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Dear Colleagues and Friends,
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In the Prevencion con Dieta Mediterranea (PREDIMED) trial, a primary prevention cohort of overweight and obese subjects at higher cardiovascular risk, baseline blood levels of triglycerides and remnant-cholesterol predicted adverse cardiovascular outcomes. This is especially noteworthy since these associations were not found for LDL-C, a well-established predictor of cardiovascular risk. This study expands our current knowledge on the atherogenicity of remnant-cholesterol and highlights the importance of this lipoprotein as a treatment target in this population. Another nested case-control study within the PREDIMED trial, with subsequent validation in a subsample of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, evaluated the association of baseline targeted lipidomics profiles with the risk of developing heart failure. The need for effective preventive strategies is critical given this life-threatening disease affects millions worldwide. The authors specifically explored single lipids and network-based lipid clusters as risk factors for heart failure incidence. After confounder-adjustments, two lipid metabolites (ceramide 16:0 and phosphatidylcholine 32_0) and several lipidomic patterns were identified as putative biomarkers of heart failure risk. Given the scarce data on human lipid profile and heart failure, particularly as indicators of incident heart failure, their use as preclinical biomarkers is especially compelling.
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The Mediterranean diet, rich in olive oil, nuts, fruits and vegetables, whole grains and pulses, fish, and limited in dairy products and red meat, has been repeatedly regarded as a healthy dietary pattern. While the evidence linking the Mediterranean diet with reduced all-cause mortality in the general population is broad, a new cohort of 1,453 women with breast cancer in northern Italy supports the beneficial role of pre-diagnostic Mediterranean diet adherence on the 15-year prognosis for these women. Both a reduction in both all-cause and breast cancer-specific mortality was observed, particularly among women over 55 years and overweight or obese.
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Numerous studies evaluating the role of the Mediterranean diet on health outcomes have used a 14-item PREDIMED questionnaire to assess adherence to this dietary pattern in a simple manner. This questionnaire is less time-demanding, inexpensive, and requires less collaboration from participants than a typical full-length FFQ or similar methods. Researchers recently assessed adherence to the Mediterranean diet in an Italian population using this tool and highlighted its practicality for nutritional counselling in addition to a food frequency questionnaire or a food record. Another way to measure the Mediterranean Diet includes a previously validated modified Mediterranean Diet Score (mMDS). The “Feeding America’s Bravest” trial recently employed the mMDS in 60 fire stations in two Indiana (USA) fire departments. As expected, greater adherence to a Mediterranean diet was favorably associated with numerous anthropometric and biochemical parameters after adjustment by age and gender. Authors also identified changes in plasma metabolic biomarkers associated with a Mediterranean Diet intervention within a subsample of firefighters. The diet prompted changes in cardiovascular risk biomarkers, namely those related to lipid metabolism, including LDL-cholesterol, ApoB/ApoA1 ratio, remnant-cholesterol, M-VLDL-CE, and higher HDL-cholesterol, and better lipoprotein composition. Nonetheless, these changes were non-significant after correcting for multiple testing (except for a decrease in M-VLDL-CE).
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