Background and purpose: Lifestyle factors have been implicated in the long‐lasting neurodegenerative process in prodromal Parkinson's disease (pPD). The aim was to investigate the associations between adherence to a Mediterranean diet (MeDi) and longitudinal changes of pPD probability and the development of Parkinson's disease (PD) or pPD in a Mediterranean older population.Methods: Data from the Hellenic Longitudinal Investigation of Aging and Diet cohort (community‐dwelling individuals, aged ≥ 65 years) were used. A detailed food frequency questionnaire was used to evaluate dietary intake and calculate MeDi adherence score, ranging from 0 to 55, with higher scores indicating higher adherence. The probability of pPD was calculated according to the updated Movement Disorder Society research criteria.Results: In all, 1047 non‐PD/dementia with Lewy bodies (DLB) participants were followed for 3 ± 1 years. MeDi adherence was associated with lower increase in pPD probability over time (b = −0.003, 95% confidence interval −0.006 to −0.001, p = 0.010). Forty‐nine participants had incident possible/probable pPD (i.e., pPD probability ≥ 30%). Compared to the participants in the lowest quartile of MeDi adherence, those in the higher quartiles had an approximately 60%–70% lower risk for possible/probable pPD (p for trend 0.003). MeDi–pPD associations were driven by both motor and non‐motor pPD markers and not from risk markers. Also, 21 participants were diagnosed with PD/DLB at follow‐up. For each unit increase in the MeDi score, there was a 9%–10% lower risk for PD/DLB (hazard ratio 0.906 [95% confidence interval 0.823–0.997], p = 0.044).Conclusions: Mediterranean diet adherence is associated with lower increase in pPD probability over time and lower possible/probable pPD and PD/DLB incidence in older Mediterranean people. More studies are needed to confirm our results in other populations.

The ideal lifestyle intervention to battle both obesity and diabetes is currently unknown. The aim of this pilot uncontrolled intervention trial was to assess the effect of a modified Mediterranean diet (MedDiet) on weight loss and glucoregulation among overweight/obese adults. Eleven men and women with overweight/obesity, aged 37 ± 12 years, participated in a free-living intervention until 10% weight loss was achieved. Participants followed an individualized MedDiet high in monounsaturated fat and protein with decreased carbohydrate and saturated fat contents. Physical activity and dietary intake were monitored with pedometers and food records, respectively. Upon weight loss achievement, anthropometric measurements, blood metabolic profiles and individual responses to oral glucose and mixed-meal tests were evaluated pre- and post-intervention. The results showed significant ameliorations in body fat, waist circumference and leptin levels (p < 0.01), with concomitant increases in adiponectin–leptin ratios (p < 0.001). Glucoregulation was significantly improved according to glucose and insulin responses, homeostatic model assessment of insulin resistance indices and postprandial insulin sensitivity indices (p < 0.05). In conclusion, the modified Mediterranean diet may induce significant improvements in body composition, adipocytokine profile and glucose metabolism in overweight/obese individuals. Notably, ameliorated glycemia and increased insulin sensitivity may be retained even at postprandial level, irrespective of the meal consumed.

Research on hyponatremia during mountain marathons is scarce. The present study aimed to investigate the prevalence of exercise-associated hyponatremia during a 44-km trail running race that reached an altitude of 2780 m (Olympus Marathon). Sixty-two runners (five women) who completed the race participated in the study (age: 34.4 ± 8.6 years; height: 1.77 ± 0.06 m; and weight: 75.3 ± 10.0 kg). Anthropometric characteristics, blood, and urine samples were collected pre- and post-race. Food and fluid intake were recorded at each checkpoint. Due to race regulations, the runners could not carry any additional food and fluids besides the ones provided at specific checkpoints. Five runners (8%) exhibited asymptomatic hyponatremia (serum sodium <135 mmol∙L⁻¹). Serum sodium in the hyponatremic runners decreased from 138.4 ± 0.9 (pre) to 131.4 ± 5.0 mmol∙L⁻¹ (post), p < 0.05. Plasma osmolality increased only in the eunatremic runners (pre: 290 ± 3; post: 295 ± 6 mmol∙kg⁻¹; p < 0.05). Plasma volume decreased more in the hyponatremic compared to eunatremic runners (−4.4 ± 2.0 vs. −3.2 ± 1.4%, p < 0.05). Lastly, dietary sodium intake was lower in the hyponatremic runners compared to eunatremic (789 ± 813 vs. 906 ± 672 mg; p < 0.05). The incidence of hyponatremia among the athletes was relatively low, possibly due to race conditions.

Background/Objectives: Pressure to stay lean may lead adolescent athletes to dietary restraint and disordered eating. Lack of nutrition awareness can also contribute to suboptimal dietary habits, increasing the risk of eating disorders and Relative Energy Deficiency in Sport [RED-S], though evidence in competitive athletes is limited. This study explored eating disorder symptoms and RED-S knowledge in adolescent artistic gymnasts. Methods: Eighty-four female artistic gymnasts, thirty-nine international and national level gymnasts [high-level; 14 [14, 15] y] and forty-five recreational and club level gymnasts [low-level; 14 [13, 15] y] completed the Eating Disorder Examination Questionnaire [EDE-Q 6.0], the RED-S knowledge Questionnaire and provided training details. Results: Seventeen gymnasts (20.2%) scored above the cutoff point on the EDE-Q. In addition, high-level gymnasts scored higher than low-level on EDE-Q [2.21 ± 1.37 (35.9%) vs. 1.19 ± 0.79 (6.7%), respectively; p < 0.001] and on its subscales: Restraint, Eating Concerns, Weight Concerns, and Shape Concerns [p < 0.001 to 0.009], thus indicating more severe disordered eating symptoms. No group differences were found in binge eating and compensatory behaviors. An important percentage of gymnasts reported at least one episode of binge eating and excessive training [39.3–58.3%], while four gymnasts reported self-induced vomiting. RED-S knowledge did not differ between groups. On average, gymnasts were unaware of correct answers related to RED-S [51.5%], its definitions [79.8–92.9%], and its association with menstrual disturbances and bone health [54.8–86.9%]. However, gymnasts reported better awareness of the impact of food restriction on illness and performance [47.6–84.5%]. Conclusions: Elite artistic gymnasts exhibited a higher prevalence of eating disorder symptoms than lower-level peers. Gymnasts at all levels demonstrated limited knowledge of the effects of RED-S on menstrual and bone health. Failure to recognize these risks may influence gymnasts’ eating behaviors and delay RED-S detection and management.