Efi Koloverou

Adherence to Mediterranean diet and 10-year incidence (2002–2012) of diabetes: correlations with inflammatory and oxidative stress biomarkers in the ATTICA cohort study

The purpose of this work was to investigate the links between oxidative stress, inflammation and coagulation and their effect on Mediterranean diet–diabetes relationship.

Effects of alcohol consumption and the metabolic syndrome on 10-year incidence of diabetes: the ATTICA study.

AIM The purpose of this prospective study was to investigate the effect of alcohol consumption on the 10-year diabetes incidence. METHODS In 2001-2002, a random sample of 1514 men (18-89 years old) and 1528 women (18-87 years old) was selected to participate in the ATTICA study (Athens metropolitan area, Greece). Among various other characteristics, average daily alcohol intakes (abstention, low, moderate, high) and type of alcoholic drink were evaluated. Diabetes was defined according to American Diabetes Association criteria. During 2011-2012, the 10-year follow-up was performed. RESULTS The 10-year incidence of diabetes was 13.4% in men and 12.4% in women. After making various adjustments, those who consumed up to 1 glass/day of alcohol had a 53% lower diabetes risk (RR=0.47; 95% CI: 0.26, 0.83) compared with abstainers, while trend analysis revealed a significant U-shaped relationship between quantity of alcohol drunk and diabetes incidence (P<0.001 for trend). Specific types of drinks were not associated with diabetes incidence; however, a one-unit increase in ratio of wine/beer/vodka vs. other spirits was associated with an 89% lower risk of diabetes (RR=0.11; 95% CI: 0.02, 0.67). The protective effect of low alcohol consumption on diabetes incidence was more prominent among individuals with stricter adherence to the Mediterranean diet (RR=0.08; 95% CI: 0.011, 0.70) and without the metabolic syndrome (RR=0.34; 95% CI: 0.16, 0.70). CONCLUSION This work revealed the protective effect of modest alcohol consumption of particularly wine and beer against the long-term incidence of diabetes, possibly due to their pleiotropic health effects.

10-year incidence of diabetes and associated risk factors in Greece: the ATTICA study (2002-2012).

BACKGROUND The incidence of diabetes in the general population is increasing world-wide. The increase is attributed to the consumption of saturated fatty acids, obesity, lack of physical activity, genetic predisposition, and other factors, but knowledge about the reasons, biological mechanisms, and late complications is insufficient. It is therefore important to clarify the reasons more exactly through long-term clinical trials to stop the rise of diabetes and its complications. AIM To evaluate the 10-year incidence of type 2 diabetes in apparently healthy Greek adults. METHODS In 2001-2002, a random sample of 1514 men (18-87 years old) and 1528 women (18-89 years old) was selected to participate in the ATTICA study. During 2011-2012, the 10-year follow-up was performed. Patients diagnosed with diabetes at baseline (n = 210) and those lost at the 10-year follow-up (n = 1347) were excluded, yielding a final sample of 1485 participants. RESULTS During the period of investigation, diabetes was diagnosed in 191 cases corresponding to a 12.9% incidence (95%CI: 10.4-15.4), with 13.4% (95%CI: 10.8-16) in men and 12.4% (95%CI: 10.1-14.7) in women. A relative increase was observed in the second half of the 10-year follow-up when age became significant. Multiple logistic regression analysis revealed that age (OR = 1.14, 95%CI: 1.09-1.19), abnormal waist-to-height ratio (OR = 3.27, 95%CI: 1.07-10.0), fasting blood glucose (OR per 1 mg/dl = 0.05, 95%CI: 1.02-1.08), energy intake (OR per 500 kcal = 1.02, 95%CI: 1.01-1.35), and family history of diabetes (OR = 2.8, 95%CI: 1.30-6.03) were the most significant baseline predictors for diabetes, after adjusting for potential confounders. Waist-to-height ratio showed the best explanatory power of all anthropometric variables. Physical activity exerts an effect on risk factors. Being active was found to eliminate the aggravating effect of diabetes family history and fasting blood glucose. CONCLUSIONS The findings confirm the escalating increase of type 2 diabetes incidence in Greece, which is in line with global trends. A lifestyle change in individuals at risk of developing diabetes towards healthier eating and increased physical activity would be an effective and inexpensive means of reducing diabetes.

Single and combined effects of inflammatory markers on 10 year diabetes incidence: The mediating role of adiposity-Results from the ATTICA cohort study

The role of inflammation in diabetes development is not fully elucidated. The aim of this work was to investigate the independent effect of individual inflammatory markers and combinations of them on diabetes incidence and the potential mediating role of obesity.

Inflammation: a New Player in the Link Between Mediterranean Diet and Diabetes Mellitus: a Review

Purpose of ReviewMediterranean diet (MD) has been inversely linked with insulin resistance and diabetes, while inflammation is recognized as a common denominator in cardiometabolic disorders. Here, we review the synergistic effect between MD and inflammation, the anti-inflammatory properties of core MD components, and the possible biological mechanisms linking nutrients with inflammation.Recent FindingsMD is abundant in anti-inflammatory foods, like whole grains, fruits and vegetables, wine, olive oil, nuts, and fish. This results in a high intake of various polyphenols, as well as high unsaturated/saturated and n3/n6 fatty acid ratios, leading through different mechanisms, such as oxidative stress reduction, alteration of NF-κB, PPAR-γ pathways, prebiotic function on gut microbiota, and others, to an attenuation of inflammation state.SummaryMD is comprised by a plethora of foods, with anti-inflammatory potential, so its observed anti-diabetic effect could, at least partially, be ascribed to an attenuation of inflammation state.

Decomposition of Mediterranean Dietary Pattern on Successful Aging, Among Older Adults: A Combined Analysis of Two Epidemiological Studies:

Objective: To investigate the association of Mediterranean food group consumption with successful aging (SA), among people more than 50 years old. Method: Dietary habits, as well as several bio-clinical characteristics of the Greek participants enrolled in the ATTICA (n = 1,128 men and women from Athens metropolitan area) and the MEDIS (n = 2,221 men and women from selected Greek islands) cohort studies were investigated in relation to SA; SA was measured using a validated 10-scale index. Results: Multivariate discriminant food group analysis revealed that legumes consumption, followed by vegetables, cereals, and poultry were associated with higher levels of SA index (explained variability: 7.9%), mainly among islanders, but not among mainland participants. Further analysis revealed that alcohol consumption was positively associated with SA for mainlanders (ATTICA study) but inversely for islanders (MEDIS study; all p’s < .05). Conclusion: The differential and hierarchical effect of various foods on SA and the diet-environmental interaction revealed in the present work may help health professionals to better understand the role of diet on SA, and to prioritize the nutritional needs of older people for better quality of life.