In a review paper, Mohsen Meydani, DVM, PhD, director of the Vascular Biology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, explores the potential benefits, beyond those achieved with weight loss alone, of a Mediterranean-style diet for patients with metabolic syndrome.
"Consuming a Mediterranean-style diet rich in olive oil, whole grains, fruits, vegetables, and nuts may reduce the risk of cardiovascular disease in patients with metabolic syndrome," says Meydani, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts. "Evidence suggests that this effect may be due to actions on two of the integral components of cardiovascular disease - inflammation and dysfunction of the cells lining the inner surfaces of blood vessels."
Meydani focuses on the results of a two-year intervention trial conducted in Italy. Subjects were divided into two groups. Both groups lost modest amounts of weight while following reduced-calorie diets and exercising, but the group eating a Mediterranean-style diet had greater improvements in several components of the metabolic syndrome, such as total cholesterol, triglycerides, and blood sugar.
Metabolic syndrome is associated with an increased risk of cardiovascular disease and death, but these outcomes can be prevented through early detection and modification of risk factors.
"Although caloric restriction and body weight reduction remain a primary approach for treating metabolic syndrome patients, intervention with a Mediterranean-style diet combined with moderate exercise might be a strategy to enhance the cardiovascular benefits of weight loss," Meydani concludes.
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Patients with eosinophilic esophagitis usually show symptoms of chest and abdominal pain, dysphagia, heartburn, vomiting and food impaction (occurs when food gets stuck in the throat). It is diagnosed by a combination of testing, including skin allergy tests, but most importantly, it requires analysis of esophageal tissue specimens obtained by endoscopy.
Eosinophilic esophagitis is commonly treated by a combination of medications and a change in diet. Many patients are so allergic to food that they can no longer eat anything. As a result, they are fed a simple elemental diet through a feeding tube. It is a chronic illness, but with proper management, most patients lead functional lives.
Dr. Rothenberg and his team of physicians and researchers (including Philip E. Putnam, M.D., and Margaret H. Collins, M.D., both of Cincinnati Children's) have shown that eosinophilic esophagitis affects one in 2,000 children in Hamilton County, Cincinnati. Health care providers are beginning to see cases of eosinophilic esophagitis in many countries, including England, Japan, Spain, Australia, Switzerland and Italy, and evidence is emerging that the incidence calculated by Dr. Rothenberg's team is likely to hold true in these countries.
"It is hopeful that these findings will contribute to predicting the general outcome of eosinophilic esophagitis and building a molecular classification for diagnosis and therapy of esophagitis," Dr. Rothenberg said. The identification of eotaxin-3 as a cause for eosinophilic esophagitis now places attention on the development of drugs that block this protein.
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