280
Views
2
CrossRef citations to date
0
Altmetric
Article

An Evaluation of Metabolic, Dietetic, and Nutritional Status Reveals Impaired Nutritional Outcomes in Breast Cancer Patients

ORCID Icon, , , , &
Pages 3611-3622 | Received 18 Mar 2022, Accepted 17 Jun 2022, Published online: 28 Jun 2022

References

  • Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA A Cancer J Clin. 2021;71(3):209–41. doi:10.3322/caac.21660
  • Institute NC, José Alencar Gomes da Silva (INCA). Estimate/2020 – Cancer Incidence in Brazil. Rio de Janeiro. 2019.
  • Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang X-S, Bannon F, Ahn JV, Johnson CJ, Bonaventure A, et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). The Lancet. 2015;385(9972):977–1010. doi:10.1016/S0140-6736(14)62038-9
  • Lee K, Kruper L, Dieli-Conwright CM, Mortimer JE. The impact of obesity on breast cancer diagnosis and treatment. Curr Oncol Rep. 2019;21:41. doi:10.1007/s11912-019-0787-1
  • Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, Ballard-Barbash R. Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. JCO. 2005;23(4):774–82. doi:10.1200/JCO.2005.04.036
  • Caan BJ, Cespedes Feliciano EM, Prado CM, Alexeeff S, Kroenke CH, Bradshaw P, Quesenberry CP, Weltzien EK, Castillo AL, Olobatuyi TA, et al. Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol. 2018;4(6):798–804. doi:10.1001/jamaoncol.2018.0137
  • Marques VA, Ferreira-Junior JB, Lemos TV, Moraes RF, Junior JRdS, Alves RR, Silva MS, Freitas-Junior R d, Vieira CA. Effects of chemotherapy treatment on muscle strength, quality of life, fatigue, and anxiety in women with breast cancer. IJERPH. 2020;17(19):7289. doi:10.3390/ijerph17197289
  • Gupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL, Grutsch JF, Lis CG. Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer. 2008;8(1):1–7. doi:10.1186/1471-2407-8-249
  • Pagano AP, Sicchieri JMF, Schiavoni IL, Barbeiro D, Manca CS, da Silva BR, Bezerra AE, Pinto LCM, Araújo RC, Teixeira AC, et al. Phase angle as a severity indicator for liver diseases. Nutrition. 2020;70:110607. doi:10.1016/j.nut.2019.110607
  • Hui D, Dev R, Pimental L, Park M, Cerana MA, Liu D, Bruera E. Association between multi-frequency phase angle and survival in patients with advanced cancer. J Pain Symptom Manage. 2017;53(3):571–7. doi:10.1016/j.jpainsymman.2016.09.016
  • da Silva BR, Gonzalez MC, Cereda E, Prado CM. Exploring the potential role of phase angle as a marker of oxidative stress: a narrative review. Nutrition. 2022;93:111493. doi:10.1016/j.nut.2021.111493
  • Ramos da Silva B, Mialich MS, Cruz LP, Rufato S, Gozzo T, Jordao AA. Performance of functionality measures and phase angle in women exposed to chemotherapy for early breast cancer. Clin Nutr ESPEN. 2021;42:105–16. doi:10.1016/j.clnesp.2021.02.007
  • Godinho-Mota JCM, Mota JF, Gonçalves LV, Soares LR, Schincaglia RM, Prado CM, Martins KA, Freitas-Junior R. Chemotherapy negatively impacts body composition, physical function and metabolic profile in patients with breast cancer. Clin Nutr. 2021;40(5):3421–8. doi:10.1016/j.clnu.2020.11.020
  • Ramos da Silva B, Rufato S, Mialich MS, Cruz LP, Gozzo T, Jordao AA. Metabolic Syndrome and unfavorable outcomes on body composition and in visceral adiposities indexes among early breast cancer women post-chemotherapy. Clin Nutr ESPEN. 2021;44:306–15. doi:10.1016/j.clnesp.2021.06.001
  • Shah RV, Murthy VL, Abbasi SA, Blankstein R, Kwong RY, Goldfine AB, Jerosch-Herold M, Lima JAC, Ding J, Allison MA, et al. Visceral adiposity and the risk of metabolic syndrome across body mass index: the MESA study. JACC Cardiovasc Imaging. 2014;7(12):1221–35. doi:10.1016/j.jcmg.2014.07.017
  • Demirbas N, Kutlu R. Importance of measured body fat, visceral adiposity index, and lipid accumulation product index in predicting cardiometabolic risk factors. Metab Syndr Relat Disord. 2021;19(3):174–9. doi:10.1089/met.2020.0098
  • Ahn N, Baumeister SE, Amann U, Rathmann W, Peters A, Huth C, Thorand B, Meisinger C. Visceral adiposity index (VAI), lipid accumulation product (LAP), and product of triglycerides and glucose (TyG) to discriminate prediabetes and diabetes. Sci Rep. 2019;9(1):9693. doi:10.1038/s41598-019-46187-8
  • Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, Galluzzo A, for the AlkaMeSy Study Group. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920–2. doi:10.2337/dc09-1825
  • Vasques ACJ, Novaes FS, de Oliveira MdS, Souza JRM, Yamanaka A, Pareja JC, Tambascia MA, Saad MJA, Geloneze B. TyG index performs better than HOMA in a Brazilian population: a hyperglycemic clamp validated study. Diabetes Res Clin Pract. 2011;93(3):e98–100–e100. doi:10.1016/j.diabres.2011.05.030
  • Cardoso-Peña E, Soto Pina AE, Villanueva ÁG, López Chavez GE, Ramírez Martínez P, Ramírez Montoya H, Berumen Lechuga MG, Benitez Arciniega AD, Alarcón Fortepiani MdL, Valdés Ramos R, et al. Visceral adiposity index in breast cancer survivors: a case-control study. Int J Endocrinol. 2020;2020:1–6. doi:10.1155/2020/8874916
  • Mialich MS, Silva BR, Cruz L d, Almeida A d, Gozzo TdO, Jordao AA. Assessment of the nutritional and metabolic profile of women with breast cancer and its association with metabolic syndrome. Journal of Nutrition and Intermediary Metabolism. 2018;12:14–9. doi:10.1016/j.jnim.2018.05.004
  • Amaral P, Miguel R, Mehdad A, Cruz C, Grillo IM, Camilo M, et al. Body fat and poor diet in breast cancer women. Nutricion Hospitalaria. 2010;25:456–61. 10.3305/nh.2010.25.3.4418.
  • Buttros DDAB, Branco MT, Orsatti CL, Almeida-Filho BDS, Nahas-Neto J, Nahas EAP. High risk for cardiovascular disease in postmenopausal breast cancer survivors. Menopause. 2019;26:1024–30. 10.1097/GME.0000000000001348.
  • Tune JD, Goodwill AG, Sassoon DJ, Mather KJ. Cardiovascular consequences of metabolic syndrome. Transl Res. 2017;183:57–70. doi:10.1016/j.trsl.2017.01.001
  • Mehta LS, Watson KE, Barac A, Beckie TM, Bittner V, Cruz-Flores S, Dent S, Kondapalli L, Ky B, Okwuosa T, et al. Cardiovascular disease and breast cancer: where these entities intersect: a scientific statement from the American heart association. Circulation. 2018;137(8):e30-e66. doi:10.1161/CIR.0000000000000556
  • Barouki R, Gluckman PD, Grandjean P, Hanson M, Heindel JJ. Developmental origins of non-communicable disease: implications for research and public health. Environ Health. 2012;11:42–9. doi:10.1186/1476-069X-11-42
  • Bagyura Z, Kiss L, Lux Á, Csobay-Novák C, Jermendy ÁL, Polgár L, Szelid Z, Soós P, Merkely B. Association between coronary atherosclerosis and visceral adiposity index. Nutr Metab Cardiovasc Dis. 2020;30(5):796–803. doi:10.1016/j.numecd.2020.01.013
  • Cheng Y-L, Wang Y-J, Lan K-H, Huo T-I, Huang Y-H, Su C-W, Hsieh W-Y, Hou M-C, Lin H-C, Lee F-Y, et al. Fatty liver index and lipid accumulation product can predict metabolic syndrome in subjects without fatty liver disease. Gastroenterol Res Pract. 2017;2017:9279836. doi:10.1155/2017/9279836
  • Cartolano FDC, Pappiani C, Freitas MCP, de F, Neto AM, Carioca AAF, Damasceno NRT. Is lipid accumulation product associated with an atherogenic lipoprotein profile in Brazilian subjects? Arq Bras Cardiol. 2018;110:339–47. 10.5935/abc.20180054.
  • Haffner S, Taegtmeyer H. Epidemic obesity and the metabolic syndrome. Circulation. 2003;108(13):1541–5. doi:10.1161/01.CIR.0000088845.17586.EC
  • Rosa CdO, Santos C d, Leite JIA, Caldas APS, Bressan J. Impact of nutrients and food components on dyslipidemias: what is the evidence? Adv Nutr. 2015;6(6):703–11. doi:10.3945/an.115.009480
  • Lubkowska A, Dudzinska W, Bryczkowska I, Dobwgowska B, Romero FJ. Body composition, lipid profile, adipokine concentration, and antioxidant capacity changes during interventions to treat overweight with exercise programme and whole-body cryostimulation. Oxid Med Cell Longev. 2015;2015:803197. doi:10.1155/2015/803197
  • La Vecchia C, Negri E, Franceschi S, Talamini R, Bruzzi P, Palli D, Decarli A. Body mass index and post-menopausal breast cancer: an age-specific analysis. Br J Cancer. 1997;75(3):441–4. doi:10.1038/bjc.1997.73
  • Redig AJ, Munshi HG. Care of the cancer survivor: metabolic syndrome after hormone-modifying therapy. Am J Med. 2010;123(1):87.e1–87.e876. doi:10.1016/j.amjmed.2009.06.022
  • Lohman TG, et al. 1988. Anthropometric standardization reference manual. Human. 1940-Roche, Alex F. 1921. n.d. http://www.sciepub.com/reference/226305 (accessed May 6, 2020).
  • WHO/Europe | Nutrition - Body mass index – BMI. n.d. http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi (accessed May 6, 2020).
  • Nishikawa H, Yoh K, Enomoto H, Ishii N, Iwata Y, Nakano C, Takata R, Nishimura T, Aizawa N, Sakai Y, et al. Extracellular water to total body water ratio in viral liver diseases: a study using bioimpedance analysis. Nutrients. 2018;10(8):1072. doi:10.3390/nu10081072
  • Fess E. Clinical assessment recommendations: American Society of Hand Therapists. Garner: the Society; pp. 41–45. 1992.
  • Luna-Heredia E, Martín-Peña G, Ruiz-Galiana J. Handgrip dynamometry in healthy adults. Clin Nutr. 2005;24:250–8. 10.1016/j.clnu.2004.10.007.
  • Bielemann RM, Gigante DP, Horta BL. Birth weight, intrauterine growth restriction and nutritional status in childhood in relation to grip strength in adults: from the 1982 Pelotas (Brazil) birth cohort. Nutrition. 2016;32(2):228–35. doi:10.1016/j.nut.2015.08.014
  • Nightingale H, Walsh KJ, Olupot-Olupot P, Engoru C, Ssenyondo T, Nteziyaremye J, Amorut D, Nakuya M, Arimi M, Frost G, et al. Validation of triple pass 24-hour dietary recall in Ugandan children by simultaneous weighed food assessment. BMC Nutr. 2016;2(1):56. doi:10.1186/s40795-016-0092-4
  • Harttig U, Haubrock J, Knüppel S, Boeing H, on behalf of the EFCOVAL Consortium. The MSM program: web-based statistics package for estimating usual dietary intake using the multiple source method. Eur J Clin Nutr. 2011;65(S1):S87–S91. doi:10.1038/ejcn.2011.92
  • Haubrock J, Nöthlings U, Volatier J-L, Dekkers A, Ocké M, Harttig U, Illner A-K, Knüppel S, Andersen LF, Boeing H, European Food Consumption Validation Consortium, et al. Estimating usual food intake distributions by using the multiple source method in the EPIC-potsdam calibration study. J Nutr. 2011;141(5):914–20. doi:10.3945/jn.109.120394
  • Sartorelli DS, Barbieri P, Perdoná GCS. Fried food intake estimated by the multiple source method is associated with gestational weight gain. Nutr Res. 2014;34(8):667–73. doi:10.1016/j.nutres.2014.07.008
  • Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, Fearon K, Hütterer E, Isenring E, Kaasa S, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11–48. doi:10.1016/j.clnu.2016.07.015
  • Korczak R, Slavin JL. Definitions, regulations, and new frontiers for dietary fiber and whole grains. Nutr Rev. 2020;78(Suppl 1):6–12. doi:10.1093/nutrit/nuz061
  • 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. doi:10.1093/clinchem/18.6.499
  • Buzby GP, Knox LS, Crosby LO, Eisenberg JM, Haakenson CM, McNeal GE, Page CP, Peterson OL, Reinhardt GF, Williford WO, et al. Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients. Am J Clin Nutr. 1988;47(2 Suppl):366–81. doi:10.1093/ajcn/47.2.366
  • Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent J-P, Nicolis I, Benazeth S, Cynober L, Aussel C. Geriatric nutritional risk index: a new index for evaluating at-risk elderly medical patients. American Journal of Clinical Nutrition. 2005;82(4):777–83. doi:10.1093/ajcn/82.4.777
  • Nahler G, Nahler G. Lorentz-formula. Dictionary of Pharmaceutical Medicine. Vienna: Springer; 2009. p. 107. 10.1007/978-3-211-89836-9_803.
  • Aziz EF, Javed F, Pratap B, Musat D, Nader A, Pulimi S, Alivar CL, Herzog E, Kukin ML. Malnutrition as assessed by nutritional risk index is associated with worse outcome in patients admitted with acute decompensated heart failure: an ACAP-HF data analysis. Heart Int. 2011;6(1):e2–8. doi:10.4081/hi.2011.e2
  • Shin KA, Kim YJ. Usefulness of surrogate markers of body fat distribution for predicting metabolic syndrome in middle-aged and older Korean populations. DMSO. 2019;ume 12:2251–9. doi:10.2147/DMSO.S217628
  • Ioachimescu AG, Brennan DM, Hoar BM, Hoogwerf BJ. The lipid accumulation product and all-cause mortality in patients at high cardiovascular risk: a precis database study. Obesity. 2010;18(9):1836–44. doi:10.1038/oby.2009.453
  • Kouli G-M, Panagiotakos DB, Kyrou I, Georgousopoulou EN, Chrysohoou C, Tsigos C, Tousoulis D, Pitsavos C. Visceral adiposity index and 10-year cardiovascular disease incidence: the ATTICA study. Nutr Metab Cardiovasc Dis. 2017;27(10):881–9. doi:10.1016/j.numecd.2017.06.015
  • Costa EC, Sá J d, Soares EMM, Lemos TMAM, Maranhão TdO, Azevedo GD. Evaluation of cardiovascular risk by the LAP index in non-obese patients with polycystic ovary syndrome. Arq Bras Endocrinol Metabol. 2010;54(7):630–5. doi:10.1590/s0004-27302010000700007
  • Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299–304. doi:10.1089/met.2008.0034
  • Kahn HS. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord. 2005;5(1):26. doi:10.1186/1471-2261-5-26
  • de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110(16):2494–7. doi:10.1161/01.CIR.0000145117.40114.C7
  • Dong H, Xu Y, Zhang X, Tian S. Visceral adiposity index is strongly associated with hyperuricemia independently of metabolic health and obesity phenotypes. Sci Rep. 2017;7(1):8822. doi:10.1038/s41598-017-09455-z
  • Li X, Liu Z-l, Wu Y-t, Wu H, Dai W, Arshad B, Xu Z, Li H, Wu K-n, Kong L-q, et al. Status of lipid and lipoprotein in female breast cancer patients at initial diagnosis and during chemotherapy. Lipids Health Dis. 2018;17(1):1–6. doi:10.1186/s12944-018-0745-1
  • Hernandez AV, Guarnizo M, Miranda Y, Pasupuleti V, Deshpande A, Paico S, Lenti H, Ganoza S, Montalvo L, Thota P, et al. Association between insulin resistance and breast carcinoma: a systematic review and meta-analysis. PLoS ONE. 2014;9(6):e99317. doi:10.1371/journal.pone.0099317
  • Bell KE, Di Sebastiano KM, Vance V, Hanning R, Mitchell A, Quadrilatero J, Russell C, Dubin JA, Bahl M, Califaretti N, et al. A comprehensive metabolic evaluation reveals impaired glucose metabolism and dyslipidemia in breast cancer patients early in the disease trajectory. Clin Nutr. 2014;33(3):550–7. doi:10.1016/j.clnu.2013.08.001
  • Fair AM, Dai Q, Shu X-O, Matthews CE, Yu H, Jin F, Gao Y-T, Zheng W. Energy balance, insulin resistance biomarkers, and breast cancer risk. Cancer Detect Prev. 2007;31(3):214–9. doi:10.1016/j.cdp.2007.04.003
  • Lopot F, Nejedly B, Novotná H, Macková M, Sulková S. Age-related extracellular to total body water volume ratio (ECV/TBW) - Can it be used for “dry weight” determination in dialysis patients? Application of multifrequency bioimpedance measurement. International Journal of Artificial Organs. 2002;25(8):762–9. doi:10.1177/039139880202500803
  • Tanaka S, Ando K, Kobayashi K, Nakashima H, Seki T, Ishizuka S, Machino M, Morozumi M, Kanbara S, Ito S, et al. Higher extracellular water-to-total body water ratio more strongly reflects the locomotive syndrome risk and frailty than sarcopenia. Arch Gerontol Geriatr. 2020;88:104042. doi:10.1016/j.archger.2020.104042
  • Ferreira A, Gonçalves I, Moreira G, Vasconcellos J, Montella T, Peres W, Ferreira CG. P1.07-06 Use of the nutritional risk index as screening for malnutrition in patients with lung cancer. Journal of Thoracic Oncology. 2019;14(10):S489. doi:10.1016/j.jtho.2019.08.1015
  • Yoshimura da Costa T, Yukari Suganuma J, Faria S d, Bernardes Spexoto MC. Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in hospitalized individuals. Nutricion Hospitalaria. 2021;(3):519–24.10.20960/nh.03319.
  • Luque RM, López-Sánchez LM, Villa-Osaba A, Luque IM, Santos-Romero AL, Yubero-Serrano EM, Cara-García M, Álvarez-Benito M, López-Mirand A J, Gahete MD, et al. Breast cancer is associated to impaired glucose/insulin homeostasis in premenopausal obese/overweight patients. Oncotarget. 2017;8(46):81462–74. doi:10.18632/oncotarget.20399
  • Kojta I, Chacińska M, Błachnio-Zabielska A. Obesity, bioactive lipids, and adipose tissue inflammation in insulin resistance. Nutrients. 2020;12(5):1305. doi:10.3390/nu12051305
  • Fernández LP, de Cedrón M, de Molina A. Alterations of lipid metabolism in cancer: implications in prognosis and treatment. Front Oncol. 2020;10:577420. doi:10.3389/fonc.2020.577420
  • He T, Wang C, Tan Q, Wang Z, Li J, Chen T, Cui K, Wu Y, Sun J, Zheng D, et al. Adjuvant chemotherapy-associated lipid changes in breast cancer patients: a real-word retrospective analysis. Medicine. 2020;99(33):e21498. doi:10.1097/MD.0000000000021498
  • Jin J-L, Cao Y-X, Wu L-G, You X-D, Guo Y-L, Wu N-Q, Zhu C-G, Gao Y, Dong Q-T, Zhang H-W, et al. Triglyceride glucose index for predicting cardiovascular outcomes in patients with coronary artery disease. J Thorac Dis. 2018;10(11):6137–46. doi:10.21037/jtd.2018.10.79
  • Amato MC, Giordano C. Visceral adiposity index: an indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. doi:10.1155/2014/730827
  • Scanferla F, Landini S, Fracasso A, Morachiello P, Righetto F, Toffoletto PP, Bazzato G. On-line bioelectric impedance during haemodialysis: monitoring of body fluids and cell membrane status. Nephrology Dialysis Transplantation. 1990;5(suppl 1):167–70. doi:10.1093/ndt/5.suppl_1.167
  • Adu EA, Obirikorang C, Acheampong E, Kwakye AS, Fokuoh F, Obirikorang Y, Anto EO, Batu EN, Amoah BY, Ansong PN, et al. Lipid accumulation product (LAP) index as a potential risk assessment for cardiovascular risk stratification among type II diabetes mellitus in a Ghanaian population: a cross-sectional study. Cogent Medicine. 2019;6(1):1639880. doi:10.1080/2331205X.2019.1639880
  • Parry SA, Hodson L. Influence of dietary macronutrients on liver fat accumulation and metabolism. J Investig Med. 2017;65(8):1102–15. doi:10.1136/jim-2017-000524
  • Lee HA, An H. The effect of high carbohydrate-to-fat intake ratios on hypo-HDL-cholesterolemia risk and HDL-cholesterol levels over a 12-year follow-up. Sci Rep. 2020;10(1):913. doi:10.1038/s41598-020-57931-w
  • Ma Y, Li Y, Chiriboga DE, Olendzki BC, Hebert JR, Li W, Leung K, Hafner AR, Ockene IS. Association between carbohydrate intake and serum lipids. J Am Coll Nutr. 2006;25(2):155–63. doi:10.1080/07315724.2006.10719527
  • Limon-Miro AT, Lopez-Teros V, Astiazaran-Garcia H. Dietary guidelines for breast cancer patients: a critical review. Adv Nutr. 2017;8:613–23. 10.3945/an.116.014423.
  • Pérez EA, González MP, Martínez-Espinosa RM, Vila MDM, Reig García-Galbis M. Practical guidance for interventions in adults with metabolic syndrome: diet and exercise vs. changes in body composition. IJERPH. 2019;16(18):3481. doi:10.3390/ijerph16183481
  • Pérez-Martínez P, Mikhailidis DP, Athyros VG, Bullo M, Couture P, Covas MI, de Koning L, Delgado-Lista J, Díaz-López A, Drevon CA, et al. Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation. Nutr Rev. 2017;75(5):307–26. doi:10.1093/nutrit/nux014
  • Santiago-Torres M, Shi Z, Tinker LF, Lampe JW, Allison MA, Barrington W, Crane TE, Garcia DO, Hayden KM, Isasi CR, et al. Diet quality indices and risk of metabolic syndrome among postmenopausal women of Mexican ethnic descent in the Women’s Health Initiative Observational Study. Nutr Healthy Aging. 2020;5(4):261–72. doi:10.3233/NHA-190076
  • Di Daniele N, Noce A, Vidiri MF, Moriconi E, Marrone G, Annicchiarico-Petruzzelli M, D’Urso G, Tesauro M, Rovella V, De Lorenzo A, et al. Impact of Mediterranean diet on metabolic syndrome, cancer and longevity. Oncotarget. 2017;8(5):8947–79. doi:10.18632/oncotarget.13553

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.