SIRT4 and obesity due to melanocortin 4 receptor deficiency: The positive association between the adherence to the MD and circulating levels of Sirt4 suggests that the Sirt4 increase might represent further aspects of the antioxidant and antitumor advantage in obese individuals of the Mediterranean dietary pattern and support the role of qualified nutritionists as members of integrated multidisciplinary teams in the complex management of obesity.