Association of Christian Orthodox Fasting with Sociodemographic, Anthropometric and Lifestyle Factors and Serum Biochemical Indices: A Cross-Sectional Study on Patients with Metabolic Diseases.

Christian Orthodox fasting, a type of time-restricted diet, which presents some similarities to the Mediterranean Diet, also including certain similarities with periodic vegetarianism or other time-restricted diets (e.g., intermittent diet and Ramadan fasting), may cumulatively be related to the same or even better beneficial healthy effects as these well-recognized dietary patterns. The present study aimed to explore the potential beneficial impact of Christian Orthodox fasting in patients with metabolic disorders, such as diabetes mellitus type 2, excessive obesity, hypothyroidism and osteoporosis. This was a cross-sectional study, including 135 patients with metabolic disorders (67 fasters and 68 non-fasters). The enrolled fasters had adapted Christian Orthodox fasting recommendations for at least twelve consecutive years or even from childhood. Relevant questionnaires were used to record sociodemographic, anthropometric and lifestyle data of the study population through face-to-face interviews between the enrolled individuals and qualified personnel during a non-fasting period. Christian Orthodox fasting patients showed a significantly and independently lower prevalence of overweight/obesity and abdominal obesity, which is highly associated with cardiometabolic disease risks, as well as a significantly and independently lower incidence of hypertension, including separately lower systolic and diastolic pressure, than non-fasting patients. Fasters also had a significantly and independently increased prevalence of an advanced educational level and no smoking history, as well as a lower incidence of sedentary behavior, and a trend of a correlation with reduced c-reactive protein (CRP), an indicator of inflammation, compared to non-fasters. Fasters also exhibited higher serum albumin and high-density lipoprotein (HDL) levels, as well as lower glucose levels, than non-fasters. This is one of the few cross-sectional studies demonstrating that Christian Orthodox fasting may promote metabolic health by improving several aspects of metabolic disorders, being associated with specific sociodemographic, anthropometric and lifestyle factors. Further studies conducted on larger sample sizes from different countries and different ethnicities that include Christian Orthodox fasters are recommended to evaluate the impact of long-term religious fasting effects on human health, either as a preventative factor reducing the risk of chronic diseases and especially cardiometabolic disorders or as a nutritional intervention to ameliorate symptom severity.

Consumption of Ultra-Processed Food and Drink Products in a Greek Christian Orthodox Church Fasting Population.

The positive effects of the Mediterranean diet on healthy living are widely known, while the health effects of religious fasting have received increased attention during the last decade. However, no study has focused on the consumption of ultra-processed foods (UPFs) in such populations. Therefore, our aim was to investigate UPF intake and its association with metabolic syndrome (MetS) in a Christian Orthodox church (COC) religious fasting population in Greece. In this cross-sectional study, 400 individuals who follow the Mediterranean diet were included, stratified as COC fasters and non-fasters. Dietary intake data were collected via three 24 h diet recalls and a monthly food frequency questionnaire (FFQ). The NOVA food classification system was used to identify the level of processing and categorize all food items. Fasters consumed significantly less chicken, turkey, and beef and significantly more seafood, fish, snails, soy products, and fresh fruits, in terms of unprocessed or minimally processed foods, as well as significantly more fried potatoes and olives in terms of processed foods when compared with non-fasters. Regarding UPFs, a significantly lower intake of pork sausages, ketchup, and mustard as well as a significantly higher consumption of margarine and tarama dip were recorded in fasters compared with non-fasters. Fasters with MetS more frequently consumed UPFs (such as cheese pastries, biscuits, and cakes) than fasters without MetS (p < 0.05 for all comparisons). Similarly, non-fasters with MetS had an increased intake of UPFs (such as Cypriot bread and Coco Pops breakfast cereals) than non-fasters without MetS. Future research should focus on UPF consumption and its associations with clinical outcomes in such populations, thus providing further data for the potential health effects of COC fasting.

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study.

In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers' and children's health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.

Pertinence of Salt-Related Knowledge and Reported Behaviour on Salt Intake in Adults: A Cross-Sectional Study.

The association between salt-related knowledge, attitude, behaviour (KAB) and actual salt consumption in Greek adults is uncertain. This study investigates the correlation between salt intake, gauged by 24-h urinary sodium excretion, with salt-related KAB. It further explores how socio-demographic factors influence these behaviors. Salt consumption was evaluated using a 24-h urinary sodium test, and compared to self-reported KAB data. Knowledge and behavior scores related to salt were computed. An overall cohort-adjusted model examined the relationship between daily salt consumption, knowledge and behavior scores, and certain covariates. Through the stratification by the cohort random effect, two models were established (Cohort I Adults; Cohort II Students) examining the same relationships of the overall cohort model. 463 Greek adults participated. The average salt intake was 9.54 g/day, nearly double the WHO recommendation. Significant differences in knowledge scores were noted based on sex, age, education, and BMI. A trend suggesting lower discretionary salt use with increased salt intake was observed (p = 0.06). However, comprehensive analysis revealed no direct correlation between salt intake and either knowledge (p = 0.562) or behavior scores (p = 0.210). The results emphasize the need for food product reforms by industry stakeholders and accelerated efforts towards reducing salt intake.

Association between Dietary Patterns and Metabolic Syndrome Risk Factors: A Cross-Sectional Study of Christian Orthodox Church Fasters and Non-Fasters in Greece.

It is well known that the Mediterranean diet contributes to healthy living, prevention of non-communicable diseases, and longevity. A cross-sectional study was conducted with participants from Greece who follow the Mediterranean diet and were further divided into two categories: (i) Christian Orthodox Church (COC) religious fasters and (ii) non-fasters. Four-hundred individuals underwent anthropometric measurements, whereas information regarding dietary intake was collected via three 24 h diet recalls and a monthly food frequency questionnaire. Principal component analysis was performed to derive dietary patterns, whereas associations between dietary patterns and metabolic syndrome (MetS) risk factors were investigated with the general linear model. Non-fasters (n = 200) were found to consume significantly more beef, chicken, turkey, sausage, broth, fried potatoes, ketchup, and mustard, while consuming less seafood, snails, soya, tarama salads, fresh fruits, margarine, olives, and decaf coffee. Two distinct dietary patterns were identified in fasters: (i) the "Mixed Diet" and (ii) the "Plant-based/Fasting Diet" pattern. Moreover, three patterns were identified in non-fasters, and were identified as follows: (i) the "Western Diet", (ii) the "Mixed Diet", and (iii) the "Mediterranean-like Diet" pattern. No significant association was observed between dietary patterns and the prevalence of MetS in our population. Further epidemiological studies should evaluate the links between dietary patterns and MetS prevalence within the adult Greek population.

Does Religious Fasting Have a Protective Role against Metabolic Syndrome in Individuals Aged >50 Years?

OBJECTIVE: The Christian Orthodox Church (COC) fasting is a periodic vegetarian-type diet lasting 180-200 days annually in which seafood and snails are allowed on all fasting days. Our aim was to investigate the effects of COC fasting on metabolic syndrome (MetS) in adults >50 years. METHODS: One hundred seventy-six individuals participated in the study (mean age 59.7 ± 6.0 years). Eighty-nine had been following the COC fasting regime since their childhood and eighty-seven were non-fasters. Anthropometric measurements, blood samples, and nutrient intake data were collected at a scheduled appointment, during a non-fasting period. RESULTS: Fasters had significantly higher hip circumference (102 ± 8.5 vs. 98.8 ± 7.5 cm, p = 0.009), low-density lipoprotein (LDL) cholesterol (136 ± 73 vs. 115 ± 51 mg/dL, p = 0.033), and folic acid levels (6.0 ± 4.0 vs. 3.0 ± 1.2 ng/mL, p = 0.018), as well as lower systolic blood pressure (SBP) (131 ± 13 vs. 136 ± 14 mmHg, p = 0.045), diastolic blood pressure (DBP) (80 ± 8 vs. 83 ± 7 mmHg, p = 0.007), glucose (87 ± 16 vs. 93 ± 25 mg/dL, p = 0.039), and triglycerides (143 ± 94 vs. 175 ± 84 mg/dL, p = 0.040). Fasters had significantly less intake of calories (1493.65 ± 363.74 vs. 1614.65 ± 426.28 kcal, p = 0.044) and fat (81.17 ± 25.47 vs. 90.74 ± 24.75 g, p = 0.012), whereas they also consumed significantly less vitamin A-retinol, vitamin B2, vitamin B12, vitamin E, folic acid, pantothenic acid, calcium, phosphorus, zinc, and significantly more vitamin C (p < 0.005 for all comparisons). BP was significantly higher in non-fasters (44.8 vs. 22.5%, p = 0.002), whereas MetS was more frequently present in non-fasters vs. fasters, with a marginal level of significance (35.6 vs. 22.5%, p = 0.055). CONCLUSIONS: COC fasting may affect beneficially MetS prevalence in individuals >50 years, although future research is needed before reaching definite conclusions.

Nutrient Intake and Risk Factors for Metabolic Syndrome in Christian Orthodox Church Religious Fasters.

OBJECTIVE: Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the impact of adherence to the periodic Christian Orthodox Church (COC) fasting on nutrient intake, body composition, and risk factors for metabolic syndrome (MetS). METHODS: Four-hundred individuals aged 42.6 ± 17.0 years participated in this cross-sectional study. Two-hundred subjects followed the COC fasting since childhood or at least the last twelve consecutive years, and two-hundred subjects did not follow the COC fasting regimes or any other restrictive dietary pattern. Socioeconomic data, lifestyle habits, and physical activity data were collected. Nutritional assessment was performed via two 24 h recalls and a food frequency questionnaire. Anthropometric data and biochemical parameters were also measured. RESULTS: Fasters had a significantly lower daily intake of calories (1547 vs. 1662 kcals, p = 0.009), protein (52 vs. 59 g, p = 0.001), fat (82 vs. 89 g, p = 0.012), and cholesterol (147 vs. 178 g, p = 0.001) compared with non-fasters. Furthermore, fasters reported a healthier way of living, with lower rates of smoking and alcohol consumption (p < 0.001 and 0.002, respectively). Insulin and magnesium levels were significantly higher, whereas levels of urea, transaminases, glucose, and phosphorus were significantly lower, as was DBP in fasters versus non-fasters. Furthermore, MetS prevalence was non-significantly higher in non-faster compared with fasters. CONCLUSION: During a non-fasting period, individuals following the COC fasting recommendations reported lower intake of calories, protein, fat, and cholesterol compared with non-fasters. Fasters tended to have a healthier lifestyle pattern and a lower risk for MetS versus non-fasters. Some biochemical parameters also significantly differed between the two study groups. Further research is warranted to establish the long-term clinical impact of these findings.

The Interplay between Metabolic Syndrome and Religious Fasting in Postmenopausal Women.

Religious fasting that involves abstinence from specific food(s) is part of many religions worldwide and has been gaining attention by the research community during the last years. The study aimed to investigate whether the periodic Christian Orthodox fasting mitigates the changes in body composition, dietary intake, and metabolic syndrome (MetS) in postmenopausal women. One hundred and thirty-four postmenopausal women aged 57.3 ± 6.7 years participated in this study. The Christian Orthodox fasting was followed by 68 postmenopausal women since their childhood, whereas 66 postmenopausal women were non-fasters. Data collection involved anthropometric, biochemical, clinical, and dietary information. Postmenopausal women who fasted according to Christian Orthodox Church recommendations had significantly higher mean fat free mass (45 vs. 44 kg, p = 0.002), hip circumference (104 vs. 99 cm, p = 0.001), and diastolic blood pressure (79 vs. 82 mmHg, p = 0.024). No other differences were found with regards to anthropometric data. Fasters also consumed significantly less fat (78 vs. 91 g, p = 0.006), as well as saturated (19 vs. 23 g, p = 0.015), monounsaturated (41 vs. 47 g, p = 0.018), and polyunsaturated fat (8.5 vs. 10 g, p = 0.023), trans fatty acids (0.5 vs. 2.3 g, p = 0.035), and cholesterol (132 vs. 176 g, p = 0.011). In terms of MetS features, non-fasters had more frequently elevated fasting blood glucose (11.8 vs. 24.2%, p = 0.039) and elevated blood pressure (13.2 vs. 36.4%, p = 0.041) compared with fasters. MetS was more common in non-fasters versus fasters with a marginal level of significance (30.3 vs. 23.5%, p = 0.052). Postmenopausal women who follow the Christian Orthodox fasting regime had lower fat intake, and no other difference in nutrient intake, compared with non-fasters. The latter were more likely to have MetS and some of its components. Overall, periodic abstinence from meat, dairy products, and eggs might play a protective role in postmenopausal women with regard to MetS.

Impact of Christian Orthodox Church Fasting on Metabolic Syndrome Components in Adults Aged 18-49 Years.

OBJECTIVE: Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the effects of Christian Orthodox Church (COC) fasting on metabolic syndrome in young adults. METHODS: Participants were 224 men and women, of whom 111 had been following the COC fasting regime and 113 were non-fasters, all aged 18 to 49 years (mean age 29.23 ± 8.78 years). Anthropometric measurements, including the Bioelectrical Impedance Analysis, were performed on individuals, and they also completed food intake questionnaires, and provided blood samples for biochemical analysis. Metabolic syndrome was defined according to criteria of the National Cholesterol Education Program-Adult Treatment Panel III and all variables were checked. RESULTS: Fasters did not statistically differ in anthropometric measurements when comparing to non-fasters. Differences were found in terms of biochemical variables, and more specific in HDL cholesterol, LDL cholesterol and total blood cholesterol, and in systemic and diastolic blood pressure, although non statistically significant. Statistically significant differences were only noticed in heart pulses and insulin levels, with fasters having lower heart pulses (69.44 ± 9.84 versus 72.63 ± 10.74) and greater mean values of insulin levels (4.16 ± 4.66 versus 3.12 ± 2.35). When analysis was carried to identify which variables were met for metabolic syndrome, it was found that fasters had statistically significant lower values of blood pressure when compared to non-fasters. In more details mean systolic blood pressure was 121.67 ± 12.21 versus 123.41 ± 11.73 for fasters and non-fasters respectively, and mean diastolic blood pressure was 75.77 ± 8.82 versus 78.27 ± 10.07 for fasters and non-fasters. Furthermore, the mean energy intake was higher in non-fasters (1698.25 ± 515.99 kcals) when compared to fasters (1590.24 ± 404.19 kcals) but not statistically significant different. CONCLUSIONS: Young adults aged 18 to 49 years who fast according to the COC fasting regimes do not have different metabolic syndrome prevalence when comparing to non-fasters, but there was a statistically significant difference in the prevalence of elevated blood pressure with fasters having lower values.

Activins, follistatins and inhibins in postmenopausal osteoporosis: A proof of concept, case-control study.

BACKGROUND: Bone metabolism has been proposed to be affected by the activins-follistatins-inhibins (AFI) hormonal system. We aimed to evaluate AFI in patients with osteoporosis and osteopenia compared with postmenopausal and premenopausal controls. METHODS: In this case-control study, circulating levels of the AFI system were evaluated, individually and jointly, between postmenopausal women with osteoporosis (BMD T-score ≤-2.5; n = 25) or osteopenia (BMD T-score >-2.5 and ≤-1; n = 25) and postmenopausal women with normal BMD (T-score >-1.0; n = 25) or premenopausal women with normal BMD (Z-score >-1.0; n = 25), with and without adjustment for potential confounders. RESULTS: In the sum of participants, AFI molecules and their ratios followed an opposite pattern of correlations for age and BMI vs. BMD. In unadjusted models, FSTL3 concentrations were higher, whereas activin B, inhibin A and inhibin B and the ratios of activin B/follistatin and activin B/FSTL3 were lower in the three postmenopausal groups compared with the premenopausal group. Activin A/follistatin and activin AB/follistatin ratios were lower in the osteoporosis group than the other three groups. After adjustment for BMI and age, inhibin B (p = 0.005), and the ratios of activin A/follistatin (p = 0.009), activin B/follistatin (p = 0.040) and activin AB/follistatin (p = 0.003) were lower in the osteoporotic group compared with the other groups. In fully adjusted logistic regression analysis log(inhibin B) (p = 0.041), log(activinA/follistatin) (p = 0.014), log(activinB/follistatin) (p = 0.025) and log(activinAB/follistatin) (p = 0.021), but not FSTL3, remained independently associated with the presence of osteoporosis. CONCLUSIONS: Lower inhibin B and higher ratios of activins A, B, and AB to follistatin are associated with lumbar spine BMD and the presence of osteoporosis independently from age or BMI.

Nutritional and Nutrition-Related Biomarkers as Prognostic Factors of Sarcopenia, and Their Role in Disease Progression.

Due to the multifactorial pathogenesis of sarcopenia, it is crucial to identify biomarkers that are risk factors for sarcopenia, and which therefore have a prognostic function. Aim: This narrative review aims to define a set of biomarkers associated with nutrition and sarcopenia. These biomarkers could contribute to individualized monitoring and enable preventive and therapeutic methods. Methods: Two electronic databases, PubMed and Google Scholar, were used. The search strategy was based on a controlled vocabulary (MeSH) and includes studies published up to February 2022. Discussion: Higher levels of serum uric acid are associated with higher handgrip strength and better muscle function in elderly people and, thus, may slow the progression of sarcopenia. Leptin, an adipokine secreted by adipose tissue, promotes the production of pro-inflammatory cytokines, which in turn lead to sarcopenia. This makes leptin a significant indirect biomarker for physical disability and sarcopenic obesity. Additionally, creatinine is a reliable biomarker for muscle mass status because of its easy accessibility and cost-effectiveness. Vitamin D status acts as a useful biomarker for predicting total mortality, hip fractures, early death, and the development of sarcopenia. Therefore, there is an increasing interest in dietary antioxidants and their effects on age-related losses of muscle mass and function. On the other hand, 3-Methylhistidine is a valuable biomarker for detecting increased muscle catabolism, as it is excreted through urine during muscle degradation. In addition, IGF-1, whose concentration in plasma is stimulated by food intake, is associated with the loss of skeletal muscle mass, which probably plays a crucial role in the progression of sarcopenia. Conclusions: Many nutritional biomarkers were found to be associated with sarcopenia, and can therefore be used as prognostic indexes and risk factors. Nutrition plays an important role in the prevention and management of sarcopenia, affecting muscle mass, strength, and function in elderly people.

Effects of Periodic Religious Fasting for Decades on Nutrient Intakes and the Blood Biochemical Profile.

The aim of the present study was to examine differences and correlations in nutrient intakes and serum parameters related to nutrient intake (lipid profile, vitamins, and trace elements) in 200 lifelong Christian Orthodox Church (COC) fasters with periodic abstinence from certain foods (predominantly of animal origin) for approximately half of the year and 200 non-fasting controls, all of whom did not take dietary supplements. Nutrient intakes were assessed through three-day dietary recalls. Blood samples were drawn for the analysis of potential biomarkers of nutrient intake. Fasters had lower energy intake, due to lower fat and protein intake, compared to non-fasters (p < 0.05). Fasters also had lower intakes of vitamins A, B1, B2, B6, B12, D, folate, pantothenate, sodium, calcium, zinc, and phosphorus. Most participants (in both groups) did not meet the recommended dietary allowances of most vitamins and elements. Most serum biochemical parameters did not reflect the differences in nutrient intakes between groups, and none exhibited a correlation coefficient above 0.5 with nutrient intakes. Our findings suggest that COC fasting is associated with reduced intake of many nutrients, although this does not seem to have an impact on the blood biochemical profile.

The Christian Orthodox Church Fasting Diet Is Associated with Lower Levels of Depression and Anxiety and a Better Cognitive Performance in Middle Life.

Lifestyle choices significantly influence mental health in later life. In this study we investigated the effects of the Christian Orthodox Church (COC) fasting diet, which includes long-term regular abstinence from animal-based products for half the calendar year, on cognitive function and emotional wellbeing of healthy adults. Two groups of fasting and non-fasting individuals were evaluated regarding their cognitive performance and the presence of anxiety and depression using the Mini Mental Examination Scale, the Hamilton Anxiety Scale, and the Geriatric Depression Scale (GDS), respectively. Data on physical activity, smoking, and vitamin levels were collected and correlated with mental health scoring. Negative binomial regression was performed to examine differences in the GDS scores between the two groups. Significantly lower levels of anxiety (7.48 ± 4.98 vs. 9.71 ± 5.25; p < 0.001) and depression (2.24 ± 1.77 vs. 3.5 ± 2.52; p < 0.001), along with better cognitive function (29.15 ± 0.79 vs. 28.64 ± 1.27; p < 0.001), were noticed in fasting compared to non-fasting individuals. GDS score was 31% lower (Incidence Rate Ratio: 0.69, 95% Confidence Interval: 0.56-0.85) in the fasting group compared to the control, while vitamin and ferrum levels did not differ. The COC fasting diet was found to have an independent positive impact on cognition and mood in middle-aged and elderly individuals.

Vitamin D status, vitamin D intake, and sunlight exposure in adults adhering or not to periodic religious fasting for decades.

We investigated whether periodic abstinence from foods of animal origin and a conservative lifestyle, with reduced sunlight exposure, affect vitamin D status. In a cross-sectional design, we measured the serum 25-hydroxyvitamin D concentration and assessed dietary vitamin D intake and sunlight exposure in 200 adults adhering to religious fasting for decades and in 200 non-fasters, with no differences between groups in bone mineral density. Fasters showed lower 25-hydroxyvitamin D concentration than non-fasters in winter and spring. Vitamin D intake and some indices of sunlight exposure (including two related to winter and spring) were lower in fasters, and 378 of the 400 participants exhibited vitamin D insufficiency or deficiency. In conclusion, individuals following a religious lifestyle had lower vitamin D intake, sunlight exposure and, at times, serum 25-hydroxyvitamin D concentration than controls, although these differences did not impact bone health.

Dietary protein intake from different animal and plant sources plays a minor role in the bone health of adults with or without intermittent fasting for decades.

We examined whether bone health is related to protein intake from different sources by utilising a distinct, rare dietary pattern: avoidance of animal foods for approximately half of the year according to Christian Orthodox Church fasting. Four-hundred adults, of whom 200 had been following religious fasting for a median of 15 years and 200 were non-fasters, underwent anthropometry, measurements of bone mineral density (BMD) and bone mineral content (BMC), and completed a food frequency questionnaire. Groups did not differ significantly in anthropometric measures, BMD, or BMC. Fasters had higher consumption of seafood and lower consumption of red meat, poultry-eggs, dairy products, and grains-cereals than non-fasters. Protein intake from these food groups exhibited similar differences; overall, fasters had lower protein intake than non-fasters. BMD and BMC were positively, though weakly, correlated with red meat and poultry-egg consumption. Thus, protein intake seems to play a minor (if any) role in bone health.

The significant effect on musculoskeletal metabolism and bone density of the Eastern Mediterranean Christian Orthodox Church fasting.

OBJECTIVE: Nutritional disorders cause secondary osteoporosis as well as musculoskeletal metabolism dysfunction. The Christian Orthodox Church's fasting in Mediterranean countries such Greece and Cyprus, or M.C.O.C. diet consists of self-restraint from food and/or food categories for 180 ± 19 days of total, especially of animal protein and dairy products. This case-control study attempts to investigate the effect of this fasting pattern on musculoskeletal metabolism and bone density. DESIGN: One hundred fasters (or M.C.O.C. diet followers; 68 women and 32 men, mean 59 ± 6.5) with 32 years average fasting time and 100 non-fasters (66 females and 34 males, mean 58.1 ± 6.8; the control group of Mediterranean diet followers) over the age of 50, including menopausal women, were interviewed, as well as physically and laboratory examined along with DEXA measurements of the L2-4 vertebrae and hips. Nutrition data gathered through a 3-day food record during a non-fasting period, while energy intakes calculated on a daily food consumption basis. RESULTS: Given the overall low incidence of osteoporosis in the Mediterranean diet, it appears to be more than three times higher than that of M.C.O.C. diet despite the periodic restriction of food intake of animal origin into a slightly hypothermic pattern, which in turn is characterized by increased consumption of multicolored vegetable foods. CONCLUSIONS: Abstinence from dairy products and meat does not adversely affect musculoskeletal metabolism or bone density. M.C.O.C. diet seems to be "healthy" eating habit for the musculoskeletal system, as future studies expected to confirm.

Bone status of young adults with periodic avoidance of dairy products since childhood.

Proper nutrition throughout childhood and adolescence is crucial for normal bone development. We investigated whether adherence to Christian Orthodox Church fasting is characterized by periodic avoidance of animal foods (including dairy products), since childhood affects stature or bone health in young adults. This cross-sectional study included 200 healthy men and women, aged 18-35, of whom 100 had been following religious fasting for a median of 14 years, starting at the age of 10, and 100 were non-fasters. Measurements included body height; bone mineral density and bone mineral content at the lumbar spine, right hip, left hip, right femoral neck, and left femoral neck; prevalence of bone fracture; serum biochemical parameters; food and nutrient intake; and physical activity and smoking habits. Fasters did not differ from non-fasters in anthropometric measures (including height), bone mineral density and content, or prevalence of low bone mineral density at any of the five sites measured; number of bone fractures; or serum calcium or 25-hydroxyvitamin D concentrations (P > 0.05). Fasters had lower daily calcium and protein intakes, as well as lower dairy consumption than non-fasters. Groups did not differ in physical activity, and fasters smoked less than non-fasters.Conclusion: Despite lower calcium intake and lower dairy product consumption, individuals adhering to religious fasting since childhood did not differ in height, bone mineral density and content, or prevalence of fractures from controls. Therefore, periodic abstention from dairy and, generally, animal products since childhood does not seem to compromise bone health in young adults.What is Known: • Bone health is an important determinant of overall health and longevity. • Proper nutrition throughout childhood and adolescence is crucial for normal bone development. • Adequate intake of dairy products is considered important due to their high calcium content.What is New: • Young adults with limited calcium intake and dairy product consumption, due to adherence to the fasting rules of the Christian Orthodox Church since childhood, do not differ in height or indices of bone health from non-fasting controls.

Correction to: Effect of periodic abstinence from dairy products for approximately half of the year on bone health in adults following the Christian Orthodox Church fasting rules for decades.

The original version of this article, published on 27 June 2019, unfortunately contained a mistake.

Effect of periodic abstinence from dairy products for approximately half of the year on bone health in adults following the Christian Orthodox Church fasting rules for decades.

Christian Orthodox Church (COC) fasting is characterized by periodic abstinence from animal foods (including dairy products). We found that, despite this, older individuals adhering to COC fasting for decades did not differ in bone mineral density, bone mineral content, or prevalence of osteoporosis at five sites from non-fasting controls. PURPOSE: The present observational study investigated whether adherence to COC fasting, characterized by periodic abstinence from animal foods (including dairy products), affects bone health and the prevalence of osteoporosis in older individuals. METHODS: Participants were 200 men and women, of whom 100 had been following the fasting rules of the COC for a median of 31 years and 100 were non-fasters, all aged 50 to 78 years. Participants underwent measurements of bone mineral density (BMD) and bone mineral content (BMC) at the lumbar spine, right hip, left hip, right femoral neck, and left femoral neck; completed a 3-day food intake record and food frequency questionnaire; and provided blood samples for biochemical measurements. RESULTS: Fasters did not differ from non-fasters in demographic characteristics, anthropometric measures, BMD, BMC, or prevalence of osteopenia or osteoporosis at any of the five sites measured (P > 0.05). Fasters had lower daily calcium intake than non-fasters (median 532 vs 659 mg, P = 0.010), daily protein intake (0.67 vs 0.71 g/kg, P = 0.028), and consumption of dairy and soy products (10.3 vs 15.3 servings per week, P < 0.001). Groups did not differ in serum calcium, vitamin D, or urea concentrations. CONCLUSIONS: Despite lower calcium intake and lower consumption of dairy and soy products, older individuals adhering to COC fasting did not differ in BMD, BMC, or prevalence of osteoporosis from controls. Thus, periodic abstinence from dairy and, generally, animal products does not seem to compromise bone health in older individuals.

Sodium and Potassium Intake in Healthy Adults in Thessaloniki Greater Metropolitan Area-The Salt Intake in Northern Greece (SING) Study.

A reduction in population sodium (as salt) consumption is a global health priority, as well as one of the most cost-effective strategies to reduce the burden of cardiovascular disease. High potassium intake is also recommended to reduce cardiovascular disease. To establish effective policies for setting targets and monitoring effectiveness within each country, the current level of consumption should be known. Greece lacks data on actual sodium and potassium intake. The aim of the present study was therefore to assess dietary salt (using sodium as biomarker) and potassium intakes in a sample of healthy adults in northern Greece, and to determine whether adherence to a Mediterranean diet is related to different sodium intakes or sodium-to-potassium ratio. A cross-sectional survey was carried out in the Thessaloniki greater metropolitan area (northern Greece) (n = 252, aged 18-75 years, 45.2% males). Participants' dietary sodium and potassium intakes were determined by 24-hour urinary sodium and potassium excretions. In addition, we estimated their adherence to Mediterranean diet by the use of an 11-item MedDietScore (range 0-55). The mean sodium excretion was 175 (SD 72) mmol/day, equivalent to 4220 (1745) mg of sodium or 10.7 (4.4) g of salt per day, and the potassium excretion was 65 (25) mmol/day, equivalent to 3303 (1247) mg per day. Men had higher sodium and potassium excretions compared to women. Only 5.6% of the sample had salt intake <5 g/day, which is the target intake recommended by the World Health Organization. Mean sodium-to-potassium excretion ratio was 2.82 (1.07). There was no significant difference in salt or potassium intake or their ratio across MedDietScore quartiles. No significant relationships were found between salt intake and adherence to a Mediterranean diet, suggesting that the perception of the health benefits of the Mediterranean diet does not hold when referring to salt consumption. These results suggest the need for a larger, nation-wide survey on salt intake in Greece and underline the importance of continuation of salt reduction initiatives in Greece.