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      Gender, Age, Geographical Area, Food Neophobia and Their Relationships with the Adherence to the Mediterranean Diet: New Insights from a Large Population Cross-Sectional Study

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          Abstract

          The Mediterranean diet (MD) is associated with many health benefits. The association between the MD and food neophobia (FN) is still unexplored in adults. The present cross-sectional study was aimed to explore the relationships between adherence to the MD, FN, and sociodemographic variables in a large Italian cohort. Familiarity and frequency use (FFI) of prototypical and non-prototypical Mediterranean foods were used to calculate a new adherence index: the Italian Taste Mediterranean Index (ITMI). The FFI of all Mediterranean foods increased with age, while butter, soft drinks, red/cured meat, and sweets were more common in younger people. Accordingly, ITMI increased with age (F 2,2384 = 54.11; p < 0.0001). Women recorded a higher ITMI (6.70) than men (6.10). Individuals with high FN showed higher FFI for soft drinks and sweets and lower ones for most typical MD foods, than individuals with low FNs. A decrease of ITMI was recorded with the increase of the FN(F 2,2384 = 22.84; p < 0.0001). With ageing, ITMI increased even in individuals with a high FN. The results suggest that FN may negatively affect adherence to the MD, lowering its potential health benefits, in the adult population. Monitoring of food habits, dietary education, and anxiety management, may be valuable tools to control FN and support the adherence to the MD.

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          THE DIET AND 15-YEAR DEATH RATE IN THE SEVEN COUNTRIES STUDY

          In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-59 years and "healthy" at entry, 2,288 died in 15 years. Death rates differed among cohorts. Differences in mean age, blood pressure, serum cholesterol, and smoking habits "explained" 46% of variance in death rate from all causes, 80% from coronary heart disease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weight, fatness, and physical activity. The cohorts differed in average diets. Death rates were related positively to average percentage of dietary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smoking habits as independent variables accounted for 85% of variance in rates of deaths from all causes, 96% coronary heart disease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all differences in monounsaturates among cohorts. All-cause and coronary heart disease death rates were low in cohorts with olive oil as the main fat. Causal relationships are not claimed but consideration of characteristics of populations as well as of individuals within populations is urged in evaluating risks.
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            Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake

            Objectives This study aimed to explore the effects of an isocaloric Mediterranean diet (MD) intervention on metabolic health, gut microbiome and systemic metabolome in subjects with lifestyle risk factors for metabolic disease. Design Eighty-two healthy overweight and obese subjects with a habitually low intake of fruit and vegetables and a sedentary lifestyle participated in a parallel 8-week randomised controlled trial. Forty-three participants consumed an MD tailored to their habitual energy intakes (MedD), and 39 maintained their regular diets (ConD). Dietary adherence, metabolic parameters, gut microbiome and systemic metabolome were monitored over the study period. Results Increased MD adherence in the MedD group successfully reprogrammed subjects’ intake of fibre and animal proteins. Compliance was confirmed by lowered levels of carnitine in plasma and urine. Significant reductions in plasma cholesterol (primary outcome) and faecal bile acids occurred in the MedD compared with the ConD group. Shotgun metagenomics showed gut microbiome changes that reflected individual MD adherence and increase in gene richness in participants who reduced systemic inflammation over the intervention. The MD intervention led to increased levels of the fibre-degrading Faecalibacterium prausnitzii and of genes for microbial carbohydrate degradation linked to butyrate metabolism. The dietary changes in the MedD group led to increased urinary urolithins, faecal bile acid degradation and insulin sensitivity that co-varied with specific microbial taxa. Conclusion Switching subjects to an MD while maintaining their energy intake reduced their blood cholesterol and caused multiple changes in their microbiome and metabolome that are relevant in future strategies for the improvement of metabolic health.
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              Quantification of consumer attitudes to health and hedonic characteristics of foods.

              Health and Taste Attitudes Questionnaires were developed to assess consumers' orientations toward the health and hedonic characteristics of foods. Items were generated in a qualitative study. The original 37 items on health and 44 on taste were rated from "strongly disagree" to "strongly agree" by a representative sample of 1005 Finnish adults (18-81 years). The number of items was reduced using factor and item analysis, resulting in 20 health- and 18 taste-related statements. Three health-related and three taste-related factors were extracted. The health-related factors were labelled as "General health interest", "Light product interest", and "Natural product interest". The taste-related factors were named "Craving for sweet foods", "Using food as a reward", and "Pleasure". Cronbach's alphas of the multi-item scales, based on the statements loading highly on each factor, ranged from 0.67 to 0.89. Age and gender affected the responses. Females were more interested in the health and taste aspects of foods than were males. Younger respondents were less concerned with health but more interested in taste than were older respondents. A preliminary test of predictive validity was conducted by analysing subjects' responses to foods with weak and strong connotations of health and taste, and currently the questionnaires are being validated with further behavioural tests. Copyright 1999 Academic Press.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                15 June 2020
                June 2020
                : 12
                : 6
                : 1778
                Affiliations
                [1 ]Institute for Bioeconomy, CNR, National Research Council, Via Gobetti 101, 40129 Bologna, Italy; stefano.predieri@ 123456ibe.cnr.it (S.P.); giuliamaria.daniele@ 123456ibe.cnr.it (G.M.D.)
                [2 ]CREA, Council for Agricultural Research and Economics, Research Center Food & Nutrition, Via Ardeatina 546, 00178 Rome, Italy; fiorella.sinesio@ 123456crea.gov.it
                [3 ]Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Via Donizetti 6, 50144 Florence, Italy; erminio.monteleone@ 123456unifi.it (E.M.); sara.spinelli@ 123456unifi.it (S.S.); dinnella@ 123456unifi.it (C.D.)
                [4 ]Center Agriculture Food Environment University of Trento via E. Mach 1, 38010 San Michele all’Adige, Italy; flavia.gasperi@ 123456fmach.it
                [5 ]Research and Innovation Centre, Fondazione Edmund Mach, Via E. Mach 1, 38010 San Michele all’Adige, Italy; isabella.endrizzi@ 123456fmach.it
                [6 ]University of Gastronomic Sciences, Piazza Vittorio Emanuele 9, 12042 Pollenzo, CN, Italy; l.torri@ 123456unisg.it
                [7 ]Department of Agricultural and Food Sciences, Alma Mater Studiorum—University of Bologna, piazza Goidanich 60, 47521 Cesena (FC), Italy; tullia.gallinatoschi@ 123456unibo.it (T.G.T.); alessandra.bendini@ 123456unibo.it (A.B.)
                [8 ]Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria 2, 20133 Milano, Italy; ella.pagliarini@ 123456unimi.it (E.P.); camilla.cattaneo@ 123456unimi.it (C.C.); monica.laureati@ 123456unimi.it (M.L.)
                [9 ]Department of Agricultural sciences, University of Naples Federico II, via Università 100, 80055 Portici (NA), Italy; dimonaco@ 123456unina.it (R.D.M.); paola.vitaglione@ 123456unina.it (P.V.)
                [10 ]Department of Biology, DBAF, University of Basilicata, Via Nazario Sauro 85, 85100 Potenza, Italy; condelli@ 123456hotmail.it
                Author notes
                [* ]Correspondence: marta.cianciabella@ 123456ibe.cnr.it ; Tel.: +39-0516398083
                Author information
                https://orcid.org/0000-0003-4270-4914
                https://orcid.org/0000-0001-6524-1276
                https://orcid.org/0000-0002-9149-969X
                https://orcid.org/0000-0002-5175-6276
                https://orcid.org/0000-0002-3706-5428
                https://orcid.org/0000-0003-0049-4306
                https://orcid.org/0000-0003-4522-6452
                https://orcid.org/0000-0001-7241-2280
                https://orcid.org/0000-0002-6515-5519
                https://orcid.org/0000-0001-5261-9276
                https://orcid.org/0000-0002-3671-4334
                https://orcid.org/0000-0002-6608-5209
                https://orcid.org/0000-0002-1986-6360
                Article
                nutrients-12-01778
                10.3390/nu12061778
                7353239
                32549267
                feaf6b65-0910-49ad-846d-171db4d7d68b
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 April 2020
                : 12 June 2020
                Categories
                Article

                Nutrition & Dietetics
                diet quality,food rejection,healthy eating,mediterranean eating pattern,socio-demographics

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