Association between Siesta (Daytime Sleep), Dietary Patterns and the Presence of Metabolic Syndrome in Elderly Living in Mediterranean Area (Medis Study): The Moderating Effect of Gender.

OBJECTIVES: Several lifestyle parameters including diet, physical activity and sleep were associated in isolation with the presence of Metabolic Syndrome (MetS) in adults, to date there is a paucity of studies which evaluated their combined role aging populations and especially with respect to gender. Therefore, the aim of the present study was to provide a global consideration of the lifestyle factors associated with MetS among elderly individuals. DESIGN: Cross-sectional observational study. SETTING: 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece. PARTICIPANTS: during 2005-2015, 2749 older (aged 65-100 years) from were voluntarily enrolled in the study. MEASUREMENTS: Dietary habits, energy intake, physical activity status, socio-demographic characteristics, lifestyle parameters (sleeping and smoking habits) and clinical profile aspects were derived through standard procedures. The presence of MetS was defined using the definition provided by NCEP ATP III (revised) and cluster analysis was used to identify overall dietary habit patterns. RESULTS: The overall prevalence of MetS in the study sample was 36.2%, but occurred more frequently in females (40.0% vs. 31.8%, respectively, p=0.03). Individuals with MetS were more likely to sleep during the day (89.4% vs. 76.8% respectively, p=0.039) and frequent 'siesta' was positively linked to the odds of MetS presence in females (Odds Ratio (OR) =3.43, 95% Confidence Intervals (CI): 1.08-10.9), but not for men (p=0.999). The lower carbohydrate (i.e., 45.2% of total daily energy, 120±16gr/day) dietary cluster was inversely associated with the odds for MetS presence, but only for men (OR=0.094, 95%CI: 0.010-0.883). CONCLUSIONS: Lifestyle parameters including sleep and diet quality are strongly associated with the presence of MetS in elderly cohort, but different their level of influence appears to be different, depending on gender. Further research is needed to better consider the role of lifestyle characteristics in the management of MetS in clinical practice.

Role of exclusive breastfeeding in energy balance and weight loss during the first six months postpartum.

PURPOSE: To investigate the energy intake (EI), energy expenditure (EE), and body weight changes of solely breastfeeding women during the first six months postpartum. MATERIALS AND METHODS: This is a prospective observational study of lactating women (n = 64). Three-day dietary records were filled in to assess EI. EE was calculated with a short physical activity questionnaire. Energy cost of milk production was not included in EE estimation. RESULTS: Daily EI and EE for the six-month period was 2,000 Kcal and 1,870 Kcal, respectively. Women had a positive energy balance throughout the study period. Nevertheless, they had a significant weight loss of 0.7 kg/month by the first trimester of lactation, but a non-significant weight loss of 0.5 kg/month by the second trimester. Overall, women lost 86% of the weight gained during pregnancy. CONCLUSION: Exclusively breastfeeding women manage to lose weight during the first six months postpartum as part of the natural process of energy cost of lactation.

Lifestyle factors are determinants of children's blood pressure levels: the CYKIDS study.

Elevated blood pressure (BP) levels represent an important risk factor for cardiovascular disease. Lifestyle factors associated with increased BP levels have been extensively investigated in adults, but not in children. Therefore, we aimed to explore associations among modifiable lifestyle and levels of BP in 10- to13-year-old children. A subsample of the CYKIDS (CYprus KIDS) national cross-sectional study consisting of 622 children (11.7+/-0.83 years) was used to evaluate the research hypothesis. Measurements included BP, height, weight and waist circumference. Body mass index (BMI) was calculated according to the International Obesity Task Force (IOTF) criteria. Adherence to the Mediterranean diet was assessed by the KIDMED (Mediterranean Diet Quality Index for children and adolescents) diet score, whereas physical activity was assessed through a physical activity index. Results have shown that the cutoff value of 120/80 mm Hg was significantly associated with various lifestyle indices. BMI was positively associated with systolic BP (SBP)>120 mm Hg (odds ratio (OR)=1.21, 95% confidence interval (CI) 1.11-1.32); diastolic BP (DBP)>80 mm Hg (OR=1.13, 95% CI 1.01-1.27) and SBP/DBP>120/80 mm Hg (OR=1.20, 95% CI 1.10-1.31). Moreover, children who reported that they frequently eat while watching television were about two times more likely to have elevated SBP or overall BP, whereas children with low socioeconomic status levels were more than 2.5 times more likely to have elevated BP levels. Finally, compared with those with low KIDMED score, children with at least an average [corrected] score were 75% less likely to have elevated DBP levels, whereas they exhibited a nonsignificant trend for lower SBP (by 29%) and lower overall BP levels (by 30%). Similar results emerged when the above analyses were repeated using the American reference values. Conclusively, our study suggests that lifestyle factors play an important role in determining BP levels in children; a finding that underlines the importance of lifestyle modifications in children.

Changes in free radical generation and antioxidant capacity during ultramarathon foot race.

BACKGROUND: Exhaustive exercise has been implicated in the generation of reactive oxygen species, resulting in oxidative stress. We studied the effect of a long-distance, endurance exercise on oxidative stress parameters in athletes who participated in the ultramarathon race Spartathlon (246 km). MATERIALS AND METHODS: This study included 18 runners (16 men and 2 women) aged 42.8 +/- 1.4 years. Blood samples were obtained 24 h before (prerace), at the end (postrace) and 48 h after the end of the race (48 h postrace). We measured oxidative stress indices, including red cell glutathione, malonyldialdehyde and 8-iso-prostaglandin F(2a), as well as the total antioxidant capacity. RESULTS: 8-Iso-prostaglandin F(2a) level increased significantly at the end of the race, compared to prerace levels (up to 914.7 +/- 61.4 pg mL(-1) from 197.6 +/- 8.4 pg mL(-1)), and remained 2.5-fold increased over the baseline 48 h after the race (532.0 +/- 54.2 pg mL(-1), P < 0.000). The total antioxidant capacity of the athletes increased from a baseline of 289.6 +/- 9.0 micromol L(-1) to 358.7 +/- 11.0 micromol L(-1) immediately after the race and remained elevated 48 h later (350.6 +/- 7.6 micromol L(-1)) (P < 0.001). CONCLUSIONS: Prolonged exercise induces a marked response of oxidative stress biomarkers, which in part is compensated by serum ability to scavenge free radicals. Whether these changes have long-term negative effects in the organism needs further investigation.

Overweight and obesity in preadolescent children and their parents in Cyprus: prevalence and associated socio-demographic factors - the CYKIDS study.

Obesity status differs by socio-demographic factors, but data for Cyprus are scarce. An in-depth understanding of this relationship may be useful in designing public health programmes. The objective of the present study is to estimate overweight and obesity (OW/OB) prevalence among children and adults in Cyprus and identify related socio-demographic variables. National cross-sectional study of 1140 children (mean age 11 +/- 0.98 years) and their parents (mean age 42.5 +/- 5.8 years, total n = 1954). Obesity was defined according to the World Health Organization classification for adults and according to IOTF (International Obesity Task Force) criteria for children. Overweight and obesity prevalence among girls was 18.3% and 2.9%, respectively, while in boys, 19.0% and 6.0%. Among parents, OW/OB prevalence was, respectively, women, 22.6% and 5.8%; men, 47.1% and 14.1%. Logistic regression analysis in both children and adults revealed that the most important socio-demographic predictors of obesity status are factors of built environment. Higher prevalence of OW/OB was observed in adults living in a house as opposed to an apartment, in older adults, in younger children, and in men, irrespective of age. There is a severe obesity problem in the Cypriot population; almost one in two adults and at least one in four preadolescent children are overweight or obese. Prevalence of OW/OB was related to socio-demographic factors, especially among adults and women.

The effect of MTHFR(C677T) genotype on plasma homocysteine concentrations in healthy children is influenced by gender.

OBJECTIVE: To explore the influence of gender, together with folate status, on the relation between the common methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and plasma total homocysteine (tHcy) concentrations in healthy children. DESIGN: Cross-sectional study by face-to-face interview. SETTING AND SUBJECTS: A total of 186 sixth-grade students participated from twelve randomly selected primary schools in Volos, Greece. METHODS: Fasting tHcy, folate, and vitamin B(12) were measured in plasma. The MTHFR genotypes were determined. Anthropometric and dietary intake data by 24-h recall were collected. RESULTS: Geometric means for plasma tHcy, plasma folate and energy-adjusted dietary folate did not differ between females and males. The homozygous mutant TT genotype was associated with higher tHcy only in children with lower plasma folate concentrations (<19.9 nmol/l, P = 0.012). As a significant gender interaction was observed (P = 0.050), we stratified the lower plasma folate group by gender and found that the association between the genotype and tHcy was restricted to males (P = 0.026). Similar results were obtained when folate status was based on estimated dietary folate. Specifically, only TT males that reported lower dietary folate consumption (<37 microg/MJ/day) had tHcy that was significantly higher than tHcy levels of C-allele carriers (P = 0.001). CONCLUSIONS: Under conditions of lower folate status (as estimated by either plasma concentration or reported dietary consumption), gender modifies the association of the MTHFR(C677T) polymorphism with tHcy concentrations in healthy children. SPONSORSHIP: Kellog Europe.

Disordered eating attitudes: an emerging health problem among Mediterranean adolescents.

Aim of the present study was to investigate eating attitudes in a group of Mediterranean high school students. One hundred and twenty high school students participated in this survey. The Eating Attitudes Test (EAT-26) was used for evaluating symptoms and attitudes associated with disordered eating. Body composition and dietary intake were also assessed. Using the cut-off point of 20 in the total EAT, 13 females (20.3%) and 4 males (7.3%) exhibited disordered eating behavior. Overweight students had significantly higher scores in the dieting scale than those in the normal BMI range. Percent fat mass was positively related to the total EAT (r=0.326, p<0.001) and the dieting scale (r=0.489, p<0.001). Waist/hip ratio was negatively related to total EAT and its scales. In conclusion, a significant percentage of students in this urban Mediterranean adolescent population found to have abnormal eating attitudes. This finding may be partly explained by the effect of cultural transition.

Gender influence on plasma triacylglycerol response to meals with different monounsaturated and saturated fatty acid content.

OBJECTIVE: Both gender and meal fatty acid composition modulate postprandial triacylglycerol (TAG) metabolism, but little information exists on their interaction. We compared postprandial TAG concentrations in men and women after test meals differing in the proportion of monounsaturated (MUFA) and saturated fatty acids (SFA). SUBJECTS: Nine men (body mass index, BMI: 24.5+/-2.3 kg/m(2)) (mean+/-s.d.) and 10 premenopausal women (BMI: 21.2+/-1.7 kg/m(2)), young and healthy, habituated to a relatively high MUFA diet. DESIGN: Plasma responses were studied after subjects consumed two meals, each providing 60 g of fat and 4.7 MJ, on different occasions: one meal was rich in MUFA (MUFA meal: 40 g MUFA; 12 g SFA) and the other meal was rich in SFA (SFA meal: 20 g MUFA; 32 g SFA). The total body and abdominal fat mass were assessed by dual energy X-ray absorptiometry. RESULTS: Fasting plasma TAG concentration did not differ between meals or genders. No gender differences were observed in either total body or abdominal fat mass. The area under the plasma concentration vs time curve was on average 60% higher (P<0.001) in men than women. Repeated measures ANOVA showed a significant effect of meal x time interaction in men (P<0.001) but not in women (P=0.84). In men, maximal plasma TAG occurred at 4 h and was significantly greater after the MUFA meal (2.10+/-0.20 mmol/l) (mean+/-s.e.m.) than after the SFA meal (1.66+/-0.19 mmol/l) (P=0.01). TAG concentration at 5 h was also significantly greater after the MUFA meal. In women, the patterns of TAG responses were identical after the MUFA and SFA meals. CONCLUSIONS: This study provides evidence that gender influences postprandial TAG concentrations when meal fatty acid composition is altered.

Body composition in dancers: the bioelectrical impedance method.

PURPOSE: The aim of this study was to generate and validate a prediction equation for estimating the body composition in dancers using the bioelectrical impedance analysis (BIA) as a method of assessment. METHODS: The fat-free mass (FFM) of 42 young female professional dance students was estimated by four different methods: dual x-ray absorptiometry (DXA), BIA, simple anthropometry, and skinfold thickness; DXA was used as a criterion method. RESULTS: The dancers' FFM was 42.6 kg (SD: 3.3) and, on the average, body fat represented the 19.4% (SD: 4.3) of their body weight. Two dancer-specific BIA equations for the prediction of FFM (E(BIA)) were developed by multiple regression analysis using weight, height, resistance index, and triceps as predictor variables (E(BIA) and E(BIA-TRICEPS)). The validity of these equations as well as of those previously reported was assessed in two randomly selected subgroups of the initial study group, as described by the Bland-Altman analysis. The bias and the limits of agreement of the equations developed in the present study were lower than those resulting from the application of the previously used equations of Segal et al. and Hergenroeder et al. It was also found that, when validated against DXA, skinfolds measurements did not accurately predict body fatness in this group of young females. CONCLUSION: The new equations allow for an accurate routine assessment of body composition in young female dancers by using the method of BIA. Further studies are needed for the cross-validation of the equations in various groups of dancers.