Introduction: The potential influence of a Mediterranean diet (MD) on PhA values has been little researched. The aim of this study was to investigate the association between adherence of a MD and PhA on adult sample population with obesity and metabolic syndrome. Methods: We conducted a cross-sectional study in 331 patients with obesity and metabolic syndrome. Anthropometrics’ data (weight, height, body mass index, and waist circumference), bioelectrical bioimpedance (BIA) parameters (resistance reactance, PhA, fat mass [FM], fat-free mass [FFM], skeletal muscle mass [SMM]), and biochemical parameters were recorded. Dietary intakes with a 3-day written food records and MD adherence with a validated 14-item questionnaire were evaluated. Patients were divided into two groups by median value of PhA. Results: Percentage of patients with high MD adherence (score >7) in high PhA group was 77.2% and in low PhA group was 41.4% (odds ratio 1.91, 95% CI = 1.27–3.54; p = 0.01). Total fat intake (saturated, monounsaturated, and polyunsaturated fats), protein intake, and cholesterol intake were higher in high PhA group than low PhA group. Total score of MD was higher in high PhA than low PhA group (3.5 ± 1.1 points; p = 0.04). FFM (3.3 ± 0.9 kg; p = 0.01), FFM index (3.9 ± 1.1 kg/m2; p = 0.01), SMM (4.6 ± 1.2 kg; p = 0.01) and SMM index (3.3 ± 0.7 kg/m2; p = 0.03) were higher in subjects of high adherence of MD group than subjects of low adherence. FM (−3.2 ± 1.1 kg; p = 0.03) was lower in subjects with good adherence to MD. MD score (Beta 1.71, CI 95% 1.06–2.16), FFM (Beta 3.99, CI 95% 1.87–7.16), and SMM (Beta 4.21, CI 95% 1.76–8.19) remained in the multivariate model. Conclusion: We concluded that a high adherence to a MD in subjects with obesity and metabolic syndrome is associated with values of PhA.

1.
Martínez-González
MA
.
Benefits of the mediterranean diet beyond the mediterranean sea and beyond food patterns
.
BMC Med
.
2016
;
14
(
1
):
157
60
.
2.
Martínez-González
MA
,
Salas-Salvadó
J
,
Estruch
R
,
Corella
D
,
Fitó
M
,
Ros
E
.
Benefits of the mediterranean diet: insights from the PREDIMED study
.
Prog Cardiovasc Dis
.
2015
;
58
(
1
):
50
60
.
3.
Oliviero
F
,
Spinella
P
,
Fiocco
U
,
Ramonda
R
,
Sfriso
P
,
Punzi
L
.
How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis
.
Swiss Med Wkly
.
2015
145
w14190
.
4.
Barceló
F
,
Perona
JS
,
Prades
J
,
Funari
SS
,
Gomez-Gracia
E
,
Conde
M
.
Mediterranean-style diet effect on the structural properties of the erythrocyte cell membrane of hypertensive patients: the Prevencion con Dieta Mediterranea Study
.
Hypertension
.
2009
;
54
(
5
):
1143
50
.
5.
Expert panel on detection, evaluation and treatment of high blood cholesterol in adults
.
Executive summary of the third report of the national cholesterol education program (NCEP) expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment Panel III)
.
JAMA
.
2001
;
285
(
19
):
2486
97
.
6.
Baumgartner
RN
,
Chumlea
WC
,
Roche
AF
.
Bioelectric impedance phase angle and body composition
.
Am J Clin Nutr
.
1988
;
48
(
1
):
16
23
.
7.
Norman
K
,
Stobäus
N
,
Pirlich
M
,
Bosy-Westphal
A
.
Bioelectrical phase angle and impedance vector analysis: clinical relevance and applicability of impedance parameters
.
Clin Nutr
.
2012
;
31
(
6
):
854
61
.
8.
Stobäus
N
,
Pirlich
M
,
Valentini
L
,
Schulzke
JD
,
Norman
K
.
Determinants of bioelectrical phase angle in disease
.
Br J Nutr
.
2012
;
107
(
8
):
1217
20
.
9.
Norman
K
,
Stobäus
N
,
Zocher
D
,
Bosy-Westphal
A
,
Szramek
A
,
Scheufele
R
.
Cutoff percentiles of bioelectrical phase angle predict functionality, quality of life, and mortality in patients with cancer
.
Am J Clin Nutr
.
2010
;
92
(
3
):
612
9
.
10.
Xu
Y
,
Xie
X
,
Duan
Y
,
Wang
L
,
Cheng
Z
,
Cheng
J
.
A review of impedance measurements of whole cells
.
Biosens Bioelectron X
.
2016
;
77
:
824
36
.
11.
Bosy-Westphal
A
,
Danielzik
S
,
Dörhöfer
RP
,
Later
W
,
Wiese
S
,
Müller
MJ
.
Phase angle from bioelectrical impedance analysis: population reference values by age, sex, and body mass index
.
J Parenter Enteral Nutr
.
2006
;
30
(
4
):
309
16
.
12.
Kumar
S
,
Dutt
A
,
Hemraj
S
,
Bhat
S
,
Manipadybhima
B
.
Phase angle measurement in healthy human subjects through bio-impedance analysis
.
Iran J Basic Med Sci
.
2012
;
15
:
1180
4
.
13.
de Luis
DA
,
Aller
R
,
Romero
E
,
Dueñas
A
,
Perez Castrillon
JL
.
Relation of phase angle tertiles with blood adipocytokines levels, insulin resistance and cardiovascular risk factors in obese women patients
.
Eur Rev Med Pharmacol Sci
.
2010
;
14
:
521
6
.
14.
De Luis
DA
,
Aller
R
,
Izaola
O
,
Terroba
MC
,
Cabezas
G
,
Cuellar
L
.
Tissue electric properties in head and neck cancer patients
.
Ann Nutr Metab
.
2006
;
50
(
1
):
7
10
.
15.
de Luis
DA
,
Aller
R
,
Bachiller
P
,
Gonzalez Sagrado
M
,
Martin
J
,
Izaola
O
.
Influence of hormonal status and oral intake on phase angle in HIV-infected men
.
Nutrition
.
2004
;
20
(
9
):
731
4
.
16.
De França
NAG
,
Callegari
A
,
Gondo
FF
,
Corrente
JE
,
Mclellan
KCP
,
Burini
RC
.
Higher dietary quality and muscle mass decrease the odds of low phase angle in bioelectrical impedance analysis in Brazilian individuals
.
Nutr Dietet
.
2016
;
73
(
5
):
474
81
.
17.
Barrea
L
,
Muscogiuri
G
,
Macchia
PE
,
Di Somma
C
,
Falco
A
,
Savanelli
MC
.
Mediterranean diet and phase angle in a sample of adult population: results of a pilot study
.
Nutrients
.
2017
;
9
(
2
):
151
.
18.
Bučan Nenadić
D
,
Radić
J
,
Kolak
E
,
Vučković
M
,
Novak
I
,
Selak
M
.
Phase angle association with dietary habits and metabolic syndrome in diabetic hypertensive patients: a cross-sectional study
.
Nutrients
.
2022
;
14
(
23
):
5058
.
19.
Friedewald
WT
,
Levy
RI
,
Fredrickson
DS
.
Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge
.
Clin Chem
.
1972
;
18
(
6
):
499
502
.
20.
Mathews
DR
,
Hosker
JP
,
Rudenski
AS
,
Naylor
BA
,
Treacher
DF
.
Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man
.
Diabetologia
.
1985
;
28
:
412
4
.
21.
Mataix
J
,
Mañas
M
Tablas de composición de alimentos españoles
University of Granada
2003
.
22.
Martínez-González
MA
,
García-Arellano
A
,
Toledo
E
,
Salas-Salvadó
J
,
Buil-Cosiales
P
,
Corella
D
.
A 14-item Mediterranean diet assessment tooland obesity indexes among high-risk subjects: the PREDIMED trial
.
PLoS One
.
2012
;
7
(
8
):
e43134
.
23.
Pan
B
,
Wu
Y
,
Yang
Q
,
Ge
L
,
Gao
C
,
Xun
Y
.
The impact of major dietary patterns on glycemic control, cardiovascular risk factors, and weight loss in patients with type 2 diabetes: a network meta-analysis
.
J Evid Based Med
.
2018
;
12
(
1
):
29
39
.
24.
Wang
Y
,
Hao
Q
,
Su
L
,
Liu
Y
,
Liu
S
,
Dong
B
.
Adherence to the mediterranean diet and the risk of frailty in old people: a systematic review and meta-analysis
.
J Nutr Health Aging
.
2018
;
22
(
5
):
613
8
.
25.
Machlin
LJ
,
Bendich
A
.
Free radical tissue damage: protective role of antioxidant nutrients
.
FASEB J
.
1987
;
1
(
6
):
441
5
.
26.
Rathod
AD
,
Bharadwaj
AS
,
Badheka
AO
,
Kizibash
M
,
Afonso
L
.
Healthy Eating Index and mortality in a nationally representative elderly cohort
.
Arch Intern Med
.
2012
;
172
(
3
):
275
7
.
27.
Gupta
D
,
Lammersfeld
CA
,
Vashi
PG
,
King
J
,
Dahlk
SL
,
Grutsch
JF
.
Bioelectrical impedance phase angle in clinical practice: implications for prognosis in stage IIIB and IV non-small cell lung cancer
.
BMC Cancer
.
2009
;
9
(
1
):
37
40
.
28.
Basile
C
,
Della-Morte
D
,
Cacciatore
F
,
Gargiulo
G
,
Galizia
G
,
Roselli
M
.
Phase angle as bioelectrical marker to identify elderly patients at risk of sarcopenia
.
Exp Gerontol
.
2014
;
58
:
43
6
.
29.
Dittmar
M
.
Reliability and variability of bioimpedance measures in normal adults: effects of age, gender, and body mass
.
Am J Phys Anthropol
.
2003
;
122
(
4
):
361
70
.
30.
Deschenes
MR
.
Effects of aging on muscle fibre type and size
.
Sports Med
.
2004
;
34
(
12
):
809
24
.
31.
León-Muñoz
LM
,
Guallar-Castillón
P
,
López-García
E
,
Rodríguez-Artalejo
F
.
Mediterranean diet and risk of frailty in community-dwelling older adults
.
J Am Med Dir Assoc
.
2014
;
15
(
12
):
899
903
.
32.
Bakaloudi
DR
,
Chrysoula
L
,
Kotzakioulafi
E
,
Theodoridis
X
,
Chourdakis
M
.
Impact of the level of adherence to mediterranean diet on the parameters of metabolic syndrome: a systematic review and meta-analysis of observational studies
.
Nutrients
.
2021
;
13
(
5
):
1514
20
.
33.
Zhang
H
,
Lin
S
,
Gao
T
,
Zhong
F
,
Cai
J
,
Sun
Y
.
Association between sarcopenia and metabolic syndrome in middle-aged and older non-obese adults: a systematic review and meta-analysis
.
Nutrients
.
2018
;
10
(
3
):
364
8
.
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