Abstract | Cilj istraživanja: Cilj istraživanja bio je ispitati postoji li povezanost između mediteranske prehrane i razine lipida u krvi u populaciji otoka Korčule i grada Splita te uz to istražiti obrazac mediteranske prehrane u navedenoj populaciji.
Materijali i metode: Presječno istraživanje, provedeno u okviru projekta „Pleitropija, genske mreže i putevi u izoliranim ljudskim populacijama: 10.001 Dalmatinac“ (HRZZ 8875), obuhvatilo je 2145 ispitanika s otoka Korčule i grada Splita. Upitnikom koji su ispitanici ispunili prikupljeni su podaci o dobi, spolu, zdravstvenom statusu, socioekonomskom statusu te prehrambenim i ostalim navikama (konzumacija alkohola, pušenje, tjelesna aktivnost). Pridržavanje mediteranskom načinu prehrane određeno je indeksom koji uključuje 14 skupina namirnica koje predstavljaju osnovne sastavnice mediteranske prehrane (108). Nadalje, ispitanicima je izmjerena tjelesna masa i visina, opseg struka i kukova, sistolički i dijastolički tlak te izračunat indeks tjelesne mase. Svaki ispitanik je nakon potpisivanja informiranog pristanka dao uzorak krvi na tašte te su biokemijskom analizom dobivene vrijednosti glukoze, kreatinina, urične kiseline, ukupnog kolesterola, LDL kolesterola, HDL kolesterola i triglicerida u krvi. U statističkoj analizi podataka korišten je hi-kvadrat test, Kruskal-Wallis test i Spearmanov test rang korelacije te logistička regresija. Rezultati su smatrani statistički značajnima ukoliko je P vrijednost iznosila <0,05.
Rezultati: Utvrđeno je relativno loše pridržavanje smjernica mediteranske prehrane, a tek 19,3% ispitanih koji su se dobro pridržavali smjernica. Ispitanici su se u najvišem postotku pridržavali smjernica za upotrebu žitarica (85,7%), krumpira (68,5%), maslinovog ulja (68,1%) i ribe (61,1%) u prehrani, a najmanje za upotrebu orašastih plodova (5,5%), vina (17,3%), mlijeka i mliječnih prerađevina (18,5%), leguminoza (21,1%), povrća (28,7%) i crvenog mesa (30,0%). Najveći udio ispitanika koji se hrane na mediteranski način bio je zabilježen u Splitu (23,4%), a najmanji u Blatu i Veloj Luci (15,9%; P=0,002). Uočeno je da se žene učestalije pridržavaju mediteranske prehrane u svim dobnim skupinama u odnosu na muškarce. Rezultati logističke regresije u skupini ispitanika bez kroničnih bolesti u anamnezi pokazali su učestaliju prisutnost povišenih triglicerida kod muškaraca u odnosu na žene (OR=3,69; 95% CI 2,59-5,25), dok je dob bila povezana sa svim parametrima, na način da su ispitanici starije dobi imali veću vjerojatnost imati povišenu koncentraciju ukupnog kolesterola, LDL-a i triglicerida, ali i manju vjerojatnost za smanjenu koncentraciju HDL-a, osim za ispitanike starije od 65 godina gdje se nije uspostavila veza između dobi i razine triglicerida. Uočeno je i da indeks tjelesne mase 25,0-29,9 kg/m2 povezan s nepovoljnim cjelokupnim lipidnim profilom, dok je ITM >30 kg/m2 povezan s nižom razinom HDL-a i s višom razinom triglicerida u krvi. Pušenje je bilo povezano s nižom koncentracijom HDL-a (OR=2,46; 95% CI 1,57-3,86) i većom koncentracijom triglicerida (OR=1,73; 95% CI 1,22-2,45). U skupini ispitanika koji imaju jednu ili više kroničnih bolesti u anamnezi ITM >25 kg/m2 bio je povezan s većom razinom triglicerida u krvi (OR=1,63; 95% CI 1,01-2,64), dok je učinak na smanjenje HDL-a bio vidljiv samo kod ispitanika s ITM >30 kg/m2 (OR=4,64; 95% CI 2,07-10,38). Nije se pronašla statistički značajna povezanost između nižeg indeksa mediteranske prehrane i vrijednosti lipidnih markera u krvi niti kod zdravih ispitanika niti onih koji imaju od ranije dijagnosticiranu jednu ili više kroničnih bolesti.
Zaključak: Dob, indeks tjelesne mase i pušenje predstavljaju rizične čimbenike za povećanje lipida u krvi. S obzirom na trend povećanja potrošnje hipolipemika u populaciji sve većeg broja osoba s dislipidemijom te rastuće pojavnosti „zapadnjačkog“ načina života i prehrane, upravo bi integriranje mediteranske prehrane u svakodnevni život moglo biti ključ ostvarenja nekih na zdravlje povoljnih učinaka. Nažalost, u istraživanoj populaciji pronađena je niska razina pridržavanja smjernica mediteranske prehrane, a visoka učestalost rizičnih čimbenika za kronične bolesti, kao i tih bolesti također, zbog čega postoji jasna potreba za javnozdravstvenom intervencijom i promocijom tradicionalnog i zdravog mediteranskog stila života i prehrane. |
Abstract (english) | Objectives: The main objective of this study was to examine whether there is a link between the Mediterranean diet and blood lipid levels in the population of the island of Korcula and the city of Split, and in addition to examine the pattern of the Mediterranean diet in that population.
Patients and Methods: A cross-sectional study, conducted in the framework of the project "Pleiotropy, gene networks and pathways in isolated human populations: 10 001 Dalmatians" (HRZZ 8875), included 2,145 respondents from the island of Korcula and the city of Split. Using the survey, data was collected on age, sex, health status, level of education, dietary and other habits (drinking, smoking, physical activity). Adherence to the Mediterranean dietary pattern was determined by index score, which includes 14 groups of foods that are basic components of the Mediterranean diet (108). Furthermore, the respondents were measured body weight and height, waist circumference and hip circumference, systolic and diastolic blood pressure, and body mass index was calculated. After signing the informed consent, fasting blood sample was taken from each participant and the biochemical analysis was performed in order to measure glucose, creatinine, uric acid, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. In statistical analysis of the data chi-square test, Kruskal-Wallis's test, Spearman's rank correlation test and logistic regression were used. Results were considered statistically significant if the P value was <0.05.
Results: Relatively poor adherence to the guidelines of the Mediterranean diet was found where only 19.3% of respondents did adhere well. Respondents highly complied with the guidelines for the use of cereals (85.7%), potatoes (68.5%), olive oil (68.1%) and fish (61.1%) in the diet, but were less likely to use nut fruits (5.5%), wine (17.3%), milk and dairy products (18.5%), legumes (21.1%), vegetables (28.7%) and red meat (30.0% ). The largest proportion of respondents who followed the Mediterranean dietary pattern was recorded in Split (23.4%) and the lowest in Blato and Vela Luka (15.9%; P = 0.002). It was observed that women more frequently adhere to the Mediterranean diet at all ages than men. The results of logistic regression in the group of patients without chronic diseases in history have shown more frequent presence of elevated triglyceride levels in men than in women (OR = 3.69; 95% CI 2.59 to 5.25), whereas age was associated with all parameters in such a way that the respondents who were older were more likely to have elevated concentrations of total cholesterol, LDL and triglycerides, but were also less likely to have lowered concentration of HDL, except for the people older than 65 years where the link between age and the levels of triglycerides was not established. It was also noted that the body mass index 25.0-29.9 kg/m2 was adversley linked with overall lipid profile, while a BMI >30 kg/m2 was associated with lower concentration of HDL and higher levels of triglycerides in the blood. Smoking was associated with a lower concentration of HDL (OR = 2.46; 95% CI 1.57 to 3.86) and a higher concentration of triglycerides (OR = 1.73; 95% CI 1.22 to 2.45). In the group of subjects having one or more chronic disease in their history, BMI >25 kg/m2 was associated with higher triglyceride levels (OR = 1.63; 95% CI 1.01 to 2.64), while the effect on decrease in HDL was seen only in patients with a BMI >30 kg/m2 (OR = 4.64; 95% CI 2.07 to 10.38). Statistically significant association between a lower index value of the Mediterranean diet and lipid markers in blood was not found in healthy subjects nor in those who have previously been diagnosed with one or more chronic diseases.
Conclusion: Age, body mass index and smoking are risk factors for the increase in blood lipids. Given the trend of increasing consumption of lipid lowering drugs in the population of a growing number of people with dyslipidemia and the growing incidence of "Western" lifestyle and diet, just integrating the Mediterranean diet in everyday life could be the key to achieving some beneficial effects on health. Unfortunately, a low level of compliance with the guidelines of the Mediterranean diet was found in the studied population along with a high prevalence of risk factors for chronic diseases, and of these diseases as well, therefore there is a clear need for public health intervention and promotion of traditional and healthy Mediterranean lifestyle and diet. |