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

Deadline for manuscript submissions: 5 January 2025 | Viewed by 15732

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Dr. Elena Silvestri

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Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy
Interests: metabolism; body adiposity; insulin sensitivity; thyroid hormone; mitochondria
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Dr. Antonia Giacco

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Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy
Interests: dietary patterns; thyroid function; thyronines; thyroid hormone receptors; metabolic syndrome
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Dr. Federica Cioffi

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Department of Science and Technologies, University of Sannio, 82100 Benevento, Italy
Interests: metabolic homeostasis; intermediate and energy metabolism; thyroid function; thyronines; thyroid hormone receptors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Metabolic syndrome (MS) is a multifaceted health issue marked by visceral obesity, insulin resistance, dyslipidemia, and high blood pressure. Lifestyle modifications, particularly increased physical activity and adherence to the Mediterranean diet (MD), are recognized as the most effective means to prevent cardiovascular, metabolic, and hepatic complications associated with MS. The MD, characterized by plant-based foods, including vegetables, legumes, fruits, and fish, with extra virgin olive oil as a primary lipid, offers anti-oxidant and anti-inflammatory effects. Its components, such as dietary fiber, omega 3 and 9 fatty acids, and polyphenols, contribute to combating oxidative stress and chronic inflammation—common MS risk factors.

Decades of research depict the MD as a rich source of compounds with antioxidant, anti-inflammatory, insulin-sensitizing, cardioprotective, neuroprotective, and anticancer properties. While adopting the Mediterranean lifestyle shows promise in reducing overall mortality and morbidity in MS, questions remain regarding its efficacy, subcellular targets, and tissue-specific effects. Considering these unresolved questions, this Special Issue, titled "Mediterranean Diet and Metabolic Syndrome", aims to compile original research, meta-analyses, and reviews further exploring the relationships between the MD and MS-related diseases. It aims to shed light on the effects of specific MD nutrients/bioactive compounds on MS and its associated pathologies; present current knowledge on the MD's potential in treating and preventing MS; and offer insights from both human and preclinical studies using cellular and animal models.

Dr. Elena Silvestri
Dr. Antonia Giacco
Dr. Federica Cioffi
Guest Editors

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Keywords

diet
obesity
diabetes
NAFLD
mitochondria
metabolic syndrome
Mediterranean diet

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Published Papers (7 papers)

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Research

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10 pages, 602 KiB

Open AccessArticle

Influence of Cardiovascular Risk Factors and Metabolic Syndrome on Epicardial Adipose Tissue Thickness in Rural Spanish Children and Adolescents

by Isabel María Blancas Sánchez, Cristhian H. Aristizábal-Duque, Juan Fernández Cabeza, Manuel Vaquero Álvarez, Pilar Aparicio-Martínez, Manuel Vaquero Abellán, Martín Ruíz Ortiz, María Dolores Mesa Rubio and Francisco Javier Fonseca del Pozo

Nutrients 2024, 16(19), 3321; https://doi.org/10.3390/nu16193321 - 30 Sep 2024

Viewed by 819

Abstract

The presence of visceral adipose tissue implies a higher risk of cardiovascular diseases than subcutaneous adiposity, the most dangerous heart fat. Epicardial adipose tissue (EAT) could have great potential as a detection indicator of cardiovascular diseases, although it has seldom been studied in Spanish children. Objective: The objective of the current research was to describe the values of EAT in a Spanish pediatric population and to investigate the associations between EAT and anthropometric measures, blood pressure, lipid and glucose profiles, and metabolic syndrome. Method: An analytical cross-sectional study of elementary and high school students (aged 6 to 17) measured anthropometrics, blood pressure, lipid and glycemic profiles, and echocardiographic fat thickness. The analysis was based on regression and discriminant analysis. Results: The results of this study (N = 227) showed that the body mass index (BMI) was 20.29 ± 4.54, with an overweight set of 49.77%, and the percentage for metabolic syndrome was 5.3%. EAT was linked to being male, BMI percentile, waist circumference, waist-to-height ratio (p < 0.001), hypertension, higher low-density lipoprotein (LDL) levels, and metabolic syndrome (p < 0.05). Conclusions: This paper argues that in children with higher elevated EAT thickness values, this correlates with cardiovascular risk factors including high blood pressure, elevated LDL levels, and metabolic syndrome. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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11 pages, 500 KiB

Open AccessArticle

Effects of Religious Fasting on Markers of Oxidative Status in Vitamin D-Deficient and Overweight Orthodox Nuns versus Implementation of Time-Restricted Eating in Lay Women from Central and Northern Greece

by Spyridon N. Karras, Konstantinos Michalakis, Fotios Tekos, Zoi Skaperda, Periklis Vardakas, Panayiotis D. Ziakas, Maria Kypraiou, Marios Anemoulis, Antonios Vlastos, Georgios Tzimagiorgis, Costas Haitoglou, Neoklis Georgopoulos, Evangelos G. Papanikolaou and Demetrios Kouretas

Nutrients 2024, 16(19), 3300; https://doi.org/10.3390/nu16193300 - 29 Sep 2024

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Abstract

Background/Objectives: The Mediterranean diet has been widely suggested to exert significant beneficial effects on endothelial oxidative status and cardiometabolic health. Greek Orthodox monasteries, due to their specific nutritional and sartorial habits, comprise a population thatstrictly adheres to nutritional patterns with restricted eating and a plant-based subset of the Mediterranean diet, often accompanied by profound hypovitaminosis D. Time-restricted eating (TRE) is also adopted bya large part of the general lay Greek population for health-promoting reasons, without restrictions on animal product consumption, as imposed by Orthodox religious fasting. However, the comparative effects of these nutritional patterns on oxidative stress markers remain scarce. Methods: The present study attempted to evaluate the effects of Christian Orthodox fasting (COF) in a group of vitamin D-deficient and overweight Orthodox nuns from Central and Northern Greece compared to the implementation of TRE, a 16:8 dietary regimen (16 h of food abstinence and 8 h of feeding) in a cohort of adult women from the general population from the same region with regard to markers of endothelial oxidative status. A group of 50 women from two Orthodox monasteries in Northern Greece and one group of 50 healthy lay women were included. During the enrollment, a detailed recording of their dietary habits was performed, along with a scientific registry of their demographic and anthropometric characteristics (via bioimpedance). The Orthodox nuns followed a typical Orthodox fasting regimen [daily feeding window (8 a.m.–4 p.m.)], whereas the lay women followed a TRE 16:8 regimen with the same feeding time-window with a recommendation to follow a low-fat diet, without characteristics of the Mediterranean diet. We included a complete biochemical analysis, as well as calciotropic profiles [calcium—Ca, albumin, parathyroid hormone—PTH, and 25-hydroxyvitamin D—25(OH)D] and markers of TAC (total antioxidant capacity), GSH (glutathione),and thiobarbituric acid reactive substances (TBARSs) concentrations as markers of oxidative status. Results: All the groups were compared at the baseline regarding their calcium, PTH, and 25(OH)D concentrations, with no statistically significant differences between the groups apart from higher PTH levels in the nuns due to lower 25(OH)D levels. The Orthodox nuns manifested a lower median GSH compared to the controls (6.0 vs. 7.2, p 0.04) and a higher median TAC (0.92 vs. 0.77, p < 0.001). The TBARS comparisons showed no significant difference between the two groups. No significant associations of oxidative status with 25(OH)D, PTH, and the markers of glucose homeostasis were evident. Conclusions: The results of this small pilot study indicate that both dietary regimens have advantages over the oxidative markers compared to each other, with increased TAC in the group of Orthodox nuns after a 16-week period of COF compared to a 16:8 TRE and increased GSH concentrations in the lay women group. Future randomized trials are required to investigate the superiority or non-inferiority between these dietary patterns in the daily clinical setting. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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16 pages, 681 KiB

Open AccessArticle

Sourdough Bread with Different Fermentation Times: A Randomized Clinical Trial in Subjects with Metabolic Syndrome

by Karla Alejandra Pérez-Vega, Albert Sanllorente, María-Dolores Zomeño, Ana Quindós, Júlia Muñoz-Martínez, Mireia Malcampo, Ana Aldea-Perona, Álvaro Hernáez, Aleix Lluansí, Marc Llirós, Isidre Elias, Núria Elias-Masiques, Xavier Aldeguer, Daniel Muñoz, Sònia Gaixas, Gemma Blanchart, Helmut Schröder, Javier Hernando-Redondo, Nerea Carrón, Pedro González-Torres, Valentini Konstantinidou, Montserrat Fitó and Olga Castañer Show full author list Hide full author list

Nutrients 2024, 16(15), 2380; https://doi.org/10.3390/nu16152380 - 23 Jul 2024

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Abstract

The Mediterranean diet, featuring sourdough bread, shows promise in managing metabolic syndrome. This study explored the effects of two sourdough breads, with differing fermentation times but similar nutritional profiles, on inflammation, satiety, and gut microbiota composition in adults with metabolic syndrome. In a double-blind clinical trial, participants were randomized to consume either Elias Boulanger^® long-fermentation (48 h) sourdough bread (EBLong) or Elias Boulanger^® short-fermentation (2 h) sourdough bread (EBShort) over a two-month period. We assessed clinical parameters, inflammatory biomarkers, satiety-related hormones, and the richness and abundance of gut microbiota at baseline and follow-up. The participants included 31 individuals (mean age, 67, 51.6% female). EBShort was associated with reduced levels of soluble intercellular adhesion molecule (sICAM), and all participants, regardless of the intervention, exhibited a decrease in sICAM and diastolic pressure from baseline (p < 0.017). At follow-up, plasminogen activator inhibitor-1 (PAI-1) levels were lower in EBShort (−744 pg/mL; 95%CI: −282 to −1210 pg/mL) compared to EBLong. No differences in microbiota richness or abundance were observed. EBShort bread was effective in reducing some inflammation markers. The consumption of sourdough bread may offer potential benefits in reducing inflammation markers in individuals with metabolic syndrome; however, longer fermentation times did not show additional benefits. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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16 pages, 890 KiB

Open AccessArticle

Relationship between the Mediterranean Diet and Metabolic Syndrome and Each of the Components That Form It in Caucasian Subjects: A Cross-Sectional Trial

by Leticia Gómez-Sánchez, Marta Gómez-Sánchez, Olaya Tamayo-Morales, Cristina Lugones-Sánchez, Susana González-Sánchez, Ruth Martí-Lluch, Emiliano Rodríguez-Sánchez, Luis García-Ortiz and Manuel A. Gómez-Marcos

Nutrients 2024, 16(12), 1948; https://doi.org/10.3390/nu16121948 - 19 Jun 2024

Cited by 2 | Viewed by 1174

Abstract

The main objective of this work is to investigate the relationship between the Mediterranean diet (MD) and metabolic syndrome (MetS) and its components in Caucasian subjects between 35 and 74 years. The secondary objective is to analyze sex differences. Methods: A cross-sectional trial. This study utilized data from the EVA, MARK, and EVIDENT studies, and a total of 3417 subjects with a mean age ± SD of 60.14 ± 9.14 years (57% men) were included. We followed the five criteria established in the National Cholesterol Education Program III to define MetS. The MD was assessed with the 14-item Mediterranean diet adherence screener (MEDAS) used in the PREDIMED study. Good adherence was considered when the MD value was higher than the median value. Results: The mean ± SD value of the MEDAS questionnaire was 5.83 ± 2.04 (men 5.66 ± 2.06 and women 6.04 ± 1.99; p < 0.001). Adherence to the MD was observed by 38.6% (34.3% men and 40.3% women; p < 0.001). MetS was observed in 41.6% (39.0% men and 45.2% women; p < 0.001). In the multiple regression analysis, after adjusting for possible confounders, the mean MD value showed a negative association with the number of MetS components per subject (β = −0.336), and with the different components of MetS: systolic blood pressure (β = −0.011), diastolic blood pressure (β = −0.029), glycemia (β = −0.009), triglycerides (β = −0.004), and waist circumference (β = −0.026), except with the HDL-cholesterol value which showed a positive association (β = 0.021); p < 0.001 in all cases. In the logistic regression analysis performed, we found that an increase in MD adherence was associated with a decrease in the probability of MetS (OR = 0.56) and its components: blood pressure levels ≥ 130/85 mmHg (OR = 0.63), fasting plasma glucose ≥ 100 mg/dL (OR = 0.62), triglyceride levels ≥ 150 mg/dL (OR = 0.65), waist circumference levels ≥ 88 cm in women and ≥102 cm in men (OR = 0.74), and increased high-density lipoprotein cholesterol < 40 mg/dL in men and <50 mg/dL in women (OR = 1.70); p < 0.001 in all cases. The results by sex were similar, both in multiple regression and logistic regression. Conclusions: The results found in our work indicate that the greater the adherence to the MD, the lower the probability of presenting MetS. This result is repeated in the study by sex. More studies are needed to clarify that these results can be extended to the rest of the Mediterranean countries, and to other countries outside the Mediterranean basin. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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Review

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27 pages, 1129 KiB

Open AccessReview

Influence of Mediterranean Diet on Sexual Function in People with Metabolic Syndrome: A Narrative Review

by Vittorio Oteri, Francesco Galeano, Stefania Panebianco, Tommaso Piticchio, Rosario Le Moli, Lucia Frittitta, Veronica Vella, Roberto Baratta, Damiano Gullo, Francesco Frasca and Andrea Tumminia

Nutrients 2024, 16(19), 3397; https://doi.org/10.3390/nu16193397 - 6 Oct 2024

Viewed by 1782

Abstract

Metabolic syndrome (MS), a cluster of cardiometabolic disorders, and sexual dysfunction are two conditions that impact a large proportion of the general population. Although they can occur independently, they are frequently linked and significantly affect people’s quality of life. In recent years, research has increasingly focused on the importance of diet, particularly the Mediterranean diet (MD), in modulating sexual function due to its anti-inflammatory, antioxidant, and vasodilatory properties. In this narrative review, we examined the relationship between MS and sexual function in both men and women, with a special emphasis on the MD’s therapeutic efficacy in improving sexual dysfunction. In men, MD has been shown to ameliorate erectile dysfunction, as well as several sperm parameters, perhaps leading to improved fertility. On the other hand, adherence to MD has been demonstrated to partially recover several sexual dysfunctions in women, such as those related to their menstrual cycle, menopause, endometriosis, and polycystic ovary syndrome. These favorable effects of MD have been demonstrated in both sexes also among people affected by MS. However, more targeted studies are needed to validate these data for different dietary approaches as well. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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16 pages, 1164 KiB

Open AccessReview

The Effects of Almond Consumption on Cardiovascular Health and Gut Microbiome: A Comprehensive Review

by Saiful Singar, Saurabh Kadyan, Cole Patoine, Gwoncheol Park, Bahram Arjmandi and Ravinder Nagpal

Nutrients 2024, 16(12), 1964; https://doi.org/10.3390/nu16121964 - 20 Jun 2024

Cited by 1 | Viewed by 7494

Abstract

The consumption of almonds has been associated with several health benefits, particularly concerning cardiovascular and intestinal health. In this comprehensive review, we compile and deliberate studies investigating the effects of almond consumption on cardiovascular disease (CVD) risk factors and gut health. Almonds are rich in monounsaturated fats, fiber, vitamins, minerals, and polyphenols, which contribute to their health-promoting properties. Regular intake of almonds has been shown to improve lipid profiles by reducing LDL cholesterol and enhancing HDL functionality. Additionally, almonds aid in glycemic control, blood pressure reduction, and chronic inflammation amelioration, which are critical for cardiovascular health. The antioxidant properties of almonds, primarily due to their high vitamin E content, help in reducing oxidative stress markers. Furthermore, almonds positively influence body composition by reducing body fat percentage and central adiposity and enhancing satiety, thus aiding in weight management. Herein, we also contemplate the emerging concept of the gut–heart axis, where almond consumption appears to modulate the gut microbiome, promoting the growth of beneficial bacteria and increasing short-chain fatty acid production, particularly butyrate. These effects collectively contribute to the anti-inflammatory and cardioprotective benefits of almonds. By encompassing these diverse aspects, we eventually provide a systematic and updated perspective on the multifaceted benefits of almond consumption for cardiovascular health and gut microbiome, corroborating their broader consideration in dietary guidelines and public health recommendations for CVD risk reduction. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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Other

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13 pages, 765 KiB

Open AccessSystematic Review

The Microbial Perspective: A Systematic Literature Review on Hypertension and Gut Microbiota

by Alexandros Tsiavos, Christina Antza, Christina Trakatelli and Vasilios Kotsis

Nutrients 2024, 16(21), 3698; https://doi.org/10.3390/nu16213698 - 30 Oct 2024

Viewed by 635

Abstract

Background: Understanding the causes of hypertension is important in order to prevent the disease. Gut microbiota (GM) seems to play an important role, but the detailed physiology remains elusive, with alpha diversity being the most studied indicator. Objectives: This review aimed to systematically synthesize data on gut microbiota (alpha diversity) and hypertension. Methods: Databases, including MEDLINE/PubMed, Scopus, and EMBASE, and citations were systematically queried. We retrieved articles reporting the association between gut microbiota and hypertension. A valid critical appraisal tool was also used to investigate the quality of the included studies. Results: Eighteen eligible studies met our inclusion criteria. In this report, we focused on the following indices of alpha diversity: Shannon, Chao1, Simpson, and Abundance-based Coverage Estimator (ACE) indices. Several studies observed a significantly lower Shannon index in hypertensive patients compared to the healthy control group. Nevertheless, no statistically significant difference was found for the Chao1, Simpson, and ACE indices between hypertensive patients and controls. A higher Firmicutes-to-Bacteroidetes ratio (F/B ratio) was consistently observed in hypertensive patients compared to healthy controls, indicating potential dysbiosis in the gut microbiota. Conclusions: Our systematic review indicates that hypertensive patients may exhibit an imbalance in gut microbiota, evidenced by decreased alpha diversity and an elevated F/B ratio. However, the absence of statistically significant differences in secondary diversity indices (Chao1, Simpson, and ACE) highlights the need for further research. Well-designed, large-scale studies are necessary to clarify these associations and explore the role of gut microbiota in hypertension development. Full article

(This article belongs to the Special Issue Mediterranean Diet and Metabolic Syndrome)

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