@misc{GalbeteSchwingshacklSchwedhelmetal.2018,
  author    = {Galbete, Cecilia and Schwingshackl, Lukas and Schwedhelm, Carolina and Boeing, Heiner and Schulze, Matthias Bernd},
  title     = {Evaluating Mediterranean diet and risk of chronic disease in cohort studies},
  series = {European journal of epidemiology},
  volume    = {33},
  journal   = {European journal of epidemiology},
  number    = {10},
  publisher = {Springer},
  address   = {Dordrecht},
  issn      = {0393-2990},
  doi       = {10.1007/s10654-018-0427-3},
  pages     = {909 -- 931},
  year      = {2018},
  abstract  = {Several meta-analyses have been published summarizing the associations of the Mediterranean diet (MedDiet) with chronic diseases. We evaluated the quality and credibility of evidence from these meta-analyses as well as characterized the different indices used to define MedDiet and re-calculated the associations with the different indices identified. We conducted an umbrella review of meta-analyses on cohort studies evaluating the association of the MedDiet with type 2 diabetes, cardiovascular disease, cancer and cognitive-related diseases. We used the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist to evaluate the methodological quality of the meta-analyses, and the NutriGrade scoring system to evaluate the credibility of evidence. We also identified different indices used to define MedDiet; tests for subgroup differences were performed to compare the associations with the different indices when at least 2 studies were available for different definitions. Fourteen publications were identified and within them 27 meta-analyses which were based on 70 primary studies. Almost all meta-analyses reported inverse associations between MedDiet and risk of chronic disease, but the credibility of evidence was rated low to moderate. Moreover, substantial heterogeneity was observed on the use of the indices assessing adherence to the MedDiet, but two indices were the most used ones [Trichopoulou MedDiet (tMedDiet) and alternative MedDiet (aMedDiet)]. Overall, we observed little difference in risk associations comparing different MedDiet indices in the subgroup meta-analyses. Future prospective cohort studies are advised to use more homogenous definitions of the MedDiet to improve the comparability across meta-analyses.},
  language  = {en}
}
@misc{Schulze2018,
  author    = {Schulze, Matthias Bernd},
  title     = {Metabolic health in normal-weight and obese individuals},
  series = {Diabetologia : journal of the European Association for the Study of Diabetes (EASD)},
  volume    = {62},
  journal   = {Diabetologia : journal of the European Association for the Study of Diabetes (EASD)},
  number    = {4},
  publisher = {Springer},
  address   = {New York},
  issn      = {0012-186X},
  doi       = {10.1007/s00125-018-4787-8},
  pages     = {558 -- 566},
  year      = {2018},
  abstract  = {Cardiovascular complications are commonly associated with obesity. However, a subgroup of obese individuals may not be at an increased risk for cardiovascular complications; these individuals are said to have metabolically healthy obesity (MHO). In contrast, metabolically unhealthy individuals are at high risk of cardiovascular disease (CVD), irrespective of BMI; thus, this group can include individuals within the normal weight category (BMI 18.5-24.9kg/m(2)). This review provides a summary of prospective studies on MHO and metabolically unhealthy normal-weight (MUHNW) phenotypes. Notably, there is ongoing dispute surrounding the concept of MHO, including the lack of a uniform definition and the potentially transient nature of metabolic health status. This review highlights the relevance of alternative measures of body fatness, specifically measures of fat distribution, for determining MHO and MUHNW. It also highlights alternative approaches of risk stratification, which account for the continuum of risk in relation to CVD, which is observable for most risk factors. Moreover, studies evaluating the transition from metabolically healthy to unhealthy phenotypes and potential determinants for such conversions are discussed. Finally, the review proposes several strategies for the use of epidemiological research to further inform the current debate on metabolic health and its determination across different stages of body fatness.},
  language  = {en}
}