{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T02:06:52Z","timestamp":1770775612643,"version":"3.50.0"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Commission Research Executive Agency (REA) Grant BIORISE","award":["669026"],"award-info":[{"award-number":["669026"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Huntington\u2019s disease (HD) is a rare progressive neurodegenerative disease characterised by autosomal dominant inheritance. The past decade saw a growing interest in the associations between the Mediterranean Diet (MD) and HD risk and outcomes. The aim of this case-control study was to assess the dietary intake and habits of Cypriot HD patients, comparing them to gender and age-matched controls, using the Cyprus Food Frequency Questionnaire (CyFFQ) and to assess adherence to the MD by disease outcomes. The method relied on the validated CyFFQ semi-quantitative questionnaire to assess energy, macro- and micronutrient intake over the past year in n = 36 cases and n = 37 controls. The MedDiet Score and the MEDAS score were used to assess adherence to the MD. Patients were grouped based on symptomatology such as movement and cognitive and behavioral impairment. The two-sample Wilcoxon rank-sum (Mann\u2013Whitney) test was used to compare cases vs. controls. Statistically significant results were obtained for energy intake (kcal\/day) (median (IQR): 4592 (3376) vs. 2488 (1917); p = 0.002) from cases and controls. Energy intake (kcal\/day) (median (IQR): 3751 (1894) vs. 2488 (1917); p = 0.044) was also found to be significantly different between asymptomatic HD patients and controls. Symptomatic patients were also different from controls in terms of energy intake (kcal\/day) (median (IQR): 5571 (2907) vs. 2488 (1917); p = 0.001); % energy monounsaturated fatty acids (median (IQR): 13.4 (5.2) vs. 15.5 (5.7); p = 0.0261) and several micronutrients. A significant difference between asymptomatic and symptomatic HD patients was seen in the MedDiet score (median (IQR): 31.1 (6.1) vs. 33.1 (8.1); p = 0.024) and a significant difference was observed between asymptomatic HD patient and controls (median (IQR): 5.5 (3.0) vs. 8.2 (2.0); p = 0.014) in the MEDAS score. This study confirmed previous findings that HD cases have a significantly higher energy intake than controls, revealing differences in macro and micronutrients and adherence to the MD by both patients and controls and by HD symptom severity. These findings are important as they are an effort to guide nutritional education within this population group and further understand diet\u2013disease associations.<\/jats:p>","DOI":"10.3390\/nu15051136","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T01:37:52Z","timestamp":1677202672000},"page":"1136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Investigating the Dietary Intake Using the CyFFQ Semi-Quantitative Food Frequency Questionnaire in Cypriot Huntington\u2019s Disease Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6071-1715","authenticated-orcid":false,"given":"Christiana","family":"Christodoulou","sequence":"first","affiliation":[{"name":"Neuroepidemiology Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-2880","authenticated-orcid":false,"given":"Christiana","family":"Demetriou","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia 2371, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0300-9572","authenticated-orcid":false,"given":"Elena","family":"Philippou","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus"},{"name":"Department of Nutritional Sciences, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Papanicolaou","sequence":"additional","affiliation":[{"name":"Neuroepidemiology Department, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/S0140-6736(07)60111-1","article-title":"Huntington\u2019s Disease","volume":"369","author":"Walker","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1124\/jpet.112.192138","article-title":"Mitochondrial Dysfunction in Neurodegenerative Diseases","volume":"342","author":"Johri","year":"2012","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1750-1172-5-40","article-title":"Huntington\u2019s Disease: A Clinical Review","volume":"5","author":"Roos","year":"2010","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_4","first-page":"153","article-title":"Juvenile Onset Huntington\u2019s Disease\u2014Clinical and Research Perspectives","volume":"7","author":"Nance","year":"2001","journal-title":"MRDD Res. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8590578","DOI":"10.1155\/2016\/8590578","article-title":"The Role of Reactive Oxygen Species in the Pathogenesis of Alzheimer\u2019s Disease, Parkinson\u2019s Disease, and Huntington\u2019s Disease: A Mini Review","volume":"2016","author":"Manoharan","year":"2016","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1111\/cge.13168","article-title":"Epidemiology of Huntington Disease in Cyprus: A 20-Year Retrospective Study","volume":"93","author":"Demetriou","year":"2018","journal-title":"Clin. Genet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.pjnns.2014.10.006","article-title":"Huntington Disease\u2014Principles and Practice of Nutritional Management","volume":"48","year":"2014","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2217\/nmt.11.69","article-title":"Nutritional Management of Individuals with Huntington\u2019s Disease: Nutritional Guidelines","volume":"2","author":"Brotherton","year":"2012","journal-title":"Neurodegener. Dis. Manag."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Russell, R.D., Black, L.J., and Begley, A. (2022). Nutrition Education Programs for Adults with Neurological Diseases Are Lacking: A Scoping Review. Nutrients, 14.","DOI":"10.3390\/nu14081577"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Christodoulou, C.C., Demetriou, C.A., and Zamba-papanicolaou, E. (2020). Dietary Intake, Mediterranean Diet Adherence and Caloric Intake in Huntington\u2019s Disease: A Review. Nutrients, 12.","DOI":"10.3390\/nu12102946"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1212\/WNL.0b013e3181b04aa2","article-title":"Dietary Intake in Adults at Risk for Huntington Disease","volume":"73","author":"Marder","year":"2009","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mochel, F., Charles, P., Seguin, F., Barritault, J., Coussieu, C., Perin, L., Le Bouc, Y., Gervais, C., Carcelain, G., and Vassault, A. (2007). Early Energy Deficit in Huntingdon Disease: Identification of a Plasma Biomarker Traceable during Disease Progression. PLoS ONE, 2.","DOI":"10.1371\/journal.pone.0000647"},{"key":"ref_13","first-page":"912","article-title":"Mediterranean Diet and Cardiodiabesity: A Systematic Review through Evidence-Based Answers to Key Clinical Questions","volume":"11","author":"Farooqui","year":"2019","journal-title":"Curr. Opin. Biotechnol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s13668-013-0041-7","article-title":"Mediterranean Diet and Minimizing Neurodegeneration","volume":"2","author":"Sofi","year":"2013","journal-title":"Curr. Nutr. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Farooqui, A.A., and Farooqui, T. (2018). Role of the Mediterranean Diet in the Brain and Neurodegenerative Diseases, Elsevier.","DOI":"10.1016\/B978-0-12-811959-4.00001-8"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.clnesp.2016.01.001","article-title":"Factors Associated with Mediterranean Diet Adherence in Huntington\u2019s Disease","volume":"12","author":"Rivadeneyra","year":"2016","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/jhn.13032","article-title":"Relative Validity and Reproducibility of the CyFFQ Semi-Quantitative Food Frequency Questionnaire for Assessing Dietary Intake in Cypriot Adults","volume":"36","author":"Philippou","year":"2022","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Huntington Study Group Unified (1996). Huntington\u2019s Disease Rating Scale: Reliability and Consistency. Mov. Disord., 11, 136\u2013142.","DOI":"10.1002\/mds.870110204"},{"key":"ref_19","unstructured":"Otten, J.J., Hellwig, J.P., and Linda, D. (2006). Dietary DRI Reference Intakes, The National Academic Press."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.ypmed.2006.12.009","article-title":"Adherence to the Mediterranean Food Pattern Predicts the Prevalence of Hypertension, Hypercholesterolemia, Diabetes and Obesity, among Healthy Adults; the Accuracy of the MedDietScore","volume":"44","author":"Panagiotakos","year":"2007","journal-title":"Prev. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Gonz\u00e1lez, M.A., Garc\u00eda-Arellano, A., Toledo, E., Salas-Salvad\u00f3, J., Buil-Cosiales, P., Corella, D., Covas, M.I., Schr\u00f6der, H., Ar\u00f3s, F., and G\u00f3mez-Gracia, E. (2012). A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0043134"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1177\/147323000803600505","article-title":"Reduction in Cerebral Atrophy Associated with Ethyl-Eicosapentaenoic Acid Treatment in Patients with Huntington\u2019s Disease","volume":"36","author":"Puri","year":"2008","journal-title":"J. Int. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1212\/01.wnl.0000169025.09670.6d","article-title":"Ethyl-EPA in Huntington Disease","volume":"65","author":"Puri","year":"2005","journal-title":"Neurology"},{"key":"ref_24","first-page":"263","article-title":"L-Acetyl-Carnitine in Huntington Disease: Double Blind Placebo Controlled Cross-over Study of Drug Effects on Movement Disorder and Dementia","volume":"5","author":"Goetz","year":"1990","journal-title":"Mov. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1002\/mds.22907","article-title":"The Relationship between Uric Acid Levels and Huntington\u2019s Disease Progression","volume":"25","author":"Auinger","year":"2010","journal-title":"Mov. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/j.nut.2004.12.012","article-title":"Use of Oral Nutritional Supplements in Patients with Huntington\u2019s Disease","volume":"21","author":"Trejo","year":"2005","journal-title":"Nutrition"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3233\/JHD-140139","article-title":"Relationship between Nutritional Status and the Severity of Huntington\u2019s Disease. A Spanish Multicenter Dietary Intake Study","volume":"4","author":"Cubo","year":"2015","journal-title":"J. Huntingt. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1172\/JCI45691","article-title":"Energy Deficit in Huntington Disease: Why It Matters","volume":"121","author":"Mochel","year":"2011","journal-title":"J. Clin. Investig."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"199","DOI":"10.14746\/sr.2017.1.1.16","article-title":"Unbalanced Distribution of Food","volume":"1","author":"Sarikaya","year":"2017","journal-title":"Soc. Regist."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.nutres.2021.11.001","article-title":"The Consumption of Energy Dense Snacks and Some Contextual Factors of Snacking May Contribute to Higher Energy Intake and Body Weight in Adults","volume":"96","author":"Bajerska","year":"2021","journal-title":"Nutr. 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