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Gregory S, Buller‐Peralta I, Bridgeman K, Góngora VDLC, Dounavi M, Low A, Ntailianis G, O'Brien J, Parra MA, Ritchie CW, Ritchie K, Shannon OM, Stevenson EJ, Muniz‐Terrera G. The Mediterranean diet is not associated with neuroimaging or cognition in middle-aged adults: a cross-sectional analysis of the PREVENT dementia programme. Eur J Neurol 2024; 31:e16345. [PMID: 38794967 PMCID: PMC11236004 DOI: 10.1111/ene.16345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 05/02/2024] [Indexed: 05/27/2024]
Abstract
BACKGROUND AND PURPOSE The Mediterranean diet (MedDiet) has been associated with reduced dementia incidence in several studies. It is important to understand if diet is associated with brain health in midlife, when Alzheimer's disease and related dementias are known to begin. METHODS This study used data from the PREVENT dementia programme. Three MedDiet scores were created (the Pyramid, Mediterranean Diet Adherence Screener [MEDAS] and MEDAS continuous) from a self-reported food frequency questionnaire. Primary outcomes were hippocampal volume and cube-transformed white matter hyperintensity volume. Secondary outcomes included cornu ammonis 1 and subiculum hippocampal subfield volumes, cortical thickness and measures of cognition. Sex-stratified analyses were run to explore differential associations between diet and brain health by sex. An exploratory path analysis was conducted to study if any associations between diet and brain health were mediated by cardiovascular risk factors for dementia. RESULTS In all, 504 participants were included in this analysis, with a mean Pyramid score of 8.10 (SD 1.56). There were no significant associations between any MedDiet scoring method and any of the primary or secondary outcomes. There were no differences by sex in any analyses and no significant mediation between the Pyramid score and global cognition by cardiovascular risk factors. CONCLUSIONS Overall, this study did not find evidence for an association between the MedDiet and either neuroimaging or cognition in a midlife population study. Future work should investigate associations between the MedDiet and Alzheimer's disease and related dementias biomarkers as well as functional neuroimaging in a midlife population.
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Affiliation(s)
- Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- Scottish Brain SciencesEdinburghUK
| | - Ingrid Buller‐Peralta
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Katie Bridgeman
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - Vanessa De La Cruz Góngora
- Global Brain Health Institute, Institute of NeuroscienceTrinity College DublinDublinIreland
- Centre for Evaluation and Survey ResearchNational Institute of Public HealthCuernavacaMexico
| | - Maria‐Eleni Dounavi
- Department of Psychiatry, School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Audrey Low
- Department of Psychiatry, School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Georgios Ntailianis
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - John O'Brien
- Department of Psychiatry, School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Mario A. Parra
- Department of Psychological Sciences and HealthUniversity of StrathclydeGlasgowUK
| | - Craig W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- Scottish Brain SciencesEdinburghUK
- Mackenzie InstituteUniversity of St AndrewsSt AndrewsUK
| | - Karen Ritchie
- INM, Université de Montpellier, INSERMMontpellierFrance
| | - Oliver M. Shannon
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Emma J. Stevenson
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Faculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- Ohio University Heritage College of Osteopathic MedicineOhio UniversityAthensOhioUSA
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Vázquez-Bolea N, Andueza N, Cuervo M, Navas-Carretero S. A Higher Adherence to the ALINFA Nutritional Intervention Is Effective for Improving Dietary Patterns in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:559. [PMID: 38790554 PMCID: PMC11120244 DOI: 10.3390/children11050559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024]
Abstract
Food patterns are deteriorating and, consequently, not meeting nutritional recommendations. Learning about the adherence to a diet is crucial for understanding children's dietary habits. The objective of the present analysis was to assess the degree of compliance with the ALINFA nutritional intervention and the effectiveness of adherence groups, and to evaluate potential baseline factors predicting a higher adherence to the intervention. A total of 44 children aged 6 to 12 years-old participated in the eight-week intervention. A two-week dietary plan was specifically designed, providing participants with food products, ready-to-eat dishes, and recipes. An intake of 75% of calories of the prescribed diet was defined to divide the participants into high- and low-adherence groups (HA/LA, respectively). From the 44 participants, 24 showed a LA to the intervention, whereas 20 of them were in the HA group. Diet quality improved in both groups (p < 0.001), mainly by increasing cereals and nuts, and reducing pastries. A decrease in BMI z-score was observed (LA: p < 0.001; HA: p = 0.021). Fat mass (p = 0.002), LDL-c (p = 0.036), and CRP (p = 0.023) reductions were only achieved in the HA group, whereas leptin decreased only in the LA group (p = 0.046). All participants ameliorated their dietary habits, but those with better diet quality at baseline experienced greater enhancements in their nutritional status.
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Affiliation(s)
- Natalia Vázquez-Bolea
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Naroa Andueza
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
| | - Marta Cuervo
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Santiago Navas-Carretero
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (N.V.-B.); (N.A.); (S.N.-C.)
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III, 28029 Madrid, Spain
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3
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Poklar Vatovec T, Jenko Pražnikar Z, Petelin A. Adherence and Sociodemographic Determinants of Adherence to the Mediterranean Diet among Slovenian Adults and the Elderly. Nutrients 2023; 15:3219. [PMID: 37513637 PMCID: PMC10384731 DOI: 10.3390/nu15143219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The Mediterranean diet (MD) is considered a model for good health, and is promoted worldwide as one of the healthiest dietary patterns. Despite the MD's health benefits, the literature suggests that adherence to the MD tends to be in decline in most populations worldwide, including those in the Mediterranean region. The aim of this study was to investigate adherence to the MD, and its main sociodemographic and lifestyle factors, in the Slovenian population. Using a nationwide cross-sectional food consumption survey (SI.Menu), data were collected from a general questionnaire, from the 14-item MD adherence screener (14-MEDAS score), and from a questionnaire on the dietary habits of 850 adults and elderly people. The mean MEDAS score for the total study sample was 5.6 (SD 2.1), indicating a low adherence to the MD among the Slovenian population. The adherence to the MD was higher among women (OR = 1.534; 95% Cl 1.156-2.034), those with a university degree (OR = 1.527; 1.098-2.125; compared to those with no university degree), those who lived in a suburb or city (OR = 1.511; 1.016-2.249; OR = 1.568; 1.122-2.191; compared with those who lived in a village), non-smokers (OR = 1.561; 1.380-1.830; compared with smokers), and those who lived in the western part of Slovenia (OR = 1.558; 1.170-2.074; compared with those who lived in eastern Slovenia). Adherence to the MD in the Slovenian population is low, and is strongly related to educational level, gender, geographic region, place of residence, and smoking status. The frequency of the consumption of different food groups is also closely related.
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Affiliation(s)
- Tamara Poklar Vatovec
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Zala Jenko Pražnikar
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
| | - Ana Petelin
- Faculty of Health Sciences, University of Primorska, Polje 42, SI-6310 Izola, Slovenia
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4
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Fernandez-Lazaro CI, Toledo E, Buil-Cosiales P, Salas-Salvadó J, Corella D, Fitó M, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Martín Sánchez V, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Ros E, Vázquez C, Daimiel L, SanJulián B, García-Gavilán JF, Sorlí JV, Castañer O, Zulet MÁ, Tojal-Sierra L, Pérez-Farinós N, Oncina-Canovas A, Moñino M, Garcia-Rios A, Sacanella E, Bernal-Lopez RM, Santos-Lozano JM, Vázquez-Ruiz Z, Muralidharan J, Ortega-Azorín C, Goday A, Razquin C, Goicolea-Güemez L, Ruiz-Canela M, Becerra-Tomás N, Schröder H, Martínez González MA. Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial. Eur J Nutr 2021; 61:1457-1475. [PMID: 34846603 PMCID: PMC8921156 DOI: 10.1007/s00394-021-02697-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25–1.83; OR12-month: 1.66, 95% CI 1.37–2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07–2.46; OR12-month: 1.62, 95% CI 1.07–2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53–0.79; OR12-month: 0.76, 95% CI 0.62–0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64–0.99; OR12-month: 0.71, 95% CI 0.57–0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. Trial registration ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02697-8.
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Affiliation(s)
- Cesar I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Pilar Buil-Cosiales
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Servicios de Atención Primaria, Navarra Regional Health Service (Osasunbidea), IdiSNA, Pamplona, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071, Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Luís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands-IUNICS and IDISBA, Palma de Mallorca, Spain
| | - Vicente Martín Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat,, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes Y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.,Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Clotilde Vázquez
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Beatriz SanJulián
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain
| | - Jesús F García-Gavilán
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
| | - Jose V Sorlí
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Olga Castañer
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - M Ángeles Zulet
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Lucas Tojal-Sierra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Napoleón Pérez-Farinós
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Epi-Phaan Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071, Málaga, Spain
| | | | - Manuel Moñino
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio Garcia-Rios
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Emilio Sacanella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Rosa M Bernal-Lopez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Zenaida Vázquez-Ruiz
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jananee Muralidharan
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain
| | - Carolina Ortega-Azorín
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Alberto Goday
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Leire Goicolea-Güemez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Nerea Becerra-Tomás
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Universitat Rovira I Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Helmut Schröder
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), Barcelona, Spain
| | - Miguel A Martínez González
- Department of Preventive Medicine and Public Health, NavarraUniversity of Navarra, IdiSNA, C/ Irunlarrea, 31008, Pamplona, Spain. .,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Pletsch-Borba L, Wernicke C, Apostolopoulou K, Spira D, Pohrt A, Hornemann S, Gerbracht C, Pfeiffer AFH, Spranger J, Mai K. Nutritional counseling frequency and baseline food pattern predict implementation of a high-protein and high-polyunsaturated fatty acid dietary pattern: 1-year results of the randomized NutriAct trial. Clin Nutr 2021; 40:5457-5466. [PMID: 34656026 DOI: 10.1016/j.clnu.2021.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/26/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS NutriAct is a 36-month randomized controlled multi-center trial designed to analyze the effects of a food pattern focusing on a high-protein and high-unsaturated fatty acids (UFA) intake on healthy aging. We aimed to determine factors associated with a successful modulation of dietary pattern after 12 months in elderly participants. METHODS 502 participants were randomized into either usual care control group including dietary recommendations of the German Nutrition Society (DGE) or an intervention group, which used supplementation of rapeseed oil and specifically designed foods as well as repetitive advices to implement a food pattern based on high intake of predominantly plant proteins, UFA and fiber (NutriAct pattern). Food intake was repeatedly assessed by 3-day food records at months 0, 3, 6 and 12. Linear regression models were used to investigate determinants of basal food intake and modulation of dietary pattern during the intervention. RESULTS Food records of 242 intervention and 246 control participants (median age 66 y, 37% males) were available at baseline and were included. At baseline, high BMI was related to higher protein and saturated fatty acids and lower fiber intake. The intervention resulted in higher intake of protein, mono- and polyunsaturated fatty acids (MUFA and PUFA) and fiber, and lower carbohydrate and saturated fatty acid consumption (all p < 0.001). While individuals who were already at baseline closer to the NutriAct pattern also achieved a diet closer to the proposed pattern at month 12, the strongest absolute changes (%E) of dietary behavior were seen in those with dietary patterns further away from the proposed pattern at baseline. Attendance to nutritional sessions was crucial to change MUFA, PUFA, fiber and carbohydrate intake. CONCLUSIONS A successful modification of dietary pattern was achieved by the performed intervention within 12 months. Baseline dietary habits and attendance to nutritional sessions were substantial determinants predicting changes in dietary pattern. CLINICAL TRIAL REGISTRATION The trial was registered at German Clinical Trials Register (drks.de) as DRKS00010049.
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Affiliation(s)
- Laura Pletsch-Borba
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Charlotte Wernicke
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Konstantina Apostolopoulou
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Dominik Spira
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany
| | - Anne Pohrt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Germany
| | - Silke Hornemann
- Human Study Center, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany
| | - Christiana Gerbracht
- Human Study Center, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Andreas F H Pfeiffer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; Human Study Center, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany
| | - Joachim Spranger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany.
| | - Knut Mai
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Endocrinology and Metabolism, 10117, Berlin, Germany; NutriAct-Competence Cluster Nutrition Research Berlin, Potsdam, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health; Charité Center for Cardiovascular Research, 10117, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
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Choo J, Yang HM, Park S, Park M, Park YM, Lim DS. Appointment Adherence to a City-Wide Cardiovascular Disease Prevention Program: Its Predictors and Outcomes. Asia Pac J Public Health 2021; 33:555-563. [PMID: 34041933 DOI: 10.1177/10105395211012912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study identified predictors of appointment adherence and examined its impacts on improvements in metabolic risk factors in a free city-wide cardiovascular disease prevention program in Seoul, South Korea. Data of 8251 citizens with metabolic syndrome were used. Appointment adherers were defined as having 70% or higher adherence rates, that is, 3 or more visits. Of the 8251 citizens, 17.6% were appointment adherers. Appointment adherers were significantly more likely to be older, low-income earners, nonsmokers, and nonobese than appointment nonadherers. Moreover, appointment adherers, compared with nonadherers, showed significant improvements in waist circumference, systolic blood pressure, and high-density lipoprotein cholesterol, but not in fasting glucose and triglycerides. Designing strategies for increasing appointment adherence to a free city-wide cardiovascular disease prevention program is essential to improve health outcomes, especially targeting population groups with young age, high-income, current smoking, or obesity.
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Affiliation(s)
- Jina Choo
- College of Nursing, Korea University, Seoul, South Korea.,Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea
| | - Hwa-Mi Yang
- College of Nursing, Korea University, Seoul, South Korea
| | - Sooyeon Park
- College of Nursing, Korea University, Seoul, South Korea
| | - MiSuk Park
- Metabolic Syndrome Management Center of Seoul Metropolitan Government, Seoul, South Korea
| | - Yoo Mi Park
- Citizens' Health Bureau, Seoul Metropolitan Government, Seoul, South Korea
| | - Do-Sun Lim
- Metabolic Syndrome Management Center of Seoul Metropolitan Government, Seoul, South Korea.,Department of Cardiology, School of Medicine, Korea University, Seoul, South Korea
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7
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Kyprianidou M, Christophi CA, Giannakou K. Quarantine during COVID-19 outbreak: Adherence to the Mediterranean diet among the Cypriot population. Nutrition 2021; 90:111313. [PMID: 34119718 DOI: 10.1016/j.nut.2021.111313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/25/2021] [Accepted: 04/25/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this study was to analyze adherence to the Mediterranean diet among the adult general population of Cyprus during the COVID-19 confinement. METHODS This was an Internet-based, cross-sectional study that collected information about socioeconomic and demographic characteristics, adherence to the Mediterranean diet and other dietary details, physical activity levels, and smoking habits using a self-administered questionnaire. The survey was conducted between April 6 and June 20, 2020, 1 to 2.5 mo after the initiation of the social confinement measures. RESULTS There were 1485 Cypriot adults who participated in the study. The median Mediterranean diet score was 21 (q1 = 19, q3 = 24) with men, married individuals, residents of rural regions, and physically active participants being more adherent to the Mediterranean diet compared with women; unmarried, divorced, or widowed; residents of urban regions; and physically inactive participants, respectively (P < 0.05). Multinomial logistic regression showed that being ≥45 y of age and physically active was positively associated with the Mediterranean diet score, whereas being unmarried, divorced, or widowed and a current smoker was negatively associated with the Mediterranean diet score (P < 0.05). CONCLUSIONS Adherence to the Mediterranean diet during the confinement imposed due to the COVID-19 pandemic among the Cypriot adult population was associated with male sex, age >45 y, being married, being physically active, and being resident of rural regions. The importance of better understanding of nutritional behavior during COVID-19 lockdowns is emphasized so public health authorities can plan future lockdown policies on nutritional recommendations, should a new pandemic occur.
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Affiliation(s)
- Maria Kyprianidou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus.
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Diet Quality Indices in the SUN Cohort: Observed Changes and Predictors of Changes in Scores Over a 10-Year Period. J Acad Nutr Diet 2021; 121:1948-1960.e7. [PMID: 33906824 DOI: 10.1016/j.jand.2021.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dietary quality indices (DQI) are widely used in nutritional epidemiology. However, how they might change over time in a Mediterranean population is not well understood. OBJECTIVE To evaluate within-participant longitudinal changes in scores for nine a priori-defined DQIs: Fat Quality Index (FQI), Carbohydrate Quality Index (CQI), Pro-vegetarian Dietary Pattern (PVG), Mediterranean Diet Adherence Screener (MEDAS), Mediterranean Diet Score (MDS), Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND), Prime Diet Quality Score (PDQS) and Alternate Healthy Eating Index (AHEI-2010) in the "Seguimiento Universidad de Navarra" (SUN) cohort, a well-known Mediterranean cohort of university graduates, and to identify baseline predictors of improvement in MEDAS and AHEI-2010 after 10 years of follow-up. DESIGN In this longitudinal cohort study, DQI scores were calculated based on responses from a validated semiquantitative food-frequency questionnaire (FFQ). PARTICIPANTS/SETTING Spanish university graduates enrolled in the SUN cohort before March 2008, who completed the 10-year FFQ and reported total dietary intake at baseline and after 10 years of follow-up, included 2,244 men and 3,271 women, whose mean age at baseline was 36.3 years (standard deviation [SD], 10.7). MAIN OUTCOME MEASURES Main outcome measures were within-participant longitudinal changes for FQI, CQI, PVG, MEDAS, MDS, DASH, MIND, PDQS, and AHEI-2010. STATISTICAL ANALYSES PERFORMED Adjusted logistic regression models were used to evaluate within-participant longitudinal changes and to identify baseline predictors of improvements ≥10% in MEDAS and AHEI-2010 scores after 10 years of follow-up. RESULTS The comparison of the nine scores of DQI calculated at baseline and after 10 years of follow-up showed an improvement in all DQI scores except for PDQS. The greatest changes in DQIs were found for MEDAS (from 6.2 to 7.2, +22.9%) and MDS (from 4.3 to 4.4, +15.4%). The strongest predictors at baseline for ≥10% improvements in MEDAS or AHEI-2010 scores varied across indices. Being female, ≥35 years old, and more physically active at baseline were associated with improvement, whereas snacking between meals was associated with <10% improvements in both indices. CONCLUSIONS In this cohort, the changes in nine a priori-defined DQI scores suggested modest improvements in diet quality, in which MEDAS and MDS scores showed the largest improvements. Additional longitudinal studies, especially intervention trials with long follow-up, are warranted to establish the most appropriate DQIs to assess long-term changes in diet quality in adult populations.
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Correlates of a southern diet pattern in a national cohort study of blacks and whites: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Br J Nutr 2021; 126:1904-1910. [PMID: 33632366 DOI: 10.1017/s0007114521000696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Southern dietary pattern, derived within the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, is characterised by high consumption of added fats, fried food, organ meats, processed meats and sugar-sweetened beverages and is associated with increased risk of several chronic diseases. The aim of the present study was to identify characteristics of individuals with high adherence to this dietary pattern. We analysed data from REGARDS, a national cohort of 30 239 black and white adults ≥45 years of age living in the USA. Dietary data were collected using the Block 98 FFQ. Multivariable linear regression was used to calculate standardised beta coefficients across all covariates for the entire sample and stratified by race and region. We included 16 781 participants with complete dietary data. Among these, 34·6 % were black, 45·6 % male, 55·2 % resided in stroke belt region and the average age was 65 years. Black race was the factor with the largest magnitude of association with the Southern dietary pattern (Δ = 0·76 sd, P < 0·0001). Large differences in Southern dietary pattern adherence were observed between black participants and white participants in the stroke belt and non-belt (stroke belt Δ = 0·75 sd, non-belt Δ = 0·77 sd). There was a high consumption of the Southern dietary pattern in the US black population, regardless of other factors, underlying our previous findings showing the substantial contribution of this dietary pattern to racial disparities in incident hypertension and stroke.
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10
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Storz MA. Adherence to Low-Fat, Vegan Diets in Individuals With Type 2 Diabetes: A Review. Am J Lifestyle Med 2020; 16:300-310. [DOI: 10.1177/1559827620964755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022] Open
Abstract
Low-fat, vegan diets seem to be particularly effective for glycemic control and may significantly lower hemoglobin A1c levels in individuals with type 2 diabetes. However, health care providers report low levels of practice and argue that this diet is hard to follow. This controversy on the acceptability of low-fat vegan diets appears to be a significant barrier to its broader clinical implementation. This review investigated dropout and adherence rates in intervention studies using a low-fat vegan diet in individuals with type 2 diabetes. In contrast to the common belief that this diet is poorly accepted, this review suggests different findings. Dietary adherence appears to be good with approximately 50% of individuals meeting the criteria for high adherence in most studies. Adherence to a low-fat vegan diet was higher than adherence to conventional diets in several studies. Group support and regular supervision improve adherence. Moreover, relatively low dropout rates were found—indirectly indicating good acceptance and high patient interest in this particular dietary modification. Although this review has several important limitations, it appears inappropriate to associate low-fat, vegan diets with poor adherence in individuals with type 2 diabetes. With good and regular support, adherence rates are more than solid and physicians should advocate for this diet more frequently.
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11
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Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2020; 8:CD011737. [PMID: 32827219 PMCID: PMC8092457 DOI: 10.1002/14651858.cd011737.pub3] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS We included 15 randomised controlled trials (RCTs) (16 comparisons, 56,675 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 17% (risk ratio (RR) 0.83; 95% confidence interval (CI) 0.70 to 0.98, 12 trials, 53,758 participants of whom 8% had a cardiovascular event, I² = 67%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 53. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Nicole Martin
- Institute of Health Informatics Research, University College London, London, UK
| | - Oluseyi F Jimoh
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Christian Kirk
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Eve Foster
- Norwich Medical School, University of East Anglia, Norwich, UK
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12
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Hooper L, Abdelhamid AS, Jimoh OF, Bunn D, Skeaff CM. Effects of total fat intake on body fatness in adults. Cochrane Database Syst Rev 2020; 6:CD013636. [PMID: 32476140 PMCID: PMC7262429 DOI: 10.1002/14651858.cd013636] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The ideal proportion of energy from fat in our food and its relation to body weight is not clear. In order to prevent overweight and obesity in the general population, we need to understand the relationship between the proportion of energy from fat and resulting weight and body fatness in the general population. OBJECTIVES To assess the effects of proportion of energy intake from fat on measures of body fatness (including body weight, waist circumference, percentage body fat and body mass index) in people not aiming to lose weight, using all appropriate randomised controlled trials (RCTs) of at least six months duration. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) to October 2019. We did not limit the search by language. SELECTION CRITERIA Trials fulfilled the following criteria: 1) randomised intervention trial, 2) included adults aged at least 18 years, 3) randomised to a lower fat versus higher fat diet, without the intention to reduce weight in any participants, 4) not multifactorial and 5) assessed a measure of weight or body fatness after at least six months. We duplicated inclusion decisions and resolved disagreement by discussion or referral to a third party. DATA COLLECTION AND ANALYSIS We extracted data on the population, intervention, control and outcome measures in duplicate. We extracted measures of body fatness (body weight, BMI, percentage body fat and waist circumference) independently in duplicate at all available time points. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity, funnel plot analyses and GRADE assessment. MAIN RESULTS We included 37 RCTs (57,079 participants). There is consistent high-quality evidence from RCTs that reducing total fat intake results in small reductions in body fatness; this was seen in almost all included studies and was highly resistant to sensitivity analyses (GRADE high-consistency evidence, not downgraded). The effect of eating less fat (compared with higher fat intake) is a mean body weight reduction of 1.4 kg (95% confidence interval (CI) -1.7 to -1.1 kg, in 53,875 participants from 26 RCTs, I2 = 75%). The heterogeneity was explained in subgrouping and meta-regression. These suggested that greater weight loss results from greater fat reductions in people with lower fat intake at baseline, and people with higher body mass index (BMI) at baseline. The size of the effect on weight does not alter over time and is mirrored by reductions in BMI (MD -0.5 kg/m2, 95% CI -0.6 to -0.3, 46,539 participants in 14 trials, I2 = 21%), waist circumference (MD -0.5 cm, 95% CI -0.7 to -0.2, 16,620 participants in 3 trials; I2 = 21%), and percentage body fat (MD -0.3% body fat, 95% CI -0.6 to 0.00, P = 0.05, in 2350 participants in 2 trials; I2 = 0%). There was no suggestion of harms associated with low fat diets that might mitigate any benefits on body fatness. The reduction in body weight was reflected in small reductions in LDL (-0.13 mmol/L, 95% CI -0.21 to -0.05), and total cholesterol (-0.23 mmol/L, 95% CI -0.32 to -0.14), with little or no effect on HDL cholesterol (-0.02 mmol/L, 95% CI -0.03 to 0.00), triglycerides (0.01 mmol/L, 95% CI -0.05 to 0.07), systolic (-0.75 mmHg, 95% CI -1.42 to -0.07) or diastolic blood pressure(-0.52 mmHg, 95% CI -0.95 to -0.09), all GRADE high-consistency evidence or quality of life (0.04, 95% CI 0.01 to 0.07, on a scale of 0 to 10, GRADE low-consistency evidence). AUTHORS' CONCLUSIONS Trials where participants were randomised to a lower fat intake versus a higher fat intake, but with no intention to reduce weight, showed a consistent, stable but small effect of low fat intake on body fatness: slightly lower weight, BMI, waist circumference and percentage body fat compared with higher fat arms. Greater fat reduction, lower baseline fat intake and higher baseline BMI were all associated with greater reductions in weight. There was no evidence of harm to serum lipids, blood pressure or quality of life, but rather of small benefits or no effect.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Oluseyi F Jimoh
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Diane Bunn
- Norwich Medical School, University of East Anglia, Norwich, UK
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13
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Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2020; 5:CD011737. [PMID: 32428300 PMCID: PMC7388853 DOI: 10.1002/14651858.cd011737.pub2] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS We included 15 randomised controlled trials (RCTs) (16 comparisons, ~59,000 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21% (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.66 to 0.93, 11 trials, 53,300 participants of whom 8% had a cardiovascular event, I² = 65%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 32. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Nicole Martin
- Institute of Health Informatics Research, University College London, London, UK
| | - Oluseyi F Jimoh
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Christian Kirk
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Eve Foster
- Norwich Medical School, University of East Anglia, Norwich, UK
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Maternal profile according to Mediterranean diet adherence and small for gestational age and preterm newborn outcomes. Public Health Nutr 2020; 24:1372-1384. [PMID: 32345384 DOI: 10.1017/s1368980019004993] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective was to evaluate maternal Mediterranean diet (MD) pattern adherence during pregnancy and its association with small for gestational age (SGA) and preterm birth. A secondary objective of the current study was to describe the sociodemographic, lifestyle and obstetric profile of the mothers studied as well as the most relevant paternal and newborn characteristics. DESIGN The current study is a two-phase retrospective population-based study of maternal dietary habits during pregnancy and their effect on newborn size and prematurity. The descriptive first phase examined maternal dietary habits during pregnancy along with the maternal sociodemographic, lifestyle and obstetric profile in a cross-sectional period study. In the second phase, newborn outcomes were evaluated in a nested case-control study. Adherence to MD during pregnancy was measured with the Spanish version of Kidmed index. SETTING Obstetrics ward of the La Fe Hospital in Valencia. PARTICIPANTS All mother-child pairs admitted after delivery during a 12-month period starting from January 2018 were assessed for eligibility. A total of 1118 provided complete outcome data after signing informed consent. RESULTS 14·5 % met the criteria of poor adherence (PA); 34·8 %, medium adherence (MA); and 50·7 %, optimal adherence (OA). Medium adherence to MD was associated in the adjusted scenarios with a higher risk of giving birth to a preterm newborn. No association was found between MD adherence and SGA. CONCLUSIONS Early intervention programmes geared towards pregnant women, where women were aided in reaching OA to MD, might reduce the risk of preterm newborn.
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Bert F, Scaioli G, Tolomeo M, Lo Moro G, Gualano MR, Siliquini R. Knowledge, attitudes and eating habits red and processed meat among gym users: a cross-sectional survey. Perspect Public Health 2019; 140:203-213. [DOI: 10.1177/1757913919883908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: In 2015, the International Agency for Research on Cancer (IARC) classified red meat (RM) and processed meat (PM) intakes as ‘probably carcinogenic’ and ‘carcinogenic’ to humans, respectively. The aim of the study was to evaluate eating behaviours and knowledge on the potential risks of RM-PM consumption among gym users. Methods: In 2018, a cross-sectional survey was conducted in 20 gyms in Turin using a 48-item questionnaire assessing sociodemographic, sports, dietary information and knowledge about RM-PM (sample size = 298). Multivariable logistic and linear regressions were performed. The significance level was p ⩽ 0.05. Results: Around 75% of the sample consumed RM and PM at least once a week, with an average of 240.55 ± 435.99 g and 106.50 ± 157.88 g consumed weekly, respectively. Only 7.69% exceeded 700 g of raw RM weekly. Females, those with higher education, those who practise sport outside gyms and those who declared to practise sport to stay healthy, declared to consume less RM. Those who practise sport at a competitive level, those who are on a diet for athletic needs, those with higher body mass index (BMI) and those who consume more eggs and alcohol had a higher RM intake. The association with PM consumption was negative for females and positive for those living without a partner. The likelihood of answering incorrectly to one of the knowledge outcomes was lower for those who had a healthcare-related background and declared to practise sport to stay healthy, while it was higher for participants who stated to have a sport-related background, to be on a diet to lose weight, to read rarely/never the RM-PM nutrition labels and to consume <400 g of fruit and vegetables daily. Conclusions: Given the relatively low knowledge of the potential risks of RM-PM consumption, it would be advisable to implement campaigns specifically focused on male athletes and people with lower socioeconomic status, in order to raise awareness about this topic.
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Affiliation(s)
- F Bert
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - G Scaioli
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - M Tolomeo
- Degree Course in Dietetics, University of Turin, Turin, Italy
| | - G Lo Moro
- Department of Public Health Sciences, University of Turin, Via Santena 5 bis, 10126 Turin, Italy
| | - MR Gualano
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - R Siliquini
- Department of Public Health Sciences, University of Turin, Turin, Italy
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16
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Cano-Ibáñez N, Bueno-Cavanillas A, Martínez-González MÁ, Salas-Salvadó J, Corella D, Freixer GL, Romaguera D, Vioque J, Alonso-Gómez ÁM, Wärnberg J, Martínez JA, Serra-Majem L, Estruch R, Tinahones FJ, Lapetra J, Pintó X, Tur JA, García-Ríos A, García-Molina L, Delgado-Rodríguez M, Matía-Martín P, Daimiel L, Martín-Sánchez V, Vidal J, Vázquez C, Ros E, Bartolomé-Resano J, Palau-Galindo A, Portoles O, Torres L, Miquel-Fiol, Sánchez MTC, Sorto-Sánchez C, Moreno-Morales N, Abete I, Álvarez-Pérez J, Sacanella E, Bernal-López MR, Santos-Lozano JM, Fanlo-Maresma M, Bouzas C, Razquin C, Becerra-Tomás N, Ortega-Azorin C, LLimona R, Morey M, Román-Maciá J, Goicolea-Güemez L, Vázquez-Ruiz Z, Barrubés L, Fitó M, Gea A. Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study. Eur J Nutr 2019; 59:2395-2409. [PMID: 31523780 DOI: 10.1007/s00394-019-02087-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/30/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The prevalence of overweight/obesity and related manifestations such as metabolic syndrome (MetS) is increasing worldwide. High energy density diets, usually with low nutrient density, are among the main causes. Some high-quality dietary patterns like the Mediterranean diet (MedDiet) have been linked to the prevention and better control of MetS. However, it is needed to show that nutritional interventions promoting the MedDiet are able to improve nutrient intake. OBJECTIVE To assess the effect of improving MedDiet adherence on nutrient density after 1 year of follow-up at the PREDIMED-Plus trial. METHODS We assessed 5777 men (55-75 years) and women (60-75 years) with overweight or obesity and MetS at baseline from the PREDIMED-Plus trial. Dietary changes and MedDiet adherence were evaluated at baseline and after 1 year. The primary outcome was the change in nutrient density (measured as nutrient intake per 1000 kcal). Multivariable-adjusted linear regression models were fitted to analyse longitudinal changes in adherence to the MedDiet and concurrent changes in nutrient density. RESULTS During 1-year follow-up, participants showed improvements in nutrient density for all micronutrients assessed. The density of carbohydrates (- 9.0%), saturated fatty acids (- 10.4%) and total energy intake (- 6.3%) decreased. These changes were more pronounced in the subset of participants with higher improvements in MedDiet adherence. CONCLUSIONS The PREDIMED-Plus dietary intervention, based on MedDiet recommendations for older adults, maybe a feasible strategy to improve nutrient density in Spanish population at high risk of cardiovascular disease with overweight or obesity.
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Affiliation(s)
- Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, 18016, Granada, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. .,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, 18016, Granada, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Jordi Salas-Salvadó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Dolores Corella
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Gal-la Freixer
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Dora Romaguera
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Nutritional Epidemiology Unit, Miguel Hernández University, ISABIAL-FISABIO, Alicante, Spain
| | - Ángel M Alonso-Gómez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Nursing, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Alfredo Martínez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Lluis Serra-Majem
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Ramón Estruch
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Endocrinology, Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain
| | - José Lapetra
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain
| | - Xavier Pintó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep A Tur
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Antonio García-Ríos
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, 18016, Granada, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Health Sciences, University of Jaen, Jaen, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Vicente Martín-Sánchez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain.,CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Clotilde Vázquez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Emilio Ros
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Lipid Clinic Department of Endocrinology and Nutrition, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Javier Bartolomé-Resano
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Health Service-Osasunbidea, Pamplona, Spain
| | - Antoni Palau-Galindo
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,ABS Reus V. Centre d'Assistència Primària Marià Fortuny, SAGESSA, Reus, Spain
| | - Olga Portoles
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Laura Torres
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Miquel-Fiol
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | | | - Carolina Sorto-Sánchez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Noelia Moreno-Morales
- Department of Physiotherapy, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Itziar Abete
- Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Jacqueline Álvarez-Pérez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Emilio Sacanella
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - María Rosa Bernal-López
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Internal Medicine, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Malaga (IBIMA), Malaga, Spain
| | - José Manuel Santos-Lozano
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain.,Department of Medicine, Facultad de Medicina, University of Sevilla, Seville, Spain
| | - Marta Fanlo-Maresma
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Bouzas
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain.,Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Nerea Becerra-Tomás
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Carolina Ortega-Azorin
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - Regina LLimona
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Marga Morey
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), 07120, Palma de Mallorca, Spain
| | | | - Leire Goicolea-Güemez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Zenaida Vázquez-Ruiz
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Laura Barrubés
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Montse Fitó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdisNa), Pamplona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
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Quintana-Navarro GM, Alcala-Diaz JF, Lopez-Moreno J, Perez-Corral I, Leon-Acuña A, Torres-Peña JD, Rangel-Zuñiga OA, Arenas de Larriva AP, Corina A, Camargo A, Yubero-Serrano EM, Rodriguez-Cantalejo F, Garcia-Rios A, Luque RM, Ordovas JM, Perez-Martinez P, Lopez-Miranda J, Delgado-Lista J. Long-term dietary adherence and changes in dietary intake in coronary patients after intervention with a Mediterranean diet or a low-fat diet: the CORDIOPREV randomized trial. Eur J Nutr 2019; 59:2099-2110. [DOI: 10.1007/s00394-019-02059-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/15/2019] [Indexed: 01/05/2023]
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Serra-Majem L, Román-Viñas B, Sanchez-Villegas A, Guasch-Ferré M, Corella D, La Vecchia C. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Mol Aspects Med 2019; 67:1-55. [PMID: 31254553 DOI: 10.1016/j.mam.2019.06.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 01/16/2023]
Abstract
More than 50 years after the Seven Countries Study, a large number of epidemiological studies have explored the relationship between the Mediterranean diet (MD) and health, through observational, case-control, some longitudinal and a few experimental studies. The overall results show strong evidence suggesting a protective effect of the MD mainly on the risk of cardiovascular disease (CVD) and certain types of cancer. The beneficial effects have been attributed to the types of food consumed, total dietary pattern, components in the food, cooking techniques, eating behaviors and lifestyle behaviors, among others. The aim of this article is to review and summarize the knowledge derived from the literature focusing on the benefits of the MD on health, including those that have been extensively investigated (CVD, cancer) along with more recent issues such as mental health, immunity, quality of life, etc. The review begins with a brief description of the MD and its components. Then we present a review of studies evaluating metabolic biomarkers and genotypes in relation to the MD. Other sections are dedicated to observation and intervention studies for various pathologies. Finally, some insights into the relationship between the MD and sustainability are explored. In conclusion, the research undertaken on metabolomics approaches has identified potential markers for certain MD components and patterns, but more investigation is needed to obtain valid measures. Further evaluation of gene-MD interactions are also required to better understand the mechanisms by which the MD diet exerts its beneficial effects on health. Observation and intervention studies, particularly PREDIMED, have provided invaluable data on the benefits of the MD for a wide range of chronic diseases. However further research is needed to explore the effects of other lifestyle components associated with Mediterranean populations, its environmental impact, as well as the MD extrapolation to non-Mediterranean contexts.
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Affiliation(s)
- Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain.
| | - Blanca Román-Viñas
- Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain; School of Health and Sport Sciences (EUSES), Universitat de Girona, Salt, Spain; Department of Physical Activity and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Almudena Sanchez-Villegas
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H.Chan School of Public Health, Boston, MA, USA; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dolores Corella
- Genetic and Molecular Epidemiology Unit. Department of Preventive Medicine. University of Valencia, Valencia, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
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Coley N, Ngandu T, Lehtisalo J, Soininen H, Vellas B, Richard E, Kivipelto M, Andrieu S. Adherence to multidomain interventions for dementia prevention: Data from the FINGER and MAPT trials. Alzheimers Dement 2019; 15:729-741. [PMID: 31047857 DOI: 10.1016/j.jalz.2019.03.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/17/2019] [Accepted: 03/03/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Multidomain interventions, targeting multiple risk factors simultaneously, could be effective dementia prevention strategies, but may be burdensome and not universally acceptable. METHODS We studied adherence rates and predictors in the Finnish Geriatric Intervevntion Study to Prevent Cognitive Impairment and Disability and Multidomain Alzheimer Preventive Trial prevention trials, for all intervention components (separately and simultaneously). Finnish Geriatric Intervevntion Study to Prevent Cognitive Impairment and Disability participants received a 2-year multidomain lifestyle intervention (physical training, cognitive training, nutritional counseling, and cardiovascular monitoring). Multidomain Alzheimer Preventive Trial participants received a 3-year multidomain lifestyle intervention (cognitive training, physical activity counseling, and nutritional counseling) with either an omega-3 supplement or placebo. RESULTS Adherence decreased with increasing intervention complexity and intensity: it was highest for cardiovascular monitoring, nutritional counseling, and the omega-3 supplement, and lowest for unsupervised computer-based cognitive training. The most consistent baseline predictors of adherence were smoking and depressive symptoms. DISCUSSION Reducing participant burden, while ensuring that technological tools are suitable for older individuals, maintaining face-to-face contacts, and taking into account participant characteristics may increase adherence in future trials.
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Affiliation(s)
- Nicola Coley
- INSERM-University of Toulouse UMR 1027, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France.
| | - Tiia Ngandu
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Jenni Lehtisalo
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Hilkka Soininen
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Bruno Vellas
- INSERM-University of Toulouse UMR 1027, Toulouse, France; Gerontopole, Toulouse University Hospital, Toulouse, France
| | - Edo Richard
- Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Miia Kivipelto
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sandrine Andrieu
- INSERM-University of Toulouse UMR 1027, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
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Peraita-Costa I, Llopis-González A, Perales-Marín A, Sanz F, Llopis-Morales A, Morales-Suárez-Varela M. A Retrospective Cross-Sectional Population-Based Study on Prenatal Levels of Adherence to the Mediterranean Diet: Maternal Profile and Effects on the Newborn. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1530. [PMID: 30029539 PMCID: PMC6069129 DOI: 10.3390/ijerph15071530] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
Abstract
The Mediterranean diet (MD) is a dietary pattern with important benefits. The objectives of this study were to assess the adherence to the MD among pregnant women in Valencia (Spain) and characterize the pregnant women according to their level of adherence. Finally, we aimed to examine the role of MD adherence during pregnancy in the anthropometric development of the newborn. The study included 492 pregnant women who were followed at La Fe Hospital in 2017. The self-administered "Kidmed" questionnaire for data collection on dietary information evaluation was used and a clinical history review of mothers and newborns was performed. Two groups of mothers were identified: those with low adherence (LA) and optimal adherence (OA). The study revealed that 40.2% of the women showed LA to the MD. The newborns born to these women presented a higher risk of being small for gestational age (SGA) {adjusted odds ratio (aOR) = 1.68; 95% confidence interval (CI) 1.02⁻5.46} when adjusting for parental body mass index (BMI) and multiple gestation, but not when adjusting for all significant possible confounders (aOR = 2.32; 95% CI 0.69⁻7.78). The association between MD and SGA was not significantly affected by the use of iron and folic acid supplements (aOR = 2.65; 95% CI 0.66⁻10.65). The profile of the pregnant woman with LA is that of a young smoker, with a low level of education and a low daily intake of dairy products. These results suggest that LA to the MD is not associated with a higher risk of giving birth to a SGA newborn.
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Affiliation(s)
- Isabel Peraita-Costa
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avinguda Vicente Andrés Estellés s/n, Burjassot, 46100 Valencia, Spain.
- CIBER in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3⁻5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Agustín Llopis-González
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avinguda Vicente Andrés Estellés s/n, Burjassot, 46100 Valencia, Spain.
- CIBER in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3⁻5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Alfredo Perales-Marín
- Department of Obstetrics, La Fe University Hospital, Avinguda de Fernando Abril Martorell, 106, 46026 València, Spain.
| | - Ferran Sanz
- Department of Obstetrics, La Fe University Hospital, Avinguda de Fernando Abril Martorell, 106, 46026 València, Spain.
| | - Agustín Llopis-Morales
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avinguda Vicente Andrés Estellés s/n, Burjassot, 46100 Valencia, Spain.
| | - María Morales-Suárez-Varela
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avinguda Vicente Andrés Estellés s/n, Burjassot, 46100 Valencia, Spain.
- CIBER in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3⁻5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
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Chauveau P, Aparicio M, Bellizzi V, Campbell K, Hong X, Johansson L, Kolko A, Molina P, Sezer S, Wanner C, ter Wee PM, Teta D, Fouque D, Carrero JJ. Mediterranean diet as the diet of choice for patients with chronic kidney disease. Nephrol Dial Transplant 2017; 33:725-735. [DOI: 10.1093/ndt/gfx085] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/05/2017] [Indexed: 02/07/2023] Open
Affiliation(s)
- Philippe Chauveau
- Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux et Aurad-Aquitaine, Bordeaux, France
| | - Michel Aparicio
- Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux et Aurad-Aquitaine, Bordeaux, France
| | - Vincenzo Bellizzi
- Division of Nephrology, Dialysis and Renal Transplantation, University Hospital "San Giovanni di Dio e Ruggi d’Aragona", Salerno, Italy
| | - Katrina Campbell
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Xu Hong
- Division of Renal Medicine, CLINTEC and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lina Johansson
- Department of Nutrition and Dietetics, Imperial College Healthcare NHS Trust, London, England
| | - Anne Kolko
- Association pour l'Utilisation du Rein Artificiel en région Parisienne (AURA) Paris, Paris, France
| | - Pablo Molina
- Department of Nephrology, Dr Peset University Hospital, Valencia, Spain
| | - Siren Sezer
- Department of Nephrology, Başkent University Hospital, Ankara, Turkey
| | | | | | - Daniel Teta
- Service of Nephrology, Hôpital du Valais, Sion and Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Denis Fouque
- Department of Nephrology, Centre Hospitalier Lyon-Sud, Université de Lyon, UCBL, Carmen, Pierre, Bénite, France
| | - Juan J Carrero
- Division of Renal Medicine, CLINTEC and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Andrade L, Zazpe I, Santiago S, Carlos S, Bes-Rastrollo M, Martínez-González MA. Ten-Year Changes in Healthy Eating Attitudes in the SUN Cohort. J Am Coll Nutr 2017; 36:319-329. [DOI: 10.1080/07315724.2016.1278566] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lucia Andrade
- University of Navarra, Department of Nutrition and Food Sciences and Physiology, Pamplona, Spain
- Centro Nutribalance, Guatemala, Guatemala
| | - Itziar Zazpe
- University of Navarra, Department of Nutrition and Food Sciences and Physiology, Pamplona, Spain
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Susana Santiago
- University of Navarra, Department of Nutrition and Food Sciences and Physiology, Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Silvia Carlos
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Maira Bes-Rastrollo
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Miguel-Angel Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona
- IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
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23
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Downer MK, Gea A, Stampfer M, Sánchez-Tainta A, Corella D, Salas-Salvadó J, Ros E, Estruch R, Fitó M, Gómez-Gracia E, Arós F, Fiol M, De-la-Corte FJG, Serra-Majem L, Pinto X, Basora J, Sorlí JV, Vinyoles E, Zazpe I, Martínez-González MÁ. Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial. Int J Behav Nutr Phys Act 2016; 13:67. [PMID: 27297426 PMCID: PMC4907003 DOI: 10.1186/s12966-016-0394-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/07/2016] [Indexed: 12/25/2022] Open
Abstract
Background Dietary intervention success requires strong participant adherence, but very few studies have examined factors related to both short-term and long-term adherence. A better understanding of predictors of adherence is necessary to improve the design and execution of dietary intervention trials. This study was designed to identify participant characteristics at baseline and study features that predict short-term and long-term adherence with interventions promoting the Mediterranean-type diet (MedDiet) in the PREvención con DIeta MEDiterránea (PREDIMED) randomized trial. Methods Analyses included men and women living in Spain aged 55–80 at high risk for cardiovascular disease. Participants were randomized to the MedDiet supplemented with either complementary extra-virgin olive oil (EVOO) or tree nuts. The control group and participants with insufficient information on adherence were excluded. PREDIMED began in 2003 and ended in 2010. Investigators assessed covariates at baseline and dietary information was updated yearly throughout follow-up. Adherence was measured with a validated 14-point Mediterranean-type diet adherence score. Logistic regression was used to examine associations between baseline characteristics and adherence at one and four years of follow-up. Results Participants were randomized to the MedDiet supplemented with EVOO (n = 2,543; 1,962 after exclusions) or tree nuts (n = 2,454; 2,236 after exclusions). A higher number of cardiovascular risk factors, larger waist circumference, lower physical activity levels, lower total energy intake, poorer baseline adherence to the 14-point adherence score, and allocation to MedDiet + EVOO each independently predicted poorer adherence. Participants from PREDIMED recruiting centers with a higher total workload (measured as total number of persons-years of follow-up) achieved better adherence. No adverse events or side effects were reported. Conclusions To maximize dietary adherence in dietary interventions, additional efforts to promote adherence should be used for participants with lower baseline adherence to the intended diet and poorer health status. The design of multicenter nutrition trials should prioritize few large centers with more participants in each, rather than many small centers. Trial registration This study was registered at controlled-trials.com (http://www.controlled-trials. com/ISRCTN35739639). International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005. Trial design: parallel randomized trial. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0394-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mary Kathryn Downer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Channing Division of Network Medicine, 181 Longwood Avenue, Room 345, Boston, MA, 02115, USA
| | - Alfredo Gea
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain
| | - Meir Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.,Channing Division of Network Medicine, 181 Longwood Avenue, Room 345, Boston, MA, 02115, USA
| | - Ana Sánchez-Tainta
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain
| | - Dolores Corella
- Department of Preventive Medicine, University of Valencia, AVDA,Vicente Blasco Ibanez, 15, 46010, Valencia, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Hospital Universitari de Sant Joan de Reus, Universitat Rovira i Virgili, C/Sant Llorenç, 21, 43201, Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ramón Estruch
- Department of Internal Medicine, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, C/Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Montserrat Fitó
- Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Carrer Dr. Aiguader, 88, 08003, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine, University of Malaga, Campus de Teatinos, 29071, Malaga, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Fernando Arós
- Department of Cardiology, University Hospital of Araba, C/Jose Atxotegi, s/n, 01009, Vitoria-Gasteiz, Araba, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Miquel Fiol
- Palma Institute of Health Research (IdISPa), University of Balearic Islands and Hospital Son Espases, Carretera de Valldemossa, 79, 07120, Palma, Illes Balears, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Francisco Jose Garcia De-la-Corte
- Department of Family Medicine, Research Unit, Distrito Sanitario Atencion Primaria Sevilla, Avda. de Jerez s/n, 41007, Sevilla, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Lluís Serra-Majem
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Juan De Quesada 30, 35001, Las Palmas, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Xavier Pinto
- Head of Lipid and Vascular Risk Unit, Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL. Universidad de Barcelona, C/Freixa Larga s/n, 08907 - Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Josep Basora
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV Universitat Rovira i Virgili, C/Sant Llorenç, 21 Planta baja del edificio 4 de la Facultat de Medicina i Ciències de la Salut, 43201, Reus, Tarragona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - José V Sorlí
- Department of Preventive Medicine, University of Valencia, AVDA,Vicente Blasco Ibanez, 15, 46010, Valencia, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ernest Vinyoles
- Jordi Gol Primary Care Research Institute, Gran Via de les Corts Catalanes 587, àtic, 08007, Barcelona, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain
| | - Miguel-Ángel Martínez-González
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, C/Irunlarrea, No. 1. Research Building, 2nd floor, Local 2520, 31008, Pamplona, Navarra, Spain. .,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain. .,IdiSNA, Navarra Institute por Health Research, 31008, Barcelona, Navarra, Spain.
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Bédard A, Corneau L, Dodin S, Lemieux S. Sex Differences in the Effects of Repeated Taste Exposure to the Mediterranean Diet: A 6-month Follow-up Study. CAN J DIET PRACT RES 2016; 77:125-32. [PMID: 26916988 DOI: 10.3148/cjdpr-2015-052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations and tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. METHODS Thirty-eight males and 32 premenopausal females (all aged 24-53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations and tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. RESULTS Compared with baseline, the Mediterranean score (MedScore) increased at the end of the 6-month follow-up (time effect P = 0.003), with no sex difference (sex-by-time interaction P = 0.97). With regard to MedScore components, sex differences were observed with males reporting changes in more dietary food groups than females. Although the intervention was not focused on body weight management, compared with baseline, BMI decreased during the intervention in both males and females; however, only females maintained the lower BMI 6 months after the intervention. CONCLUSIONS Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both sexes and helps in the management of body weight, especially in females.
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Affiliation(s)
- Alexandra Bédard
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6.,b École de Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Université Laval, QC G1V 0A6
| | - Louise Corneau
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6
| | - Sylvie Dodin
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6.,c Département d'obstétrique et de gynécologie, Pavillon Ferdinand-Vandry, 1050 Avenue de la médecine, Université Laval, QC G1V 0A6
| | - Simone Lemieux
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6.,b École de Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Université Laval, QC G1V 0A6
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Hooper L, Abdelhamid A, Bunn D, Brown T, Summerbell CD, Skeaff CM. Effects of total fat intake on body weight. Cochrane Database Syst Rev 2015:CD011834. [PMID: 26250104 PMCID: PMC10403157 DOI: 10.1002/14651858.cd011834] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In order to prevent overweight and obesity in the general population we need to understand the relationship between the proportion of energy from fat and resulting weight and body fatness in the general population. OBJECTIVES To assess the effects of proportion of energy intake from fat on measures of weight and body fatness (including obesity, waist circumference and body mass index) in people not aiming to lose weight, using all appropriate randomised controlled trials (RCTs) and cohort studies in adults, children and young people SEARCH METHODS We searched CENTRAL to March 2014 and MEDLINE, EMBASE and CINAHL to November 2014. We did not limit the search by language. We also checked the references of relevant reviews. SELECTION CRITERIA Trials fulfilled the following criteria: 1) randomised intervention trial, 2) included children (aged ≥ 24 months), young people or adults, 3) randomised to a lower fat versus usual or moderate fat diet, without the intention to reduce weight in any participants, 4) not multifactorial and 5) assessed a measure of weight or body fatness after at least six months. We also included cohort studies in children, young people and adults that assessed the proportion of energy from fat at baseline and assessed the relationship with body weight or fatness after at least one year. We duplicated inclusion decisions and resolved disagreement by discussion or referral to a third party. DATA COLLECTION AND ANALYSIS We extracted data on the population, intervention, control and outcome measures in duplicate. We extracted measures of weight and body fatness independently in duplicate at all available time points. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity and funnel plot analyses. MAIN RESULTS We included 32 RCTs (approximately 54,000 participants) and 30 sets of analyses of 25 cohorts. There is consistent evidence from RCTs in adults of a small weight-reducing effect of eating a smaller proportion of energy from fat; this was seen in almost all included studies and was highly resistant to sensitivity analyses. The effect of eating less fat (compared with usual diet) is a mean weight reduction of 1.5 kg (95% confidence interval (CI) -2.0 to -1.1 kg), but greater weight loss results from greater fat reductions. The size of the effect on weight does not alter over time and is mirrored by reductions in body mass index (BMI) (-0.5 kg/m(2), 95% CI -0.7 to -0.3) and waist circumference (-0.3 cm, 95% CI -0.6 to -0.02). Included cohort studies in children and adults most often do not suggest any relationship between total fat intake and later measures of weight, body fatness or change in body fatness. However, there was a suggestion that lower fat intake was associated with smaller increases in weight in middle-aged but not elderly adults, and in change in BMI in the highest validity child cohort. AUTHORS' CONCLUSIONS Trials where participants were randomised to a lower fat intake versus usual or moderate fat intake, but with no intention to reduce weight, showed a consistent, stable but small effect of low fat intake on body fatness: slightly lower weight, BMI and waist circumference compared with controls. Greater fat reduction and lower baseline fat intake were both associated with greater reductions in weight. This effect of reducing total fat was not consistently reflected in cohort studies assessing the relationship between total fat intake and later measures of body fatness or change in body fatness in studies of children, young people or adults.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK, NR4 7TJ
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26
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Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev 2015:CD011737. [PMID: 26068959 DOI: 10.1002/14651858.cd011737] [Citation(s) in RCA: 226] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally it is unclear whether the energy from saturated fats that are lost in the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. This review is part of a series split from and updating an overarching review. OBJECTIVES To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA) or monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and EMBASE (Ovid) on 5 March 2014. We also checked references of included studies and reviews. SELECTION CRITERIA Trials fulfilled the following criteria: 1) randomised with appropriate control group; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) not multifactorial; 4) adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 5) intervention at least 24 months; 6) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Two review authors working independently extracted participant numbers experiencing health outcomes in each arm, and we performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses and funnel plots. MAIN RESULTS We include 15 randomised controlled trials (RCTs) (17 comparisons, ˜59,000 participants), which used a variety of interventions from providing all food to advice on how to reduce saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of cardiovascular events by 17% (risk ratio (RR) 0.83; 95% confidence interval (CI) 0.72 to 0.96, 13 comparisons, 53,300 participants of whom 8% had a cardiovascular event, I² 65%, GRADE moderate quality of evidence), but effects on all-cause mortality (RR 0.97; 95% CI 0.90 to 1.05; 12 trials, 55,858 participants) and cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 12 trials, 53,421 participants) were less clear (both GRADE moderate quality of evidence). There was some evidence that reducing saturated fats reduced the risk of myocardial infarction (fatal and non-fatal, RR 0.90; 95% CI 0.80 to 1.01; 11 trials, 53,167 participants), but evidence for non-fatal myocardial infarction (RR 0.95; 95% CI 0.80 to 1.13; 9 trials, 52,834 participants) was unclear and there were no clear effects on stroke (any stroke, RR 1.00; 95% CI 0.89 to 1.12; 8 trials, 50,952 participants). These relationships did not alter with sensitivity analysis. Subgrouping suggested that the reduction in cardiovascular events was seen in studies that primarily replaced saturated fat calories with polyunsaturated fat, and no effects were seen in studies replacing saturated fat with carbohydrate or protein, but effects in studies replacing with monounsaturated fats were unclear (as we located only one small trial). Subgrouping and meta-regression suggested that the degree of reduction in cardiovascular events was related to the degree of reduction of serum total cholesterol, and there were suggestions of greater protection with greater saturated fat reduction or greater increase in polyunsaturated and monounsaturated fats. There was no evidence of harmful effects of reducing saturated fat intakes on cancer mortality, cancer diagnoses or blood pressure, while there was some evidence of improvements in weight and BMI. AUTHORS' CONCLUSIONS The findings of this updated review are suggestive of a small but potentially important reduction in cardiovascular risk on reduction of saturated fat intake. Replacing the energy from saturated fat with polyunsaturated fat appears to be a useful strategy, and replacement with carbohydrate appears less useful, but effects of replacement with monounsaturated fat were unclear due to inclusion of only one small trial. This effect did not appear to alter by study duration, sex or baseline level of cardiovascular risk. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturated fats. The ideal type of unsaturated fat is unclear.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, UK, NR4 7TJ
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Martínez-González MA, Salas-Salvadó J, Estruch R, Corella D, Fitó M, Ros E. Benefits of the Mediterranean Diet: Insights From the PREDIMED Study. Prog Cardiovasc Dis 2015; 58:50-60. [PMID: 25940230 DOI: 10.1016/j.pcad.2015.04.003] [Citation(s) in RCA: 461] [Impact Index Per Article: 51.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The PREDIMED (PREvención con DIeta MEDiterránea) multicenter, randomized, primary prevention trial assessed the long-term effects of the Mediterranean diet (MeDiet) on clinical events of cardiovascular disease (CVD). We randomized 7447 men and women at high CVD risk into three diets: MeDiet supplemented with extra-virgin olive oil (EVOO), MeDiet supplemented with nuts, and control diet (advice on a low-fat diet). No energy restriction and no special intervention on physical activity were applied. We observed 288 CVD events (a composite of myocardial infarction, stroke or CVD death) during a median time of 4.8years; hazard ratios were 0.70 (95% CI, 0.53-0.91) for the MeDiet+EVOO and 0.70 (CI, 0.53-0.94) for the MeDiet+nuts compared to the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 non-diabetic participants were 0.60 (0.43-0.85) and 0.82 (0.61-1.10) for MeDiet+EVOO and MeDiet+nuts, respectively versus control. Significant improvements in classical and emerging CVD risk factors also supported a favorable effect of both MeDiets on blood pressure, insulin sensitivity, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis. In nutrigenomic studies beneficial effects of the intervention with MedDiets showed interactions with several genetic variants (TCF7L2, APOA2, MLXIPL, LPL, FTO, M4CR, COX-2, GCKR and SERPINE1) with respect to intermediate and final phenotypes. Thus, the PREDIMED trial provided strong evidence that a vegetable-based MeDiet rich in unsaturated fat and polyphenols can be a sustainable and ideal model for CVD prevention.
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Affiliation(s)
- Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA (Navarra Health Research Institute), Pamplona, Spain; The PREDIMED Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Jordi Salas-Salvadó
- The PREDIMED Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
| | - Ramón Estruch
- The PREDIMED Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
| | - Montse Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Differences between men and women in dietary intakes and metabolic profile in response to a 12-week nutritional intervention promoting the Mediterranean diet. J Nutr Sci 2015; 4:e13. [PMID: 26090094 PMCID: PMC4463935 DOI: 10.1017/jns.2015.2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 06/27/2014] [Accepted: 12/15/2014] [Indexed: 01/22/2023] Open
Abstract
Few studies have compared men and women in response to nutritional interventions but none
has assessed differences between men and women in the response to a nutritional
intervention programme based on the self-determination theory (SDT) and using the
Mediterranean diet (MedDiet) as a model of healthy eating, in a context of CVD prevention
and within a non-Mediterranean population. The present study aimed to document differences
between men and women in changes in dietary, anthropometric and metabolic variables, in
response to a nutritional intervention programme promoting the adoption of the MedDiet and
based on the SDT. A total of sixty-four men and fifty-nine premenopausal women presenting
risk factors for CVD were recruited through different media advertisements in the Québec
City Metropolitan area (Canada). The 12-week nutritional programme used a motivational
interviewing approach and included individual and group sessions. A validated FFQ was
administered to evaluate dietary intakes from which a Mediterranean score (Medscore) was
derived. Both men and women significantly increased their Medscore in response to the
intervention (P < 0·0001). Men showed a significantly greater
decrease in red and processed meat (−0·4 (95 % CI −0·7, −0·1) portions per d) and a
greater increase in fruit (0·9 (95 % CI 0·2, 1·6) portions per d) intakes than women.
Significant decreases were observed for BMI and waist circumference in both men and women
(P ≤ 0·04). Significant greater decreases were found for total
cholesterol (total-C):HDL-cholesterol (HDL-C) (−0·2; 95 % CI −0·4, −0·03) and TAG:HDL-C
(−0·2; 95 % CI −0·4, −0·04) ratios in men than in women. When adjusting for the baseline
value of the response variable, differences between men and women became non-significant
for red and processed meat and fruit intakes whereas significant differences between men
and women (i.e. larger increases in men than women) were observed for legumes, nuts and
seeds (0·6 (95 % CI 0·2, 1·0) portions per d) and whole-grain products (0·5 (95 % CI 0·01,
1·0) portions per d) intakes. For metabolic variables, differences between men and women
became non-significant for total-C:HDL-C and TAG:HDL-C ratios when adjusted for the
baseline value of the response variable. The present results suggest that the nutritional
intervention promoting the adoption of the Mediterranean diet and based on the SDT led to
greater improvements in dietary intakes in men than in women, which appear to have
contributed to beneficial anthropometric and metabolic changes, more particularly in men.
However, the more deteriorated metabolic profile found in men at baseline seems to
contribute to a large extent to the more beneficial changes in CVD risk factors observed
in men as compared with women.
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Leblanc V, Bégin C, Hudon AM, Royer MM, Corneau L, Dodin S, Lemieux S. Gender differences in the long-term effects of a nutritional intervention program promoting the Mediterranean diet: changes in dietary intakes, eating behaviors, anthropometric and metabolic variables. Nutr J 2014; 13:107. [PMID: 25416917 PMCID: PMC4247653 DOI: 10.1186/1475-2891-13-107] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-term adherence to principles of the Mediterranean diet (MedDiet) following a nutritional intervention promoting the Mediterranean food pattern in Canadian men and women is not known. Moreover, gender differences in dietary and metabolic profile in such an intervention context has never been addressed. Objective was to determine gender differences in long-term effects of a 12-week nutritional intervention program promoting the adoption of the MedDiet and based on the Self-Determination Theory (SDT) on dietary intakes, eating behaviors, anthropometric and metabolic variables, in men and women presenting cardiovascular risk factors. METHODS Sixty-four men and 59 premenopausal women were recruited. The 12-week nutritional program used a motivational interviewing approach and included individual and group sessions. A food frequency questionnaire was administered to evaluate dietary intakes from which a Mediterranean score (Medscore) was derived and the Three-Factor Eating Questionnaire allowed assessment of eating behaviors. Measurements were performed at baseline and after the 12-week nutritional intervention, and then at 3 and 6-month post intervention. RESULTS No gender difference was observed in changes in the Medscore during the nutritional intervention and follow-up. However, the Medscore returned towards baseline values during follow-up in men and women (P < 0.0001). Men reported larger decreases in red and processed meat and larger increases in whole fruit intakes than women (P = 0.03 and P = 0.04, respectively). Men showed a greater decrease in habitual susceptibility to disinhibition than women (P = 0.03). A gender by time interaction was found for waist circumference, i.e. men had lower waist circumference at the end of the intervention as well as at follow-up than at baseline while women's waist circumference decreased in response to the intervention only (P = 0.05). As for metabolic variables, changes observed in total-cholesterol (C) to HDL-C ratio, triglyceride levels and triglycerides to HDL-C ratio were more pronounced in men than in women after the intervention as well as at follow-up (P ≤ 0.03). CONCLUSIONS Our results indicate that the 12-week nutritional intervention based on the SDT leads to more pronounced beneficial changes in long-term dietary intakes in men than in women and to greater improvements in metabolic profile in men. TRIAL REGISTRATION Current Controlled Trials NCT01852721.
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Affiliation(s)
- Vicky Leblanc
- />Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec, G1V 0A6 Canada
| | - Catherine Bégin
- />School of Psychology, Laval University, Pavillon Félix-Antoine Savard, 2325 rue des Bibliothèques, Québec, G1V 0A6 Canada
| | - Anne-Marie Hudon
- />Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec, G1V 0A6 Canada
| | - Marie-Michelle Royer
- />Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec, G1V 0A6 Canada
| | - Louise Corneau
- />Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec, G1V 0A6 Canada
| | - Sylvie Dodin
- />Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec, G1V 0A6 Canada
- />Department of Obstetrics and Gynaecology, Laval University, Pavillon Ferdinand-Vandry, 1050 Medicine Avenue, Québec, G1V 0A6 Canada
| | - Simone Lemieux
- />Institute of Nutrition and Functional Foods, Laval University, 2440 Hochelaga Boulevard, Québec, G1V 0A6 Canada
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Santos DM, Rodrigues SSP, de Oliveira BMPM, Vaz de Almeida MD. Diet quality in elderly Portuguese households. J Nutr Health Aging 2014; 18:243-50. [PMID: 24626750 DOI: 10.1007/s12603-013-0431-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To identify diet quality time trends in Portuguese elderly households and the association of diet quality with sociodemographic characteristics. DESIGN Set of four cross-sectional studies. SETTING Portuguese population. SUBJECTS Nationally representative samples from Household Budget Surveys (1989-1990, 1994-1995, 2000-2001 and 2005-2006 versions). Households with members aged ≥ 65 years were categorized as solitary elderly female, solitary elderly male, or elderly couple (composed of one elderly female and one elderly male) and compared with adult households with the same composition. METHODS Diet quality was assessed through a revised version of the Healthy Diet Indicator (HDIr). Univariate and multiple backward linear regression models were used to study the association with sociodemographic characteristics. RESULTS Mean values of dietary index were low and the proportion of elderly households with low diet quality (HDIr≤4) was high (between 47.4% and 68.4%). However, the frequency of HDIr inadequacy for adult household was even higher (P<0.05). In general, adjusted coefficients for survey year, educational level of the household head, and eating out expenses were inversely associated with HDIr; whilst semi-urban and rural location of the households predicted higher HDIr values. Exceptions were found in elderly male households where the educational level of the household head was positively associated with HDIr values. CONCLUSIONS Overall, diet quality was low and decreased over time but lonely elderly female and elderly couple households had higher values of HDIr. Adherence to a healthier diet was associated with lower educational level of the household head and location of the household in less urbanized areas.
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Affiliation(s)
- D M Santos
- D.M. Santos, Department of Social Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil,
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Vesnaver E, Keller HH. Social influences and eating behavior in later life: a review. J Nutr Gerontol Geriatr 2013; 30:2-23. [PMID: 23286638 DOI: 10.1080/01639366.2011.545038] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Food intake is often poor within the older population and many are at nutritional risk. Food intake is complex, as there are multiple individual, social, and environmental determinants that may interact and change over time. Social isolation has long been recognized as a key factor predicting nutrition risk in this population. However, the mechanisms by which social relationships influence diet among older adults remain poorly understood. The purpose of this review is two-fold: ( 1 ) to identify and, where possible, clarify the social concepts used in older adult nutrition research over the past two decades, specifically, the concepts of social integration, social support, companionship and commensality; and ( 2 ) to provide a review and summary of the empirical literature on social factors and diet among cognitively well older adults living in the community. Finally, challenges to studying social concepts in older adult nutrition and areas of future research will be discussed.
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Affiliation(s)
- Elisabeth Vesnaver
- Department of Family Relations and Applied Nutrition, Macdonald Institute, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
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Patino-Alonso MC, Recio-Rodríguez JI, Belio JFM, Colominas-Garrido R, Lema-Bartolomé J, Arranz AG, Agudo-Conde C, Gomez-Marcos MA, García-Ortiz L. Factors associated with adherence to the Mediterranean diet in the adult population. J Acad Nutr Diet 2013; 114:583-9. [PMID: 24209889 DOI: 10.1016/j.jand.2013.07.038] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 07/18/2013] [Indexed: 12/21/2022]
Abstract
Our aim was to analyze the variables associated with adherence to the Mediterranean diet in the adult population. We conducted a cross-sectional study in an established cohort of 1,553 healthy study participants (mean age=55 ± 14 years; 60.3% women). Mediterranean diet adherence was evaluated based on a 14-item questionnaire and the Mediterranean diet adherence screener, which defines adequate adherence as a score of ≥ 9. Physical activity was evaluated using the 7-day physical activity record. Sociodemographic, biological, and anthropometric variables were also evaluated. The differences between Mediterranean diet compliers and noncompliers are defined by the consumption of fruit, red meats, carbonated beverages, wine, fish/shellfish, legumes, pasta, and rice (P<0.01). Adherence was lower among individuals younger than 49 years of age. In the first age tertile, adherence was greater in women and in nonobese individuals, and the triglyceride levels were lower among compliers. In the second age tertile, the compliers exercised more and had a lower body fat percentage. In the third age tertile, the compliers also possessed less body fat. The logistic regression analysis revealed the following factors associated with improved Mediterranean diet adherence: more physical exercise (odds ratio=1.588), older age (odds ratio=2.162), and moderate alcohol consumption (odds ratio=1.342). The factors associated with improved Mediterranean diet adherence included female sex, age older than 62 years, moderate alcohol consumption, and more than 17 metabolic equivalents (METs)/h/wk of physical exercise. Poorer adherence was associated with males and obesity.
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Ortega E, Franch J, Castell C, Goday A, Ribas-Barba L, Soriguer F, Vendrell J, Casamitjana R, Bosch-Comas A, Bordiú E, Calle-Pascual A, Carmena R, Castaño L, Catalá M, Delgado E, Gaztambide S, Girbés J, López-Alba A, Martínez-Larrad MT, Menéndez E, Mora-Peces I, Pascual-Manich G, Rojo-Martínez G, Serrano-Rios M, Urrutía I, Valdés S, Vázquez JA, Gomis R. Mediterranean diet adherence in individuals with prediabetes and unknown diabetes: the Di@bet.es Study. ANNALS OF NUTRITION AND METABOLISM 2013; 62:339-46. [PMID: 23838479 DOI: 10.1159/000346553] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 12/16/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Mediterranean diet (MedDiet) is causally related to diabetes and is a dietary pattern recommended to individuals with diabetes. We investigated MedDiet adherence in individuals with prediabetes and unknown (PREDM/UKDM) or known diabetes (KDM) compared to those with normal glucose metabolism (NORMAL). METHODS This was a national, population-based, cross-sectional, cluster-sampling study. MedDiet adherence was scored (MedScore, mean ± SD 24 ± 5) using a qualitative food frequency questionnaire. Logistic regression was used to examine the association between MedScore and PREDM/UKDM or KDM versus control subjects. RESULTS We evaluated 5,076 individuals. Mean age was 50 years, 57% were female, 826 (582/244) were PREDM/UKDM, 478 were KDM and 3,772 were NORMAL. Mean age increased across MedScore tertiles (46, 51 and 56 years, p < 0.0001). Higher age-adjusted adherence to MedDiet (5-unit increment in the MedScore) was associated with lower and nondifferent odds (OR, 95% CI) of prevalent PREDM/UKDM (0.88, 0.81-0.96, p = 0.001) and KDM (0.97, 0.87-1.07, p = 0.279), respectively, compared to individuals in the NORMAL group. CONCLUSIONS In a representative sample of the whole Spanish population, MedDiet adherence is independently associated with PREDM/UKDM. Therapeutic intervention may be, in part, responsible for the lack of differences in adherence observed between the KDM and NORMAL groups. However, reverse causation bias cannot be ruled out in cross-sectional studies.
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Affiliation(s)
- E Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
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Hu EA, Toledo E, Diez-Espino J, Estruch R, Corella D, Salas-Salvado J, Vinyoles E, Gomez-Gracia E, Aros F, Fiol M, Lapetra J, Serra-Majem L, Pintó X, Portillo MP, Lamuela-Raventos RM, Ros E, Sorli JV, Martinez-Gonzalez MA. Lifestyles and risk factors associated with adherence to the Mediterranean diet: a baseline assessment of the PREDIMED trial. PLoS One 2013; 8:e60166. [PMID: 23637743 PMCID: PMC3639284 DOI: 10.1371/journal.pone.0060166] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 02/22/2013] [Indexed: 11/28/2022] Open
Abstract
Background The traditional Mediterranean dietary pattern (MedDiet) is associated with longevity and low rates of cardiovascular disease (CVD). However, there is little information on who is more likely to follow this food pattern. Aim To evaluate how different factors are associated with lower MedDiet adherence in older Spanish subjects. Methods We included 7305 participants (men aged 55–80 y, women 60–80 y) at high-risk of CVD recruited into the PREDIMED trial (ISRCTN35739639). Socioeconomic, anthropometric, lifestyle characteristics and CVD risk factors were recorded. A validated 14-item questionnaire was used to evaluate MedDiet adherence at baseline. Multivariate models were used to estimate odds ratios (OR) and 95% confidence intervals for lower adherence to the MedDiet (<9 points out of 14) and ascertain factors independently associated with it. Results Former smoking (OR = 0.87; 95% CI, 0.78–0.98), physical activity (OR for the 3rd vs. the 1sttertile: 0.69; 0.62–0.78), and higher educational level (OR for university vs. less than primary school: 0.54; 0.38–0.77) were associated with higher MedDiet adherence. Conversely, having a larger waist-to-height ratio (OR for 0.1 units, 1.35; 1.22–1.49), being diabetic (OR = 1.13; 1.03–1.24), being single (OR = 1.27; 1.01–1.61) or divorced or separated (OR = 1.44; 1.09–1.89), and current smoking (OR = 1.28; 1.11–1.47) were associated with lower adherence. Conclusions Participants with little education, a larger waist-to-height ratio, or diabetes and those who were less physically active, single, divorced or separated, or smokers were less likely to adhere to the MedDiet, an ideal model for food choices. Stronger efforts of health promotion are needed in these groups to foster adoption of the MedDiet.
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Affiliation(s)
- Emily A. Hu
- Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, Massachusetts, United States of America
| | - Estefania Toledo
- Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- * E-mail:
| | - Javier Diez-Espino
- Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Primary Health Care Center of Tafalla-Osasunbidea, Tafalla, Navarra, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Internal Medicine, Institut d’Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jordi Salas-Salvado
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Ernest Vinyoles
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- La Mina Primary Care Center, University of Barcelona, Spain
- IDIAP JordiGol. Barcelona, Spain
| | - Enrique Gomez-Gracia
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, University of Malaga, Malaga, Spain
| | - Fernando Aros
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Miquel Fiol
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain
| | - Jose Lapetra
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Lluis Serra-Majem
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Xavier Pintó
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Puy Portillo
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Nutrition and Food Science, School of Pharmacy, University of the Basque County (UPV/EHU), Vitoria, Spain
| | - Rosa M. Lamuela-Raventos
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Nutrition and Food Science, School of Pharmacy, XaRTA, INSA, University of Barcelona, Barcelona, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jose V. Sorli
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Miguel A. Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain
- RETIC RD06/0045, Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Madrid, Spain
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Sánchez-Benito JL, Pontes Torrado Y, González Rodríguez A. La intervención de pérdida de peso conlleva una disminución significativa de la presión arterial y del colesterol. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS 2012. [DOI: 10.1016/j.arteri.2012.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, Davey Smith G. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev 2012; 2012:CD002137. [PMID: 22592684 PMCID: PMC6486029 DOI: 10.1002/14651858.cd002137.pub3] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. OBJECTIVES To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. SEARCH METHODS For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. SELECTION CRITERIA Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. MAIN RESULTS This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I(2) 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis.Few studies compared reduced with modified fat diets, so direct comparison was not possible. AUTHORS' CONCLUSIONS The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK.
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Ross LJ, Tapsell LC, Probst Y. Optimizing dietary fat in a weight-loss trial requires advice based on a structured “whole-of-diet” model. Nutr Res 2011; 31:683-90. [DOI: 10.1016/j.nutres.2011.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 08/23/2011] [Accepted: 08/24/2011] [Indexed: 10/16/2022]
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Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore H, Smith GD. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev 2011:CD002137. [PMID: 21735388 PMCID: PMC4163969 DOI: 10.1002/14651858.cd002137.pub2] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. OBJECTIVES To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. SEARCH STRATEGY For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. SELECTION CRITERIA Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. MAIN RESULTS This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I(2) 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis.Few studies compared reduced with modified fat diets, so direct comparison was not possible. AUTHORS' CONCLUSIONS The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Carolyn D Summerbell
- School of Medicine and Health, Wolfson Research Institute, Queen’s Campus, Durham University, Stockton-on-Tees, UK
| | | | | | | | - Helen Moore
- School of Medicine and Health, Wolfson Research Institute, Queen’s Campus, Durham University, Stockton-on-Tees, UK
| | - George Davey Smith
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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