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Carnauba RA, Sarti FM, Hassimotto NMA, Lajolo FM. 100% Orange Juice Consumption is Associated with Socioeconomic Status, Improved Nutrient Adequacy, and Higher Bioactive Compounds Intake: Results from Brazilian National Dietary Survey 2017-2018. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:498-504. [PMID: 38407157 DOI: 10.1080/27697061.2024.2318598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The consumption of 100% orange juice (OJ) has been associated with nutrient adequacy and better diet quality. To date, there are few analyses exploring 100% OJ consumption patterns across populations, with no data from Brazil. We aimed to explore the associations between 100% OJ consumption, sociodemographic factors, and nutrient intake in a representative sample of the Brazilian general population aged 10 years or older. METHODS Data were obtained from the National Dietary Survey 2017-2018, a cross-sectional study including data on individual food intake of 46,164 subjects aged ≥10 years collected using two 24-h dietary recalls. RESULTS 100% OJ was consumed by 11% of the population, with a mean intake of 43.0 ml/d. Males were more frequent consumers compared to females, and the percentage of consumers increased with education and income. 100% OJ consumption was associated with higher intakes of energy, vitamin C, folate, calcium, magnesium, potassium, polyphenols, and carotenoids. There is no significant difference in fiber intake between consumers and non-consumers. 100% OJ consumers had a higher percentage of the population meeting the Estimated Average Requirement for vitamin A, vitamin C, vitamin D, folate, calcium, and magnesium. CONCLUSION Our results suggest that 100% OJ could be a component of a healthy diet, helping individuals to achieve nutrient recommendations.
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Affiliation(s)
- Renata A Carnauba
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil
| | - Flavia M Sarti
- Center for Research in Complex Systems Modeling, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Neuza M A Hassimotto
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil
| | - Franco M Lajolo
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil
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Cost-effective options for increasing consumption of under-consumed food groups and nutrients in the USA. Public Health Nutr 2022; 25:710-716. [PMID: 33551013 PMCID: PMC9991711 DOI: 10.1017/s1368980021000537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify the most cost-effective options/contributors of under-consumed food groups and nutrients in the USA. DESIGN Twenty-four-hour dietary recall data were used for the dietary sources of under-consumed food groups and nutrients. Costs were estimated using USDA National Food Price Database 2001-2004 after adjustments for inflation using Consumer Price Index. SETTING National Health and Nutrition Examination Survey, 2013-2016. PARTICIPANTS A total of 10 112 adults aged 19+ years. RESULTS Top five cost-effective options for food groups were apple and citrus juice, bananas, apples, and melons for fruit; baked/boiled white potatoes, mixtures of mashed potatoes, lettuce, carrots and string beans for vegetables; oatmeal, popcorn, rice, yeast breads and pasta/noodles/cooked grains for whole grain; and reduced-fat, low-fat milk, flavoured milk and cheese for dairy. Top five cost-effective sources of under-consumed nutrients were rice, tortillas, pasta/noodles/cooked grains, rolls and buns, and peanut butter-jelly sandwiches for Mg; grits/cooked cereals, low- and high-sugar ready-to-eat (RTE) cereal, rolls and buns, and rice for Fe; low- and high-sugar RTE cereals, rice, protein and nutritional powders, and rolls and buns for Zn; carrots, margarine, other red and orange vegetables, liver and organ meats, butter and animal fats for vitamin A; and citrus juice, other fruit juice, vegetable juice, mustard and other condiments, and apple juice for vitamin C. CONCLUSIONS Apple/citrus juice, white potatoes/carrots, oatmeal, RTE cereals and milk were the most cost-effective food sources of multiple under-consumed food groups and nutrients and can help promote healthy eating habits at minimal cost.
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Ho KKHY, Ferruzzi MG, Wightman JD. Potential health benefits of (poly)phenols derived from fruit and 100% fruit juice. Nutr Rev 2020; 78:145-174. [PMID: 31532485 DOI: 10.1093/nutrit/nuz041] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
(Poly)phenol-rich diets have been associated with reduced risk of various diseases. Coffee and tea are typically identified as dietary sources of chlorogenic acid and flavan-3-ols; however, 100% fruit juice greatly contributes to anthocyanin, flavonol, flavan-3-ols, and flavanone intake, making them complementary sources of dietary (poly)phenols. Thus, the aim of this narrative review was to provide an overview of fruit (poly)phenols and their potential health benefits. Fruit (poly)phenols have been associated with several health benefits (eg, reduced risk of cardiovascular disease and neurocognitive benefits). Although perspectives on 100% fruit juice consumption are controversial due to the perception of sugar content, growing evidence supports the role of fruit in whole and 100% juice forms to provide consumer benefits in alignment with dietary guidance. However, differences in (poly)phenol profiles and bioavailability likely exist between whole fruit and 100% fruit juice due to processing and the presence/absence of fiber. Ongoing studies are better defining similarities and differences between whole fruit and 100% fruit juice to elucidate protective mechanisms and align with processing and consumer products.
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Affiliation(s)
- Kacie K H Y Ho
- Kacie K.H.Y. Ho is with the Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Mario G Ferruzzi
- Mario G. Ferruzzi is with the Department of Food Bioprocessing and Nutrition Science, Plants for Human Health Institute, North Carolina State University, Kannapolis, North Carolina, USA
| | - JoLynne D Wightman
- JoLynne D. Wightman is with Welch Foods Inc, Concord, Massachusetts, USA
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Maillot M, Vieux F, Rehm C, Drewnowski A. Consumption of 100% Orange Juice in Relation to Flavonoid Intakes and Diet Quality Among US Children and Adults: Analyses of NHANES 2013-16 Data. Front Nutr 2020; 7:63. [PMID: 32478089 PMCID: PMC7237568 DOI: 10.3389/fnut.2020.00063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/20/2020] [Indexed: 12/15/2022] Open
Abstract
This study explored consumption patterns of 100% orange juice by socio-demographics among US children and adults. Dietary intakes data for 15,983 persons aged >2 y came from the nationally representative National Health and Nutrition Examination Survey (NHANES 2013-2016). The What We Eat in America nutrient composition database was merged with the USDA Expanded Flavonoid Database to assess flavonoid intakes. Diet quality measures were the Healthy Eating Index (HEI-2015) and Nutrient Rich Food (NRF9.3) Index. Orange juice consumption accounted for a mean of 14 kcal/d and varied with age, incomes, and race/ethnicity. Orange juice consumption was associated with higher intakes of bioactive flavonoids, lower added sugars, and higher-quality diets overall. Diets of consumers were higher in vitamin C, potassium, calcium, vitamin D (adults), flavanones, and total flavonoids (children) as compared to non-consumers. Consumers had significantly higher HEI-2015 and NRF9.3 scores and lower body mass index values (adults). However, only 15.9% of the NHANES sample consumed any orange juice at all; of these 11.8% had <1 serving/day and only 3.4% had 1 serving/day or more.
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Affiliation(s)
| | | | - Colin Rehm
- Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
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Child Consumption of Whole Fruit and Fruit Juice Following Six Months of Exposure to a Pediatric Fruit and Vegetable Prescription Program. Nutrients 2019; 12:nu12010025. [PMID: 31877635 PMCID: PMC7019436 DOI: 10.3390/nu12010025] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/16/2022] Open
Abstract
Public health recommendations suggest limiting child consumption of fruit juice in favor of whole fruit due to juice’s high sugar content, lack of fruit fiber, and potential for excess intake. However, replacing juice with whole fruit may be particularly challenging for low-income and minority children, who report the highest intake of 100% juice. To address access and affordability challenges among low-income children, researchers partnered with pediatricians in an urban food desert community, to introduce a fruit and vegetable prescription program (FVPP) that provided a $15 prescription for fresh produce to every child during each office visit. Participating vendors included a farmers’ market and local mobile market. This study assessed changes in daily consumption of total fruit and whole fruit among 108 pediatric patients following six months of exposure to the FVPP. Child-reported mean daily intake of whole fruit increased significantly from the baseline to the 6-month follow-up (p = 0.03): 44% of children reported an increased intake of at least ¼ cup per day, and 30% reported an increased intake of at least ½ cup per day. Changes in total fruit intake (including fruit juice) were not significant. Results suggest a pediatric FVPP may have meaningful impacts on children’s dietary behaviors, particularly with regard to the intake of whole fruits.
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Maillot M, Vieux F, Rehm CD, Rose CM, Drewnowski A. Consumption Patterns of Milk and 100% Juice in Relation to Diet Quality and Body Weight Among United States Children: Analyses of NHANES 2011-16 Data. Front Nutr 2019; 6:117. [PMID: 31440512 PMCID: PMC6694734 DOI: 10.3389/fnut.2019.00117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/16/2019] [Indexed: 12/27/2022] Open
Abstract
Background: The American Academy of Pediatrics (AAP) has recommended placing limits on the consumption of milk and 100% juice by children. Methods: Consumption data for 9,069 children aged 2-19 years came from three cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES 2011-2016). Beverages were classified into 100% juices, milk (whole, reduced fat, and skim), caloric sugar sweetened beverages (SSB), low calorie beverages (LCB), and drinking water. The Healthy Eating Index 2015 and Nutrient Rich Food Index NRF9.3 were two measures of diet quality. Analyses examined consumption patterns for milk and 100% juice in relation to diet quality, AAP recommendations, and BMI z-scores across time and for different age groups. Results: Intakes of milk and 100% juice declined sharply with age, whereas SSB and water increased. Top quartiles of HEI 2015 and NRF9.3 diet quality scores were associated with higher intakes of water, milk, and 100% juice and with lower intakes of SSB. Lower-income groups drank less skim milk and water and more whole milk and SSB. Only 30% of the children consumed any 100% juice. There was no association between the consumption of milk or 100% juice and BMI z-scores for any age group. Conclusions: Top quartiles of diet quality were associated with more milk, 100% juice, and water, and less SSB. Higher quality diets were associated with lower compliance with the AAP 100% juice recommendations. Compliance with the AAP 100% juice recommendations was not associated with lower body weights. Attempts to limit the consumption of milk and 100% juice by children might have the unintended consequence of increasing consumption of SSB and may have limited value for obesity prevention.
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Affiliation(s)
- Matthieu Maillot
- MS-Nutrition, Faculté de Médecine la Timone, Laboratoire C2VN, Marseille, France
| | - Florent Vieux
- MS-Nutrition, Faculté de Médecine la Timone, Laboratoire C2VN, Marseille, France
| | - Colin D. Rehm
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY, United States
| | - Chelsea M. Rose
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
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Rehm CD, Drewnowski A. Replacing Dairy Fat With Polyunsaturated and Monounsaturated Fatty Acids: A Food-Level Modeling Study of Dietary Nutrient Density and Diet Quality Using the 2013-16 National Health and Nutrition Examination Survey. Front Nutr 2019; 6:113. [PMID: 31448278 PMCID: PMC6691138 DOI: 10.3389/fnut.2019.00113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 07/10/2019] [Indexed: 11/23/2022] Open
Abstract
Recent dietary guidelines have become more food-based, as opposed to purely nutrient-based. By contrast, assessing the impact of dietary changes on chronic disease risk continues to rely on single-nutrient substitutions. To assess the real-world implications of a nutrient-for-nutrient swap, this study examined dietary nutrient density and healthy diet scores following removal of food sources of dairy fat from diets of 15,260 individuals age ≥4 y in the National Health and Nutrition Examination Survey (NHANES 2013–2016). Those foods were then replaced with foods containing a comparable amount of non-dairy polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA). The present food-level substitution model was based on 576 diverse eating patterns of US population subgroups. Diet quality measures were the Nutrient Rich Food (NRF 9.3) Index and the 2015-Healthy Eating Index (HEI-2015). Removing 5% of dietary energy from dairy fat led to lower levels of multiple micronutrients and to lower NRF 9.3 scores. These deficits were not remedied by the modeled replacements. Although swapping dairy fat for foods containing non-dairy MUFA/PUFA did alter the fatty acid ratios, the resulting food patterns were still significantly lower in some key micronutrients. Nutrient-based dietary guidance is prone to ignore the complexity of food patterns and the recommended dietary change may have unintended nutritional consequences.
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Affiliation(s)
- Colin D Rehm
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
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Abstract
Objective: Nutritional advice based on strengthening the dietary pattern offers a very different perspective from the reductionist practice of reporting risks or benefits for individual foods.Methods: A healthful dietary pattern can be composed of innumerable different combinations of foods and beverages that collectively and synergistically protect health. Although pure juices lack fiber, juicing retains the majority of health-promoting nutrients and phytochemicals of the whole fruit. Bioactive components of 100% fruit juice have demonstrated positive clinical effects on oxidative markers, inflammation, endothelial reactivity, lipid profiles, hypertension, and platelet aggregation. Fruit juice consumers have higher scores for diet quality. They consume more whole fruit, less added sugar, and greater amounts of vitamin C, magnesium, potassium, and fiber-containing foods than non-consumers.Results: Concerns that 100% fruit juice may be associated with childhood weight gain or metabolic consequences have not been supported by recent systematic reviews and meta-analyses. Juice consumption may be particularly important for the diet quality of lower-socioeconomic-status populations. Over the past 3 decades, as fruit juice intake has fallen substantially, the vacuum has not been filled by a comparable increase in servings of whole fruit, keeping Americans from meeting daily fruit recommendations.Conclusions: Counseling about individual foods without considering their impact on overall diet quality may harm the dietary pattern without discernible health benefits.
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Affiliation(s)
- Robert D Murray
- College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
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Maillot M, Rehm CD, Vieux F, Rose CM, Drewnowski A. Beverage consumption patterns among 4-19 y old children in 2009-14 NHANES show that the milk and 100% juice pattern is associated with better diets. Nutr J 2018; 17:54. [PMID: 29793492 PMCID: PMC5968613 DOI: 10.1186/s12937-018-0363-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/13/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Patterns of beverage consumption among children and adolescents can be indicative of food choices and total diet quality. METHODS Analyses of beverage consumption patterns among 8119 children aged 4-19 y were based on the first 24-h recall of the National Health and Nutrition Examination Survey (2009-14 NHANES). Four pre-defined beverage patterns were: 1) milk pattern; 2) 100% juice pattern; 3) milk and 100% juice pattern; and 4) other caloric beverages. Food- and nutrient-based diet quality measures included the Healthy Eating Index 2010. RESULTS Most children drank other caloric beverages, as opposed to milk (17.8%), 100% juice (5.6%), or milk and 100% juice (13.5%). Drinkers of milk and 100% juice had diets that did not differ from each other in total calories, total and added sugars, fiber, or vitamin E. Milk drinkers consumed more dairy and had higher intakes of calcium, potassium, vitamin A and vitamin D as compared to all other patterns. Juice drinkers consumed more total fruit, same amounts of whole fruit, and had higher intakes of vitamin C as compared to the other consumption patterns. Drinkers of both milk and 100% juice had the highest HEI 2010 scores of all the consumption patterns. CONCLUSIONS Beverage consumption patterns built around milk and/or 100% juice were relatively uncommon. Promoting the drinking of milk and 100% juice, in preference to other caloric beverages, may be an effective strategy to improve children's diet quality. Restricting milk and 100% juice consumption may encourage the selection of other caloric beverages.
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Affiliation(s)
- Matthieu Maillot
- MS-Nutrition, 27 bld Jean Moulin Faculté de Médecine la Timone, Laboratoire NORT, 13385 Marseille cedex 5, France
| | - Colin D. Rehm
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, NY 10467 USA
| | - Florent Vieux
- MS-Nutrition, 27 bld Jean Moulin Faculté de Médecine la Timone, Laboratoire NORT, 13385 Marseille cedex 5, France
| | - Chelsea M. Rose
- Center for Public Health Nutrition, University of Washington, Box 353410, Seattle, WA 98195 USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Box 353410, Seattle, WA 98195 USA
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Mok Y, Sang Y, Ballew SH, Rebholz CM, Rosamond WD, Heiss G, Folsom AR, Coresh J, Matsushita K. American Heart Association's Life's Simple 7 at Middle Age and Prognosis After Myocardial Infarction in Later Life. J Am Heart Assoc 2018; 7:JAHA.117.007658. [PMID: 29455158 PMCID: PMC5850193 DOI: 10.1161/jaha.117.007658] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The American Heart Association recommends focusing on 7 health factors (Life's Simple 7) for primordial prevention of cardiovascular health. However, whether greater adherence to Life's Simple 7 in midlife improves prognosis after myocardial infarction (MI) in later life is unknown. Methods and Results In 1277 participants who developed MI during the ARIC (Atherosclerosis Risk in Communities) Study follow‐up, a 14‐point score of Life's Simple 7 was constructed according to the status (2 points for ideal, 1 point for intermediate, and 0 points for poor) of each of 7 factors (smoking, adiposity, physical activity, diet, total cholesterol, blood pressure, and fasting glucose) at baseline (1987–1989). Hazard ratios for composite and individual adverse outcomes of all‐cause mortality, cardiovascular mortality, recurrent MI, heart failure, and stroke were calculated according to Life's Simple 7 score. During a median follow‐up of 3.3 years, 918 participants (72%) had subsequent adverse outcomes after MI. Life's Simple 7 score at middle age was inversely associated with adverse outcomes after MI (adjusted hazard ratios of composite outcome, 0.57 [95% confidence interval, 0.39–0.84] if score is ≥10, 0.78 [95% confidence interval, 0.57–1.07] if score is 7–9, and 0.82 [95% confidence interval, 0.60–1.11] if score is 4–6 versus ≤3). The association was largely independent of access to care and MI severity. Individual factors related to better prognosis after MI were ideal nonsmoking, body mass index, blood pressure, and fasting glucose. Conclusions Optimal Life's Simple 7 at middle age was associated with better prognosis after MI in later life. Our findings suggest a secondary prevention benefit of having better cardiovascular health status in midlife.
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Affiliation(s)
- Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yingying Sang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Shoshana H Ballew
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Wayne D Rosamond
- Department of Epidemiology, University of North Carolina at Chapel Hill, NC
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, NC
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Alonso-Domínguez R, Gómez-Marcos MA, Patino-Alonso MC, Sánchez-Aguadero N, Agudo-Conde C, Castaño-Sánchez C, García-Ortiz L, Recio-Rodríguez JI. Effectiveness of a multifactorial intervention based on an application for smartphones, heart-healthy walks and a nutritional workshop in patients with type 2 diabetes mellitus in primary care (EMID): study protocol for a randomised controlled trial. BMJ Open 2017; 7:e016191. [PMID: 28912193 PMCID: PMC5640135 DOI: 10.1136/bmjopen-2017-016191] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION New information and communication technologies (ICTs) may promote lifestyle changes, but no adequate evidence is available on their combined effect of ICTs with multifactorial interventions aimed at improving diet and increasing physical activity in patients with type 2 diabetes mellitus (DM2). The primary objective of this study is to assess the effect of a multifactorial intervention to increase physical activity and adherence to Mediterranean diet in DM2. METHODS AND ANALYSIS: Study scope and population: The study will be conducted at 'La Alamedilla' primary care research unit in Salamanca (Spain). 200 patients with DM2 of both sexes, aged 25-70 years and who meet the inclusion criteria and sign the informed consent will be recruited. Each participant will attend the clinic at baseline and 3 and 12 months after intervention. INTERVENTION Both groups will be given short advice on diet and physical activity. The intervention group will also take five heart-healthy walks and attend a group session on diet education and will be trained on use of an application for smartphone (EVIDENT II) for 3 months. VARIABLES AND MEASUREMENT INSTRUMENTS The main study endpoints will be changes in physical activity, as assessed by a pedometer and the International Physical Activity Questionnaire, and adherence to the Mediterranean diet, as evaluated by an adherence questionnaire and the Diet Quality Index. Anthropometric parameters and laboratory values, lifestyles and quality of life will also be assessed. ETHICS AND DISSEMINATION It was approved by the Clinical Research Ethics Committee of Salamanca on 28/11/2016. TRIAL REGISTRATION NCT02991079; Pre-results.
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Affiliation(s)
- Rosario Alonso-Domínguez
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Department of Medicine, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca. Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Maria C Patino-Alonso
- Department of Statistics, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Natalia Sánchez-Aguadero
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Carmen Castaño-Sánchez
- Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - Luis García-Ortiz
- Department of Biomedical and Diagnostic Sciences, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca, Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
| | - José I Recio-Rodríguez
- Department of Nursing and Physiotherapy, Primary Care Research Unit, The Alamedilla Health Center, Biomedical Research Institute of Salamanca (IBSAL), Castilla and León Health Service (SACYL), University of Salamanca. Spanish Network for Preventive Activities and Health Promotion (reIAPP), Salamanca, Spain
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