Mediterranean diet, tobacco consumption and body composition during perimenopause. The FLAMENCO project

When writing a manuscript, we often use words such as perfect, strong, good or weak to name the strength of the relationship between variables. However, it is unclear where a good relationship turns into a strong one. The same strength of r is named differently by several researchers. Therefore, there is an absolute necessity to explicitly report the strength and direction of r while reporting correlation coefficients in manuscripts. This article aims to familiarize medical readers with several different correlation coefficients reported in medical manuscripts, clarify confounding aspects and summarize the naming practices for the strength of correlation coefficients.

Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain. We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis. Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P≤0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P 8 hours of sleep), and television watching (0.31 lb per hour per day). Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.).

It has been suggested that overall dietary patterns and not single nutrients should be studied, since food items might have a synergistic and antagonistic effect on health. The Mediterranean diet has long been associated with lower incidence of cardiovascular disease and cancer. Therefore, we developed a diet score that incorporates the inherent characteristics of this dietary pattern. We used 11 main components of the Mediterranean diet (non-refined cereals, fruits, vegetables, potatoes, legumes, olive oil, fish, red meat, poultry, full fat dairy products and alcohol). For the consumption of items presumed to be close to this pattern we assigned scores 0, 1, 2, 3, 4 and 5 when a participant reported no consumption, rare, frequent, very frequent, weekly and daily, respectively. For the consumption of foods presumed to be away from this pattern we assigned the scores on a reverse scale. Especially for alcohol, we assigned score 5 for consumption of less than 300 ml/day, score 0 for consumption of more than 700 ml/day or none and scores 1-4 for consumption of 300-400, 400-500, 500-600, and 600-700 ml/day (100 ml = 12 g ethanol), respectively. Then a total score ranging from 0 to 55 was calculated. After having applied this diet score in the participants of the ATTICA study we observed a significant positive association with monounsaturated fat and monounsaturated-to-saturated fat intake. We also observed, an inverse association with serum lipids, blood pressures, inflammation and coagulation markers related to cardiovascular disease. The application of that score in a case-control study (CARDIO2000) suggested that the score was inversely associated with the odds of having acute coronary syndromes. The Mediterranean diet score proposed above may be useful in assessing the nutritional status of an individual and investigating the relationship of the Mediterranean diet with various health outcomes.