. 2020 Mar 13;12(3):759.

doi: 10.3390/nu12030759.

Gender-Related Determinants of Adherence to the Mediterranean Diet in Adults with Ischemic Heart Disease

Valeria Raparelli¹, Giulio Francesco Romiti², Valeria Spugnardi², Marco Borgi², Roberto Cangemi², Stefania Basili², Marco Proietti^{3

4

5}; The Eva Collaborative Group

Collaborators, Affiliations

Collaborators

The Eva Collaborative Group:
Andrea Lenzi⁶, Claudio Tiberti⁶, Francesca Panimolle⁶, Andrea Isidori⁶, Elisa Giannetta⁶, Mary Anna Venneri⁶, Laura Napoleone⁶, Silvia Quattrino⁶, Simona Ceccarelli⁶, Eleni Anastasiadou⁶, Francesca Megiorni⁶, Cinzia Marchese⁶, Carlo Gaudio⁷, Enrico Mangieri⁷, Gaetano Tanzilli⁷, Nicola Viceconte⁷, Francesco Barillà⁷, Vincenzo Paravati⁷, Guglielmo Tellan⁷, Evaristo Ettorre⁷, Adriana Servello⁷, Fabio Miraldi⁷, Andrea Moretti⁷, Alessandra Tanzilli⁷, Piergiovanni Mazzonna⁷, Suleyman Al Kindy⁷, Riccardo Iorio⁷, Martina Di Iorio⁷, Gennaro Petriello⁷, Laura Gioffrè⁷, Eleonora Indolfi⁷, Gaetano Pero⁷, Nino Cocco⁷, Loredana Iannetta⁷, Sara Giannuzzi⁷, Emilio Centaro⁷, Sonia Cristina Sergi⁷, Simona Bartimoccia⁷, Antonio Fraioli⁷, Silvia Nocchi⁷, Mario Fontana⁷, Sergio Morelli⁷, Pasquale Pignatelli⁷, Salvatore Minisola⁷, Francesco Violi⁷, Filippo Toriello², Eleonora Ruscio², Tommaso Todisco², Nicolò Sperduti², Giuseppe Santangelo², Giacomo Visioli², Marco Vano², Ludovica Maria Antonini², Silvia Robuffo², Bernadette Corica², Claudia Tucci², Agostino Rossoni², Annarita Vernile², Mariateresa Santoliquido², Verdiana Santori², Giulia Tosti², Fabrizio Recchia², Francesco Morricone², Roberto Scacciavillani², Alice Lipari², Andrea Zito², Floriana Testa², Giulia Ricci², Ilaria Vellucci², Marianna Vincenti², Silvia Pietropaolo², Camilla Scala², Nicolò Rubini², Marta Tomassi², Claudia Ciancarella², Biagio Scotti², Claudio Cantelmi², Floriana Santomenna², Giacomo Costanzo², Gloria Rozzi², Lucas Rumbolà², Salvatore Giarrizzo², Carlotta Sapia², Giuseppina Cusano², Andrea Palladino², Francesca Villani², Antonella Cacciani², Massimo Granata², Lucia Stefanini², Giovanni Talerico², Sebastiano Filetti², Massimo Fiorilli², Danilo Toni⁸, Anne Falcou⁸, Louise Pilote⁹, Uri Bender⁹, Anna Rita Vestri¹⁰, Patrizia Ferroni¹¹, Clara Crescioli¹², Cristina Antinozzi¹², Francesca Serena Pignataro¹², Tiziana Bellini¹³, Alessandro Trentini¹³, Roberto Carnevale¹⁴, Cristina Nocella¹⁵, Carlo Catalano¹⁶, Iacopo Carbone¹⁶, Nicola Galea¹⁶, Giuliano Bertazzoni¹⁷, Marianna Suppa¹⁷, Antonello Rosa¹⁷, Gioacchino Galardo¹⁷, Maria Alessandroni¹⁷, Lorena Cipollone¹⁷, Alessandro Coppola¹⁸, Mariangela Palladino¹⁸, Giulio Illuminati¹⁹, Fabrizio Consorti¹⁹, Paola Mariani²⁰, Fabrizio Neri²⁰, Paolo Salis²⁰, Antonio Segatori²⁰, Laurent Tellini²⁰, Gianluca Costabile²⁰

Affiliations

¹ Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy.
² Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy.
³ Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
⁴ Geriatric Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
⁵ Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK.
⁶ Department of Experimental Medicine, Medical Physiopathology, Food Science and Endocrinology Section, Sapienza University of Rome, Rome, Italy
⁷ Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
⁸ Emergency Department Stroke Unit, Sapienza University of Rome, Rome, Italy
⁹ McGill University Health Centre Research Institute, Centre for Outcomes Research and Evaluation, Montreal, QC, Canada
¹⁰ Department of Public Health and Infectious Disease, Sapienza University of Rome, Roma, Italy
¹¹ San Raffaele Roma Open University and Inter-institutional Multidisciplinary Biobank, IRCCS San Raffaele Pisana, Rome, Italy
¹² Department of Movement, Human and Health Sciences Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma “Foro Italico”, Rome, Italy
¹³ Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
¹⁴ Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
¹⁵ Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy
¹⁶ Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
¹⁷ Department of Emergency Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
¹⁸ Chest Pain Unit, Policlinico Umberto I, Rome, Italy
¹⁹ Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
²⁰ Nursing Team Catheterization Lab Policlinico Umberto I, Rome, Italy

PMID: 32183044
PMCID: PMC7146303
DOI: 10.3390/nu12030759

Gender-Related Determinants of Adherence to the Mediterranean Diet in Adults with Ischemic Heart Disease

Valeria Raparelli et al. Nutrients. 2020.

. 2020 Mar 13;12(3):759.

doi: 10.3390/nu12030759.

Authors

Valeria Raparelli¹, Giulio Francesco Romiti², Valeria Spugnardi², Marco Borgi², Roberto Cangemi², Stefania Basili², Marco Proietti^{3

4

5}; The Eva Collaborative Group

Collaborators

The Eva Collaborative Group:
Andrea Lenzi⁶, Claudio Tiberti⁶, Francesca Panimolle⁶, Andrea Isidori⁶, Elisa Giannetta⁶, Mary Anna Venneri⁶, Laura Napoleone⁶, Silvia Quattrino⁶, Simona Ceccarelli⁶, Eleni Anastasiadou⁶, Francesca Megiorni⁶, Cinzia Marchese⁶, Carlo Gaudio⁷, Enrico Mangieri⁷, Gaetano Tanzilli⁷, Nicola Viceconte⁷, Francesco Barillà⁷, Vincenzo Paravati⁷, Guglielmo Tellan⁷, Evaristo Ettorre⁷, Adriana Servello⁷, Fabio Miraldi⁷, Andrea Moretti⁷, Alessandra Tanzilli⁷, Piergiovanni Mazzonna⁷, Suleyman Al Kindy⁷, Riccardo Iorio⁷, Martina Di Iorio⁷, Gennaro Petriello⁷, Laura Gioffrè⁷, Eleonora Indolfi⁷, Gaetano Pero⁷, Nino Cocco⁷, Loredana Iannetta⁷, Sara Giannuzzi⁷, Emilio Centaro⁷, Sonia Cristina Sergi⁷, Simona Bartimoccia⁷, Antonio Fraioli⁷, Silvia Nocchi⁷, Mario Fontana⁷, Sergio Morelli⁷, Pasquale Pignatelli⁷, Salvatore Minisola⁷, Francesco Violi⁷, Filippo Toriello², Eleonora Ruscio², Tommaso Todisco², Nicolò Sperduti², Giuseppe Santangelo², Giacomo Visioli², Marco Vano², Ludovica Maria Antonini², Silvia Robuffo², Bernadette Corica², Claudia Tucci², Agostino Rossoni², Annarita Vernile², Mariateresa Santoliquido², Verdiana Santori², Giulia Tosti², Fabrizio Recchia², Francesco Morricone², Roberto Scacciavillani², Alice Lipari², Andrea Zito², Floriana Testa², Giulia Ricci², Ilaria Vellucci², Marianna Vincenti², Silvia Pietropaolo², Camilla Scala², Nicolò Rubini², Marta Tomassi², Claudia Ciancarella², Biagio Scotti², Claudio Cantelmi², Floriana Santomenna², Giacomo Costanzo², Gloria Rozzi², Lucas Rumbolà², Salvatore Giarrizzo², Carlotta Sapia², Giuseppina Cusano², Andrea Palladino², Francesca Villani², Antonella Cacciani², Massimo Granata², Lucia Stefanini², Giovanni Talerico², Sebastiano Filetti², Massimo Fiorilli², Danilo Toni⁸, Anne Falcou⁸, Louise Pilote⁹, Uri Bender⁹, Anna Rita Vestri¹⁰, Patrizia Ferroni¹¹, Clara Crescioli¹², Cristina Antinozzi¹², Francesca Serena Pignataro¹², Tiziana Bellini¹³, Alessandro Trentini¹³, Roberto Carnevale¹⁴, Cristina Nocella¹⁵, Carlo Catalano¹⁶, Iacopo Carbone¹⁶, Nicola Galea¹⁶, Giuliano Bertazzoni¹⁷, Marianna Suppa¹⁷, Antonello Rosa¹⁷, Gioacchino Galardo¹⁷, Maria Alessandroni¹⁷, Lorena Cipollone¹⁷, Alessandro Coppola¹⁸, Mariangela Palladino¹⁸, Giulio Illuminati¹⁹, Fabrizio Consorti¹⁹, Paola Mariani²⁰, Fabrizio Neri²⁰, Paolo Salis²⁰, Antonio Segatori²⁰, Laurent Tellini²⁰, Gianluca Costabile²⁰

Affiliations

¹ Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy.
² Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy.
³ Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
⁴ Geriatric Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
⁵ Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK.
⁶ Department of Experimental Medicine, Medical Physiopathology, Food Science and Endocrinology Section, Sapienza University of Rome, Rome, Italy
⁷ Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
⁸ Emergency Department Stroke Unit, Sapienza University of Rome, Rome, Italy
⁹ McGill University Health Centre Research Institute, Centre for Outcomes Research and Evaluation, Montreal, QC, Canada
¹⁰ Department of Public Health and Infectious Disease, Sapienza University of Rome, Roma, Italy
¹¹ San Raffaele Roma Open University and Inter-institutional Multidisciplinary Biobank, IRCCS San Raffaele Pisana, Rome, Italy
¹² Department of Movement, Human and Health Sciences Section of Health Sciences, Unit of Endocrinology, Università degli Studi di Roma “Foro Italico”, Rome, Italy
¹³ Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
¹⁴ Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
¹⁵ Department of AngioCardioNeurology, IRCCS NeuroMed, Pozzilli, Italy
¹⁶ Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
¹⁷ Department of Emergency Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
¹⁸ Chest Pain Unit, Policlinico Umberto I, Rome, Italy
¹⁹ Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
²⁰ Nursing Team Catheterization Lab Policlinico Umberto I, Rome, Italy

PMID: 32183044
PMCID: PMC7146303
DOI: 10.3390/nu12030759

Abstract

Background: The reasons behind low adherence to the Mediterranean diet (Med-diet) are still not entirely known. We aimed to evaluate the effect of biological (i.e., sex-related) and psycho-socio-cultural (i.e., gender-related) factors on Med-diet adherence.

Methods: Baseline Med-diet adherence was measured using a self-administered questionnaire among adults with ischemic heart disease (IHD) from the EVA (Endocrine Vascular Disease Approach) study. A multivariable analysis was performed to estimate the effect of sex- and gender-related factors (i.e., identity, roles, relations, and institutionalized gender) on low adherence.

Results: Among 366 participants (66 ± 11 years, 31% women), 81 (22%) adults with low adherence demonstrated higher rates of diabetes, no smoking habit, lower male BSRI (Bem Sex Role Inventory) (median (IQR) 4.8 (4.1 to 5.5) vs. 5.1 (4.5 to 5.6) and p = 0.048), and higher Perceived Stress Scale 10 items (PSS-10) (median (IQR) 19 (11 to 23) vs. 15 (11 to 20) and p = 0.07) scores than those with medium-high adherence. In the multivariable analysis, only active smoking (odds ratio, OR = 2.10, 95% confidence interval, CI 1.14 to 3.85 and p = 0.017), PPS-10 (OR = 1.04, 95% CI 1.00 to 1.08, and p = 0.038) and male BSRI scores (OR = 0.70, 95% CI 0.52 to 0.95, and p = 0.021) were independently associated with low adherence.

Conclusions: Male personality traits and perceived stress (i.e., gender identity) were associated with low Med-diet adherence regardless of the sex, age, and comorbidities. Therefore, gender-sensitive interventions should be explored to improve adherence in IHD.

Keywords: Ischemic heart disease; Mediterranean diet; adherence; gender; sex.

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Conflict of interest statement

The authors declare no conflict of interest. The funder agency had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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Gender-Related Determinants of Adherence to the Mediterranean Diet in Adults with Ischemic Heart Disease

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Gender-Related Determinants of Adherence to the Mediterranean Diet in Adults with Ischemic Heart Disease

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