23 November 2020 In General Health

BACKGROUND: Frailty is a common geriatric syndrome in old people. It remains controversial whether Mediterranean diet could prevent old people from developing into frailty. The aim of this study is to summarize the relevant studies and assess the effectiveness of adherence to Mediterranean diet on frailty in old people.

METHOD: A systematic search of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials was conducted to identify all relevant studies up to Oct 2017. We included studies regarding the associations between adherence to Mediterranean diet and risk of frailty among elders. A meta-analysis was performed to explore the effects of Mediterranean diet on frailty.

RESULTS: Six studies matched the inclusion criteria, of which five were prospective and one was cross-sectional. A total of 10,210 participants from the five prospective cohort studies were included to perform the meta-analyses. In comparison with lowest adherence to Mediterranean diet, elders with highest adherence to Mediterranean diet were significantly associated with lower risk of frailty in the future (RR= 0.56, 95% CI=0.36-0.89, p=0.015). Furthermore, the pooled estimates from four studies performed among participants in western countries (European and North American) showed that higher adherence to Mediterranean diet was associated with a 52% reduced risk of frailty (RR= 0.48, 95% CI=0.32-0.72, p<0.001). However, one study showed no association between Mediterranean diet and frailty among Asian elders (RR=1.06, 95% CI=0.83-1.36, p=0.638).

CONCLUSION: A higher adherence to Mediterranean diet is associated with a lower risk of frailty in old people. Meanwhile, the benefits may be more obvious among elders from western countries.

23 November 2020 In General Health

A previous meta-analysis provided convincing evidence for an inverse association between adherence to a Mediterranean diet (MedDiet) and the risk of all-cause mortality. Since then, 19 prospective studies have been published. We updated the evidence from these prospective studies and conducted a dose-response meta-analysis to test the linear and potential nonlinear dose-response associations between adherence to a MedDiet and the risk of all-cause mortality.

The PubMed, Scopus, ISI Web of Knowledge, and Embase bibliographic databases were systematically searched up to August 24, 2018. Summary HRs were estimated with the use of a random-effects meta-analysis to assess the association between a 2-point increment in MedDiet adherence and the risk of all-cause mortality. Sensitivity and subgroup analyses were performed and potential publication bias was tested. Twenty-nine prospective studies with 1,676,901 participants and 221,603 cases of all-cause mortality were included in the final analysis.

The pooled HR of all-cause mortality was 0.90 (95% CI: 0.89, 0.91; I2 = 81.1%) for a 2-point increment in adherence to a MedDiet. Subgroup analyses showed that a significant inverse association was stronger in participants who lived in the Mediterranean region compared with non-Mediterranean areas (HRs: 0.82 compared with 0.92, respectively), and in studies that used the Panagiotakos MedDiet score.

A nonlinear dose-response meta-analysis indicated that the risk of all-cause mortality linearly decreased with the increase in adherence to a MedDiet. The robustness of findings was confirmed in the sensitivity analyses. In conclusion, low-quality evidence from prospective cohort studies suggests an inverse association between adherence to a MedDiet and the risk of all-cause mortality, especially in Mediterranean regions. An inverse linear dose-response relation was also observed between adherence to a MedDiet and the risk of all-cause mortality.

23 November 2020 In Drinking Patterns

AIMS: The aims of the article are (a) to estimate coverage rates (i.e. the proportion of 'real consumption' accounted for by a survey compared with more reliable aggregate consumption data) of the total, the recorded and the beverage-specific annual per capita consumption in 23 European countries, and (b) to investigate differences between regions, and other factors which might be associated with low coverage (prevalence of heavy episodic drinking [HED], survey methodology).

METHODS: Survey data were derived from the Standardised European Alcohol Survey and Harmonising Alcohol-related Measures in European Surveys (number of surveys: 39, years of survey: 2008-2015, adults aged 20-64 years). Coverage rates were calculated at the aggregated level by dividing consumption estimates derived from the surveys by alcohol per capita estimates from a recent global modelling study. Fractional response regression models were used to examine the relative importance of the predictors.

RESULTS: Large variation in coverage across European countries was observed (average total coverage: 36.5, 95% confidence interval [CI] [33.2; 39.8]), with lowest coverage found for spirits consumption (26.3, 95% CI [21.4; 31.3]). Regarding the second aim, the prevalence of HED was associated with wine- and spirits-specific coverage, explaining 10% in the respective variance. However, neither the consideration of regions nor survey methodology explained much of the variance in coverage estimates, regardless of the scenario.

CONCLUSION: The results reiterate that alcohol survey data should not be used to compare or estimate aggregate consumption levels, which may be better reflected by statistics on recorded or total per capita consumption.

23 November 2020 In Drinking Patterns

AIMS: Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults.

METHODS: We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains.

RESULTS AND CONCLUSION: Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted.

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