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Sánchez-Tainta A, Zazpe I, Bes-Rastrollo M, Salas-Salvadó J, Bullo M, Sorlí JV, Corella D, Covas MI, Arós F, Gutierrez-Bedmar M, Fiol M, de la Corte FG, Serra-Majem L, Pinto X, Schröeder H, Ros E, López-Sabater MC, Estruch R, Martínez-González MA. Nutritional adequacy according to carbohydrates and fat quality. Eur J Nutr 2015; 55:93-106. [PMID: 25616935 DOI: 10.1007/s00394-014-0828-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 12/23/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the association between carbohydrate quality, fat quality or adherence to the Mediterranean diet and intake adequacy of 19 micronutrients in the PREDIMED (PREvención con DIeta MEDiterránea) trial, a multicenter, randomized, controlled, parallel group and primary prevention trial conducted in Spain. METHODS We assessed baseline dietary intake of 6,542 elderly subjects at high cardiovascular risk through a validated food frequency questionnaire (FFQ) and a validated 14-item Mediterranean diet (Med-diet) score. We used a multidimensional carbohydrate quality index (CQI) using four criteria and a fat quality index (FQI) according to the ratio (MUFA + PUFA)/(SFA + TFA). The probability of intake adequacy was calculated comparing the intakes to DRI, and also using the probabilistic approach. Absolute and adjusted probability of having inadequate intake for either ≥6 DRI or ≥8 DRI were estimated to assess nutritional adequacy according to quintiles of each index. RESULTS The lowest prevalence of inadequate micronutrient intake (≥8 DRI) was found in the highest quintile of CQI or Med-diet score, and in the lowest quintile of FQI (adjusted fold risk: 1.4, 3.4 and 10.2 respectively in comparison with the lowest quintile). P for trend <0.001 in three multivariable models. A higher CQI or Med-Diet score and a lower FQI were significantly associated with a lower fold risk of unmet EAR values. CONCLUSIONS A multidimensional assessment of CQI can be a useful tool to evaluate the quality of carbohydrates. This score and a 14-item Med-diet score were positively related to overall micronutrient adequacy in elderly participants.
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Affiliation(s)
- Ana Sánchez-Tainta
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
| | - Itziar Zazpe
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Department of Nutrition and Food Sciences, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain.
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
| | - Jordi Salas-Salvadó
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Human Nutrition Unit, Sant Joan Hospital, IISPV, Universitat Rovira i Virgili, Reus, Spain.
| | - Mónica Bullo
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Human Nutrition Department, University Rovira i Virgili, Reus, Spain.
| | - José Vicente Sorlí
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
- Primary Care Division, Valencia Institute of Health and Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Dolores Corella
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, Valencia, Spain.
| | - M Isabel Covas
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research (IMIM), Barcelona, Spain.
| | - Fernando Arós
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Cardiology, University Hospital Txagorritxu-University Hospital of Alava, Vitoria, Spain.
| | - Mario Gutierrez-Bedmar
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Málaga, Málaga, Spain.
| | - Miquel Fiol
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Son Espases, Palma de Mallorca, Spain.
| | - F García de la Corte
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Primary Care Division of Sevilla, Department of Family Medicine, San Pablo Health Center, Sevilla, Spain.
| | - Lluis Serra-Majem
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - Xavier Pinto
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
| | - Helmut Schröeder
- IMIM-Hospital del Mar Medical Research Institute and CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.
- Instituto de Salud Carlos III, Madrid, Spain.
| | - Emilio Ros
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Lipid Clinic, Department of Endocrinology and Nutrition, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
| | - M Carmen López-Sabater
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
| | - Ramón Estruch
- Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
- Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
| | - Miguel Angel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, 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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