Dietary Patterns in the Ageing European Population: an Interdisciplinary Approach to combat Overweight-Related Metabolic Diseases. The EURODIET project

Impact of Diet, Food Components and Food Processing on Body Weight Regulation and Overweight Related Metabolic Diseases (METADIS 2019)
Dietary Patterns in the Ageing European Population: an Interdisciplinary Approach to combat Overweight-Related Metabolic Diseases. The EURODIET project
Fawzi Kadi
Örebro University


Partner Organization Partner Country
Hospital Clínico Universitario in Valencia, INCLIVA,Spain
Department of Economics, University of BarcelonaSpain
Alma Mater Studiorum-University of Bologna- Dept. of Experimental, Diagnostic and Specialty Medicine;Italy

1. Overall project description

1.1 Summary

An epidemic of overweight/obesity, metabolic syndrome and cardio-metabolic diseases is emerging at planetary level, and healthy nutrition represents a critical help to counteract this trend. Unfortunately, simplistic guidelines failed totally or partially, mainly because of the complexity and heterogeneity of nutrition/dietary habits in humans. EURODIET will tackle such complexity and the urgent/unmet need of integrated studies by investigating how the combination of variables usually analyzed separately (ethnicity/geography, sex/gender, socio-economic status/education, previous dietary habits, physical activity and smoking) affects adoption of healthy dietary habits and conventional as well as novel metabolic and inflammatory biomarkers in a large number of subjects spanning from 50 to 79 years of age. This approach is feasible being EURODIET a multidisciplinary consortium having access to existing datasets/biological samples of large European projects SHARE and NU-AGE. EURODIET  will: i) integrate existing cohorts and collect new ad hoc data (e.g. omics-based biomarker identification); ii) perform a follow-up study on dietary habits, health status and incident diseases on a subsample of subjects based on existing data collected at two time points within the NU-AGE project; iii) perform two proof-of-concept randomized controlled trials to assess the effects of adherence to a healthy a whole-diet approach in adults with and without metabolic disease; iv) determine facilitators and barriers for adherence to healthy dietary patterns; v) bridge the gap between academic research, public health practice and the food production industry; vi) provide state-of-the-art training to young scientists focusing on the importance of addressing/combining biological and non-biological variables in dietary interventions and metabolic diseases.

1.2 Highlights

In the first year of the project, EURODIET has generated new data evidencing the beneficial impact of mediteranean diet on the occurrence of chronic diseases in older European adults after adjutments with several socio-demographic factors and provided in depth-knowledge on the role of fat subtypes and protein amount and source on skeletal muscle, an important metabolic organ. Further experimental work is warranted in order to elucidate the mechanisms underpinning the action of dietary fibre on the regulation of muscle mass. 

Using isocaloric substitution modelling, a reduced sarcopenia risk was observed when increasing plant protein to the detriment of animal protein, while holding total protein intake constant. Further, this result remained significant after stratifying the analysis by adherence to different levels of protein intake. Our findings suggest that older adults may benefit from increasing protein intakes above current recommendations. Besides total amount, protein source should be considered when promoting health dietary habits in older adults for the prevention of sarcopenia.

We have also shown that a reduction of saturated fatty acids for the benefit of polyunsaturated fatty acids is associated with a lower sarcopenia risk, particularly in those with a protein intake below current guidelines, irrespective of age, smoking habits, metabolic disturbances, and adherence to physical activity guidelines. 

In the second year of the project, in series of work devoted to depict the role of plant-based diets in prevention of metabolic diseases, we have preliminarily shown that fruit and vegetable (FV) intake in general and vegetables in particular is associated to a reduced likelihood of having the metabolic syndrome in older adults. This finding is independent of adherence to health-enhancing physical activity and time spent sedentary. Additionally, we have shown for the first time that adherence to healthy dietary patterns is related to beneficial impacts on indicators of muscle health. We have also conducted a randomized controlled trial to determine the effect of increased FV intake on metabolic and inflammatory biomarkers in older men and women. Based on an educational approach, the intervention successfully doubled the FV intake in the experimental group only. Importantly, the increased FV intake was accompanied by a significant reduction in pro-inflammatory biomarkers, indicating the potential of plant-based diets in reducing systemic inflammation. We have also collected a large set of qualitative data regarding attitudes and barriers for adoption of healthy dietary habits in older men and women with elevated metabolic risk

4. Impact

4.1 List of publications

AuthorsTitleYear, Issue, PPPartners NumberDoiPdf
Diego Montiel-Rojas *, Andreas Nilsson* , Aurelia Santoro * , Alberto Bazzocchi , Lisette C P G M de Groot , Edith J M Feskens , Agnes A M Berendsen , Dawid Madej, Joanna Kaluza , Barbara Pietruszka , Amy Jennings , Susan Fairweather-Tait , Giuseppe Battista , Miriam Capri , Claudio Franceschi* , Fawzi Kadi*Fighting Sarcopenia in Ageing European Adults: The Importance of the Amount and Source of Dietary Proteins2020 Nov 24;12(12):3601. 1,4 doi: 10.3390/nu12123601.
Judit Vall Castelló* , Charisse TubianosaLinking Mediterranean Diet and Lifestyle with Cardio Metabolic Disease and Depressive Symptoms: A Study on the Elderly in Europe2020 Sep 26;17(19):7053. 3doi: 10.3390/ijerph17197053
Diego Montiel-Rojas* , Aurelia Santoro* , Andreas Nilsson*, Claudio Franceschi *, Miriam Capri, Alberto Bazzocchi , Giuseppe Battista , Lisette C P G M de Groot, Edith J M Feskens , Agnes A M Berendsen , Agata Bialecka-Debek , Olga Surala , Barbara Pietruszka, Susan Fairweather-Tait , Amy Jennings , Frederic Capel , Fawzi Kadi *Beneficial Role of Replacing Dietary Saturated Fatty Acids with Polyunsaturated Fatty Acids in the Prevention of Sarcopenia: Findings from the NU-AGE Cohort2020 Oct 9;12(10):3079. 1,4 doi: 10.3390/nu12103079.
Nilsson A*, Cano A*, Bergens O*, Kadi F*.Randomized Controlled Trial for Promotion of Healthy Eating in Older Adults by Increasing Consumption of Plant-Based Foods: Effect on Inflammatory Biomarkers. 2021 Oct 24;13(11):37531,2doi: 10.3390/nu13113753
Papaioannou KG, Nilsson A, Nilsson LM, Kadi FHealthy Eating Is Associated with Sarcopenia Risk in Physically Active Older Adults2021 Aug 16;13(8):2813. 1doi: 10.3390/nu13082813.
Bergens O, Nilsson A, Kadi F.Associations between Circulating Inflammatory Biomarkers and Indicators of Muscle Health in Older Men and Women. 2021 Nov 15;10(22):5316. 1doi: 10.3390/jcm10225316.
Edholm P, Veen J, Kadi F, Nilsson A. . Muscle mass and aerobic capacity in older women: Impact of regular exercise at middle age2021 May;147:1112591doi: 10.1016/j.exger.2021.11125
Veen J, Montiel-Rojas D, Nilsson A, Kadi FEngagement in Muscle-Strengthening Activities Lowers Sarcopenia Risk in Older Adults Already Adhering to the Aerobic Physical Activity Guidelines. 2021 Jan 22;18(3):9891doi: 10.3390/ijerph18030989
Santoro A, Zhao J, Wu L, Carru C, Biagi E, Franceschi CMicrobiomes other than the gut: inflammaging and age- related diseases.2020, 42:589-6054
Tavella T, Rampelli S, Guidarelli G, Bazzocchi A, Gasperini C, Pujos-Guillot E, Comte B, Barone M, Biagi E, Candela M, Nicoletti C, Kadi F, Battista G, Salvioli S, O'Toole PW, Franceschi C, Brigidi P, Turroni S, Santoro A. . . .Elevated gut microbiome abundance of Christensenellaceae, Porphyromonadaceae and Rikenellaceae is associated with reduced visceral adipose tissue and healthier metabolic profile in Italian elderly2021, 13:1-191,4
Conte M, Martucci M, Mosconi G, Chiariello A, Cappuccilli M, Totti V, Santoro A, Franceschi C, Salvioli S.GDF15 Plasma Level Is Inversely Associated With Level of Physical Activity and Correlates With Markers of Inflammation and Muscle Weakness2020, 11:915.4
Conte M, Sabbatinelli J, Chiariello A, Martucci M, Santoro A, Monti D, Arcaro M, Galimberti D, Scarpini E, Bonfigli AR, Giuliani A, Olivieri F, Franceschi C, Salvioli S. . . .Disease-specific plasma levels of mitokines FGF21, GDF15, and Humanin in type II diabetes and Alzheimer's disease in comparison with healthy aging2021, 43:985-10014
Conte M, Santoro A, Collura S, Martucci M, Battista G, Bazzocchi A, Morsiani C, Sevini F, Capri M, Monti D, Franceschi C, Salvioli S.Circulating perilipin 2 levels are associated with fat mass, inflammatory and metabolic markers and are higher in women than men2021, 13:7931-79424
Santoro A, Bientinesi E, Monti D. Immunosenescence and inflammaging in the aging process: age-related diseases or longevity?2021, 71:101422.4

4.2 Presentation of the project

Target groupAuthorsMeans of communicationHyperlinkPdf

4.3 List of submitted patents and other outputs

Patent licencePartners involvedYearInternational eu or national patentCommentPdf

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This project has received funding from the European Union’s
H2020 Research and Innovation Programme under grant agreement n.696300

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