Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study.

Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.

Adherence to the Mediterranean diet and 20-year incidence of hypertension: the ATTICA prospective epidemiological study (2002-2022).

BACKGROUND/OBJECTIVES: Dietary habits are a significant predictor of hypertension (HTN). We aimed to evaluate the long-term association between adherence to the Mediterranean diet and HTN incidence. SUBJECTS/METHODS: This was a prospective study among 1415 non-hypertensive adults (44% men, age: 41 ± 13 years) followed up for 20 years. Anthropometric, lifestyle, and clinical parameters were evaluated at baseline. Adherence to the Mediterranean diet was evaluated both at baseline and 10 years through the MedDietScore (range: 0-55, higher values indicate greater adherence). RESULTS: At the 20-year follow-up, 314 new HTN cases were recorded. HTN incidence was 35.5%, 22.5%, and 8.7% in the lowest, middle, and upper tertile of baseline MedDietScore, respectively (p < 0.001). For each 1-point increase in baseline MedDietScore, the 20-year HTN risk decreased by 7% [relative risk (RR): 0.925, 95% confidence interval (CI): 0.906, 0.943], and this effect remained significant after adjustment for age, sex, and baseline lifestyle and clinical confounders, i.e., body mass index, physical activity, smoking, systolic and diastolic blood pressure, family history of HTN, and presence of hypercholesterolemia and diabetes mellitus (RR: 0.973, 95%CI: 0.949, 0.997). In a similar multiadjusted model, compared to subjects who were consistently away from the Mediterranean diet (in the lowest MedDietScore tertile both at baseline and 10 years), only those who were consistently close (in the middle and upper MedDietScore tertiles both at baseline and 10 years) exhibited a 47% lower 20-year HTN risk. CONCLUSION: A high adherence to the Mediterranean diet, particularly when longitudinally sustained, is associated with lower incidence of HTN.

Addressing a Growing Crisis: Exploring Novel Insights and Solutions in Research on Nutrition and Childhood and Adolescent Obesity.

Given the escalating global prevalence of non-communicable diseases (NCDs), it is consequently crucial to address childhood obesity by promoting lifestyle adjustments, as exemplified in the World Health Organization's Package of Essential Non-Communicable Disease Interventions for Primary Healthcare [...].

Physicians' Words, Patients' Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study.

Background: Preventive cardiology aims to educate patients about risk factors and the importance of mitigating them through lifestyle adjustments and medications. However, long-term adherence to recommended interventions remains a significant challenge. This study explores how physician counselling contributes to successful behavior changes in various aspects of lifestyle. Methods: A cross-sectional study conducted in Greece in 2022-2023 included 1988 participants. Validated questionnaires assessed patients' characteristics, dietary habits, and lifestyle choices. Results: The findings revealed that patients who received lifestyle advice from physicians demonstrated increased compliance with the Mediterranean diet and a higher involvement in physical activity. Notably, they were also less likely to be non-smokers. Importantly, physicians' recommendations had a more pronounced association with adherence level to the Mediterranean diet compared to other lifestyle behaviors. Additionally, specific dietary components like cereal, legume, and red meat consumption were significantly associated with physicians' guidance. Conclusions: This study highlights the complex relationship between patients' cardiometabolic health, lifestyle decisions, and healthcare professionals' guidance. The substantial influence of physicians on Mediterranean diet adherence underscores the necessity for a multidisciplinary healthcare approach. Collaborative efforts involving physicians, dietitians, and fitness experts can offer comprehensive support to patients in navigating the intricate landscape of cardiometabolic health.

The Level of Adherence to the ESPEN Guidelines for Energy and Protein Intake Prospectively Influences Weight Loss and Nutritional Status in Patients with Cancer.

Nutrition therapy aims to prevent weight loss and its health consequences in patients with cancer. The aim of this study was to assess Greek patients' adherence to the ESPEN guidelines for oncology patients and its prospective effect on their body weight (BW) and nutritional status. In total, 152 patients with cancer were recruited from the Attikon University Hospital, Greece, and provided data in 2019 (baseline) and 2020 (follow-up) (drop-out rate = 28.3%). Nutritional status was assessed with the PG-SGA questionnaire. Patients were categorized based on whether they adhered at least to the minimum ESPEN-recommended intakes of energy (≥25 kcal/kg/day) or protein (≥1.0 g/kg/day) or not. On average, patients did not adhere to ESPEN guidelines for energy and protein intake. Most patients meeting the minimum recommendations had an improvement of their nutritional status at follow-up and increased their BW compared to those not meeting them. All patients with head, neck, and spinal cancer who met the minimum recommendations for energy intake improved their nutritional status at follow-up. This study showed that consuming at least the minimum amounts of protein and energy recommended by ESPEN may prevent from weight loss and improve nutritional status; however, the exact amounts need to be personalized.

Adherence to a Mediterranean type of diet in the world: a geographical analysis based on a systematic review of 57 studies with 1,125,560 participants.

This systematic review aimed to assess the level and time-trends of adherence to Mediterranean-type diets (MTD) among the general population, globally. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a comprehensive literature search of the MEDLINE and Scopus databases was carried out, until 04/09/2023, based on specific criteria. Fifty-seven studies with 1,125,560 apparently healthy adults from Europe (n = 37), US (n = 8), Asia (n = 8), Australia (n = 4) and Africa (n = 1) were included. Adherence to an MTD was moderate with a significant decline observed in the last decade. European countries, mainly driven by Mediterranean countries, showed higher adherence than other regions. Geographical analysis revealed that adherence to an MTD is related to both geographic location and socioeconomic status throughout the world.

Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece-The IACT-Study.

BACKGROUND: Evidence has shown that poor adherence to vascular medications contributes to a considerable proportion of all cardiovascular disease (CVD) events and mortality. The aim of the present work was to examine patients' beliefs/views that affect their level of adherence to the assigned medical treatment in the context of a multi-center study in Greece. METHODS: Between July 2022 and April 2023, 1988 patients (1180 females) with established cardiovascular disease or relevant cardiometabolic disorders were chosen from seven medical centers in Greece. The 4-item Morisky Medication Adherence Questionnaire gauged medication adherence and investigated patients' beliefs/views regarding treatment. RESULTS: Among participants, 51.2% showed perfect medication adherence, contrasting with 48.8% displaying poor adherence. Patients with negative medication beliefs were around three times more likely to be non-adherent (OR = 2.73; 95% CI = 2.28-3.28). Non-adherers held concerns about drug efficacy (OR = 2.34; 95% CI = 1.10-4.97) and favored alternative therapies (OR = 2.25; 95% CI = 1.75-2.91). CONCLUSION: The findings highlight the significance of addressing patient beliefs/views to improve medication adherence. The distinct Mediterranean context, influenced by cultural, socioeconomic, and clinical factors, emphasizes the need for tailored interventions. This underscores the call for contextually sensitive strategies to boost medication adherence and improve health outcomes in this unique region.

Associations between meat type consumption pattern and incident cardiovascular disease: The ATTICA epidemiological cohort study (2002-2022).

BACKGROUND: Meat consumption has shown from detrimental to beneficial effects against cardiovascular disease (CVD) incidence, mainly depending on the type of meat studied (i.e., red/white, processed/unprocessed) and quantity consumed. OBJECTIVE: To examine the associations between meat type consumption patterns and incident CVD among apparently healthy adults. DESIGN: ATTICA study was conducted in the greater metropolitan Athens area, Greece, during 2001-2002 studying adults free-of-CVD at baseline. Twenty-year follow-up was performed in n = 1988 participants (n = 718 incident cases). Meat consumption during the follow-up period was categorized as: never/rare meat consumption (i.e., <1 time/week), mostly red meat (i.e., compared to other types of meat or processed meat), mostly white meat, and mostly processed meat products (e.g., bacon, sausage). RESULTS: Approximately 38% of the participants reported rare or no consumption of any type of meat, 31% consumed mostly red meat, 19% mostly white meat and the remainder 12% mostly processed meat. In multivariate analysis, compared to never/rarely consuming any type of meat, consuming mostly processed meat [HR: 2.89, 95%CI: 1.05, 7.89], but not red meat [HR: 1.22, 95%CI: 0.81, 1.82], was positively associated with incident CVD during 20 years of follow-up, while consuming mostly white meat was inversely associated with incident CVD [HR: 0.35, 95%CI: 0.17, 0.71]. CONCLUSIONS: The findings of this study suggest that the type of meat, irrespective of the frequency of consumption, plays a role in the risk of developing CVD. In clinical practice, emphasis should be placed on avoiding processed meat and replacing it with white unprocessed meat.

Assessment of Diet Quality in Children and Adolescents with Overweight or Obesity in Greece.

The adoption of healthy nutritional habits constitutes one of the most important determinants of healthy growth and development in childhood. Few studies in Greece have examined children's diet quality using diet indices. The present study aimed to assess the diet quality of a large cohort of children and adolescents with overweight or obesity. Study participants (n = 1335), aged 2-18, were recruited through the Out-patient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, Aghia Sophia Children's Hospital, Athens, Greece. Anthropometric, socio-demographic, and behavioral data were collected using standard methods and equipment. The Diet Quality Index (DQI), which includes four subcomponents (i.e., dietary diversity, dietary quality, dietary equilibrium, and meal index), was calculated to assess each subject's diet quality. According to the results of this study, children's total DQI score was 63.1%. It was observed that 66.7% of the children had at least moderate diet quality (total DQI ≥ 59.34%). Boys had higher values of the total DQI and certain components of the DQI (i.e., dietary equilibrium score and meal index) compared to girls. Three out of ten children with overweight/obesity had poor diet quality (i.e., DQI ≤ 59.33). Younger children (2-5 years old) were found to have the lowest values of dietary equilibrium compared to older children (6-9 and 12-18 years old). Moreover, boys had higher values of the total DQI score and of specific components of this index (i.e., dietary equilibrium and meal index) compared to girls. Children living in urban areas had higher values in the dietary quality score compared to those living in rural areas. Children with overweight had higher values of the dietary quality score and the total DQI score compared to children with obesity. The present study highlighted that children and adolescents with overweight or obesity have poor diet quality. Multilevel and higher intensity interventions should be designed specifically for this group to achieve tangible outcomes.

Depression and Anxiety Mediate the Associations between Nutritional Status, Functional Capacity, and Quality of Life in Patients with Cancer.

Cancer patients are at risk of malnutrition, which influences their functional status, mental health (MH), and quality of life (QoL). This study aimed to examine the associations between nutritional status, functional capacity, and aspects of QoL in cancer patients, as well as the potential mediating role of depression and anxiety in these associations. Patients with various types of cancer (n = 152) were recruited from the Attikon University Hospital, Greece. Validated questionnaires were used to assess nutritional status (PG-SGA), QoL (SF-36 and EQ-5D-3L), functional capacity (ECOG), depression, and anxiety (HADS and BEDS). Handgrip strength (HGS) was also measured. Poor nutritional status was inversely associated with functional capacity, QoL, depression, and anxiety, after adjusting for confounding factors (all P ≤ 0.05). Mediation analysis indicated a significant indirect effect of nutritional status on various parameters of functional capacity and QoL through depression and anxiety, after adjusting for age and sex. Mediated proportion ranged from 26.3-34% to 23.1-82.8% for functional capacity and QoL, respectively. A significant proportion of the effect of nutritional status on QoL and functional capacity can be partly attributed to psychological effects, highlighting the significance of integrating all aforementioned aspects in the nutritional intervention for cancer patients.

Combined Effects of Diet and Physical Activity on Inflammatory Joint Disease: A Systematic Review and Meta-Analysis.

Research evidence suggests that, individually, diet and physical activity are effective interventions for reducing levels of inflammation in inflammatory joint diseases (IJD), however little is known about their combined use. This systematic review and meta-analysis aimed to examine the effects and/or associations of combined diet and physical activity interventions in IJD, specifically rheumatoid arthritis (RA) and the spondyloarthropathies (SpA) (PROSPERO registration number: CRD42022370993). Ten out of 11 eligible studies examined RA patients. We found that a combination of diet/nutrition and physical activity/exercise improved Health Assessment Questionnaire score (standardized mean difference = -1.36, confidence interval (CI) = (-2.43)-(-0.30), I2 = 90%, Z = 2.5, p = 0.01), while surprisingly they increased erythrocyte sedimentation rate (mean difference = 0.20, CI = 0.09-0.31, I2 = 0%, Z = 3.45, p < 0.01). No effects were found on C-reactive protein or weight (p > 0.05) of RA patients. We did not find studies in other IJDs that provided sufficient data for a meta-analysis. The narrative data synthesis provided limited evidence to address our research question. No firm conclusions can be made as to whether the combination of diet/nutrition and physical activity/exercise affects inflammatory load in IJDs. The results of this study can only be used as a means of highlighting the low-quality evidence in this field of investigation and the need for further and better-quality research.

Cardiometabolic Patient-Related Factors Influencing the Adherence to Lifestyle Changes and Overall Treatment: A Review of the Recent Literature.

It is well acknowledged that most of the modifiable risk factors for Cardiovascular Diseases (CVDs) can be averted through lifestyle modifications beyond medication adherence. This review aims to critically evaluate the cardiometabolic (CM) patient-related factors that influence the adherence to lifestyle changes studied alone and/or in combination with medication. A comprehensive literature search of PubMed articles from 2000 to 2023 retrieved 379 articles. After removing the articles which were not relevant, a total of 28 cross-sectional studies was chosen (12 qualitative, and 16 quantitative). The findings confirmed that five groups of factors influence patients' adherence to overall treatment: (1) health beliefs, knowledge, and perceptions regarding the risks and challenges of disease and medication intake along with adherence process perceptions; (2) self-concept; (3) emotions; (4) patient-healthcare providers relationship/communication and (5) social and cultural interactions. It is worth mentioning that cultural issues, such as culinary particularities, ethnic identity, social life as well as patients' skills and abilities, play a profound role in the effectiveness of the recommended lifestyle modifications beyond the aforementioned common factors. The need for clear-cut culturally adapted guidelines along with personalized advice from physicians is imperative as it could improve patients' self-efficacy. These socio-psychological factors should be seriously considered as a means to increase the effectiveness of future community prevention programs.

Clustering of Activity-Related Behaviors in Relation to Self-Reported Causes of Stress among Pre-Adolescents: Results from a National Epidemiological Study.

An epidemiological study was conducted among 1728 10-12-year-old students (55.1% girls) and their parents during 2014-2016 in Greece. This study aimed to identify the dominant clusters of physical activity/sedentariness among preadolescents and investigate their association with self-reported sources of stress. Children's physical activity levels and sources of stress were evaluated using validated questionnaires that assessed daily hours of activities, both on weekdays and on weekends, including physical activity, screen-based sedentary time, and non-screen-based sedentary time. The k-means algorithm of cluster analysis was applied. Three clusters of children's physical activity/sedentariness were revealed. Cluster 1 was characterized as "Inactive-Non sedentary", cluster 2 as "Active -Non-screen sedentary", and cluster 3 as "Inactive-Sedentary". Parental needs/expectations were associated with physical activity patterns (p = 0.009), i.e., children assigned to the third and second clusters had 36% and 51% lower odds to be stressed due to parental requirements [(OR for cluster 3 = 0.64, 95% CI = 0.41-0.99), (OR for cluster 2 = 0.49, 95% CI = 0.32-0.76)], compared with their first-cluster counterparts. Considering the need to promote physical activity in early life stages, the identification of these complex activity-related patterns along with their significant interaction with parental expectations as a cause of stress could enhance the effectiveness of targeted behavior change interventions among those parent-child dyads most in need.

The Synergetic Effect of Soft Drinks and Sweet/Salty Snacks Consumption and the Moderating Role of Obesity on Preadolescents' Emotions and Behavior: A School-Based Epidemiological Study.

The consumption of ultra-processed foods (UPFs) is high along with the prevalence of emotional and behavioral problems among children and adolescents. The present study sought to investigate the synergetic effect of soft drinks and sweet/salty snacks consumption, and the moderating role of obesity on preadolescents' emotions and behavior. A cross-sectional study was conducted among 1728 Greek preadolescents aged 10-12 and their parents, during the school years 2014-2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, soft drinks and sweet/salty snacks consumption was recorded, classifying preadolescents as low or at least moderate consumers, while anthropometric characteristics (height, weight, Body Mass Index (BMI)) were also recorded. Approximately 6 out of 10 preadolescents were characterized by at least moderate consumption of either sweet/salty snacks, or soft drinks, while 22.7% of the participants had at least moderate consumption of both soft drinks and sweet/salty snacks. Boys and preadolescents with a lower level of adherence to the Mediterranean diet, as well as those living in a more obesogenic family environment were more likely to be in the higher consumption groups. When compared to just either the moderate consumption of sweet/salty snacks, or the moderate consumption of soft drinks, the combination of both unhealthy eating habits was associated with significantly higher odds of both aggressiveness and loneliness, while the examined relationships were significantly stronger in overweight/obese children. The positive synergistic effect of soft drinks and sweet/salty snacks consumption on preadolescents' emotions of loneliness and aggressive behavior is even burdened by obesity status highlighting the urgent need for policymakers to take preventive measures to halt the detrimental consequences of UPFs consumption on health outcomes, particularly in overweight/obese children. The importance of the improvement of children's unhealthy eating habits by emphasizing the association between food intake and emotional and behavioral status is highlighted.

Association between Family and School Pressures, Consumption of Ultra-Processed Beverages, and Obesity in Preadolescents: A School-Based Epidemiological Study.

The aim of the present work was two-fold. Firstly, to evaluate the association between the consumption of ultra-processed beverages (UPB) on preadolescents' likelihood of being obese. Secondly, to investigate the potential impact of family and school environmental stressors on this unhealthy lifestyle habit. A cross-sectional study was conducted among 1718 Greek preadolescents and their parents, during the school years 2014 to 2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, UPB consumption (soft and flavored drinks) was recorded, classifying children as low, moderate, or high consumers, while anthropometric characteristics [height, body weight, Body Mass Index (BMI)] were also recorded. Almost seven out of ten preadolescents were classified as at least moderate UPB consumers, while approximately three out of ten were classified as high UPB consumers. Higher UPB consumption was associated with significantly higher levels of BMI, while preadolescents living in a more stressful family and school environment were found to consume significantly higher amounts of UPB. Stakeholders should implement programs that raise awareness among parents and teachers about the sources of stress in preadolescence as a potential "triggering factor" of unhealthy dietary preferences.

The path between breakfast eating habit, sleep duration and physical activity on obesity status: An epidemiological study in schoolchildren.

Background: Although the literature suggests that skipping breakfast, insufficient sleep, and reduced physical activity are associated with childhood obesity their co-influence and their in-between interactions on weight status have rarely been studied. Aim: To examine the co-influence of breakfast eating habits, sleep duration, and physical activity on the weight status of children 10-12 years old from several schools of Greece. Methods: A cross-sectional study was conducted on 1688 students in Greece, during 2014-2016. Children's Body Mass Index (BMI) was calculated and classified according to the International Obesity Task Force (IOTF) classification. Logistic regression models and path analysis were used. Results: Overweight/obesity prevalence was higher in boys (32.5% vs. 20.4%; p < 0.001). Average sleep duration decreased the odds of overweight/obesity [OR (95% CI): 0.86 (0.76, 0.97)] independently of the frequency of breakfast habit. Interaction between sleep duration with breakfast habit (p = 0.002) and physical activity (p < 0.001) was observed. Path analysis showed a negative association of BMI with sleep duration (standardized beta = -0.095, p < 0.001). A third-order interaction between breakfast habit, sleep duration, and physical activity revealed that daily breakfast eating along with adequate sleep and moderate/adequate physical activity levels, decreased the odds of over-weight/obesity by 55% [OR 0.45, 95% CI (0.27, 0.72)]. Conclusion: Although sleep duration is inversely associated with weight status independently of breakfast habit, the co-influence of adequate sleep duration with frequent breakfast eating and moderate/adequate physical activity seems to be a profoundly higher associated as a result of synergy against childhood obesity.

The association of specific types of vegetables consumption with 10-year type II diabetes risk: Findings from the ATTICA cohort study.

BACKGROUND: The present study aimed to investigate the association between vegetable consumption, in total as well as per type/category, and 10-year type-2 diabetes mellitus (T2DM) incidence. METHODS: The ATTICA study was conducted during 2001-2012 in 3042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetable consumption (total, per type) was evaluated through a validated semi-quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10-year follow-up, data from 1485 participants were used for the current analysis. RESULTS: After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had a 0.42-times lower risk of developing T2DM (hazard ratio [HR] = 0.42; 95% confidence interval [CI] = 0.29-0.61); the benefits of consumption were greater in women (HR = 0.29; 95% CI = 0.16-0.53) compared to men (HR = 0.56; 95% CI = 0.34-0.92). Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men. CONCLUSIONS: The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at the population level.

Αssessment of Dietary Intake and Nutritional Status of Former Opioid Users Undergoing Detoxification Process.

RATIONALE: Opioid dependence is often associated with impaired nutritional status, weight changes, nutritional deficiencies, and increased sugar consumption. Scientific quantified data on the dietary habits and intake of such patients are sparse. METHODS: This was a cross-sectional study. The study was conducted among 60 male and female former heroin addicts, who sought detoxification at the OKANA replacement therapy unit, in a public university hospital. All patients were treated for their addiction with buprenorfine/naloxone in combination with counseling. With the use of an administered questionnaire, several parameters were assessed and recorded, including nutritional habits, anthropometric characteristics, recent weight and medical history, and physical activity level of the participants. Additionally, a three-day dietary recall was performed and quantified with the aid of nutritional analysis software. The results were compared with the macronutrient requirements, calculated total energy expenditure, and the population reference intake (PRI) of the participants. Finally, the level of compliance of the participants to the Mediterranean diet model was assessed using the Mediterranean diet score tool. RESULTS: The vast majority of the participants (77%) had a normal BMI of 18.5-25, and 15% were categorized as underweight (<18.5). Furthermore, 63% of the patients reported a mean unintended weight reduction of 9 kg over the last three months. Regarding mean energy and protein intake, no significant differences between reported intake and calculated requirements were recorded. Sugar consumption was high since it reached 20% of the total energy intake. Micronutrient intake was significantly lower for vitamins K, E, and C and potassium compared with the PRI (p=0.034, p=0.001, p=0.046, and p=0.001, respectively). Finally, a low adherence of the participants to the Mediterranean diet model was observed since 38% scored ≤15 and 62% ≤ 30 on the Mediterranean diet score tool. CONCLUSIONS: According to the results of the study, the general nutritional status of this category of patients seems to be impaired, presenting an apparent weight reduction and an inadequate intake of some micronutrients and displaying disturbed eating behaviors. Further data on the field are required to build a future evidence base. Dietary assessment and individualized nutritional counseling, when necessary, might need to be incorporated into the typical clinical management of this patient category to avoid nutritional deficiencies and improve the withdrawal process.

The Association of Junk Food Consumption with Preadolescents' Environmental Influences: A School-Based Epidemiological Study in Greece.

The aim of the present study was to evaluate the impact of environmental influences on Greek preadolescents' junk food consumption. A cross-sectional study, was conducted among 1718 preadolescents (mean (standard deviation(SD)) age: 11.2(0.8) years old; 54% girls) and their parents, during the school years 2014-2016. Parental and child characteristics were collected anonymously, through self-administered and validated questionnaires. Among others, junk food consumption was recorded, classifying children as low, moderate, and high consumers. The majority of the preadolescents were classified as at least moderate junk food consumers, while almost 3/10 children were classified as high junk food consumers. A significantly lower junk food consumption was observed among preadolescents with a healthier family environment, consisting of normal-weight parents who consume junk foods less frequently, prefer home-cooked meals and adhere more to the Mediterranean diet, while more frequent family meals were also associated with lower junk food consumption. In addition, influence from teachers and participation in extracurricular sports activities were significantly associated with lower junk food consumption, while advertisements were found to have a significant negative impact on preadolescents' eating habits. Notwithstanding, peers were not found to influence their dietary choices in terms of junk food consumption. Both parents and teachers seem to be positive influencers on preadolescents' low junk food consumption. The detrimental role of advertisements on junk food consumption is reconfirmed, while peers' influence is not significant on junk food consumption. The need for urgent public health initiatives for the promotion of healthy dietary habits among preadolescents is warranted.

White Meat Consumption and Cardiometabolic Risk Factors: A Review of Recent Prospective Cohort Studies.

Although the association between meat consumption and cardiovascular diseases (CVDs) has been extensively investigated, studies focusing specifically on the relationship between white meat consumption and CVD risk factors are fewer with controversial findings. The aim was to evaluate the relationship between white meat consumption and the incidence of cardiometabolic risk factors. A comprehensive literature search of PubMed articles was conducted from 2010 to 2022 (1 November), according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Thirteen prospective cohort studies were selected studying mainly poultry, with the exception of one study that also analyzed rabbit meat. From the seven studies on the risk of type 2 diabetes mellitus, four studies found no association, two studies found positive associations, and two studies found inverse associations when comparing poultry to other meats. Of the two studies on the risk of hypertension, one observed no association and one a positive association. Of the two studies on weight management, one observed a positive association with weight gain, the other study observed the same relationship only for chicken with skin, while for chicken without skin a positive relationship with relative weight loss was found. As for metabolic syndrome and its components, two studies revealed inverse associations with white meat intake. Only fresh lean white meat consumption seems to have potential beneficial effects on cardiometabolic risk factors. Future research should scrutinize consumption habits related to white meat intake when investigating its association with cardiometabolic risk factors.