A Clinical Trial of Mediterranean Diet Enriched with Fatty Fish in Pediatric Asthma： Study Protocol

Background： Considerable interest exists in the therapeutic potential of dietary omega 3 fatty acids in asthma, due to anti-inflammatory and immune-modulating effects. The aim of this Randomized Controlled Trial is to investigate the efficacy of fatty fish consumption in the context of the Mediterranean diet in ameliorating symptoms in pediatric asthma. Methods： Children aged 5-12 years with physician-diagnosed ＂mild asthma＂ will be recruited from a pediatric asthma clinic in Athens and randomized to two groups. The intervention group will consume two meals of fatty fish （≥ 150g cooked fish） per week over a period of 6 months as part of the Greek Mediterranean diet. The control group consumes their usual diet. Questionnaires will be used to collect data on socio-demographics, medical history, dietary habits, adherence to the Mediterranean dietary pattern, asthma control and quality of life. Pulmonary function will be assessed using spirometry and exhaled nitric oxide analysis. In addition, blood tests will be undertaken to assess metabolic profile, biomarkers of nutritional status and dietary intake. Discussion： This clinical dietary intervention will evaluate the therapeutic potential of a Mediterranean diet enriched with fatty fish on pediatric asthma and assist in devising dietary guidelines for the management of pediatric asthma.

Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease

AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease(NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODS Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention(based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting(about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound(US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid-and end-interventions and US was repeated at end-intervention.RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients(20%). At the end of the treatment the end-point concerning the weight(i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients(i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme(altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement(P < 0.01) between baseline and end-treatment.CONCLUSION Outcomes of this study further strengthen the hypothesis that Med Diet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients.

Alimentary regimen in non-alcoholic fatty liver disease:Mediterranean diet

Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide.The mechanisms of the underlying disease development and progression are awaiting clarification.Insulin resistance and obesity-related inflammation status,among other possible genetic,dietary,and lifestyle factors,are thought to play the key role.There is no consensus concerning the pharmacological treatment.However,the dietary nutritional management to achieve weight loss is an essential component of any treatment strategy.On the basis of its components,the literature reports on the effectiveness of the Mediterranean diet in reducing cardiovascular risk and in preventing major chronic diseases,including obesity and diabetes.New evidence supports the idea that the Mediterranean diet,associated with physical activity and cognitive behaviour therapy,may have an important role in the prevention and the treatment of NAFLD.

Mediterranean diet and non-alcoholic fatty liver disease:New therapeutic option around the corner?

Non-alcoholic fatty liver disease(NAFLD)represents the most common chronic liver disease in Western countries,being considered as the hepatic manifestation of metabolic syndrome.NAFLD has a common pathogenic background to that of metabolic syndrome,and shares many risk factors such as obesity,hypertension,insulin resistance and dyslipidemia.Although there is no currently available evidence-based established treatment for NAFLD,all the recommendations from the medical associations indicate that the most effective treatment is to reduce weight through lifestyle modifications.Diet,indeed,plays a key role in the management of NAFLD patients,as both the quantity and quality of the diet have been reported to have a beneficial role in the onset and severity of the liver disease.Among all the diets that have been proposed,a Mediterranean diet was the most effective dietary option for inducing weight loss together with beneficial effects on all the risk factors associated with metabolic syndrome and NAFLD.Over the last few years,research has demonstrated a beneficial effect of a Mediterranean diet in NAFLD.In this review,we will examine all the available data on the association between diet,nutrients and the Mediterranean diet in association with onset and severity of NAFLD.

Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes

BACKGROUND In recent years,American Diabetes Association started to strongly advocate the Mediterranean diet(MD)over other diets in patients with diabetes mellitus(DM)because of its beneficial effects on glycemic control and cardiovascular(CV)risk factors.Tissue levels of advanced glycation endproducts(AGEs)emerged as an indicator of CV risk in DM.Skin biopsy being invasive,the use of AGE Reader has been shown to reflect tissue AGEs reliably.AIM To examine the association between adherence to MD and AGEs in patients with DM type II.METHODS This cross-sectional study was conducted on 273 patients with DM type II.A survey questionnaire was composed of 3 separate sections.The first part of the questionnaire included general data and the habits of the participants.The second part aimed to assess the basic parameters of participants’diseases and associated conditions.The third part of the questionnaire was the Croatian version of the 14-item MD service score(MDSS).AGEs levels and associated CV risk were measured using AGE Reader(DiagnOptics Technologies BV,Groningen,The Netherlands).RESULTS A total of 27(9.9%)patients fulfilled criteria for adherence to MD,with a median score of 8.0(6.0-10.0).Patients with none/limited CV risk had significantly higher percentage of MD adherence in comparison to patients with increased/definite CV risk(15.2%vs 6.9%,P=0.028),as well as better adherence to guidelines for nuts(23.2%vs 12.6%,P=0.023)and legumes(40.4%vs 25.9%,P=0.013)consumption.Higher number of patients with glycated hemoglobin(HbA1c)<7%adhered to MD when compared to patients with HbA1c>7%(14.9%vs 7.3%,P=0.045).Moreover,those patients followed the MDSS guidelines for eggs(33.0%vs 46.8%,P=0.025)and wine(15.6%vs 29.8%,P=0.006)consumption more frequently.MDSS score had significant positive correlation with disease duration(r=0.179,P=0.003)and negative correlation with body mass index(BMI)values(r=-0.159,P=0.008).In the multiple linear regression model,BMI(β±SE,-0.09±0.04,P=0.037)and disease duration(β±SE,0.07±0.02,P<0.001)remained significant independent correlates of the MDSS score.Patients with HbA1c>7%think that educational programs on nutrition would be useful for patients in significantly more cases than patients with HbA1c<7%(98.9%vs 92.6%,P=0.009).CONCLUSION Although adherence to MD was very low among people with diabetes,we demonstrated that adherence to MD is greater in patients with lower CV risk,longer disease duration,and well-controlled glycaemia.

Good adherence to mediterranean diet can prevent gastrointestinal symptoms:A survey from Southern Italy

AIMTo evaluate how different levels of adherence to a mediterranean diet (MD) correlate with the onset of functional gastrointestinal disorders. METHODSAs many as 1134 subjects (598 M and 536 F; age range 17-83 years) were prospectively investigated in relation to their dietary habits and the presence of functional gastrointestinal symptoms. Patients with relevant chronic organic disease were excluded from the study. The Mediterranean Diet Quality index for children and adolescents (KIDMED) and the Short Mediterranean Diet Questionnaire were administered. All subjects were grouped into five categories according to their ages: 17-24 years; 25-34; 35-49; 50-64; above 64. RESULTSOn the basis of the Rome III criteria, our population consisted of 719 (63.4%) individuals who did not meet the criteria for any functional disorder and were classified as controls (CNT), 172 (13.3%) patients meeting criteria for prevalent irritable bowel syndrome (IBS), and 243 (23.3%) meeting criteria for prevalent functional dyspepsia (FD). A significantly lower adherence score in IBS (0.57 &plusmn; 0.23, P P P P P P P P P CONCLUSIONLow adherence to MD may trigger functional gastrointestinal symptoms, mainly in younger subjects. Moreover, with increasing age, patients tend to adopt dietary regimens closer to MD.

Role of Mediterranean diet in preventing platinum based gastrointestinal toxicity in gynecolocological malignancies: A single Institution experience

BACKGROUND Gynecological malignancies represent a major cause of death in women and are often treated with platinum-based regimens.Patients undergoing chemotherapy suffer from alterations in nutritional status which may worsen gastrointestinal(GI)toxicities,quality of life and affect the overall prognosis.Indeed,assuring a good nutritional status and limiting toxicities during treatment are still major goals for clinicians.AIM To assess the role of Mediterranean Diet(MD)in reducing GI toxicities in patients with gynecological cancers treated with platinum-based regimens.METHODS We conducted an observational study on 22 patients with gynecological tumors treated with a platinum-based chemotherapy at Candiolo Cancer Institute FPO/IRCCS between January 2018 and June 2018.The food and frequency(FFQ)and the Patient-Reported Outcomes Common Terminology Criteria For Adverse Events(PRO-CTCAE)questionnaires were administered at baseline and at every Day 1 of each cycle.To evaluate the differences in GI toxicities the study population was divided in two groups according to the currently validated Mediterranean Diet Serving Score(MDSS)at baseline.RESULTS Patients with high MDSS reported a trend toward lower GI toxicities according to PRO-CTCAE at each timepoint(first evaluation:P=0.7;second:P=0.52;third:P=0.01).In particular,difference in nausea frequency and gravity(P<0.001),stomach pain frequency and gravity(P=0.01 and P=0.02),abdomen bloating frequency and gravity(P=0.02 and P=0.03),and interference with daily activities(P=0.02)were highly statistically significant at the end of treatment.More than 60%of patients changed their food habits during chemotherapy mainly because of GI toxicities.A higher reduction of food intake,both in terms of caloric(P=0.29)and of single nutrients emerged in the group experiencing higher toxicity.CONCLUSION Our results show that adherence to MD possibly reduces GI toxicity and prevents nutritional status impairment during chemotherapy treatment.Bigger studies are needed to confirm our results.

Role of Mediterranean diet, tropical vegetables rich in antioxidants, and sunlight exposure in blindness, cataract and glaucoma among African type 2 diabetics

AIM: To assess whether regular Mediterranean diet and regular intake of vegetables may reduce the risk of blindness, cataract, and glaucoma in these type 2 diabetics. · METHODS: A cross-sectional design was carried out among known black diabetics admitted at the diabetic clinics of Kinshasa, between October 2008 and March 2009. The Mediterranean-style dietary score (MSDPS) was used to characterize a Mediterranean-style dietary pattern in the study population using the Harvard semi quantitative FFQ adapted for Africa. · RESULTS: Five hundred Type 2 diabetic patients were included in this study (48% of males; 40% aged ≥60 years). There was a significant association between blindness, cataract and aging; between blindness (P <0.05), cataract (P<0.05), glaucoma (P <0.05), and physical inactivity; between blindness (P<0.05), cataract (P <0.0001), glaucoma (P <0.01) and high SES, and a very significant association between blindness (P <0.0001), cataract (P <0.0001), glaucoma (P <0.0001) and exposure to sunlight. There was also a significant association between blindness, glaucoma, and male sex. Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, Musa acuminata reduced significantly the risk of blindness, cataract and glaucoma. · CONCLUSION: Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, and Musa acuminata may significantly reduce the risk of blindness or its major causes among type 2 diabetes mellitus in Africa.

Shifting towards a Mediterranean Diet in the US： How Far Do We Have to Go, What Are the Potential Health Benefits and Can We Get There？

In the public dialogue surrounding the development of the 2015 dietary guidelines for Americans, public health and environmental advocates converged around a simple theme of shifting towards a more plant-forward Mediterranean-style diet. A robust body of literature documenting the health benefits of this eating pattern provides compelling reasons to change our dietary habits in ways that also benefit our environment, but we also need to have the right foods available and affordable to support this modest shift. This commentary discusses the gaps in current US dietary intakes compared to recommendations for meat and protein versus plant-based foods and the potential health benefits of shifting towards a more plant-based diet, focusing on the complex role of Mediterranean crops, such as tree nuts and olive oils, needed to support this shift.

Methodologic quality of systematic reviews and meta-analyses on the Mediterranean diet and cognitive function： a review

Background and aim： Several systematic reviews and meta-analyses published within the past years have examined the associations of Mediterranean-style diets （MedSDs） on cognitive. However, these reviews have not been evaluated for satisfying Contemporary methodologies quality standards. At the same time, due to the high demand for related care during the aging process in China, it is necessary to summarize the ex-isting system evaluation and evaluate the quality of it, so as to provide strong evidence for the development of relevant work and to standardize the research process and methods in this field. This study evaluated the quality of recent systematic reviews and meta-analyses on MedSD and cognitive outcomes by using an established methodology quality scale, and to provide some valuable references for future research and Chinese systematic review and meta-analysis developing. Methods： We used the AMSTAR Methodology Quality Assessment Scale to evaluate the quality of methodology of the existing meta-analyses and systematic review. Meta analysis and systematic review that meets our criteria must contain the following characteristics： 1） used systematic or meta-analytic procedures to review the lit-erature, and 2） had MedSD interventions independently. Results： Reviews satisfied with 5 to 9 of the AMSTAR MedSD items （mean 7.35, standard deviation： 1.27）, quality is above average with those published in higher-impact journals having a greater quality score. Conclusion： These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on cognitive do not fully meet contemporary methodology quality standards. The methodological quality of the literature needs to be im- proved. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects cognitive. To clarify associations between MedSD and cognitive, future meta-analyses and systematic reviews should not only follow methodology quality standards but also include more statistical modeling results when data allow. And in order to make the conclusions more reliable, we expect higher quality RCTs in the future.

Effects of adherence to the Mediterranean diet in children and adolescents with irritable bowel syndrome

BACKGROUND Irritable bowel syndrome(IBS)is a highly prevalent gastrointestinal disorder in children and adults,which increased over the past twenty years.The Mediterranean diet is a well-known diet full of antioxidants and anti-inflammatory ingredients.AIM To evaluate the safety,tolerability,and effects of adherence to the Mediterranean diet on disease patterns in children and adolescents with IBS.METHODS This prospective,cross-sectional case-controlled study included 100 consecutive IBS patients diagnosed according to Rome IV criteria,aged 12-18 years.Patients Group II on their regular diet for six months.Besides IBS scores(IBS-SSS,IBS-QoL,and total score),different clinical and laboratory parameters were evaluated at the start and end of the study.RESULTS The Mediterranean diet was safe and well-tolerated in IBS patients.IBS children and adolescents with good adherence to the Mediterranean diet(KIDMED Score≥8 points);group I showed significant improvement in IBS scores.IBS-SSS in the Mediterranean diet group was 237.2±65 at the beginning of the study and decreased to 163.2±33.8 at the end of the study(P<0.001).It did not show a significant improvement in the group with a regular diet(248.3±71.1 at the beginning of the study compared to 228.5±54.3 at the study end with P<0.05).The mean IBS-SSS in the Mediterranean diet group significantly improved compared with the group with a regular diet.Mean IBS-QoL in group I improved from 57.3±12.9 at the start of the study to 72.4±11.2 at the study end(P<0.001)and significantly improved when compared to its level in group II at the study end(59.2±12.7 with P<0.001),while group II showed no significant improvement in IBSQoL at the study end when compared to the beginning of the study(59.2±11.7 with P>0.05).The mean total IBS score in group I became 28.8±11.2 at the end of our study compared to 24.1±10.4 at the start(P<0.05)and significantly improved when compared to its level in group II at the end of the study(22.1±12.5 with P<0.05),while in group II,non-significant improvement in the total score at the end of our study compared to its mean level at the start of the study(22.8±13.5 with P>0.05).CONCLUSION The Mediterranean diet was safe and associated with significant improvement in IBS scores in children and adolescent patients with IBS.

Mediterranean diet and nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD) is emerging as the most common chronic liver disease, and is characterized by a wide spectrum of fat-liver disorders that can result in severe liver disease and cirrhosis. Inflammation and oxidative stress are the major risk factors involved in the pathogenesis of NAFLD. Currently, there is no consensus concerning the pharmacological treatment of NAFLD. However, lifestyle interventions based on exercise and a balanced diet for quality and quantity, are considered the cornerstone of NAFLD management. Mediterranean diet(MD), rich in polyunsaturated fats, polyphenols, vitamins and carotenoids, with their anti-inflammatory and antioxidant effects, has been suggested to be effective in preventing cardiovascular risk factors. In adults, MD has also been demonstrated to be efficacious in reducing the risk of metabolic syndrome. However, few studies are available on the effects of the MD in both adult and pediatric subjects with NAFLD. Thus, the aims of the present narrative review are to analyze the current clinical evidence on the impact of MD in patients with NAFLD, and to summarize the main mechanisms of action of MD components on this condition.

Physical Activity, Mediterranean Diet and Biomarkers-Assessed Risk of Alzheimer’s: A Multi-Modality Brain Imaging Study

Increased physical activity and higher adherence to a Mediterranean-type diet (MeDi) have been independently associated with reduced risk of Alzheimer’s disease (AD). Their association has not been investigated with the use of biomarkers. This study examines whether, among cognitively normal (NL) individuals, those who are less physically active and show lower MeDi adherence have brain biomarker abnormalities consistent with AD. Methods: Forty-five NL individuals (age 54 ± 11, 71% women) with complete leisure time physical activity (LTA), dietary information, and cross-sectional 3D T1-weigthed MRI, 11C-Pittsburgh Compound B (PiB) and 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) scans were examined. Voxel-wise multivariate partial least square (PLS) regression was used to examine the effects of LTA, MeDi and their interaction on brain biomarkers. Age, gender, ethnicity, education, caloric intake, BMI, family history of AD, Apolipoprotein E (APOE) genotype, presence of hypertension and insulin resistance were examined as confounds. Subjects were dichotomized into more and less physically active (LTA+ vs. LTA-;n = 21 vs. 24), and into higher vs. lower MeDi adherence groups (n = 18 vs. 27) using published scoring methods. Spatial patterns of brain biomarkers that represented the optimal association between the images and the groups were generated for all modalities using voxel-wise multivariate Partial Least Squares (PLS) regression. Results: Groups were comparable for clinical and neuropsychological measures. Independent effects of LTA and MeDi factors were observed in AD-vulnerable brain regions for all modalities (p β load and lower glucose metabolism) were observed in LTA- compared to LTA+ subjects, and in MeDi- as compared to MeDi+ subjects. A gradient effect was observed for all modalities so that LTA+/MeDi+ subjects had the highest and LTA+/MeDi+ subjects had the lowest AD-burden (p < 0.001), although the LTA × MeDi interaction was significant only for FDG measures (p < 0.03). Adjusting for covariates did not attenuate these relationships. Conclusion: Lower physical activity and MeDi adherence were associated with increased brain AD-burden among NL individuals, in-dicating that lifestyle factors may modulate AD risk. Studies with larger samples and longitudinal evaluations are needed to determine the predictive power of the observed associations.

Mediterranean diet and diabetes prevention:Myth or fact?

Type 2 diabetes is a major, non-communicable disease with increasing prevalence at a global level. Therefore, in order to prevent this condition action should be taken regarding the modifiable factors that influence its development - lifestyle and dietary habits. As the Mediterranean dietary pattern has beneficial effects on both human health and regarding the development and treatment of type 2 diabetes, promoting adherence to this pattern is of considerable public health importance.

Wine Consumption in the Mediterranean Diet: Old Concepts in a New Sight

The term “Mediterranean diet” is widely employed to indicate the typical diet of the Countries located on the Mediterranean sea coast. A growing body of scientific literature pointed out the healthy effects of this diet. In recent years we investigated about the protective effects of a regular and moderate wine consumption. As we know, alcoholic and non alcoholic wine constituents are responsible of different effects by means of molecular and cell mechanisms. Among the non alcoholic components, polyphenols (for example resveratrol and quercetin) were deeply investigated. The aim of this review is to underline the effects of a moderate and regular wine drinking in the context of the Mediterranean diet in light of the interactions between wine and important dietary factors such as olive oil, fruit and vegetables.

Effect of the Mediterranean Diet on BMI in Middle-Aged Hispanic Women with Pre-Obesity and Obesity Central Washington State

Background: Conclusive evidence has yet to emerge regarding the effectiveness and applicability of the Mediterranean diet on middle-aged Hispanic women, the largest female minority group in the United States who is at-risk of metabolic disorders. Objective: The aim of this study is to evaluate the effect of the Mediterranean diet (MED) on the BMI in middle-aged Hispanic women with pre-obesity and obesity in Central Washington State. Design: A prospective study was performed to determine the effect of Mediterranean diet on the BMI of 67 Hispanic women with pre-obesity and obesity between 45 to 65 years of age in Central Washington State. The study was carried out for eight weeks. Dietary adherence was monitored to ensure consistent results. Results: The proportion of Hispanic women who reported a reduction in BMI was 94%, with a decrease in mean BMI after eight weeks of 2.8 (95% CI: 2.5 to 3.0) and P = 0.02, with an odds ratio of 2.6. Multiple linear regression analysis was used to adjust for age, education, physical activity, and smoking. Conclusion: The reduction in BMI demonstrates that the Mediterranean diet can be a promising, culturally appropriate therapy to address the obesity epidemic that is prevalent among Hispanic women.

Effective roles of exercise and diet adherence in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is characterized by symptoms of excessive fat accumulation and steatosis in the liver without alcohol intake in patients.The associated pathogenic mechanism is not completely understood and there are no specific drugs for patients with NAFLD.Exercise and diet adherence are the best options for the management of NAFLD patients.Questionnaire associated analysis models of adherence to these interventions are used to assess their effectiveness in the management of NAFLD patients using specificity,sensitivity,and so on.Studies have indicated that the relative ratio of NAFLD can be reduced by physical activity with diet control.In the future,the pathogenesis of NAFLD should be clarified with stratified efforts to develop appropriate drugs,and both exercise and diet adherence should be optimized using better questionnaire design and evaluation models for patients with NAFLD.

Role of Mediterranean diet in prevention and management of type 2 diabetes

Objective To summarize the importance of Mediterranean diet in the prevention and management of type 2 diabetes. Data sources We searched electronic database on PubMed up to 14 April 2014, we identified these articles with following key words： ＂Mediterranean diet＂ and ＂diabetes＂. The initial search resulted in 451 entries. The search strategy had no language and publication date restrictions. The relevance of the studies was assessed based only on the title and abstract. The studies included in our review had to match the following inclusion criteria： （1） randomized clinical trials and meta-analysis or systematic review, and （2） provided strong evidence for the diet as a way to prevent type 2 diabetes, and improve glycemic control and cardiovascular risk factors in diabetic patients. We reviewed 49 manuscripts and only 22 met our inclusion criteria. Study selection Relevant literatures including randomized control trials, meta-analysis or systematic review. Results Based on several studies, Mediterranean diet is inversely related to type 2 diabetes and plays important roles in the management of type 2 diabetes. Based on the evidence gathered and evaluated from various studies, we concluded combination and interaction of Mediterranean diet components, such as fruits, vegetables, nuts, legumes, whole grains, fish and moderate intakes of red wine, which contain essential nutrients and health promoting properties, including high fibers, high magnesium, high anti-oxidant and high monounsaturatal fatty acids （MUFA）. Interaction and combination of these essential nutrients and health promoting properties found to lower body weight, hemoglobin A1C （HbAlc）, low density lipoprotein （LDL）, oxidative-stress and improve high density lipoprotein （HDL） level; which are beneficial for prevention and prognosis improvement of type 2 diabetes. Conclusions In the modern society, poor dietary habits accompanied by inadequate physical activity are associated with the risk of having obesity and type 2 diabetes. Promoting healthy lifestyle and diet are not only beneficial in the prevention and treatment of various diseases but also important in maintaining the overall health. Switching from unhealthy diet to health-friendly diet such as Mediterranean diet represents healthy lifestyle choice.

Management of non-alcoholic fatty liver disease:Lifestyle changes

In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of Gastroenterology.We focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population globally.Existing therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder symptoms.Although several drugs are in late-stage development,potent drugs against the diseases are lacking.Additionally,existing surgical approaches such as bariatric surgery are not routinely used to treat NAFLD.Intervening in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with NAFLD.With sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.

地中海饮食对肺癌相关性影响的研究进展

肺癌是当今世界十大死因之一,它以其高死亡率令全世界深感忧愁。在现代医学研究中,研究人员正致力于深入挖掘肺癌发生和发展的不同影响因素,以降低其发病率,提高肺癌的治疗成功率,改善肺癌患者的预后。地中海饮食(Mediterranean diet,MD)是一种特殊的膳食结构,它以吃蔬菜、水果、粗粮、豆类和低脂鱼类为主,被报道具有抗炎、抗氧化、降脂等作用。近年来的研究发现,MD可能会在一定程度上预防肺癌,并对其发病和进展产生重要影响。本文旨在对相关文献进行综述,总结及分析性地探讨MD对肺癌发病及进展的影响,从而更好地为预防和治疗肺癌提供研究方向。