.30;
P
value = 0.029), whereas the minor G allele of
CD209
(rs4804803) SNP exerted a protective role (aHR: 0.54; 95% CI: 0.29–1.00;
P
value = 0.050). A higher incidence of BKPyV viremia was also observed for the minor G allele of
IL10
(rs1800872) SNP, although the absence of BKPyV events among homozygotes for the reference allele prevented multivariable analysis. The BKPyV viremia-free survival rate decreased with the increasing number of unfavorable genotypes (100% no unfavorable genotypes, 85.4% 1 genotype, 70.9% 2 genotypes, 52.5% 3 genotypes;
P
value = 0.008). In conclusion, SNPs in
TLR3
,
CD209
and
IL10
genes play a role in modulating the susceptibility to any-level BKPyV viremia among KT recipients.
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