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Dear Colleagues and Friends,
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Cardiovascular disease/ Metabolic disease
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The Mediterranean diet is considered one of the healthiest dietary patterns to prevent diseases, in particular for the reduction of cardiovascular risk factors. Overweight, but more specifically obesity; an indisputable component of the metabolic syndrome, shows strong associations with many diseases such as diabetes, some types of cancer, and especially cardiovascular diseases. As such, it is comprehensible that overwhelming evidence supports the reduction of disease risk and weight through suitable diets such as the Mediterranean diet. In an 8-week randomized controlled trial among overweight and obese subjects Tagliamonte et al. found novel mechanisms mediating the beneficial effects of the Mediterranean diet such as the reduced activation of the endocannabinoid system and processes involving the nuclear receptor for the peroxisome proliferator-activated receptor alpha (PPAR-α). The changes were observed independently from weight changes and resulted in improvements in insulin sensitivity and lower inflammation markers such as C-reactive protein. This study revealed interesting pathways explaining some of the beneficial effects of the Mediterranean diet, however follow-up studies at a larger scale are necessary to assess whether the temporary metabolic and gut microbiome changes are maintained in the long term.
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In a short dietary intervention with olive oil Monfort-Pires et al. investigated brown adipose tissue (BAT) as a potential target for the treatment of obesity and metabolic disorders. Endogenous mediators of BAT activity, secretin, fibroblast growth factor 21 (FGF21), and 12,13-dihydroxy-9Z-octadecenoic acid (12,13-diHOME) were increased by intervention in lean subjects, whereas secretin and FGF21 were increased in subjects with excessive weight. The authors of the study concluded that a significant activation of BAT with a concurrent increase in blood monounsaturated fatty acid levels by olive oil occurs primarily among lean people.
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For the prevention of metabolic syndrome (MS), many recommendations for dietary strategies emphasize the Mediterranean diet. The aforementioned articles underline the breadth of mechanisms and beneficial effects conferred by the Mediterranean diet, which cannot be reduced to a single component. Nevertheless, special attention should placed on micronutrients such as potassium. 24-h potassium excretion, as the most valid proxy for dietary intake, was used to assess the relation between potassium intake and the prevalence of the metabolic syndrome. MS occurred more often in subjects with higher potassium excretion in a dose-response relationship. Potassium excretion also proved to have adequate predictive ability to evaluate the risk for the development of MS. These findings shed light on potassium, an important micronutrient which should be considered for dietary pattern recommendations, according to individual potassium levels at baseline.
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