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Medicina
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What Makes a Healthy Diet? From Old Questions to New...
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What Makes a Healthy Diet? From Old Questions to New Perspectives

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 25320

Special Issue Editors

Dr. Andrea Maugeri

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy
Interests: epidemiology; biostatistics; public health; prevention; chronic diseases; dietary pattern; nutrigenomics; nutriepigenomics
Special Issues, Collections and Topics in MDPI journals
Dr. Martina Barchitta

E-Mail Website
Co-Guest Editor
Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy
Interests: nutritional epidemiology; molecular epidemiology; public health; mediterranean diet; nutrigenetics; nutrigenomics; nutriepigenomics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Antonella Agodi

E-Mail Website
Co-Guest Editor
Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy
Interests: public health; epidemiology and prevention; nutritional epidemiology; molecular epidemiology; epigenetics; genomics; healthcare-associated infections
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Few, if any, would contest that diet has an essential and significant impact on human health. However, there are still a lot of unanswered questions about what makes a healthy diet.

First, nutrition research has provided mounting evidence for potential causal relationships between specific dietary factors (e.g., fruits, vegetables, processed meat, and trans-fat intake) and chronic non-communicable diseases (NCDs). Although these findings have been widely used to inform dietary guidelines aimed at preventing NCDs, the complexity of dietary assessment and nutritional scoring systems across different populations and settings remains a challenge to overcome.

Second, recent scientific shifts emphasizing the importance of overall diet patterns—rather than a single nutrient or food deficiencies—has stimulated not only scientific inquiry but also a deluge of empirical, commercial, and popular dietary patterns of varying origin and scientific backing. Although these diets may be recommendable, only the Mediterranean diet has been shown both in observational studies and a randomized trial to lower disease risk.

Finally, new priorities for research are emerging in nutrition science, including those related to interactions with gut microbiota, the effects of specific bioactive foods and nutrients, personalized nutrition, and the influences of social status on nutritional and disease disparities.

This Special Issue of Medicina, entitled "What makes a healthy diet? From old questions to new perspectives", welcomes the submission of original research, narrative reviews, systematic reviews and meta-analyses.

Potential topics may include, but are not limited, to the development of novel tools for dietary assessment, to evaluate the association between dietary habits and health outcomes, and to suggest new horizons for the research on the potential influences of social determinants, molecular mechanisms, and gut microbiota.

Dr. Andrea Maugeri
Prof. Antonella Agodi
Dr. Martina Barchitta
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutritional epidemiology
  • dietary assessment
  • dietary guidelines
  • healthy diet
  • dietary risk
  • bioactive foods
  • gut microbiota

Published Papers (5 papers)

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Research

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12 pages, 792 KiB  
Article
The Impact of Socio-Demographic Factors on Breastfeeding: Findings from the “Mamma & Bambino” Cohort
by Roberta Magnano San Lio, Andrea Maugeri, Maria Clara La Rosa, Antonio Cianci, Marco Panella, Giuliana Giunta, Antonella Agodi and Martina Barchitta
Medicina 2021, 57(2), 103; https://doi.org/10.3390/medicina57020103 - 24 Jan 2021
Cited by 10 | Viewed by 2842
Abstract
Background and objectives: The World Health Organization (WHO) recommends women (1) to initiate breastfeeding within one hour of birth; (2) to exclusively breastfeed for the first six months; and (3) to continue breastfeeding until two years of age. However, women do not always [...] Read more.
Background and objectives: The World Health Organization (WHO) recommends women (1) to initiate breastfeeding within one hour of birth; (2) to exclusively breastfeed for the first six months; and (3) to continue breastfeeding until two years of age. However, women do not always adhere to these recommendations, threatening the health of their children. The present study aims to evaluate breastfeeding status and the main maternal factors associated with exclusive breastfeeding for six months among women from the “Mamma & Bambino” study, a prospective cohort settled in Catania, Italy. Materials and Methods: We used data from 220 women (median age = 37 years) enrolled in the “Mamma & Bambino” cohort during prenatal obstetric counselling. Self-reported breastfeeding status was collected during the follow-up interviews at 1 and 2 years, referring to breastfeeding status (i.e., yes or no) and type of breastfeeding (i.e., exclusive or predominant). We also collected data about duration of breastfeeding to classify women into those who adhered to the WHO recommendation and those who did not. Results: In the general population, we noted that the proportion of women who have breastfed increased with increasing educational level. Accordingly, logistic regression analysis demonstrated that medium (OR = 3.171; 95% CI = 1.285–7.822; p = 0.012) and high educational levels (OR = 4.549; 95% CI = 1.525–13.570; p = 0.007) were positively associated with breastfeeding if compared to low educational level. Among women who have breastfed, instead, the proportion of adherents to the WHO recommendation was higher among those with medium–high educational level and those who were employed. In line with this, we demonstrated that full-time employment (OR = 2.158; 95% CI = 1.033–4.508; p = 0.041) and medium educational level (OR = 4.632; 95% CI = 1.227–17.484; p = 0.024) were positively associated with exclusive breastfeeding for the first six months. Conclusions: Socio-demographic factors should be taken into account through public health strategies for improving maternal knowledge about health benefits of exclusive breastfeeding. Full article
(This article belongs to the Special Issue What Makes a Healthy Diet? From Old Questions to New Perspectives)
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10 pages, 2670 KiB  
Article
The Impact of Time-Restricted Diet on Sleep and Metabolism in Obese Volunteers
by Hyeyun Kim, Bong Jin Jang, A Ram Jung, Jayoung Kim, Hyo jin Ju and Yeong In Kim
Medicina 2020, 56(10), 540; https://doi.org/10.3390/medicina56100540 - 14 Oct 2020
Cited by 9 | Viewed by 2631
Abstract
Background and objectives: A time-restricted diet is one of the various ways to improve metabolic condition and weight control. However, until now, there have been few pieces of evidence and research to verify the methods and effectiveness of time-restricted diets on metabolic improvement [...] Read more.
Background and objectives: A time-restricted diet is one of the various ways to improve metabolic condition and weight control. However, until now, there have been few pieces of evidence and research to verify the methods and effectiveness of time-restricted diets on metabolic improvement and health promoting. We designed this study to make a healthy diet program and to verify the effectiveness of a time-restricted diet on general health, including sleep and metabolism, in healthy volunteers. Materials and Methods: This study was conducted in healthy adults who are obese but do not have related metabolic disease. Fifteen participants were recruited. Before and after this program, serologic tests including ketone level, questionnaires—daytime sleepiness evaluation such as the Epworth sleepiness scale and the Stanford sleepiness scale, the Korean version of the Pittsburgh sleep questionnaire index, STOP BANG to evaluate sleep apnea, the Hospital Anxiety and Depression Scale for emotion/sleep—and polysomnography (PSG) were conducted to evaluate the effects on sleep of the program. They were divided into two groups based on ketone levels that could reflect the constancy of participation in this study. We analyzed the before and after results of each group. Results: Fifteen participants (nine males and six females) completed this program without significant adverse events. Body weight after this program decreased to 78.2 ± 14.1 from 82.0 ± 15.6 kg (p = 0.539), and BMI decreased to 27.9 ± 3.8 from 29.3 ± 4.6 kg/m2 (p = 0.233). Weight loss was observed in 14 subjects except 1 participant. The results from questionnaires before and after this were not significant changes. They were classified into high/low-ketone groups according to the ketone level of the participants. In the results of the PSG, the apnea hypopnea index (25.27 ± 12.67→15.11 ± 11.50/hr, p = 0.25) and oxygen desaturation (18.43 ± 12.79→10.69 ± 10.0/hr, p = 0.004), which are indicators of sleep apnea, also improved in the high-ketone group, compared with the low-ketone group. Satisfaction interviews for this restricted diet program showed that 86% of the participants were willing to participate in the same program again. Conclusion: The time-restricted diet was successful in weight loss for a period of 4 weeks in obese participants, which did not affect the efficiency and architecture of sleep. In addition, successful weight loss and significant improvement of sleep apnea were showed in the high-ketone group. Further research is needed to demonstrate mechanisms for weight loss, sleep apnea, and time-restricted diets. Full article
(This article belongs to the Special Issue What Makes a Healthy Diet? From Old Questions to New Perspectives)
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Review

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26 pages, 566 KiB  
Review
How Dietary Factors Affect DNA Methylation: Lesson from Epidemiological Studies
by Andrea Maugeri and Martina Barchitta
Medicina 2020, 56(8), 374; https://doi.org/10.3390/medicina56080374 - 25 Jul 2020
Cited by 28 | Viewed by 3884
Abstract
Over the past decades, DNA methylation has been proposed as a molecular mechanism underlying the positive or negative effects of diet on human health. Despite the number of studies on this topic is rapidly increasing, the relationship between dietary factors, changes in DNA [...] Read more.
Over the past decades, DNA methylation has been proposed as a molecular mechanism underlying the positive or negative effects of diet on human health. Despite the number of studies on this topic is rapidly increasing, the relationship between dietary factors, changes in DNA methylation and health outcomes remains unclear. In this review, we summarize the literature from observational studies (cross-sectional, retrospective, or prospective) which examined the association of dietary factors (nutrients, foods, and dietary patterns) with DNA methylation markers among diseased or healthy people during the lifetime. Next, we discuss the methodological pitfalls by examining strengths and limitations of published studies. Finally, we close with a discussion on future challenges of this field of research, raising the need for large-size prospective studies evaluating the association between diet and DNA methylation in health and diseases for appropriate public health strategies. Full article
(This article belongs to the Special Issue What Makes a Healthy Diet? From Old Questions to New Perspectives)
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19 pages, 1304 KiB  
Review
Properties, Extraction Methods, and Delivery Systems for Curcumin as a Natural Source of Beneficial Health Effects
by Aleksandra Zielińska, Henrique Alves, Vânia Marques, Alessandra Durazzo, Massimo Lucarini, Thais F. Alves, Margreet Morsink, Niels Willemen, Piotr Eder, Marco V. Chaud, Patricia Severino, Antonello Santini and Eliana B. Souto
Medicina 2020, 56(7), 336; https://doi.org/10.3390/medicina56070336 - 03 Jul 2020
Cited by 58 | Viewed by 8279
Abstract
This review discusses the impact of curcumin—an aromatic phytoextract from the turmeric (Curcuma longa) rhizome—as an effective therapeutic agent. Despite all of the beneficial health properties ensured by curcumin application, its pharmacological efficacy is compromised in vivo due to poor aqueous [...] Read more.
This review discusses the impact of curcumin—an aromatic phytoextract from the turmeric (Curcuma longa) rhizome—as an effective therapeutic agent. Despite all of the beneficial health properties ensured by curcumin application, its pharmacological efficacy is compromised in vivo due to poor aqueous solubility, high metabolism, and rapid excretion that may result in poor systemic bioavailability. To overcome these problems, novel nanosystems have been proposed to enhance its bioavailability and bioactivity by reducing the particle size, the modification of surfaces, and the encapsulation efficiency of curcumin with different nanocarriers. The solutions based on nanotechnology can improve the perspective for medical patients with serious illnesses. In this review, we discuss commonly used curcumin-loaded bio-based nanoparticles that should be implemented for overcoming the innate constraints of this natural ingredient. Furthermore, the associated challenges regarding the potential applications in combination therapies are discussed as well. Full article
(This article belongs to the Special Issue What Makes a Healthy Diet? From Old Questions to New Perspectives)
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Other

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23 pages, 1533 KiB  
Perspective
Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19
by Ronald B. Brown
Medicina 2021, 57(8), 739; https://doi.org/10.3390/medicina57080739 - 22 Jul 2021
Cited by 8 | Viewed by 6717
Abstract
Dietary factors in the etiology of COVID-19 are understudied. High dietary sodium intake leading to sodium toxicity is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, hepatic disease, cardiac arrhythmias, thrombosis, migraine, tinnitus, Bell’s palsy, multiple [...] Read more.
Dietary factors in the etiology of COVID-19 are understudied. High dietary sodium intake leading to sodium toxicity is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, hepatic disease, cardiac arrhythmias, thrombosis, migraine, tinnitus, Bell’s palsy, multiple sclerosis, systemic sclerosis, and polycystic ovary syndrome. This article synthesizes evidence from epidemiology, pathophysiology, immunology, and virology literature linking sodium toxicological mechanisms to COVID-19 and SARS-CoV-2 infection. Sodium toxicity is a modifiable disease determinant that impairs the mucociliary clearance of virion aggregates in nasal sinuses of the mucosal immune system, which may lead to SARS-CoV-2 infection and viral sepsis. In addition, sodium toxicity causes pulmonary edema associated with severe acute respiratory syndrome, as well as inflammatory immune responses and other symptoms of COVID-19 such as fever and nasal sinus congestion. Consequently, sodium toxicity potentially mediates the association of COVID-19 pathophysiology with SARS-CoV-2 infection. Sodium dietary intake also increases in the winter, when sodium losses through sweating are reduced, correlating with influenza-like illness outbreaks. Increased SARS-CoV-2 infections in lower socioeconomic classes and among people in government institutions are linked to the consumption of foods highly processed with sodium. Interventions to reduce COVID-19 morbidity and mortality through reduced-sodium diets should be explored further. Full article
(This article belongs to the Special Issue What Makes a Healthy Diet? From Old Questions to New Perspectives)
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