Jaime Rozowski, Ph.D. - Oldways€¦ · Jaime Rozowski, Ph.D. Characteristic eating pattern of the...
Transcript of Jaime Rozowski, Ph.D. - Oldways€¦ · Jaime Rozowski, Ph.D. Characteristic eating pattern of the...
Mediterranean Diet and HealthJaime Rozowski, Ph.D.
Characteristic eating pattern of theMediterranean Diet
Olive oil as the main fat
Abundance of vegetable foods
Fresh fruits and vegetables
Cereals and legumes
Nuts
Frequent consumption of fish
Wine
Low consumption of red meats, dairy products and simple sugars
Frequent use of spices (lemon, garlic, herbs)
Proximal composition of the MD
•Proteins : 18% of total calories (TC)
•Carbohidrates : 55% TC
•Total fat : 27% (25 a 40%)TC
•Polyunsaturated : 7% of fat calories
•Monounsaturated: 13% of fat cfalories
•Saturated : 7% of fat calories
•Cholesterol : 270 mg/day
•Fiber : 40 - 50 g/day
Mediterranean Diet in Chile
Chile is a Mediterranean country
WhyWhy??
1. Climate
2. Agriculture
3. Health
4. Diet
Chile is a Mediterranean country
CLIMATE
1. Climate
• Dry summer and relatively humid winter
• 30° - 45° latitud
• Chile is one of the 5 regions in the world that have amediterranean climate:
– Mediterranean area in Europe and Africa– Central California in USA– Central Chile in South America– Area of Cape Town in South Africa– Southwest Australia
1. Mediterranean Climate
California Entorno delMediterráneo
Chile Sudáfrica Australia
Fuente: Presentación Inaugural Seminario “Chile Potencia Agroalimentaria”, Alberto Montanari, Octubre2004
2. MEDITERRANEAN
AGRICULTURE
2. MEDITERRANEAN
AGRICULTURE
• It is not specific of countries around theMediterranean Sea
• It is the result of geographic, climatic,demographic and cultural conditions
2. MEDITERRANEAN
AGRICULTURE
Fruits and vegetablesCerealsLegumes and nutsWineOlive oil
2. Mediterranean Agriculture
Countries where olives are grown
3. MEDITERRANEAN
HEALTH
3. Mediterranean Health
107
136,3
185,2 191,2
219,1
150,3
233,9
260,6275,3
0
50
100
150
200
250
300
Francia
España
Italia
Grecia
EEUU
Chile
Cuba
Argentina
Brasil
Adjusted Mortality Rate Due to Coronary Heart Disease (deaths/100.000)
4. DIET
Food Contributions to Caloric Intake
España Chile1993-1995
Source: FAO Balance Sheets
Foods Contributions to Caloric Intake
España Chile1993-19951961
Source: FAO Balance Sheets
Intervention Studies using Mediterraneandiet and Wine
-1998 Western Diet, Mediterranean diet in youngstudents
-1999Western MUFA or PUFA in young students
-2000 Mediterranean diet, 51-70 years old
-2008 Meditteranean diet by cafeteria modification
STUDY DESIGN
0 30 60 90
TIME (DAYS)
MEDITERRANEANn=21
HIGH FATn=21
Componentes de la Dieta Experimental
0 200 400 600 800 1000
1
2
3
4
5
6
7aceite (32 ml oliva/32 ml maravilla)
fibra (44/12)
papas (117/230)
pan, cereales y
legumbres (311/261)
carnes blancas (157/74)
carnes rojas (72/209)
frutas y verduras (675/246)
Gramos/día
OXIDATIVE DNA DAMAGEOXIDATIVE DNA DAMAGE8-
OH
8-
OH
dG
dG
High fat diet Mediterranean diet
PLASMATIC POLYPHENOLSµ
M R
uti
n e
qu
ival
ent
High fat dietHigh fat diet MediterraneanMediterranean dietdiet
Time (days)
00 3030 6060 9090 00 3030 6060 9090
MUFA n = 22MUFA n = 22
DISEÑO DEL ESTUDIODISEÑO DEL ESTUDIO
PUFA n = 20
TIEMPO (semanas)
0 74 10 13
CALORIC DISTRIBUTIONCALORIC DISTRIBUTION
MUFA DIETMUFA DIET PUFA DIETPUFA DIET
CHOCHOCHOCHO
PROTPROTPROTPROT
SFASFA SFASFA
MUFAMUFA MUFAMUFA
PUFAPUFAPUFAPUFA
OXYDATIVE DNA DAMAGEOXYDATIVE DNA DAMAGE8-
OH
8-
OH
dG
dG
a
*b
c
ed
A
*B
C
D
E
OBJETIVOSPrograma de Alimentación Laboral
Disminuir la incidencia de SíndromeMetabólico
Una familia, 1989
Fernando Botero
2. SÍNDROMEMETABÓLICO
ENCUESTA NACIONAL DE SALUD (ENS 2003)(Directora, Dra. Catterina Ferreccio, DSP, FM, UC)
• Workers
• Mediterranean Diet(on a freedom to choose basis)
• Metabolic Syndrome
Canteen intervention strategy:
PAL(Food at Work Program)
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
DESIGN OF THE INTERVENTION:
• All workers that use the industry canteen (lunch) are invited toparticipate
• The physical-architecture distribution of food stands at thecanteen is modified. Also the food offer is modified.
• Educational talks (4 per year) plus printed material and a bookspecifically designed for the workers
• Supported by a multidisciplinary team
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
Time 4 months
Oct 06Time 8 months
Mar 07
Time 12 months
Jul 07
MEASUREMENTS IN VOLUNTEERS: clinical and nutritional interview, bloodsamples
DIETARY INTERVENTION:
Food Mediterranization in MD canteen (free choice)Food Mediterranization in MD canteen (free choice)
Metabolic Syndrome risk factors:Metabolic Syndrome risk factors:- Abdominal Obesity
- HDL-Cholesterol Other measurements:Other measurements:- Blood Pressure - Nutrients in blood
- Triglycerides - Oxidation parameters
- Fasting Glucose - Inflammation, hemostasis, and others
Time 0
Jun 06
INTERVENTION STUDYINTERVENTION STUDY
in Maestranza Dieselin Maestranza Diesel
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
Junio 2006 Octubre 2006 Marzo 2007 Junio 2007
71% increase71% increase
VEGETABLES, excluding potatoesVEGETABLES, excluding potatoes(grams daily, per person, weekly averages,
consumption at the industry canteen)
June 2006 October 2006 March 2007 July 2007weeks
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
PAN BLANCO Y PAN INTEGRAL
-
20
40
60
80
100
Basal 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52
Co
nsu
mo
pro
med
io d
iari
o e
n c
asin
o
(g/d
ía/p
ers
on
a)
Pan blanco
Pan Integral
White bread
Whole bread
BREAD(grams daily, per person, weekly averages,
consumption at the industry canteen)
June 2006 October 2006 March 2007 July 2007weeks
Evolution of food composition at lunch time, average daily consumption per person at the cafeteria, along the twelve months diet mediterranization intervention period.
Food item at lunch(grams/person)
Basal Month 4 Month 8 Month 12 p value*
Vegetables (withoutpotatoes)
175 ± 27 280 ± 19 330 ± 63 264 ± 19 0.001
Potatoes 87 ± 36 83 ± 50 56 ± 32 83 ± 26 0.623
Fruits 47 ± 21 93 ± 30 149 ± 5 106 ± 13 0.000
White meat 53 ± 27 43 ± 28 56 ± 25 69 ± 16 0.535
Red meat 104 ± 19 38 ± 13 32 ± 4 38 ± 13 0.000
Fish and shellfish 3 ± 1 26 ± 9 17 ± 8 21 ± 2 0.001
Legumes 13 ± 4 16 ± 6 16 ± 2 14 ± 4 0.622
Dairy products 20 ± 8 7 ± 7 9 ± 6 11± 5 0.075
White bread 80 ± 9 31 ± 12 34 ± 5 34 ± 3 0.000
Whole grain bread 0 31 ± 6 24 ± 5 33 ± 2 0.000
Cereals 45 ± 8 57 ± 11 49 ± 3 62 ± 15 0.154
Vegetable fat 15 ± 9 0 13 ± 10 0 ± 1 0.011
Olive oil 0 7 ± 0 7 ± 1 6 ± 0 0.000
Canola oil 0 21 ± 0 9 ± 11 21 ± 3 0.000
Eggs 12 ± 6 6 ± 4 6 ± 2 4± 3 0.058
Sugar 16 ± 4 8 ± 4 14 ± 1 18 ± 3 0.005
MUFA/SFA 1.1 ± 0.0 3.7 ± 0.1 3.1 ± 1.1 3.2 ± 0.4 0.000
Omega-6/omega-3 39.3 ± 6.3 2.6 ± 0.2 15.4 ±11.9 2.7 ± 0.1 0.000
Data include all the workers that had lunch at the canteen, an average of 140, 145, 132, 155 workers per day at the basalmonth characterization period and at months 4, 8 and 12, respectively. * One way ANOVA of daily consumption values for
each food item.
Vegetables (without potatoes)Leguminous (plus nuts and dried fruits)Fruits (raw or cooked)Whole cereales (in pasta, rice, bread, others)Lean red meat - (beef, chicken, pork, 7 - 8% fat)Fish and seafoodRed meat (all fat-rich meats plus ham, viscera, sausages, from pork, bovine, and
ovine sources)Alcohol (moderate and regular, versus abstinence, excess, or binge)Dairy products, low-fat, fermentedDairy high fat non-fermented (cream, whole milk, butter)Vegetable oil (sunflower, soy, canola, vegetable margarines)Olive oilAvocadoSugar and sugar in food
Vegetables (without potatoes)Leguminous (plus nuts and dried fruits)Fruits (raw or cooked)Whole cereales (in pasta, rice, bread, others)Lean red meat - (beef, chicken, pork, 7 - 8% fat)Fish and seafoodRed meat (all fat-rich meats plus ham, viscera, sausages, from pork, bovine, and
ovine sources)Alcohol (moderate and regular, versus abstinence, excess, or binge)Dairy products, low-fat, fermentedDairy high fat non-fermented (cream, whole milk, butter)Vegetable oil (sunflower, soy, canola, vegetable margarines)Olive oilAvocadoSugar and sugar in food
MEDITERRANEAN DIET SCORE,in elaboration (PAM-Chile)
MEDITERRANEAN DIET SCORE,in elaboration (PAM-Chile)
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
0
30
- 1 2 3 4 5 6 7 8 9 10 11 12 13 14
0
4
8
12
Mediterranean Diet ScoreMediterranean Diet Score
Mon
thM
onth
NN
Evolución del Índice de Alimentación Mediterránea(Hombres)
X = 4,85X = 4,85
X = 5,65X = 5,65
X = 6,74X = 6,74
X = 7,38X = 7,38
MEDITERRANEAN DIET SCORE,in elaboration (PAM-Chile)
MEDITERRANEAN DIET SCORE,in elaboration (PAM-Chile)
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
WHAT HAPPENED WITH
THE PREVALENCE OF
METABOLIC SYNDROME?
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
JUNIO 2006 OCTUBRE 2006
ESTADO DE LA SALUDSíndrome Metabólico
24%
45%4455%%
32%19%
23%
56%5566%%
Distribución en Nº de factores de riesgo SM alterados
0 FR1 FR2 FR3 FR4 FR5 FR
19%
27%
29%
16%
29%
32%
7% 4%
16%18%
2% 1%
ESTADO DE LA SALUDSíndrome Metabólico
Factores de Riesgo de SM alterados
Junio 2006
1,68
Octubre 2006
1,35
20%20% de disminución
p < 0,000
Center for Molecular Nutrition and Chronic DiseasesCatholic University of Chile
Average number of Metabolic Syndrome RiskAverage number of Metabolic Syndrome RiskFactors per personFactors per person
(n = 90 , a cohort of men that completed all controls, without medical(n = 90 , a cohort of men that completed all controls, without medicaltreatment for these factors)treatment for these factors)
June 2006
1.611.61
July 2007
1.091.09
32% decrease32% decrease
p < 0,000
SM y DM en Maestranza Diesel (n = 90, hombres sin HTA)
23%19%
15% 12%
77%81%
85% 88%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Basal 4 meses 8 meses 12 meses
% d
e v
olu
nta
rio
s
sin SM
SM
Metabolic Syndrome and Mediterranean Diet (n = 90)
without MS
with MS
Basal 4 months 8 months 12 months
N°
volu
ntee
rs
Casos de SM durante el estudio (sólo hombres)
21 1
4
32
15
13
10
8
3
0
3
6
9
12
15
18
21
Basal 4 meses 8 meses 12 meses
Nº
de
vo
lun
tari
os
3 FR
4 FR
5 FR
48%48%
decreasedecrease
Metabolic Syndrome and Mediterranean Diet (n = 90)
Basal 4 months 8 months 12 months
N°
volu
ntee
rs
CONCLUSIONS
1- Diet Mediterranization in adults is feasible. Nutritionand Gastronomy must act synergistically to promote the diet.
2- Clinical, Nutritional and Biochemical parametersallow monitoring the effect of this Functional Food Diet
3- Metabolic Syndrome is effectively controlled withMediterranean Diet. A suitable Score has been developed
4- Further efforts should center on functional foods,rich and enriched in:
- polyphenol antioxidants (gut & systemic)- sirtuin agonists- w3, w9 fatty acids- dietary fiber
PARTICIPANTS
PONTIFICIA UNIVERSIDAD CATOLICA DECHILE
Faculty of Biological Sciences
Faculty of Medicine
Faculty of Engineering
THANK YOU