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Background The measurement of the skin carotenoids using the Veggie Meter® has emerged as a rapid objective method for assessing fruit and vegetable intake, highly recommended by the Mediterranean Diet (MD), which represents one of the healthiest dietary patterns, worldwide. This study aimed to examine differences in skin carotenoid content and degree of adherence to the MD pattern between two adult populations from Southern Italy and the Dominican Republic. Methods This cross-sectional study enrolled a total of 995 adults, 601 subjects from Italy and 394 from the Dominican Republic. All participants underwent anthropometric measurements and skin carotenoid assessment by Veggie Meter®. Adherence to the MD and lifestyle were evaluated using the Mediterranean Diet Adherence Screener (MEDAS) and the Mediterranean Lifestyle Index (MEDLIFE) questionnaires. Correlations between the skin carotenoid and MEDAS score were estimated using Pearson’s correlation coefficient. Multiple linear regression models were created to determine variables that affect skin carotenoid score for both populations. Results Mean total skin carotenoids were higher in the Italian compared to the Dominican Republic population (342.4 ± 92.4 vs 282.9 ± 90.3; p < 0.005) regardless of sex (women: 318.5 ± 88.9 vs 277.3 ± 91.9, p < 0.005 and men: 371.7 ± 88.3 vs 289.5 ± 88.1, p < 0.005), and remaining statistically significant after age-adjustment of the Dominican Republic sample. Using the MEDAS questionnaire, we found a higher MD adherence score in the Italian than in the Dominican Republic population also after age-adjusting data (7.8 ± 2.1 vs 6.2 ± 3.7; p < 0.005) and even when categorized by sex (Italian vs age-adjusted Dominican Republic women: 7.9 ± 2.1 vs 6.3 ± 2.6; Italian vs age-adjusted Dominican Republic men: 7.7 ± 2.2 vs 6.0 ± 4.7; p < 0.005). Using the MEDLIFE test, total Italians presented a lower score with respect to the age-adjusted Dominican Republic population (3.2 ± 1.2 vs 3.4 ± 1.4; p < 0.05). In multiple regression analysis, skin carotenoids were associated with sex and negatively associated with BMI in the Italian population (sex: β: 54.95; 95% CI: 40.11, 69.78; p < 0.0001; BMI: β: − 1.60; 95% CI: − 2.98,0.86; p = 0.03), while they resulted associated with age and sex in the Dominican Republic population (age: β: 2.76; 95% CI: 1.92, 3.56; p < 0.001; sex: β: 23.29; 95% CI: 5.93, 40.64; p = 0.009). Interestingly, skin carotenoids were positively correlated with MEDAS score in both populations (Italy: r = 0.03, p < 0.0001, Dominican Republic: r = 0.16, p = 0.002). Conclusions This study provides the assessment of the adherence to the MD and skin carotenoid content in adults living in Southern Italy and the Dominican Republic, showing a higher MD adherence score and a skin carotenoid content in inhabitants from the Mediterranean region. Our findings highlight the need to globally encourage fruit and vegetable intake, particularly in non-Mediterranean area.

Childhood obesity represents a public concern worldwide. Evidence indicates that fruits and vegetables (FV) consumed as part of the daily diet reduce the global burden of obesity. Indeed, FV are rich in bioactive compounds, including carotenoids, which exert health benefits as very potent natural antioxidants. Here, we compared the anthropometric characteristics and the skin carotenoid content between two schoolchildren populations from Southern and Central Italy to evaluate their dietary habits. A sample of 121 and 124 schoolchildren from primary schools in Central and Southern Italy, respectively, was recruited. All participants underwent anthropometric measurements and assessment of the adherence to the Mediterranean Diet (MD) by the KIDMED questionnaire and the skin carotenoid score by Veggie Meter®. The mean body mass index (BMI) was significantly lower in participants from Central Italy than in those from Southern Italy. A significantly higher percentage of overweight and obesity was found in the overall sample from Southern than in Central Italy. The adherence to the MD was in the average range for both populations, with no gender-related differences. The carotenoid score was higher and negatively correlated with BMI in the schoolchildren from Central Italy. In multiple regression analyses, skin carotenoids were positively associated with the consumption of fruit in the entire sample. This study suggests the importance of increasing FV intake, particularly in Southern Italy, as a strategy for preventingof obesity during the whole lifespan. Further studies are essential to better understand the influence of skin carotenoids on different variables and their potential role as indicators of health status in children.

In a volleyball team, an optimal body composition might be reachable by monitoring both training plan and nutritional habits to obtain success in competitions. The Mediterranean Diet (MD) may represent a good choice to cover the nutritional needs of those practicing competitive sports. The aim of this study was to monitor body composition changes through bioelectrical impedance vector analysis (BIVA) during pre-season training sessions (P), the championship (C), and the play-off period, in volleyball players following MD recommendations. Our data showed that athletes maintained an optimal MD adherence over the study period. In the total population, we observed an upward and leftward shift of the vector on the resistance (Rz)/reactance (Xc) graph within the specific tolerance ellipses for the volleyball players. Using Hotelling’s T² test, we found significant changes in BIVA parameters from P to C of the entire team, due to reduction in Rz/height (H) and increase in Xc/H, along with an increase in phase angle, body cell mass index, and skeletal muscle mass. Our findings support BIVA as a useful tool to monitor body adaptations of athletes and the MD as an optimal dietary pattern in sport setting to allow good performance in athletes.

The Mediterranean Diet (MD) is characterized by a high intake of fruits and vegetables (FVs), which is considered as an important contributor to the beneficial effects of the MD pattern. In this cross-sectional study, we compared the food choices, evaluated by dietary habit questionnaires, of a sample of 995 adults, including 601 and 394 participants from Southern Italy and the Dominican Republic, respectively. In addition, we focused on their FV consumption, assessed by the Mediterranean Diet Adherence Screener (MEDAS) questionnaire, and on its association with skin carotenoid levels as measured by the Veggie Meter®. We found that a significantly higher percentage of Italians had five meals/day and breakfast compared to Dominicans (five meals/day: 43 vs. 25, p < 0.05; breakfast: 89 vs. 79, p < 0.05), whereas a lower percentage of participants from Italy consumed snacks between the two meals compared to the Dominican Republic population (47 vs. 70, p < 0.005). Most of the participants from both populations had breakfast at home. However, 59.3% of Italians and 27.5% of Dominicans (p = 0.005) had breakfast between 7:00 and 9:00 a.m., whereas 5.8% and 27.5% (p = 0.001) had breakfast after 9:00 a.m., respectively. Milk/yogurt and eggs were the most consumed foods for breakfast in Italy and the Dominican Republic, respectively. Regarding the main meals, most of the Italians and Dominicans had a first course for lunch and a second course for dinner. Of note, we observed that approximately half of the Italians ate FVs in their main meals and had a higher carotenoid score than the Dominicans. Interestingly, in the multiple linear regression analysis, we found that the carotenoid score was positively associated with sex (β = 0.078; p = 0.009), age (β = 0.008; p = 0.001), vegetable consumption (β = 0.12; p = 0.041) and the perception of a healthy diet (β = 0.12; p = 0.001) in the Dominic Republic population, while the carotenoid score was directly associated with sex (β = 54.97; p < 0.0001) and both vegetable (β = 25.42; p = 0.0008) and fruit (β = 38.61; p < 0.0001) consumption in the Italian sample. Our findings confirm the need to promote nutrition-based interventions to encourage FV intake, particularly in non-Mediterranean countries.

The Veggie Meter® (Longevity Link Corporation, Salt Lake City, UT, USA), is a new portable device for the non-invasive and rapid detection of skin carotenoid content, which represents an acceptable biomarker for the evaluation of fruit and vegetable (FV) intake. FVs are important components of a healthy diet, including the Mediterranean Diet (MD), which is a plant-based dietary pattern. Here, we evaluated the adherence to the MD via the administration of two online food questionnaires, and we measured the skin carotenoid content using the Veggie Meter® in a cohort of 498 healthy adolescents (233 males and 265 females) from Southern Italy. Using KIDMED and the MD Pyramid tests to assess the adherence to the MD, we found an average adherence (5.43 ± 2.57 and 7.20 ± 1.93, respectively) to the MD in our sample population. Moreover, we observed that the skin carotenoid score was 364.75 ± 98.29, which was within the normal range and inversely related to the BMI (r = −0.1461, p = 0.0011). Similar results were observed when the population was categorized by sex. Interestingly, we demonstrated, for the first time, a positive correlation between the carotenoid score and the adherence to the MD assessed using both the KIDMED and MD Pyramid tests in the total population (r = −0.2926, p < 0.0001 and r = −0.1882, p < 0.0001, respectively). The same direct correlation was found in adolescents according to their sex. Our findings highlight the potential of the Veggie Meter® as a feasible and promising tool for evaluating adherence to the MD and, ultimately, to promote healthy eating habits among adolescents.

Abstract Context The COVID-19 pandemic and its lockdown restrictions changed people's lifestyles with potential negative impact on health. Objective This longitudinal study aimed to assess the COVID-19 lockdown influence on the adherence to the Mediterranean diet (MD) pattern and its effects on the metabolic inflammatory profile in a cohort of healthy adolescents. Methods We analyzed anthropometric measurements, body composition, and MD adherence along with serum metabolic and inflammatory profile in 77 healthy adolescents from southern Italy before and after the COVID-19 pandemic lockdown. Additionally, we evaluated the biological properties of prelockdown and postlockdown serum on human HepG2 and HuH-7 hepatic cells. Results We did not observe any significant differences in anthropometric and body composition parameters as well as MD adherence score in adolescents between prelockdown and postlockdown COVID-19. Intriguingly, although the metabolic profile of adolescents postlockdown was within the normal range, we evidenced increased levels of fasting glucose, triglycerides, total cholesterol, and low-density lipoprotein (LDL) along with a reduction in high-density lipoprotein (HDL) in postlockdown compared with prelockdown adolescent serum. In addition, elevated levels of tumor necrosis factor (TNF)-α, interleukin-1β, and ferritin were found in postlockdown adolescents compared with their prelockdown counterparts. Consistent with the biochemical parameters, we observed enhanced lipid accumulation with altered mitochondrial functions and increased reactive oxygen species production in HepG2 and HuH-7 cells treated with pooled serum from postlockdown with respect to prelockdown period. Receiver operator characteristic curve analysis identified total cholesterol, LDL, HDL, TNF-α, and ferritin to be predictive serum markers for metabolic and inflammatory profiling after the lockdown period. Conclusion Our findings highlight that the COVID-19 lockdown, forcing sedentary behavior, had a negative impact on adolescents’ metabolic and inflammatory profile which may result in long-term poor health outcomes.

Adolescent nutrition and healthy dietary patterns, particularly the Mediterranean diet (MD), have been associated with improved health status and decreased risk of various chronic and metabolic diseases later in life. The aim of this study was to evaluate the impact of the Mediterranean food choices on lipid and glycemic metabolic profile in the total population and in adolescents grouped according to their physical activity (PA) levels at the time of recruitment (T0) and after six months from the administration of a personalized Mediterranean meal plan (T1). As part of the DIMENU study, 85 adolescents underwent measurements of lipid and glucose metabolic profile at T0 and T1. Using three positive items from KIDMED test related to the consumption of typical Mediterranean food (olive oil, fish, and nuts) and three negative items on dietary habits (going to fast-food, consuming biscuits, and candies), we categorized adolescents into six sets in which biochemical parameters were analyzed. In the total sample, significant reductions in serum total cholesterol, LDL, and glucose concentrations were observed for all the sets over the study period. Notably, active subjects, who had a better serum metabolic profile, showed significant improvements of glycemic control after 6 month follow up, while in sedentary adolescents and in those performing moderate PA significant reduction in glycemia, total cholesterol, and LDL was found in all sets. In conclusion, adopting the typical Mediterranean food choices led to a significant reduction in glucose and lipid profile in healthy adolescents, thus making the MD and PA a winning combination for health status.

Background Healthy lifestyle behaviors are the cornerstone for the prevention of a wide range of metabolic and chronic non-communicable diseases (NCSs). Among lifestyle factors, diet, body mass index (BMI), smoking habits and physical activity are associated with the risk of developing NCSs, including obesity, type 2 diabetes, cardiovascular diseases and certain types of cancer. Particularly, as a part of a healthy diet, increased intake of fruit and vegetable (FV), rich sources of vitamins and minerals, dietary fiber and non-nutrient substances including antioxidants, are known to improve overall health. Carotenoid levels can be measured in skin providing an objective biomarker of long-term FV intake. This study aimed to explore the potential role of skin carotenoids as indicators of health status examining their associations with lifestyle factors among a cohort of young adults. This study aimed to explore the potential role of skin carotenoids as indicators of health status examining their associations with lifestyle factors among a cohort of young adults. Methods A sample of 2078 university students were enrolled at the University of Calabria, Italy. All participants underwent anthropometric measurements, assessment of the adherence to the Mediterranean Diet (MD) pattern by the Mediterranean Diet Adherence Screener (MEDAS) and Mediterranean Life Style Index (MEDLIFE) questionnaires and the skin carotenoid content by Veggie Meter®. Student’s t-test, chi-squared test, and univariate and multiple linear regressions were used for analyses. Results Participants had a mean BMI of 23.30 ± 3.79, which falls within the normal range as well as a medium adherence to the dietary (MEDAS: 7.19 ± 1.86) and lifestyle (MEDLIFE: 3.38 ± 1.21) MD patterns. Mean skin carotenoid levels were 360.61 ± 97.02, with higher carotenoid score in participants stocking up on FV from garden than market (368.28 ± 99.98 vs 357.84 ± 95.88, p  = 0.03). Moreover, skin carotenoids were significantly higher in participants declaring to consume more than 2 servings of vegetables and more than 3 servings of fruits/day compared to those having less FV intakes (391.67 ± 101.03 vs 349.27 ± 90.92, p  < 0.0001). Multiple regression analyses have revealed that the carotenoid score was positively associated with age, male gender, MEDAS, stocking up on FV from the garden and consuming high FV, while it was negatively associated with BMI and smoking habits. Conclusions Skin carotenoids are objective indicators of health status showing a positive association with the adherence to healthy diet and lifestyle behaviors among a cohort of young adults. Findings from this study may contribute to identify individuals with potential risk factors for NCDs and to develop public health strategies to encourage healthier lifestyles.