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Diet therapy or nutritional therapy has become a real challenge in the fight against the increasing number of modern illnesses such as obesity, diabetes, cardiovascular diseases and cancers. The scientific community has recognized the importance of studies that will support or rebut the association of certain nutrition/energy inputs with the prevention and/or improvement of certain diseases. Patient counseling is offered by medical doctors, nutritionists and dieticians, but patients often seek additional sources of information from popular media that may not be adequately scientifically supported. Whose responsibility is it when the Diet Therapy is not an effective treatment and where does the consequent ethical and moral responsibility lie?

This chapter argues for the importance of a nutritionally educated scientist evaluating the diets that are seen to be related with the health improvement also excluding diets that are mostly related to the patients’ well-being as the Mediterranean, DASH (Dietary Approaches to Stop Hypertension), Ketogenic and Vegetarian diet. Diet guidelines are often explained with linguistic variables (as “reduce the input of” etc.) which can be differently perceived by the end user. The interpretation if a linguistic variable is presented using the body mass index categories using a bell-shaped curve. The preferable area fits to the linguistic variable “acceptable BMI.” But also are indicated those areas which are less preferable. Those examples of information interpretations show the necessity of knowledge transfer. The quantity of information presented in diet guidelines can be experienced as a great muddle for patients; leaving them not knowing where and how to start. So, remains the ethical and moral responsibility of all links in the chain of nutritional and diet research and recommendations. Only objective and open-minded recommendations based on the latest scientific facts can gain confidence of the social, economical, and political subjects which must put the well-being of the population uppermost in their mind.

This study aims to identify the dietary patterns of two groups of subjects (with and without COVID-19), and to assess the relationship of findings with the prognosis of COVID-19 and metabolic risk parameters.

This study included 100 individuals in the age range of 19–65 years. The medical history, and data on biochemical, hematological and inflammatory indicators were retrieved from the files. A questionnaire for the 24-h food record and the food intake frequency was administered in face-to-face interviews, and dietary patterns of subjects were assessed.

In individuals with COVID-19, the hip circumference, the waist-hip ratio and the body fat percentage were significantly higher (p < 0.05), and the muscle mass percentage was significantly lower (p < 0.05). Mediterranean diet adherence screener (MEDAS), dietary approaches to stop hypertension (DASH) and healthy eating ındex-2015 (HEI-2015) scores were low in the two groups. A linear correlation of DASH scores was found with the muscle mass percentage (p = 0.046) and a significant inverse correlation of with the body fat percentage (p = 0.006). HEI-2015 scores were significantly and negatively correlated with body weight, body mass index, waist circumference, hip circumference and neck circumference (p < 0.05). Every one-unit increase in MEDAS, DASH and HEI-2015 scores caused reductions in C-reactive protein levels at different magnitudes. Troponin-I was significantly and negatively correlated with fruit intake (p = 0.044), a component of a Mediterranean diet and with HEI-2015 total scores (p = 0.032).

The limitation of this study includes the small sample size and the lack of dietary interventions. Another limitation is the use of the food recall method for the assessment of dietary patterns. This way assessments were performed based on participants’ memory and statements.

Following a healthy diet pattern can help reduce the metabolic risks of COVİD-19 disease.

Despite these limitations, this study is valuable because, to the best of the authors’ knowledge, it is the first study demonstrating the association of dietary patterns with disease prognosis and metabolic risks concerning COVID-19. This study suggests that dietary patterns during the COVID-19 process may be associated with several metabolic risks and inflammatory biomarkers.

Recently, evidences have suggested that healthy eating index (HEI), an index-based dietary pattern, may be a predictor for the risk of cancer. This paper aims to examine the association of HEI-2015 and its all components scores with the risk of breast cancer (BC), separately, among Iranian women.

In the present hospital-based, case-control study, 150 age-matched of cases (newly diagnosed female) and 150 controls were recruited. Data of dietary habits and anthropometric measures were obtained, and eventually, the HEI-2015 score was calculated. Multivariate odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the relationship between the risk of BC across tertiles (Ts) of total HEI-2015 and its all component scores.

The results presented that in adjusted model, there was no significant difference between total HEI-2015 (p = 0.14) and its all component scores (p > 0.09) of healthy subjects and females with BC. Moreover, multivariable logistic regression analyses indicated that HEI-2015 score was not associated with the risk of BC in either crude (p-trend = 0.94) or adjusted (p-trend = 0.73) analyses. In the analyses of HEI-2015 components scores, it was observed that the scores of grains (OR, 0.53; 95% CI, 0.30–0.94) and total protein foods (OR, 0.13; 95% CI, 0.02–0.58) may have a relation with BC risk in crude model but after adjusting for BC risk factors, the mentioned associations changed to non-significant.

The findings of current study suggested that there was no significant association of total HEI-2015 and its components scores, independently, with BC incidence among Iranian women.

Established data revealed a relationship between obesity and increasing the risk of mortality and morbidity of chronic diseases. There are conflicting data regarding the association between adherence of dietary approach to stop hypertension (DASH) and obesity. Therefore, this study aims to investigate this relationship among a large sample of Iranian adults.

This cross-sectional study was performed by 10,693 individuals; 6750 individuals related to Yazd Health Study living in the urban area and 3943 individuals related to Shahedieh cohort study living in the suburb area. Dietary intake was evaluated by using a validated food frequency questionnaire. In all participants, anthropometric indices including body mass index were measured. The DASH score was considered using gender-specific quintiles of DASH items. To evaluate the relationship of DASH diet and obesity, multivariate logistic regression analysis was used.

By adjusting confounders, participants in highest quintiles of DASH diet were compared to the lowest have lower odds of obesity in suburb area (odds ratio [OR]: 0.78; 95% confidence interval [CI]: 0.63, 0.96), in urban (OR: 0.71; 95% CI: 0.52, 0.99) and in whole population of both studies (OR: 0.75; 95% CI: 0.63, 0.90). Besides, more compliance of women to this diet in urban (OR: 0.64; 95% CI: 0.48, 0.85) and population of both studies (OR: 0.77; 95% CI: 0.62, 0.96) were associated with reduced odds of central obesity.

Considering this study limitations, the following can be mentioned: in this cross-sectional study, the causal relationship between DASH diet and obesity could not be assessed. Consequently, further prospective studies are required in this area. Second, although a valid food frequency questionnaire was used, but there was a measurement error and an error in the classification of people participating in the study. Moreover, we cannot reject the possibility of residual confounding bias because unknown or unmeasured confounders may exist that affected our results. Finally, our participants with odds of obesity might have been advised to reduce their fat intake, which led them to alter their dietary habits. However, such possibility cannot be resolved in a cross-sectional study.

DASH dietary pattern could decrease odds of obesity in both urban and suburb area and central obesity in urban area only. Further prospective studies are needed for causal conclusion.

The purpose of this paper is to investigate the effectiveness of consumer information and advice issued by the UK Food Standards Agency (FSA) in terms of consumer understanding.

A total of 118 female respondents in Scotland completed a questionnaire investigating their knowledge about the role of dietary salt and testing their understanding of educational material supplied by the FSA.

A significant proportion (p<0.01) of the respondents considered themselves to be health conscious and nutritionally aware, but they were less aware of their salt intake and specific “salt in the diet” details prior to FSA information.

The study is limited to a convenience sample of relatively advantaged consumers, so that further work is required with more vulnerable consumers.

A survey tool was employed that may be adapted to evaluate consumer information campaigns in any area of food policy.

The purpose of this paper is to examine the effect of mindfulness practice on health behaviors and quality of life (QOL) among hypertensive patients.

A quasi-experimental research was designed by before, after and a follow-up phase (i.e. on the 0th, 6th and 12th weeks). Two primary health care units (PCU) were selected as control and experiment groups. Samples included patients 35–59 years old who had been diagnosed with stage I hypertension. Both groups received treatment according to standard hypertension guidelines. The experimental group was added as a drill for the purpose of a mindfulness-based health education (MBHE) practice that would emphasize behavior skills (in diet, exercise and mental function) and instill a feeling of adaptation to everyday life.

The total mean score of the prevention and promotional hypertension behaviors (PPHB), QOL, perceived in mindfulness (MF) and self-efficacy (SE) in the experiment group showed a significant statistical difference when compared to the control group in the 6th week in PPHB and SE (p<0.001), QOL and MF (p=0.001). Similar results were found in the 12th week in PPHB, QOL, SE (p<0.001) and MF (p=0.023), respectively.

However, finished implementation in experiment group, during the follow-up phase on the 12th week, ten participants in the control group were excluded (Figure 1). It may be no active intervention or as usual in the control group. Thus, the authors controlled missing data using intention-to-treat analysis comparison and the data distribution was successfully tested by a normality plot before the use of statistical data. Based on the results of this study, the following recommendations can be made: patients should practice in mindfulness in lifestyle modification continued for intensive skill practice over the long term in order to promote sustainability in behavior and in QOL.

Mindfulness trainer should drill and faith in the value of mindfulness corporation owner with patients learning all of the times; and for health practitioner, it should add MBHE for patients.

Education institution should add mindfulness in educational programs all of graduates.

The mindfulness practice-based health education training should be in counterpart with modern medicine in order to promote sound health behaviors and an improved QOL for stage I hypertensive patients and to forestall cardiovascular and blood-pressure diseases.

This paper determined sodium provisions from a seven-day cycle menu and commissary at a rural Southwest County jail and compared it to Dietary Reference Intakes (DRI) and Dietary Approaches to Stop Hypertension (DASH) recommendations for sodium.

A seven-day cycle menu and commissary items were used to determine sodium content for each meal and commissary pack. Estimates for the menu and commissary packs paired with the menu (commissary scenarios) were converted to a daily average of sodium and compared to DRI and DASH recommendations.

Menu provisions provided 167% of daily DRI sodium recommendations and 256% of daily DASH sodium recommendations. The sodium content for individual commissary scenarios averaged 218% of DRI and 334% of DASH recommendations. Commissary items are notably high in sodium and if eaten can significantly exceed dietary recommendations.

Small changes to one meal within the cycle menu and the inclusion of fresh or frozen produce could reduce sodium content to align with DRI and DASH recommendations.

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. GDM is defined as glucose intolerance of variable severity with onset or first recognition during pregnancy. The purpose of this paper is to produce information on prevalence, screening and diagnosis, pathophysiology and dietary, medical and lifestyle management of GDM.

This literature review aimed to document and record the results of the most updated studies published dealing with dietary, medical and lifestyle factors in managing GDM.

The prevalence of GDM differs worldwide based on population characteristics, race/ethnicity and diagnostic criteria. The pathophysiology of GDM is multifactorial and it is likely that genetic and environmental factors are associated with the occurrence of GDM. Medical nutritional therapy remains the mainstay of GDM management and aerobic and resistance physical activities are helpful adjunctive therapy when euglycemia is not attained by the medical nutritional therapy alone. When diet and exercise fail to achieve glycemic control, pharmacological agents such as insulin therapy and oral hypoglycemic medications are prescribed. Plasma glucose measurement is an essential part of glycemic control during pregnancy, as well as glycemic control can be evaluated using indicators of glycemic control such as hemoglobin A1c (HbA1c), glycated albumin and fructosamine.

This review is a comprehensive review that illustrates the effect of healthy diet, medical therapy and lifestyle change on improving GDM condition.

Diet is recognized as a possible potential factor in migraine pathogenesis. Limited evidence exists on the effect of diet on pediatric migraine, so this paper aims to investigate the association between fruit and vegetable consumption and odds of migraine in children.

The authors conducted a case-control study in tertiary Sina hospital, Tehran, Iran. A hundred children with migraine as case group and 190 sex-matched healthy controls were included in this study. Definite diagnosis of migraine was based on 2018 international classification of headache disorder 3 (ICHD3) criteria. Demographic and anthropometric characteristics were collected. Common dietary intake of participants was obtained using a validated semi-quantitative food frequency questionnaire.

Children in the migraine group had significantly higher BMI and age compared with the control group (p-value = <0.01). After adjustment for age, gender, BMI and total energy intake, a significant association between higher intake of vegetables in second tertile (OR: 0.47; CI: 0.24-0.92), fruits in third tertile (OR: 0.31; CI:0.14-0.69) and fiber in fourth quartile (OR:0.28; CI:0.095-0.85) was obtained. Controlling for all confounders in Model 3, the odds of migraine, decreased by 50 per cent and 70 per cent as the consumption of vegetables and fruits increased, in the second tertile of vegetables (p-value = 0.04) and the third tertile of fruits (p-value = <0.01).

The findings confirm a plausible protective role of dietary fruits and vegetables against the risk of migraine in children, which can be attributed to the probable effect of dietary fiber.

The purpose of this paper is to examine whether line extensions (modified brands) create their own loyalties or induce variety-seeking within the brand. Prior research has explored how the branded house strategy (i.e. multiple products bearing the same brand name) retains customers from competing brands. However, this research investigates loyalty within the brand by comparing loyalty and variety-seeking rates of modified brands.

Markov chains examine behavioral loyalty and switching rates of panel households in the USA over several quarters for two family brands of carbonated beverages. Emphasis is placed on the consumers who purchase the upper median of volume (heavy half) and constitute a disproportionate amount of brand’s sales (86 per cent of the volume).

Three propositions find that loyalty rates are high among modified brands with little switching to other lines within the brand. Further, loyalty and switch to rates are highest for the flagship branded product (the master modified brand).

Managers segment the market using the branded house strategy, yet loyalty rates vary for each product line. The switching rates can guide managers as to which products have established a loyal consumer base.

While brand switching is a considerable research stream, this research is believed to be the first to explore loyalty versus variety-seeking in the branded house strategy.