Antonio Capurso · Gaetano Crepaldi Cristiano Capurso Benefits of the Mediterranean Diet in the Elderly Patient Practical Issues in Geriatrics

Practical Issues in Geriatrics Series Editor: Stefania Maggi Antonio Capurso · Gaetano Crepaldi Cristiano Capurso Benefits of the Mediterranean Diet in the Elderly Patient Practical Issues in Geriatrics Series Editor Stefania Maggi Ageing Branch CNR-Neuroscience Institute Padua Italy This practically oriented series presents state of the art knowledge on the principal diseases encountered in older persons and addresses all aspects of management, including current multidisciplinary diagnostic and therapeutic approaches. It is intended as an educational tool that will enhance the everyday clinical practice of both young geriatricians and residents and also assist other specialists who deal with aged patients. Each volume is designed to provide comprehensive information on the topic that it covers, and whenever appropriate the text is complemented by additional material of high educational and practical value, including informative video-clips, standardized diagnostic flow charts and descriptive clinical cases. Practical Issues in Geriatrics will be of value to the scientific and professional community worldwide, improving understanding of the many clinical and social issues in Geriatrics and assisting in the delivery of optimal clinical care. More information about this series at http://www.springer.com/series/15090 Antonio Capurso • Gaetano Crepaldi Cristiano Capurso Benefits of the Mediterranean Diet in the Elderly Patient Antonio Capurso Gaetano Crepaldi Department of Internal Medicine Department of Biomedical Science School of Medicine CNR Neuroscience Institute University of Bari Padua Bari Italy Italy Cristiano Capurso Department of Medical and Surgical Sciences School of Medicine, University of Foggia Foggia Italy ISSN 2509-6060 ISSN 2509-6079 (electronic) Practical Issues in Geriatrics ISBN 978-3-319-78083-2 ISBN 978-3-319-78084-9 (eBook) https://doi.org/10.1007/978-3-319-78084-9 Library of Congress Control Number: 2018944287 © Springer International Publishing AG, part of Springer Nature 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recita- tion, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by the registered company Springer International Publishing AG part of Springer Nature. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface This book illustrates the role of the Mediterranean diet in connection with well- being and particularly its impact on health and elderly care, as well as on the mechanisms of aging. Aging is a natural process of human life. The knowledge that a healthy dietary regimen like the Mediterranean diet can effectively prevent or delay many diseases typically affecting aging people may help to better manage the aging process. From this point of view, knowledge of the numerous benefits of the Mediterranean-style diet may effectively reduce the burden of elderly care. As early as the 1950s, Ancel Keys pointed out the effectiveness of the Mediterranean diet in helping to control, and possibly avoid, myocardial infarction and in improving cholesterol metabolism. Quite soon after the first studies were published, it became clear that the Mediterranean diet was beneficial in the preven- tion and management of not only cardiovascular disease but also many other diseases, from diabetes to hypertension, from cancer and thrombosis to neurodegenerative diseases, including dementia. The biological effects of the Mediterranean diet appear to be due to the synergis- tic effects of its phytochemicals. This is why no single component can replace the combination of natural phytochemicals of the Mediterranean diet to achieve the observed health benefits. In this context, the Mediterranean diet with its main component virgin olive oil has been shown to exert a potent anti-inflammatory, anti- oxidant, and anti- cancer activity. The many components of Mediterranean diet, and particularly the polyphenols of virgin olive oil, promote these protective effects through epigenetic mechanisms, modifying the gene transcription activity toward a protective mode. Examining those benefits in detail, this book offers a valuable educational tool for young professionals and caregivers, as well as for students and trainees in geriatrics and nutrition. Bari, Italy Antonio Capurso Padua, Italy Gaetano Crepaldi Foggia, Italy Cristiano Capurso v Acknowledgements The authors would like to acknowledge the assistance of Ms. Linda Inverso in edit- ing some of the book’s chapters. This book has been endorsed by the “Fondazione Dieta Mediterranea, Ostuni, Italy” https://www.fondazionedietamediterranea.it/. vii Contents 1 The Historical Origins and Composition of Mediterranean Diet �� 1 1.1 The Historical Scenario of Mediterranean Diet Around 1000 AD . 1 1.2 The Implementation of the Mediterranean Diet Along the Centuries �� 3 1.3 The Rediscovery of the Mediterranean Diet . 4 1.4 What Is the Mediterranean Diet? �� 5 1.5 The First Studies on the Mediterranean Diet . 7 1.5.1 The Rockefeller Foundation Report: The Cretan Study . 7 1.5.2 The Meeting of Ancel Keys with the Mediterranean Diet �� 8 References ................................................. 9 2 Extra-Virgin Olive Oil (EVOO): History and Chemical Composition 11 2.1 The History of Olive Oil and Olive Trees 11 2.2 Olive Oil Composition 14 2.2.1 The Saponifiable Fraction . 15 2.2.2 The Unsaponifiable Fraction . 16 References ........................................................... 21 3 Extra-Virgin Olive Oil and Cardiovascular Disease . 23 3.1 Premises: Cardiovascular Disease ........................... 23 3.2 The History of CHD Risk Factors ........................... 23 3.3 EVOO and CHD ........................................ 26 3.4 EVOO and CHD: The Epidemiological Studies ................ 27 3.5 EVOO and CHD: The Impact of EVOO at the Molecular and Clinical Level ....................................... 29 3.5.1 Its Impact at the Molecular Level . 29 3.5.2 Its Impact at the Clinical and Laboratory Level . 34 3.5.3 Thrombosis: Factor VII . 43 3.5.4 Platelets . 45 References ................................................. 48 4 Extra-Virgin Olive Oil and Type 2 Diabetes Mellitus �� 57 4.1 Premises: Insight Into Type 2 Diabetes Mellitus ................ 57 ix x Contents 4.2 Epidemiology ........................................... 57 4.3 Visceral Obesity, Metabolic Syndrome, and T2DM ............. 58 4.3.1 Insulin Resistance . 58 4.3.2 Mechanisms of Adipogenesis and Fat Accumulation . 59 4.3.3 Visceral Fat: Role and Metabolism . 59 4.4 The Impact of Extra-Virgin Olive Oil on Type 2 DM ............ 67 4.4.1 EVOO Reduces the Risk of Type 2 DM . 67 4.4.2 EVOO and MUFA Improve Glycemic Control �� 68 4.4.3 EVOO and the Pro-inflammatory State �� 69 4.4.4 Phenolic Compounds in EVOO �� 70 References ................................................... 73 5 Extra-virgin Olive Oil, the Mediterranean Diet, and Neurodegenerative Diseases �� 81 5.1 Premises ............................................... 81 5.2 Mild Cognitive Impairment (MCI) and the Mediterranean Diet .... 81 5.3 The Incidence of MCI and the Rate of Progression to Dementia ... 84 5.4 The Mediterranean Diet and the Incidence of Dementia .......... 85 5.5 The Mediterranean Diet and Parkinson’s Disease ............... 89 References ................................................. 91 6 Extra-virgin Olive Oil and Cancer . 97 6.1 Premises ............................................... 97 6.2 Adherence to the Mediterranean Diet and Cancer ............... 98 6.3 Olive Oil and Cancer ..................................... 99 6.3.1 Breast Cancer �� 100 6.3.2 Colorectal Cancer. 102 6.3.3 Pancreatic Cancer �� 103 6.3.4 Stomach Cancer �� 103 6.3.5 Esophageal Cancer �� 104 6.3.6 Cancer of the Larynx ��

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