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Vega-Cabello V, Struijk EA, Caballero FF, Yévenes-Briones H, Ortolá R, Calderón-Larrañaga A, Lana A, Rodríguez-Artalejo F, Lopez-Garcia E. Diet Quality and Multimorbidity in Older Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad285. [PMID: 38157322 DOI: 10.1093/gerona/glad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The role of diet quality in the accumulation of multiple chronic conditions is mostly unknown. This study examined diet quality in association with the number of chronic conditions and the rate of multimorbidity development among community-dwelling older adults. METHODS We used data from 2 784 adults aged ≥65 years from the Seniors-ENRICA 2 cohort. Diet quality was assessed at baseline (2015-17) with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Mediterranean Diet Adherence Screener (MEDAS). Information on medical diagnoses was obtained from electronic clinical records up to 2021. RESULTS Higher adherence to the AHEI-2010 was associated with a lower number of total chronic conditions (β [95% CI] quartile 4 vs 1: -0.57 [-0.86 to 0.27], p trend < .001] and cardiometabolic conditions (-0.30 [-0.44 to -0.17], p trend < .001) at baseline, while higher adherence to the MEDAS was associated with a lower number of total chronic conditions (-0.30 [-0.58 to -0.02], p trend = .01) and neuropsychiatric and neurodegenerative conditions (-0.09 [-0.17 to -0.01], p trend = .01). After a median follow-up of 5.2 years (range: 0.1-6.1 years) higher adherence to the AHEI-2010 was associated with a lower increase in chronic conditions (β [95% confidence interval] quartile 4 vs 1: -0.16 [-0.30 to -0.01], p trend = .04) and with lower rate of chronic disease accumulation. CONCLUSIONS Higher diet quality, as measured by the AHEI-2010, was associated with a lower number of chronic health conditions and a lower rate of multimorbidity development over time.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Francisco Felix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences. Universidad de Oviedo/ISPA; Oviedo, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid, Spain
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Yévenes-Briones H, Caballero FF, Struijk EA, Estrada-deLeón DB, Rey-Martinez J, Rodríguez-Artalejo F, Banegas JR, Lopez-Garcia E. The Hearing Function and Ambulatory Blood Pressure in Older Adults. Otolaryngol Head Neck Surg 2024. [PMID: 38494745 DOI: 10.1002/ohn.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/01/2024] [Accepted: 02/19/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE To examine the association between hearing function, assessed with pure-tone average (PTA) of air conduction thresholds, and 24-hour ambulatory blood pressure (BP) in older adults. STUDY DESIGN Cross-sectional study. SETTING A total of 1404 community-dwelling individuals aged ≥65 years from the Seniors-ENRICA cohort were examined. METHODS Hearing loss was defined as PTA > 40-AudCal hearing loss decibels (dB-aHL) in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency (3, 4, and 8 kHz). Circadian BP patterns were calculated as the percentage decline in systolic BP during the night, and participants were classified as dipper, nondipper, and riser. Ambulatory hypertension was defined as BP ≥ 130/80 mm Hg (24 hour), ≥135/85 (daytime), and ≥120/70 (nighttime) or on antihypertensive treatment. Analyses were performed with linear- and logistic-regression models adjusted for the main confounders. RESULTS In multivariable analyses, the PTA was associated with higher nighttime systolic BP [β coefficient per 20 dB-aHL increment standard frequency (95% confidence interval, CI): 2.41 mm Hg (0.87, 3.95); β (95% CI) per 20 dB-aHL increment speech frequency 2.17 mm Hg (0.70, 3.64)]. Among hypertensive patients, hearing loss at standard and high-frequency PTA was associated with the riser BP pattern [odds ratio: 2.01 (95% CI, 1.03-3.93) and 1.45 (1.00-2.09), respectively]; also, hearing loss at standard PTA was linked to uncontrolled nighttime BP [1.81 (1.01-3.24)]. CONCLUSION PTA was associated with higher nighttime BP, and hearing loss with a riser BP pattern and uncontrolled BP in older hypertensives.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Daniela B Estrada-deLeón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Jorge Rey-Martinez
- Osakidetza Basque Health Service, Biodonostia Health Research Institute, San Sebástian-Donostia, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Struijk EA, Fung TT, Rodriguez-Artalejo F, Bischoff-Ferrari HA, Willett WC, Lopez-Garcia E. Specific dairy foods and risk of frailty in older women: a prospective cohort study. BMC Med 2024; 22:89. [PMID: 38424524 PMCID: PMC10905813 DOI: 10.1186/s12916-024-03280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dairy contains a complex mixture of lipids, proteins, and micronutrients. Whether habitual dairy consumption is associated with health benefits is not well established. Since dairy is high in nutrients that are potentially protective against frailty, the association between dairy products and the risk of frailty is of interest. METHODS We analyzed data from 85,280 women aged ≥ 60 years participating in the Nurses' Health Study. Consumption of milk, yogurt, and cheese was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥ 5 chronic illnesses, and a weight loss of ≥ 5%. The occurrence of frailty was assessed every four years from 1992 to 2018. Cox proportional hazard models were used to examine the association between the intake of dairy foods and frailty. RESULTS During follow-up we identified 15,912 incident cases of frailty. Consumption of milk or yogurt was not associated with the risk of frailty after adjustment for lifestyle factors, medication use, and overall diet quality. Cheese consumption was positively associated with risk of frailty [relative risk (95% confidence interval) for one serving/day increment in consumption: 1.10 (1.05, 1.16)]. Replacing one serving/day of milk, yogurt, or cheese with one serving/day of whole grains, nuts, or legumes was associated with a significant lower risk of frailty, while replacing milk, yogurt, or cheese with red meat or eggs was associated with an increased risk. When milk was replaced with a sugar-sweetened or artificially sweetened beverage, a greater risk of frailty was observed, while replacing milk with orange juice was associated with a lower risk of frailty. CONCLUSIONS The results suggest that the association between milk, yogurt, and cheese and frailty partly depends on the replacement product. Habitual consumption of milk or yogurt was not associated with risk of frailty, whereas cheese consumption may be associated with an increased risk.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Avda, Arzobispo Morcillo, 4, 28029, Madrid, Spain.
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Avda, Arzobispo Morcillo, 4, 28029, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Centre On Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Avda, Arzobispo Morcillo, 4, 28029, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute. CEI UAM+CSIC, Madrid, Spain
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Yévenes-Briones H, Caballero FF, Struijk EA, Arias-Fernández L, Lana A, Rey-Martinez J, Rodríguez-Artalejo F, Lopez-Garcia E. Association Between Speech Reception Threshold in Noise and Multimorbidity: The UK Biobank Study. Otolaryngol Head Neck Surg 2024; 170:480-489. [PMID: 37622533 DOI: 10.1002/ohn.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/17/2023] [Accepted: 08/06/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To investigate the association between hearing function, as approached with the functional auditory capacity, and multimorbidity. STUDY DESIGN Cross-sectional study. SETTING The UK Biobank was established from 2006 to 2010 in the United Kingdom. This cross-sectional analysis included 165,524 participants who provided baseline information on hearing function. METHODS Functional auditory capacity was measured with a digit triplet test. Three categories were defined according to the speech reception threshold in noise (SRTn): normal (SRTn < -5.5 dB signal-to-noise ratio [SNR]), insufficient (SRTn ≥ -5.5 to ≤ -3.5 dB SNR) and poor hearing function (SRTn > -3.5 dB SNR). To define multimorbidity, 9 chronic diseases were considered, including chronic obstructive pulmonary disease, dementia, Parkinson's disease, stroke, cancer, depression, osteoarthritis, coronary heart disease, and diabetes; multimorbidity was defined as the coexistence of 2 or more in the same individual. Analyses were conducted using logistic models adjusted for relevant confounders. RESULTS Among the study participants, 54.5% were women, and the mean (range) age was 56.7 (39-72) years. The prevalence of insufficient and poor hearing function and multimorbidity was 13% and 13.2%, respectively. In comparison with having a normal SRTn, the odds ratio (95% confidence interval) of multimorbidity associated with insufficient SRTn was 1.13 (1.08-1.18), and with poor SRTn was 1.25 (1.14-1.37). CONCLUSION Insufficient and poor hearing function was associated with multimorbidity. This association suggests common biological pathways for many of the considered morbidities.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Alberto Lana
- Department of Medicine, Universidad de Oviedo/ISPA, Oviedo, Spain
| | - Jorge Rey-Martinez
- Neurotology Unit, ENT Department, Hospital Universitario Donostia, San Sebastián-Donostia, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM, Madrid, Spain
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Carballo-Casla A, Sotos-Prieto M, García-Esquinas E, A Struijk E, Caballero FF, Calderón-Larrañaga A, Lopez-Garcia E, Rodríguez-Artalejo F, Ortolá R. Animal and vegetable protein intake and malnutrition in older adults: a multicohort study. J Nutr Health Aging 2024; 28:100002. [PMID: 38267163 DOI: 10.1016/j.jnha.2023.100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES Malnutrition is a global concern in older adults, as it negatively affects morbidity and mortality. While higher animal protein intake may help prevent and treat malnutrition, it might also increase the risk of chronic diseases and death. Conversely, vegetable protein intake might have a lower anabolic effect and not be as effective to improve nutritional status. We studied whether animal and vegetable protein intake are associated with changes in nutritional status in older adults. DESIGN We used pooled data from two Spanish cohorts: the Seniors-ENRICA 1 and Seniors-ENRICA 2. SETTINGS AND PARTICIPANTS 2,965 community-dwelling adults aged 62-92 years. MEASUREMENTS Protein intake was estimated at baseline via an electronic, validated diet history. Nutritional status was assessed at baseline and after 2.6 years with the GLIM (Global Leadership Initiative on Malnutrition) phenotypic criteria: weight loss, low body mass index, and reduced muscle mass. The odds of improvements in nutritional status were assessed with logistic regression models, extensively adjusted for potential confounders. RESULTS Higher animal and vegetable protein intake were associated with improvements in nutritional status [odds ratios (95% confidence intervals) per 0.25 g/kg/day were 1.15 (1.00, 1.32) and 1.77 (1.35, 2.32), respectively]. Cereal protein intake drove most of the latter association [2.07 (1.44, 2.98)]. Replacing 0.25 g/kg/day of total animal protein, meat, or fish protein (but not dairy or egg protein) with vegetable protein was associated with improvements in nutritional status [1.54 (1.13, 2.09), 1.70 (1.20, 2.41), and 1.77 (1.18, 2.64), respectively]. CONCLUSIONS Higher animal and, especially, vegetable protein intake were associated with improvements in nutritional status in older adults. Replacing total animal protein, meat, or fish protein with vegetable protein may help improve malnutrition.
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Affiliation(s)
- Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Tomtebodavägen 18 A SE-171 77 Stockholm, Sweden.
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049 Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
| | - Esther García-Esquinas
- Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; National Center of Epidemiology, Instituto de Salud Carlos III, Avenida de Monforte de Lemos 5, Hall 12, 28029 Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Tomtebodavägen 18 A SE-171 77 Stockholm, Sweden
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049 Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049 Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
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Vázquez-Fernández A, Lana A, Struijk EA, Vega-Cabello V, Cárdenas-Valladolid J, Salinero-Fort MÁ, Rodríguez-Artalejo F, Lopez-Garcia E, Caballero FF. Cross-sectional Association Between Plasma Biomarkers and Multimorbidity Patterns in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glad249. [PMID: 37886823 DOI: 10.1093/gerona/glad249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Indexed: 10/28/2023] Open
Abstract
Multimorbidity is the simultaneous presence of 2 or more chronic conditions. Metabolomics could identify biomarkers potentially related to multimorbidity. We aimed to identify groups of biomarkers and their association with different multimorbidity patterns. Cross-sectional analyses were conducted within the Seniors-ENRICA-2 cohort in Spain, with information from 700 individuals aged ≥65 years. Biological samples were analyzed using high-throughput proton nuclear magnetic resonance metabolomics. Biomarker groups were identified with exploratory factor analysis, and multimorbidity was classified into 3 types: cardiometabolic, neuropsychiatric, and musculoskeletal. Logistic regression was used to estimate the association between biomarker groups and multimorbidity patterns, after adjusting for potential confounders including sociodemographics, lifestyle, and body mass index. Three factors were identified: the "lipid metabolism" mainly reflected biomarkers related to lipid metabolism, such as very-low-density lipoprotein and low-density lipoprotein cholesterol; the "high-density lipoprotein cholesterol" mainly included high-density lipoprotein cholesterol subclasses and other lipids not included in the first factor; and the "amino acid/glycolysis/ketogenesis," composed of some amino acids, glycolysis-related metabolites, and ketone bodies. Higher scores in the "lipid metabolism" factor were associated with a higher likelihood of cardiometabolic multimorbidity, odds ratio for tertile 3 versus tertile 1 was 1.79 (95% confidence interval: 1.17-2.76). The "high-density lipoprotein cholesterol" factor was associated with lower odds of cardiometabolic multimorbidity [0.51 (0.32-0.82)], and the "amino acid/glycolysis/ketogenesis" factor was associated with more frequent cardiometabolic multimorbidity [1.85 (1.18-2.90)]. Different metabolomic biomarkers are associated with different multimorbidity patterns; therefore, multiple biomarker measurements are needed for a complete picture of the molecular mechanisms of multimorbidity.
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Affiliation(s)
- Aitana Vázquez-Fernández
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Verónica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Juan Cárdenas-Valladolid
- Dirección Técnica de Sistemas de Información, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain
- Enfermería, Universidad Alfonso X El Sabio, Villanueva de la Cañada, Spain
| | - Miguel Ángel Salinero-Fort
- Subdirección General de Investigación Sanitaria, Consejería de Sanidad, Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Grupo de Envejecimiento y Fragilidad de las personas mayores, IdIPAZ, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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Caballero FF, Lana A, Struijk EA, Arias-Fernández L, Yévenes-Briones H, Cárdenas-Valladolid J, Salinero-Fort MÁ, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Prospective Association Between Plasma Concentrations of Fatty Acids and Other Lipids, and Multimorbidity in Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:1763-1770. [PMID: 37156635 DOI: 10.1093/gerona/glad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Indexed: 05/10/2023] Open
Abstract
Biological mechanisms that lead to multimorbidity are mostly unknown, and metabolomic profiles are promising to explain different pathways in the aging process. The aim of this study was to assess the prospective association between plasma fatty acids and other lipids, and multimorbidity in older adults. Data were obtained from the Spanish Seniors-ENRICA 2 cohort, comprising noninstitutionalized adults ≥65 years old. Blood samples were obtained at baseline and after a 2-year follow-up period for a total of 1 488 subjects. Morbidity was also collected at baseline and end of the follow-up from electronic health records. Multimorbidity was defined as a quantitative score, after weighting morbidities (from a list of 60 mutually exclusive chronic conditions) by their regression coefficients on physical functioning. Generalized estimating equation models were employed to assess the longitudinal association between fatty acids and other lipids, and multimorbidity, and stratified analyses by diet quality, measured with the Alternative Healthy Eating Index-2010, were also conducted. Among study participants, higher concentrations of omega-6 fatty acids [coef. per 1-SD increase (95% CI) = -0.76 (-1.23, -0.30)], phosphoglycerides [-1.26 (-1.77, -0.74)], total cholines [-1.48 (-1.99, -0.96)], phosphatidylcholines [-1.23 (-1.74, -0.71)], and sphingomyelins [-1.65 (-2.12, -1.18)], were associated with lower multimorbidity scores. The strongest associations were observed for those with a higher diet quality. Higher plasma concentrations of omega-6 fatty acids, phosphoglycerides, total cholines, phosphatidylcholines, and sphingomyelins were prospectively associated with lower multimorbidity in older adults, although diet quality could modulate the associations found. These lipids may serve as risk markers for multimorbidity.
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Affiliation(s)
- Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Alberto Lana
- Department of Medicine, Universidad de Oviedo/ISPA, Oviedo, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid, Spain
| | | | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Juan Cárdenas-Valladolid
- Dirección Técnica de Sistemas de Información. Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid, Spain
- Enfermería, Universidad Alfonso X El Sabio, Villanueva de la Cañada, Spain
| | - Miguel Ángel Salinero-Fort
- Subdirección General de Investigación Sanitaria, Consejería de Sanidad, Fundación de Investigación e Innovación Sanitaria de Atención Primaria, Madrid, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Grupo de Envejecimiento y Fragilidad de las personas mayores. IdIPAZ, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid, Spain
- IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid, Spain
- IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
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8
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Yévenes-Briones H, Caballero FF, Estrada-deLeón DB, Struijk EA, Mesas AE, Banegas JR, Rodríguez-Artalejo F, Lopez-García E. Duration and Quality of Sleep and Risk of Self-reported Hearing Loss: The UK Biobank Study. Ear Hear 2023; 44:1182-1189. [PMID: 36973871 DOI: 10.1097/aud.0000000000001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE The duration and quality of sleep have been associated with multiple health conditions in adults. However, whether sleep duration and quality are associated with hearing loss (HL) is uncertain. The present study investigates the prospective association between duration and quality of sleep and HL. DESIGN This longitudinal analysis included 231,650 participants aged 38 to 72 years from the UK Biobank cohort, established in 2006-2010 in the United Kingdom. Duration and sleep complaints (snoring at night, daytime sleepiness, sleeplessness, difficulty getting up in the morning, and eveningness preference) were self-reported. HL was self-reported at baseline and during the follow-up. RESULTS Over a median follow-up of 4.19 (SD: 2.15) years, 6436 participants reported incident HL. In fully adjusted models, in comparison with sleeping between 7 and 8 hours a day, the adjusted hazard ratio (HR) (95% CI) associated with sleeping <7 hours a day was 1.01 (0.95 to 1.07), and for sleeping >8 hours a day was 0.98 (0.88 to 1.08). After adjustment for potential confounders, the HRs (95% confidence interval) of HL associated with having 1, 2, 3, and 4 to 5 vs. 0 sleep complaints were: 1.15 (1.05 to 1.27), 1.16 (1.05 to 1.28), 1.32 (1.19 to 1.47), and 1.49 (1.31 to 1.69), respectively; p for trend: <0.001. An increase in the number of sleep complaints was associated with higher risk of HL among participants with non-optimal sleep duration than among participants with optimal sleep duration. CONCLUSION In this large population-based study, poor sleep quality was associated with an increased risk of HL; however, sleep duration was not associated with risk.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Daniela B Estrada-deLeón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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9
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Vega-Cabello V, Struijk EA, Caballero FF, Lana A, Arias-Fernández L, Banegas JR, Artalejo FR, Lopez-Garcia E. Dietary micronutrient adequacy and risk of multimorbidity in community-dwelling older adults. Am J Clin Nutr 2023:S0002-9165(23)48901-0. [PMID: 37146761 DOI: 10.1016/j.ajcnut.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/21/2023] [Accepted: 05/01/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Multimorbidity refers to the coexistence of multiple chronic health conditions. The effect of nutritional adequacy on multimorbidity is mostly unknown. OBJECTIVE The aim of this study was to assess the prospective association between dietary micronutrient adequacy and multimorbidity among community-dwelling older adults. METHODS This cohort study included 1461 adults aged ≥65 years from the Seniors-ENRICA II cohort. Habitual diet was assessed at baseline (2015 to 2017) with a validated computerized diet history. Intake of 10 micronutrients (calcium, magnesium, potassium, vitamins A, C, D, E, zinc, iodine, and folate) was expressed as a percentage relative to dietary reference intakes, with higher scores indicating greater adequacy. Dietary micronutrient adequacy was computed as the average of all the nutrient scores. Information on medical diagnosis was obtained from the electronic health records up to December 2021. Conditions were grouped into a comprehensive list of 60 categories and occurrence of multimorbidity was defined as having ≥6 chronic conditions. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders. RESULTS The mean age was 71.0 (SD: 4.2) years and 57.8% of participants were males. During a median follow-up of 4.79 years, we documented 561 incident cases of multimorbidity. Participants in the highest (85.8-97.7%) versus the lowest tertile (40.1-78.7%) of dietary micronutrient adequacy had a lower risk of multimorbidity [fully adjusted hazard ratio (95% confidence interval): 0.75 (0.59-0.95); p trend: 0.02]. A 1-SD increment in minerals adequacy and in vitamins adequacy were associated with lower risk of multimorbidity, although estimates were attenuated after additional adjustment for the opposite subindex [minerals subindex: 0.86 (0.74-1.00); vitamins subindex: 0.89 (0.76-1.04)]. No differences were observed by strata of sociodemographic and lifestyle factors. CONCLUSION A higher micronutrient index score was associated with lower risk of multimorbidity. Improving the dietary micronutrient adequacy could prevent multimorbidity among older adults. CLINICAL TRIAL REGISTRY ClinicalTrials.gov NCT03541135.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences. Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | | | - José Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain..
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10
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Vega-Cabello V, Caballero FF, Rodriguez-Artalejo F, Lopez-Garcia E, Struijk EA. Leucine Intake and Risk of Impaired Physical Function and Frailty in Older Adults. J Gerontol A Biol Sci Med Sci 2023; 78:241-249. [PMID: 36107140 DOI: 10.1093/gerona/glac191] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Leucine is suggested to play a central role in age-related physical decline, but the effect of dietary leucine intake on physical functioning is uncertain. We examined the prospective association between dietary leucine intake and impaired lower-extremity function (ILEF) and frailty in older adults. METHODS We used data from 2 956 adults aged ≥60 and older from the Seniors-ENRICA cohort. At baseline (2008-2010) and in 2012, dietary information was obtained with a validated computerized face-to-face diet history, from which energy-adjusted cumulative leucine intake per body weight was calculated. Participants were followed up through 2017 to assess incident ILEF, ascertained with the Short Physical Performance Battery, and incident frailty, according to the Fried phenotype criteria. Statistical analysis was performed with Cox models adjusted for the main potential confounders. RESULTS During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared with participants in the lowest tertile of leucine intake (35.5-89.0 mg/kg/d), those in the highest tertile (107.4-372.5 mg/kg/d) had a lower risk of ILEF (fully adjusted hazard ratio [95% confidence interval]: 0.70 [0.53-0.93], p trend: .01) and of frailty (0.63 [0.41-0.96], p trend: .03]. A higher consumption of important sources of leucine in this population, including unprocessed beef, oily and white fish, and bread, were also associated with a lower risk of incident ILEF and frailty. CONCLUSIONS Higher leucine intake was associated with reduced risk of ILEF and frailty. Dietary leucine, obtained from foods rich in high-quality protein, could be a key nutrient to prevent age-related physical function decline in older adults.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Felix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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11
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Caballero FF, Lana A, Struijk EA, Arias-Fernández L, Cárdenas-Valladolid J, Salinero-Fort MÁ, Banegas JR, Rodriguez-Artalejo F, López-García E. Multimorbidity patterns in older adults: the role of social variables and lifestyle behaviors. Gerontology 2023:000529406. [PMID: 36724741 DOI: 10.1159/000529406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION While some conditions clusters represent the chance co-occurrence of common individual conditions, others may represent shared causal factors. The aims of this study were to identify multimorbidity patterns in older adults, and to explore the relationship between social variables, lifestyle behaviors, and the multimorbitidity patterns identified. METHODS This was a cross-sectional design. Data came from 3273 individuals aged ≥65 from the Seniors-ENRICA-2 cohort; information on 60 chronic diseases categories, categorized according to the 2nd edition of the International Classification of Primary Care and the 10th edition of the International Classification of Diseases, was obtained from clinical records linkage. To identify multimorbidity patterns, an exploratory factor analysis was conducted over chronic disease categories with prevalence >5%, using Oblimin rotation and Kaiser's eigenvalues-greater-than-one rule. The association between multimorbidity patterns and their potential determinants was assessed with multivariable linear regression. RESULTS The three-factor solution (Musculoskeletal diseases and mental disorders, Cardiometabolic diseases, and Cardiopulmonary diseases) explained 64.5% of the total variance. Being older, lower occupational category, higher levels of loneliness, lower levels of physical activity, and higher body mass index were associated with higher scores in the multimorbidity patterns identified. Female sex was linked to the Musculoskeletal diseases and mental disorders pattern, while being male was revealed to the two remaining multimorbidity patterns. A high diet quality was inversely related to Cardiometabolic diseases, while optimal sleep duration was inversely related to Cardiopulmonary diseases. DISCUSSION/CONCLUSION Three multimorbidity patterns were identified in older adults. Multimorbidity patterns were differently associated with social variables and lifestyles behavioral factors.
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12
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Sotos-Prieto M, Struijk EA, Fung TT, Rodríguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between the quality of plant-based diets and risk of frailty. J Cachexia Sarcopenia Muscle 2022; 13:2854-2862. [PMID: 36177985 PMCID: PMC9745455 DOI: 10.1002/jcsm.13077] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The Mediterranean diet and other dietary patterns rich in fruits and vegetables have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk. Our aim was to assess the association between plant-based diet quality and risk of frailty. METHODS Prospective cohort consisted with 82 234 women aged ≥60 years from the Nurses' Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to June 23, 2021. Dietary data were collected every 4 years using a validated semi-quantitative food frequency questionnaire. The plant-based diet quality was assessed with two indices (range 18-90 points): (a) healthful plant-based diet index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils and tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets/desserts) and animal foods received reverse scores; and (b) unhealthful plant-based diet index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods. Frailty incidence was assessed every 4 years, being defined as having three or more of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and their 95% confidence interval (CI). RESULTS We identified 12 910 incident cases of frailty over 1 176 401 person-year follow-up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (hazard ratio [HR] for the highest vs. lowest quintile: 0.77, 95% confidence interval: 0.72-0.81; P trend <0.001). In addition, a 10-unit increment in the hPDI was associated with a relative 15% lower risk of frailty. Conversely, a direct association was found between the uPDI and risk of frailty (HR highest vs. lowest quintile: 1.24 [1.17, 1.32], P trend <0.001). These associations were consistent for each frailty criterion, among participants with no frailty criteria at baseline, after excluding participants with diabetes, cancer and cardiovascular disease at baseline, for alternative versions of the plant-based diet indices (PDIs), in subgroup analysis by categories of potential confounders, and in latency analysis. CONCLUSIONS A healthful plant-based diet was associated with lower risk of frailty whereas an unhealthful plant-based diet was associated with higher risk.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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13
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Caballero FF, Lana A, Struijk EA, Arias-Fernández L, Yévenes-Briones H, Cárdenas-Valladolid J, Salinero-Fort MÁ, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Prospective Association Between Plasma Amino Acids And Multimorbidity In Older Adults. J Gerontol A Biol Sci Med Sci 2022; 78:637-644. [PMID: 35876753 DOI: 10.1093/gerona/glac144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some amino acids have been associated with aging-related disorders and risk of physical impairment. The aim of this study was to assess the association between plasma concentrations of nine amino acids, including branched-chain and aromatic amino acids, and multimorbidity. METHODS This research uses longitudinal data from the Seniors-ENRICA 2 study, a population-based cohort from Spain which comprises non-institutionalized adults older than 65. Blood samples were extracted at baseline and after a follow-up period of two years for a total of 1488 subjects. Participants' information was linked with electronic health records. Chronic diseases were grouped into a list of 60 mutually exclusive conditions. A quantitative measure of multimorbidity, weighting morbidities by their regression coefficients on physical functioning, was employed and ranged from 0 to 100. Generalized estimating equation models were used to explore the relationship between plasma amino acids and multimorbidity, adjusting for sociodemographics, socioeconomic status and lifestyle behaviors. RESULTS The mean age of participants at baseline was 73.6 (SD = 4.2) years, 49.6% were women. Higher concentrations of glutamine [coef. per mmol/l (95% confidence interval = 10.1 (3.7, 16.6)], isoleucine [50.3 (21.7, 78.9)] and valine [15.5 (3.1, 28.0)] were significantly associated with higher multimorbidity scores, after adjusting for potential confounders. Body mass index could have influenced the relationship between isoleucine and multimorbidity (p = 0.016). CONCLUSIONS Amino acids could play a role in regulating aging-related diseases. Glutamine and branched-chain amino acids as isoleucine and valine are prospectively associated and could serve as risk markers for multimorbidity in older adults.
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Affiliation(s)
- Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Alberto Lana
- Department of Medicine. Universidad de Oviedo/ISPA, Oviedo
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | | | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Juan Cárdenas-Valladolid
- Dirección Técnica de Sistemas de Información. Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid.,Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid.,Enfermería. Universidad Alfonso X El Sabio, Villanueva de la Cañada
| | - Miguel Ángel Salinero-Fort
- Fundación de Investigación e Innovación Biosanitaria de Atención Primaria, Madrid.,Subdirección General de Investigación Sanitaria. Consejería de Sanidad, Madrid.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas.,Grupo de Envejecimiento y Fragilidad de las personas mayores. IdIPAZ, Madrid
| | - José R Banegas
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid and CIBER of Epidemiology and Public Health, Madrid.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid
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14
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Delgado-Velandia M, Ortolá R, García-Esquinas E, Struijk EA, López-García E, Rodríguez-Artalejo F, Sotos-Prieto M. Adherence to a Mediterranean Lifestyle and Changes in Frequency, Severity, and Localization of Pain in Older Adults. Mayo Clin Proc 2022; 97:1282-1293. [PMID: 35461661 DOI: 10.1016/j.mayocp.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/16/2021] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the association between adherence to a Mediterranean lifestyle and changes in pain, and its characteristics over time in older adults. PATIENTS AND METHODS We analyzed data from 864 and 862 community-dwelling individuals aged 65+ years from the Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain (Seniors-ENRICA) Seniors-ENRICA-1 (2008-2010 to 2012) and Seniors-ENRICA-2 (2015-2017 to 2019) cohorts, with a median follow-up of 2.8 and 2.4 years, respectively. Adherence to a Mediterranean lifestyle was assessed at baseline with the 27-item Mediterranean lifestyle (MEDLIFE) index. Pain changes over time were calculated with a pain scale that assessed the frequency, severity, and the number of pain locations both at baseline and follow-up. Multivariable-adjusted relative risk ratios (RRRs) were obtained using multinomial logistic regression. RESULTS In the pooled cohorts, after a median follow-up of 2.6 years, pain worsened for 697 participants, improved for 734, and did not change for 295. Compared with the lowest category of MEDLIFE adherence, those in the highest category showed an RRR of improvement vs worsening of overall pain of 1.85 (95% CI, 1.28 to 2.67; P-trend<.001). MEDLIFE adherence was also linked to improvement in pain frequency (RRR, 1.98; 95% CI, 1.31 to 3.01; P-trend=.001), pain severity (RRR, 2.00; 95% CI, 1.33 to 3.00; P-trend=.001), and a reduction in the number of pain locations (RRR, 1.68; 95% CI, 1.13 to 2.50; P-trend=.004). Limitations of this study are the use of self-reported lifestyle data. CONCLUSION A Mediterranean lifestyle was associated with improvement of pain characteristics in older adults. Experimental studies should assess the efficacy of an integral lifestyle approach for the management of pain in older adults.
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Affiliation(s)
- Mario Delgado-Velandia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA.
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Struijk EA, Fung TT, Rodríguez-Artalejo F, Bischoff-Ferrari HA, Hu FB, Willett WC, Lopez-Garcia E. Protein intake and risk of frailty among older women in the Nurses' Health Study. J Cachexia Sarcopenia Muscle 2022; 13:1752-1761. [PMID: 35318829 PMCID: PMC9178161 DOI: 10.1002/jcsm.12972] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/21/2022] [Accepted: 02/15/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is evidence that an overall healthy diet is associated with lower risk of frailty. However, the effect of diet composition, specifically the role of protein intake on frailty, is mostly unclear. The aim of this study was to evaluate the intake of protein, including total, plant, animal, and dairy protein, in relation to frailty incidence in a large cohort of older women. METHODS We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Intake of protein was measured nine times during follow-up from 1980 until 2010. Frailty was defined as having at least three of the following five criteria from the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss of ≥5%. The occurrence of frailty was assessed every 4 years from 1992 up to 2014. RESULTS During follow-up, we identified 13 279 incident cases of frailty. Women with a higher intake of plant protein had a lower risk of developing frailty after adjustment for all relevant confounders [relative risks across quintiles of consumption: 1.00, 0.94, 0.89, 0.86, and 0.86; P-trend < 0.001]. In contrast, those with a higher intake of animal protein intake had a higher risk of frailty [relative risks across quintiles of consumption: 1.00, 0.98, 0.99, 1.00, and 1.07; P-trend 0.04]. The intake of total and dairy protein showed no significant association with frailty in the full model. Substituting 5% of energy from plant protein intake at the expense of animal protein, dairy protein, or non-dairy animal protein was associated with 38% (29%, 47%), 32% (21%, 42%), and 42% (33%, 50%) reduced risk of frailty. CONCLUSIONS A higher intake of plant protein, but not animal or dairy protein, was associated with a lower risk of frailty. Substitution of plant protein for animal protein, especially non-dairy animal protein, was associated with lower risk of frailty.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
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16
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Estrada-deLeón DB, Struijk EA, Caballero FF, Ortolá R, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Association of prolonged nightly fasting with cardiovascular, renal, inflammation, and nutritional status biomarkers in community-dwelling older adults. Am J Clin Nutr 2022; 115:1282-1289. [PMID: 35102374 DOI: 10.1093/ajcn/nqac021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/24/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Prolonged fasting as a dietary strategy has been linked to metabolic benefits; however, data supporting these benefits corresponded to studies in very small samples of young participants in controlled environments, with few cardiovascular risk markers, who were studied for short periods of time. OBJECTIVES We sought to assess the association of habitual prolonged nightly fasting with a wide array of cardiovascular, renal, inflammation, and nutritional status biomarkers among community-dwelling older adults. METHODS Cross-sectional analysis of data were obtained from 1047 adults aged ≥65 y from the Seniors Study on Nutrition and Cardiovascular Risk in Spain 2 (Seniors-ENRICA-2) cohort. Habitual diet was assessed through a validated diet history. Fasting time was classified into the following categories: <10, 10 to <12, and 2 h/d, the latter being considered prolonged nightly fasting. Adjusted geometric means of biomarker concentrations in blood and serum were estimated using linear regression models, by categories of fasting time. Main confounders included overall diet quality, defined as adherence to a Mediterranean diet score, and BMI (in kg/m2). RESULTS Longer fasting time was associated with: lower concentration of HDL cholesterol (difference between the longest and shortest fasting category: -2.94 mg/dL; 95% CI: -4.80, -1.09; P-trend: 0.01); higher potassium concentration (0.11 mEq/L; 95% CI: 0.03, 0.19; P-trend: 0.01); and lower concentration of chloride (-0.50 mEq/L; 95% CI: -0.91, -0.09; P-trend: 0.03). These results were slightly attenuated after additional adjustment for BMI. CONCLUSIONS Habitual prolonged nightly fasting did not show beneficial associations with the examined biomarkers. By contrast, some modest detrimental associations were found suggesting that extended periods of time between meals may not be beneficial for older adults.
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Affiliation(s)
- Daniela B Estrada-deLeón
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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17
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Ortolá R, García-Esquinas E, Buño-Soto A, Cabanas-Sánchez V, Martínez-Gómez D, Sotos-Prieto M, Struijk EA, Caballero FF, Lopez-Garcia E, Banegas JR, Rodríguez-Artalejo F. Associations of device-measured sleep, sedentariness and physical activity with growth differentiation factor 15 in older adults. J Cachexia Sarcopenia Muscle 2022; 13:1003-1012. [PMID: 35132822 PMCID: PMC8977966 DOI: 10.1002/jcsm.12924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is a biomarker for chronic disease burden that might explain the health effects of sedentary behaviours (SBs) and physical activity (PA). We examined associations of device-measured sleep, SB and PA, and time reallocations among them, with GDF-15 in older adults. METHODS We used data from 2245 older adults participating in the Seniors-ENRICA-2 study. Wrist-worn accelerometers were employed to ascertain total time in sleep, SB, light PA (LPA) and moderate-to vigorous PA (MVPA). Associations between these activities and serum GDF-15 levels were analysed using linear regression, including isotemporal substitution models for time reallocations among activities, and adjusted for potential confounders. Analyses were conducted separately in two groups (less active and more active individuals) according to the median total PA time. RESULTS In the less active participants, 30 min/day more of MVPA were related to lower levels of GDF-15 when replacing sleep (fully adjusted mean percentage differences [95% confidence interval] in GDF-15 of -9.2% [-13.2, -5.0]), SB (-9.8% [-13.6, -5.8]) and LPA (-5.8% [-11.1, -0.3]), whereas 30 min/day more of LPA were related to lower GDF-15 when replacing both sleep (-3.6% [-6.1, -1.0]) and SB (-4.2% [-6.7, -1.7]). In the more active participants, 30 min/day more of MVPA were also associated with lower GDF-15 when replacing sleep (-2.9% [-5.3, -0.3]), SB (-2.4% [-4.6, -0.2]) and LPA (-3.5% [-6.6, -0.3]), but no associations were found for more time in LPA. Spending more time in SB was associated with higher GDF-15 levels only among those less active (1.9% [0.9, 2.9] per 30 min/day increment). Sleep time did not appear to be associated with GDF-15. CONCLUSIONS The MVPA was inversely associated with GDF-15, with stronger associations at lower PA volumes. Also, more LPA and less SB time were linked to lower GDF-15 in the less active individuals. This suggests that simply moving more and sitting less may reduce chronic disease burden in older adults.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Antonio Buño-Soto
- Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM + CSIC, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM + CSIC, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM + CSIC, Madrid, Spain
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18
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Sotos-Prieto M, Struijk EA, Fung TT, Rimm EB, Rodriguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study. Age Ageing 2022; 51:afab268. [PMID: 35136897 PMCID: PMC8826375 DOI: 10.1093/ageing/afab268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence on the comprehensive role of lifestyle in frailty risk is scarce. To assess the association between a lifestyle-based Healthy Heart Score (HHS), which estimates the 20-year risk of cardiovascular disease (CVD), and risk of frailty among older women. METHODS Prospective cohort study in 121,700 nurses from the USA participating at the Nurses' Health Study. This study included 68,416 women aged ≥60 year with a follow-up from 1990 to 2014. The HHS was computed using the gender-specific beta-coefficients of the nine lifestyle factors, including current smoking, high body mass index, low physical activity, lack of moderate alcohol intake and unhealthy diet. Frailty incidence was assessed every 4 years from 1992 to 2014 as having ≥3 of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. RESULTS During 22 years of follow-up, 11,041 total incident cases of frailty were ascertained. Compared to women in the lowest quintile of the HHS (lowest estimated CVD risk), the multivariable-adjusted hazard ratio of frailty across quintiles was: Q2:1.67 (95% confidence interval 1.53, 1.82); Q3: 2.34 (2.15, 2.53); Q4: 3.54 (3.28, 3.83) and Q5: 5.92 (5.48, 6.38); P-trend > 0.001. Results were consistent for each frailty criterion, among participants with 0 frailty criteria at baseline, when using only baseline exposure or in 6-year-, 10-year- and 14-year-exposure lagged analyses, and after excluding participants with diabetes and CVD at baseline. CONCLUSIONS The HHS, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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19
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Struijk EA, Fung TT, Sotos-Prieto M, Rodriguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Red meat consumption and risk of frailty in older women. J Cachexia Sarcopenia Muscle 2022; 13:210-219. [PMID: 34755477 PMCID: PMC8818608 DOI: 10.1002/jcsm.12852] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Red meat is a nutrient-dense source of protein fundamental for older adults; however, red meat is also high in detrimental components, including saturated fat. It is unclear whether habitual red meat consumption is associated with risk of frailty. This study aimed to examine the prospective association between the consumption of total, unprocessed, and processed red meat and the risk of frailty in older adults. METHODS We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Consumption of total, unprocessed, and processed red meat was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 chronic illnesses, and unintentional weight loss ≥5%. The occurrence of frailty was assessed every four years from 1992 to 2014. RESULTS During 22 years of follow-up (median follow-up 14 years), we identified 13 279 incident cases of frailty. Women with a higher intake of red meat showed an increased risk of frailty after adjustment for lifestyle factors, medication use, and dietary factors. The relative risk (95% confidence interval) for one serving/day increment in consumption was 1.13 (1.08, 1.18) for total red meat, 1.08 (1.02, 1.15) for unprocessed red meat, and 1.26 (1.15, 1.39) for processed red meat. When each component of the frailty syndrome was individually examined, each of them was positively associated with total red meat consumption, except for the weight loss criterion. Replacing one serving/day of unprocessed red meat with other protein sources was associated with significantly lower risk of frailty; the risk reduction estimates were 22% for fish and 14% for nuts, while for replacement of processed red meat, the percentages were 33% for fish, 26% for nuts, 13% for legumes, and 16% for low-fat dairy. CONCLUSIONS Habitual consumption of unprocessed and processed red meat was associated with a higher risk of frailty. Replacement of red meat by other protein sources might reduce the risk of frailty. These findings are in line with dietary guidelines promoting diets that emphasize plant-based sources of protein.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,IMDEA/Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM + CSIC, Madrid, Spain
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20
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Vega-Cabello V, Caballero FF, Lana A, Arias-Fernandez L, Banegas JR, Rodriguez-Artalejo F, Lopez-Garcia E, Struijk EA. Association of zinc intake with risk of impaired physical function and frailty among older adults. J Gerontol A Biol Sci Med Sci 2022; 77:2015-2022. [PMID: 35034112 DOI: 10.1093/gerona/glac014] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Zinc could be a target nutrient in the prevention of physical impairment and frailty in older adults due to its anti-inflammatory/antioxidant properties. However, prospective studies evaluating this inquiry are scarce. Thus, we aimed to assess the association between zinc intake and impaired lower-extremity function (ILEF) and frailty among community-dwelling older adults. METHODS We examined 2,963 adults aged ≥60 years from the Seniors-ENRICA cohort. At baseline (2008-2010) and subsequent follow-up (2012), zinc intake (mg/d) was estimated with a validated computerized face-to-face diet history and adjusted for total energy intake. From 2012 to 2017, the occurrence of ILEF was ascertained with the Short Physical Performance Battery, and of frailty according to the Fried phenotype criteria. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders, including lifestyle, comorbidity, and dietary factors. RESULTS During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared to participants in the lowest tertile of zinc intake (3.99-8.36 mg/d), those in the highest tertile (9.51-21.2 mg/d) had a lower risk of ILEF [fully-adjusted hazard ratio (95% confidence interval): 0.75 (0.58-0.97); p for trend: 0.03] and of frailty [0.63 (0.44-0.92); p for trend: 0.02]. No differences in the association were seen by strata of socio-demographic and lifestyle factors. CONCLUSIONS Higher zinc intake was prospectively associated with a lower risk of ILEF and frailty among older adults, suggesting that adequate zinc intake, that can be achieved through a healthy diet, may help preserve physical function and reduce the progression to frailty.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | - Lucia Arias-Fernandez
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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21
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Yévenes-Briones H, Caballero FF, Struijk EA, Rey-Martinez J, Montes-Jovellar L, Graciani A, Rodríguez-Artalejo F, Lopez-Garcia E. Association Between Hearing Loss and Impaired Physical Function, Frailty, and Disability in Older Adults: A Cross-sectional Study. JAMA Otolaryngol Head Neck Surg 2021; 147:951-958. [PMID: 34554203 DOI: 10.1001/jamaoto.2021.2399] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Several studies have examined the association between hearing loss (HL) and physical function, with inconsistent results. Few used pure-tone thresholds and considered possible confounders in the association. Objective To examine the association between hearing loss and impaired lower extremity function, frailty syndrome, and disability in older adults. Design, Setting, and Participants The Seniors-ENRICA-2 is a cohort study that was established in 2015-2017 in Spain. The present study was conducted from December 2015 to June 2017. Data were analyzed from January 2, 2021, to March 10, 2021. This cross-sectional analysis included 1644 community-dwelling individuals aged 65 years or older (range, 66-91 years) of both sexes. Participants had hearing threshold measurements and data on impaired lower extremity function, frailty syndrome, and disability. Exposures Hearing loss defined as pure-tone average greater than 40 dB HL in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency (3, 4, and 8 kHz). Main Outcomes and Measures Impaired lower extremity function was defined with the Short Physical Performance Battery; the frailty syndrome was defined as having at least 3 of the 5 criteria, including weakness, slow walking speed, low physical activity, exhaustion, and weight loss; and disability in instrumental activities of daily living (IADL) was evaluated with the Lawton and Brody scale. Results Of the 1644 participants, 831 were men (50.5%); mean (SD) age was 73.8 (4.3) years. The prevalence of moderate HL was 13.6% at speech frequency. After adjustment for age, sex, lifestyle, comorbidities, impaired cognition, and social isolation, HL in standard frequency was associated with impaired lower extremity function, with an odds ratio (OR) of 2.20 (95% CI, 1.25-3.88); the corresponding estimate for the frailty syndrome was 1.85 (95% CI, 0.98-3.49) and for the IADL disability, was 2.25 (95% CI, 1.29-3.94). When considering speech frequency pure-tone average, HL was also associated with impaired function (OR, 2.59; 95% CI, 1.57-4.28), frailty syndrome (OR, 1.85; 95% CI, 1.06-3.22), and IADL disability (OR, 2.18; 95% CI, 1.32-3.60). Conclusions and Relevance In this cross-sectional analysis of data from the Seniors-ENRICA-2 cohort study, hearing loss was associated with impaired lower extremity function, frailty syndrome, and IADL disability. It may be useful to examine this association with the mechanisms elucidated in further studies.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Jorge Rey-Martinez
- Neurotology Unit, ENT Department, Hospital Universitario Donostia, San Sebastián-Donostia, Spain
| | - Lourdes Montes-Jovellar
- Otolaryngology Department, Head and Neck Section, Hospital Universitario Ramón Y Cajal, Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain.,IMDEA-Food Institute, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain.,IMDEA-Food Institute, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain.,IMDEA-Food Institute, Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas, Madrid, Spain
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Maroto-Rodriguez J, Delgado-Velandia M, Ortolá R, García-Esquinas E, Martinez-Gomez D, Struijk EA, Lopez-Garcia E, Rodriguez-Artalejo F, Sotos-Prieto M. A Mediterranean lifestyle and frailty incidence in older adults: the Seniors-ENRICA-1 cohort. J Gerontol A Biol Sci Med Sci 2021; 77:1845-1852. [PMID: 34614144 DOI: 10.1093/gerona/glab292] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Frailty is a geriatric syndrome that entails high risk of hospitalization, disability, and death. While adherence to Mediterranean diet has been associated with lower risk of frailty, the joint effect of diet and lifestyle is uncertain. This study examined the association between a Mediterranean lifestyle (diet, customs, and traditions) and frailty incidence in older adults. METHODS We analyzed data from 1,880 individuals aged ≥ 60 from the prospective Seniors-ENRICA-1 cohort. Adherence to the Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (higher scores representing better adherence), divided into three blocks: 1) "Mediterranean food consumption", 2) "Mediterranean dietary habits" (practices around meals)" and 3) "Physical activity, rest, social habits and conviviality". Frailty was ascertained as the presence of ≥ 3 of the 5 Fried criteria: a) Exhaustion; b) Muscle weakness; c) Low physical activity; d) Slow walking speed; e) Unintentional weight loss. Main statistical analyses were performed using logistic regression models, adjusting for the main confounders. RESULTS After a 3.3-y follow-up, 136 incident frailty cases were ascertained. Compared with participants in the lowest tertile of the MEDLIFE score, the OR (95% CI) for frailty was 0.88 (0.58-1.34) for the second tertile, and 0.38 (0.21-0.69) for the third tertile (p-trend = 0.003). Blocks 1 and 3 of the MEDLIFE score were independently associated with lower frailty risk. Most items within these blocks showed a tendency to reduced frailty. CONCLUSIONS Higher adherence to a Mediterranean lifestyle was associated with lower risk of frailty.
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Affiliation(s)
- Javier Maroto-Rodriguez
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain
| | - Mario Delgado-Velandia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain
| | - David Martinez-Gomez
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco, Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco, Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Yévenes-Briones H, Caballero FF, Struijk EA, Lana A, Rodríguez-Artalejo F, Lopez-Garcia E. Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study. Eur J Nutr 2021; 61:231-242. [PMID: 34287672 PMCID: PMC8783872 DOI: 10.1007/s00394-021-02644-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/16/2021] [Indexed: 11/25/2022]
Abstract
Purpose To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study. Methods This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up. Results Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women. Conclusions PUFA intake was associated with decreased risk of disabling hearing function in women, but not in men. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02644-7.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), C/ Arzobispo Morcillo, s/n, 28029, Madrid, Spain.
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), C/ Arzobispo Morcillo, s/n, 28029, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), C/ Arzobispo Morcillo, s/n, 28029, Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo /ISPA, Oviedo, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), C/ Arzobispo Morcillo, s/n, 28029, Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), C/ Arzobispo Morcillo, s/n, 28029, Madrid, Spain.
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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24
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García-Esquinas E, Ortolá R, Gine-Vázquez I, Carnicero JA, Mañas A, Lara E, Alvarez-Bustos A, Vicente-Rodriguez G, Sotos-Prieto M, Olaya B, Garcia-Garcia FJ, Gusi N, Banegas JR, Rodríguez-Gómez I, Struijk EA, Martínez-Gómez D, Lana A, Haro JM, Ayuso-Mateos JL, Rodríguez-Mañas L, Ara I, Miret M, Rodríguez-Artalejo F. Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain. Int J Environ Res Public Health 2021; 18:ijerph18137067. [PMID: 34281004 PMCID: PMC8297096 DOI: 10.3390/ijerph18137067] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- Correspondence:
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Iago Gine-Vázquez
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (B.O.); (J.M.H.)
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
| | - José A. Carnicero
- Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; (J.A.C.); (A.A.-B.); (L.R.-M.)
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
| | - Asier Mañas
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
| | - Elvira Lara
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Alejandro Alvarez-Bustos
- Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; (J.A.C.); (A.A.-B.); (L.R.-M.)
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
| | - German Vicente-Rodriguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón IA2, Universidad de Zaragoza, 50013 Zaragoza, Spain;
- CIBEROBN (CIBER of Obesity and Nutrition), 28029 Madrid, Spain
- Faculty of Health and Sport Science, University of Zaragoza, 22001 Huesca, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 22002 Aragón, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
| | - Beatriz Olaya
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (B.O.); (J.M.H.)
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
| | - Francisco José Garcia-Garcia
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- Hospital Virgen del Valle, Complejo Hospitalario de Toledo, 45071 Toledo, Spain
| | - Narcis Gusi
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- AFYCAV (Physical Activity, Quality of Life and Health) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jose R. Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Irene Rodríguez-Gómez
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
| | - Ellen A. Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, 33003 Oviedo, Spain;
| | - Josep María Haro
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (B.O.); (J.M.H.)
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
| | - José Luis Ayuso-Mateos
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; (J.A.C.); (A.A.-B.); (L.R.-M.)
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
| | - Ignacio Ara
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
| | - Marta Miret
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
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Caballero FF, Struijk EA, Buño A, Rodríguez-Artalejo F, Lopez-Garcia E. Plasma Ceramides and Risk of Impaired Lower-Extremity Function in Older Adults: A Nested Case-Control Study. J Gerontol A Biol Sci Med Sci 2021; 76:1280-1287. [PMID: 32756936 DOI: 10.1093/gerona/glaa188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Higher levels of ceramides have been linked to several chronic diseases; also there is emerging cross-sectional evidence that ceramides are associated with lower physical functioning. This research assessed for the first time the prospective relationship between ceramide species and impaired lower-extremity function (ILEF) in older adults. METHODS Case-control study with 43 cases of ILEF and 86 age- and sex-matched controls, which was nested in the Seniors-ENRICA cohort of community-dwelling older adults. Incident ILEF from 2015 to 2017 was ascertained with the Short Physical Performance Battery. In 2015, 27 ceramide species were measured in plasma by liquid chromatography-tandem mass spectrometry. Conditional logistic regression models were used to assess the longitudinal relationship between ceramides concentration and incidence of ILEF. RESULTS After adjusting for education level, body mass index, alcohol and total energy intake, physical activity, and presence of chronic conditions, some ceramide species were related to 2-year incidence of ILEF. Specifically, the odds ratios of ILEF per 1-SD increase in ceramide concentration were: 1.66 [95% CI = (1.03, 2.68)] for ceramide C14:0, 1.61 (1.00, 2.59) for ceramide C16:0, and 1.64 (1.03, 2.60) for ceramide C16:1 (n-7). In the case of ceramides C16:0 and C16:1 (n-7), a stronger relationship was found in those with a higher body mass index; systolic blood pressure could also mediate the relationship between ceramide C16:1 (n-7) and ILEF (p for interaction = .03). CONCLUSIONS Higher plasma levels of ceramides C14:0, C16:0, and C16:1 (n-7) are associated with higher risk of ILEF, and might serve as risk markers for functional decline in older adults.
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Affiliation(s)
- Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Spain
| | - Antonio Buño
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Ortolá R, García-Esquinas E, Buño-Soto A, Sotos-Prieto M, Struijk EA, Caballero FF, Lopez-Garcia E, Banegas JR, Rodríguez-Artalejo F. Healthy dietary patterns are associated with lower concentrations of growth differentiation factor 15 in older adults. Am J Clin Nutr 2021; 113:1619-1626. [PMID: 33668053 DOI: 10.1093/ajcn/nqaa444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/21/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is a biomarker for aging and chronic disease burden that may capture the anti-inflammatory and antioxidant effects attributed to healthy diets. OBJECTIVE The aim was to examine whether several healthy dietary patterns and a lower inflammatory potential of diet are associated with lower concentrations of GDF-15 in older adults. METHODS We used cross-sectional data from 2501 older adults participating in the Seniors-ENRICA-2 study. Four diet indices were derived from habitual food consumption estimated with a validated diet history: Mediterranean Diet Adherence Screener (MEDAS), Alternate Healthy Eating Index-2010 (AHEI-2010), Dietary Approaches to Stop Hypertension (DASH), and Dietary Inflammatory Index (DII). Associations of these indices with GDF-15 concentrations were analyzed using linear regression models and adjusted for risk factors and biomarkers associated with chronic disease. RESULTS There was a clear dose-response association between all dietary patterns and serum GDF-15 concentrations; the GDF-15 mean reductions (95% CI) per 1-SD increment in the diet indices were 1.6% (0.1%, 3.1%) for the MEDAS, 2.1% (0.5%, 3.7%) for the AHEI-2010, and 1.6% (0.1%, 3.2%) for the DASH, whereas a mean GDF-15 increase of 1.7% (0.2%, 3.4%) was observed per 1-SD increment in the DII. In analyses excluding fruit and vegetable components from the diet indices, the association for the MEDAS and the AHEI-2010 remained but was attenuated for the DASH. Analyses excluding participants with cardiovascular disease or diabetes rendered very similar results. CONCLUSIONS A higher adherence to several healthy dietary patterns and a lower inflammatory potential of diet were related to lower concentrations of GDF-15 in older adults, suggesting that improving diet quality may reduce inflammation and possibly promote healthy aging.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Antonio Buño-Soto
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, Campus of International Excellence Universidad Autónoma de Madrid+Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC) , Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, Campus of International Excellence Universidad Autónoma de Madrid+Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC) , Madrid, Spain
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Caballero FF, Struijk EA, Buño A, Vega-Cabello V, Rodríguez-Artalejo F, Lopez-Garcia E. Plasma Amino Acids and Risk of Impaired Lower-Extremity Function and Role of Dietary Intake: A Nested Case-Control Study in Older Adults. Gerontology 2021; 68:181-191. [PMID: 33965943 DOI: 10.1159/000516028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/22/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Amino acids are key elements in the regulation of the aging process which entails a progressive loss of muscle mass. The health effects of plasma amino acids can be influenced by dietary intake. This study assessed the prospective association between amino acid species and impaired lower-extremity function (ILEF) in older adults, exploring the role of diet on this association. METHODS This is a case-control design comprising 43 incident cases of ILEF and 85 age- and sex-matched controls. Plasma concentrations of 20 amino acid species were measured at baseline using liquid chromatography-tandem mass spectrometry, and incident cases of ILEF were measured after 2 years by means of the Short Physical Performance Battery. Conditional logistic regression models were used to assess longitudinal relationships. RESULTS After adjusting for potential confounders, higher levels of tryptophan were associated with a decreased 2-year risk of ILEF (OR per 1-SD increase = 0.64, 95% CI = [0.42, 0.97]), while glutamine and total essential amino acids were linked to higher ILEF risk (OR = 1.57, 95% CI = [1.01, 2.45]; OR = 1.89, 95% CI = [1.18, 3.03], respectively). Those with a lower adherence to a Mediterranean diet, a higher BMI, a higher consumption of red meat, and a lower consumption of nuts and legumes had an increased risk of ILEF associated with higher levels of essential amino acids. DISCUSSION/CONCLUSION Some amino acid species could serve as risk markers for physical function decline in older adults, and healthy diet might attenuate the excess risk of ILEF linked to essential amino acids.
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Affiliation(s)
- Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Antonio Buño
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Verónica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Carballo-Casla A, García-Esquinas E, Buño-Soto A, Struijk EA, López-García E, Rodríguez-Artalejo F, Ortolá R. Metabolic syndrome and Growth Differentiation Factor 15 in older adults. GeroScience 2021; 44:867-880. [PMID: 33961185 DOI: 10.1007/s11357-021-00370-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/19/2021] [Indexed: 02/06/2023] Open
Abstract
Growth Differentiation Factor 15 (GDF-15) is a cytokine produced in response to tissue injury and inflammatory states that may capture distinct pathways between the risk factors aggregated within metabolic syndrome (MS) and the development of diabetes and cardiovascular disease. This work aims to study the association of MS and its components with GDF-15 among older adults, examining the roles of body fat distribution, glucose metabolism, and inflammation. Data were taken from the Seniors-ENRICA-2 study in Spain, which included 1938 non-institutionalized individuals aged ≥65 years free of diabetes and cardiovascular disease. MS was defined as the presence of ≥3 of the following components: high waist circumference, elevated fasting blood glucose levels, raised blood pressure, increased triglyceride levels, and low serum high-density lipoprotein (HDL) cholesterol. Statistical analyses were performed with linear regression models and adjusted for potential sociodemographic and lifestyle confounders. MS was associated with higher GDF-15 levels (fully adjusted mean increase [95% confidence interval] = 9.34% [5.16,13.7]). The MS components showing the strongest associations were high waist circumference (6.74% [2.97,10.6]), elevated glucose levels (4.91% [0.77,9.23]), and low HDL-cholesterol (8.13% [3.51,13.0]). High waist-to-hip ratio (7.07% [2.63,11.7]), urine albumin (12.1% [2.57,22.5]), and C-reactive protein (10.4% [3.89,17.3]) were also associated with increased GDF-15. In conclusion, MS was associated with higher GDF-15 levels in older adults. Abdominal obesity, hyperglycemia -possibly linked to microvascular disease, as inferred from elevated urine albumin-, low HDL-cholesterol, and inflammation were the main drivers of this association.
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Affiliation(s)
- Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029, Madrid, Spain.
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Antonio Buño-Soto
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029, Madrid, Spain.,IMDEA Food Institute, CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029, Madrid, Spain.,IMDEA Food Institute, CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029, Madrid, Spain.
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Ortolá R, García-Esquinas E, Sotos-Prieto M, Struijk EA, Caballero FF, Lopez-Garcia E, Rodríguez-Artalejo F. Mediterranean diet and changes in frequency, severity and localization of pain in older adults: The Seniors-ENRICA cohorts. J Gerontol A Biol Sci Med Sci 2021; 77:122-130. [PMID: 33839765 DOI: 10.1093/gerona/glab109] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although some components of the Mediterranean diet have shown benefits in pain risk through its anti-inflammatory/antioxidant properties, no population-based studies have investigated the effect of adherence to this diet on changes in pain over time. METHODS We used data from 864 and 862 older adults recruited in the Seniors-ENRICA-1 and Seniors-ENRICA-2 cohorts and followed-up for 2.8 and 2.4 years, respectively. Adherence to the Mediterranean diet was assessed with the MEDAS score at baseline. Frequency, severity and locations of pain obtained at baseline and follow-up were used to compute a pain scale. Analyses were performed using multinomial logistic regression models, and adjusted for the main confounders. RESULTS Participants had a mean (SD) age of 71.5 (5.1) years, 36.8% were men and 78.3% had chronic conditions. In the pooled cohorts, compared with participants in the lowest quartile of the MEDAS score (lowest adherence to the Mediterranean diet), those in the highest quartile showed a higher frequency of pain improvement versus worsening (relative risk ratio [95% confidence interval]: 1.43 [1.03,1.99]). This association was also evidenced in two components of the pain scale: improvement in pain severity (1.43 [1.01,2.04]) and reduction in pain locations (1.54 [1.08,2.20]), but a tendency to pain frequency improvement (1.34 [0.92,1.93]) was also observed. The main contributors to these associations were high consumption of fruit and vegetables, and low consumption of sugar-sweetened beverages. CONCLUSIONS A higher adherence to the Mediterranean diet was related to a subsequent improvement in pain characteristics in older adults, suggesting that improving diet quality may help reduce the high health impact of pain.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard T.H. Chan School of Public Health. Boston, MA, USA
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
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Machado-Fragua MD, Struijk EA, Yévenes-Briones H, Caballero FF, Rodríguez-Artalejo F, Lopez-Garcia E. Coffee consumption and risk of hearing impairment in men and women. Clin Nutr 2020; 40:3429-3435. [PMID: 33298331 DOI: 10.1016/j.clnu.2020.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/21/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hearing loss is the fifth leading cause of disability in the world. Coffee consumption might have a beneficial effect on hearing function because of the antioxidant and anti-inflammatory properties of some of its compounds. However, no previous longitudinal study has assessed the association between coffee consumption and the risk of hearing impairment. OBJECTIVE To assess the prospective association between coffee consumption and risk of disabling hearing impairment in middle and older men and women from the UK Biobank study. METHODS Analytical cohort with 36,923 participants (16,142 men and 20,781 women) [mean (SD): 56.6 (7.8) years, 1.6 (1.4) cups/d, and -7.6 (1.3) dB for age, total coffee consumption and speech reception threshold in noise at baseline, respectively]. At baseline, coffee consumption was measured with 3-5 multiple-pass 24-h food records. Hearing function was measured with a digit triplet test, and disabling hearing impairment was defined as a speech reception threshold in noise > -3.5 dB in any physical exam during the follow-up. Analyses were stratified by sex and Cox regression models were used to assess the prospective association proposed. RESULTS Over 10 years of follow-up, 343 men and 345 women developed disabling hearing impairment. Among men, compared with those who consumed <1 cup/d of coffee, those who consumed 1, and ≥2 cups/d had a lower risk of hearing impairment (hazard ratio [95% confidence interval]: 0.72 [0.54-0.97] and 0.72 [0.56-0.92], respectively; P-trend: 0.01). This association was similar for caffeinated and decaffeinated coffee, and for filtered and non-filtered coffee, and was stronger in those with obesity (hazard ratio [95% confidence interval] for consumption of ≥2 vs. <1 cups/d: 0.39 [0.21-0.74]). No association was found between coffee and hearing function among women. CONCLUSIONS Coffee consumption was associated with lower risk of disabling hearing impairment in men but not in women. The association appeared to be independent of the coffee type and the preparation method.
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Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Struijk EA, Rodríguez-Artalejo F, Fung TT, Willett WC, Hu FB, Lopez-Garcia E. Sweetened beverages and risk of frailty among older women in the Nurses' Health Study: A cohort study. PLoS Med 2020; 17:e1003453. [PMID: 33290392 PMCID: PMC7723265 DOI: 10.1371/journal.pmed.1003453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages (SSBs) has been consistently associated with a higher risk of obesity, type 2 diabetes, cardiovascular disease, and premature mortality, whereas evidence for artificially sweetened beverages (ASBs) and fruit juices on health is less solid. The aim of this study was to evaluate the consumption of SSBs, ASBs, and fruit juices in association with frailty risk among older women. METHODS AND FINDINGS We analyzed data from 71,935 women aged ≥60 (average baseline age was 63) participating in the Nurses' Health Study (NHS), an ongoing cohort study initiated in 1976 among female registered nurses in the United States. Consumption of beverages was derived from 6 repeated food frequency questionnaires (FFQs) administered between 1990 and 2010. Frailty was defined as having at least 3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, reduced aerobic capacity, having ≥5 chronic illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every 4 years from 1992 to 2014. During 22 years of follow-up, we identified 11,559 incident cases of frailty. Consumption of SSBs was associated with higher risk of frailty after adjustment for diet quality, body mass index (BMI), smoking status, and medication use, specifically, the relative risks (RRs) and 95% confidence interval (95% CI) for ≥2 serving/day versus no SSB consumption was 1.32 (1.10, 1.57); p-value <0.001. ASBs were also associated with frailty [RR ≥2 serving/day versus no consumption: 1.28 (1.17, 1.39); p-value <0.001]. Orange juice was associated with lower risk of frailty [RR ≥1 serving/day versus no consumption: 0.82 (0.76, 0.87); p-value <0.001], whereas other juices were associated with a slightly higher risk [RR ≥1 serving/day versus no consumption: 1.15 (1.03, 1.28); p-value <0.001]. A limitation of this study is that, due to self-reporting of diet and frailty, certain misclassification bias cannot be ruled out; also, some residual confounding may persist. CONCLUSIONS In this study, we observed that consumption of SSBs and ASBs was associated with a higher risk of frailty. However, orange juice intake showed an inverse association with frailty. These results need to be confirmed in further studies using other frailty definitions.
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Affiliation(s)
- Ellen A. Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- * E-mail:
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Teresa T. Fung
- Department of Nutrition, Simmons University, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
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Lana A, Struijk EA, Ortolá R, Rodríguez-Artalejo F, Lopez-Garcia E. Longitudinal Association Between Sodium and Potassium Intake and Physical Performance in Older Adults. J Gerontol A Biol Sci Med Sci 2020; 75:2379-2386. [PMID: 32009144 DOI: 10.1093/gerona/glaa031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Aging is associated with a progressive difficulty to maintain ion regulation, which might impair the capacity for muscle contraction. Thus, the aim of this study was to examine the association between 5-year changes in dietary intake of sodium and potassium and changes in physical performance among older adults. METHODS We performed a prospective study with 868 participants from the Seniors-ENRICA cohort. Diet was measured with a validated diet history and physical performance was measured with the Short Physical Performance Battery (SPPB), both in 2012 and 2017. Analyses were performed with linear regression models adjusted for sociodemographic variables, lifestyle, and morbidity, using changes in the intake of sodium and potassium and changes in the sodium/potassium ratio during follow-up as independent variables, and the continuous change in the SPPB score as the dependent variable. RESULTS Over 5 years of follow-up, a 1 SD increase in sodium intake (ie, 0.73 g/d) was associated with a 0.13 (95% confidence interval [CI]: 0.26-0.01) points reduction in the SPPB score, while a 1 SD increase in potassium intake (ie, 0.70 g/d) was associated with a 0.19 (0.05-0.34) points increment in the score. In addition, a 1 SD increase in the sodium-to-potassium ratio (ie, 0.30) was associated with worse SPPB (-0.58 [-0.95 to -0.21]). Participants who adhered to dietary recommendations for minerals at baseline but became noncompliant during follow-up decreased their result in the SPPB. CONCLUSION An increase of dietary sodium intake, a decrease of potassium intake and the resulting increment in the sodium-to-potassium ratio were prospectively associated with worse physical performance in older adults.
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Affiliation(s)
- Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Fung TT, Struijk EA, Rodriguez-Artalejo F, Willett WC, Lopez-Garcia E. Fruit and vegetable intake and risk of frailty in women 60 years old or older. Am J Clin Nutr 2020; 112:1540-1546. [PMID: 33022693 PMCID: PMC7727483 DOI: 10.1093/ajcn/nqaa256] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 08/17/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Prior research has suggested that the antioxidative and anti-inflammatory potential of fruits and vegetables may ameliorate aging-related frailty. OBJECTIVE We sought to prospectively examine the association between fruit and vegetable intake and incident frailty in older women. DESIGN We followed 78,366 nonfrail women aged ≥60 y from the Nurses' Health Study from 1990 to 2014. In this analysis, the primary exposure was the intake of total fruits and vegetables, assessed with an FFQ administered 6 times during follow-up. Frailty was defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, low aerobic capacity, having ≥5 illnesses, and ≥5% weight loss. Cox models adjusted for potential confounders were used to estimate HRs and 95% CIs for the association between fruit and vegetable intake and incident frailty. RESULTS In total, 12,434 (15.9%) incident frailty cases were accrued during follow-up. Total fruit and vegetable intakes were associated with a lower risk of frailty (adjusted HR comparing 7+ servings/d compared with <3 servings/d: 0.92; 95% CI: 0.85, 0.99). The inverse association appeared to be stronger for those with physical activity above the median (P-interaction < 0.05). Among physically active women, compared with those who consumed <3 servings/d, the HR for 7+ servings/d was 0.68 (95% CI: 0.57, 0.81). CONCLUSION Higher fruit and vegetable intake was associated with a lower risk of frailty in this cohort of US women aged ≥60 y. Because of limited evidence on intakes of fruits and vegetables and the development of frailty, more data are needed to confirm our results.
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Affiliation(s)
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain,Instituto Madrileño De Estudios Avanzado-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid+Centro Superior de Investigaciones Científicas, Madrid, Spain
| | - Walter C Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-Idi Paz, Madrid, Spain,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain,Instituto Madrileño De Estudios Avanzado-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid+Centro Superior de Investigaciones Científicas, Madrid, Spain
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Carballo-Casla A, García-Esquinas E, Lopez-Garcia E, Sotos-Prieto M, Struijk EA, Caballero FF, Rodríguez-Artalejo F, Ortolá R. Consumption of food fried in olive oil and unhealthy aging in a Mediterranean country. Clin Nutr 2020; 40:277-285. [PMID: 32660791 DOI: 10.1016/j.clnu.2020.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIMS Fried food has usually shown neutral or detrimental effects on many chronic diseases, possibly depending on the type of food fried and the frying oil, but its relationship with unhealthy aging is unknown. We examined how changes in fried food consumption over a 3-year period were linked to unhealthy aging over 3 and 6 years. METHODS Prospective cohort study in Spain with 2043 individuals aged ≥60 years, recruited in 2008-2010 and followed-up to 2012 and 2015. Fried food consumption was ascertained with a validated diet history, and unhealthy aging was measured with a 52-item health deficit accumulation index. RESULTS Compared with participants who reduced fried food consumption, those who increased it showed less deficit accumulation over 3 years (multivariable β [95% confidence interval]: -1.45 [-2.30, -0.61]), but not over 6 years of follow-up. More 3-year deficit accumulation was observed when replacing 100 g/day of fried food with an equal amount of non-fried food (1.48 [0.59, 2.37]); corresponding values in substitution analyses were 2.03 [1.03, 3.03] for fried protein-rich food, 10.76 [5.20, 16.33] for fried eggs, and 2.06 [0.68, 3.43] for fried fish. Also, increased olive oil intake was significantly associated with less 3-year deficit accumulation (total olive oil: -1.14 [-2.07, -0.21], and olive oil with non-fried food: -0.99 [-1.89, -0.08]). CONCLUSIONS In a Mediterranean country, where olive oil is the most common frying medium, increased fried food consumption was associated with delayed unhealthy aging over 3 years of follow-up; consumption of olive oil and fried protein-rich food (especially eggs and fish) were its main drivers. However, these associations did not generally remain after 6 years.
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Affiliation(s)
- Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049 Madrid, Spain.
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Carretera de Canto Blanco 8, 28049 Madrid, Spain.
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/Idipaz, Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Avenida de Monforte de Lemos 3-5, 28029 Madrid, Spain.
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Estrada-DeLeón DB, Struijk EA, Caballero F, Rodríguez-Artalejo F, Lopez-Garcia E. Distribution of daily protein intake across meals and lower extremity functioning in community-dwelling Spanish older adults: a prospective cohort study. Eur J Nutr 2020; 60:665-675. [PMID: 32417947 DOI: 10.1007/s00394-020-02273-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/04/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Total dietary protein intake has been associated with better physical function in older adults. However, it is unclear whether an even mealtime distribution of protein intake also has an impact on physical functioning. The aim of this study was to examine the prospective association between distribution of daily protein intake across meals and the risk of impaired lower extremity function (ILEF). METHODS We used information of 2975 individuals ≥ 60 years from the Seniors-ENRICA cohort. Habitual dietary protein intake was assessed in 2008-2010 with a validated diet history. For each participant, dietary protein intake across meals was determined using the coefficient of variation (CV) of the distribution. Study participants were followed up until 2017 to identify incident ILEF, assessed with the short physical performance battery (SPPB). RESULTS Over a median follow-up of 6.3 years, we identified 521 participants with ILEF (SPPB ≤ 6). After adjusting for potential confounders including total protein intake/kg/day, a higher CV (less even distribution) of protein intake did not show an association with the risk of ILEF [hazard ratios (HR) and 95% confidence intervals (CI) for second and third vs. the first tertile: 1.08 (0.87-1.34), and 1.06 (0.85-1.32), respectively; p trend = 0.60]. When assessing each component of the SPPB, a higher CV of protein intake was associated with higher risk of impaired standing balance (HR for tertile 3 vs. tertile 1: 1.26 (1.03-1.54); p trend = 0.02). CONCLUSION The mealtime distribution of protein intake was not associated with ILEF. The possibility of a detrimental effect of uneven distribution of protein on standing balance needs to be further investigated.
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Affiliation(s)
- Daniela B Estrada-DeLeón
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Machado-Fragua MD, Hoogendijk EO, Struijk EA, Rodriguez-Artalejo F, Lopez-Garcia E, Beulens JW, van Ballegooijen AJ. High dephospho-uncarboxylated matrix Gla protein concentrations, a plasma biomarker of vitamin K, in relation to frailty: the Longitudinal Aging Study Amsterdam. Eur J Nutr 2020; 59:1243-1251. [PMID: 31069456 DOI: 10.1007/s00394-019-01984-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE No previous study has evaluated the relationship between vitamin K and frailty. Thus, we assessed the relationship between vitamin K status and frailty over 13 years in the Longitudinal Aging Study Amsterdam (LASA). METHODS Prospective cohort study with 644 community-dwelling adults ≥ 55 years from the LASA cohort. In 2002-2003, plasma desphospho-uncarboxylated matrix Gla protein (dp-ucMGP) was measured as marker of vitamin K status through a sandwich ELISA. Frailty was measured at baseline and in four follow-up examinations with the LASA Frailty Index (LASA-FI), which was used as both a continuous and a dichotomous measure (FI ≥ 0.25), as indicator of the degree of frailty and frailty risk, respectively. Statistical analyses were performed with multivariable generalized estimating equations using the lowest dp-ucMGP tertile, reflecting a high vitamin K status, as reference. RESULTS The mean (SD) age was 59.9 (2.9) years, and 54% were female. Compared with the lowest tertile, the medium and highest dp-ucMGP tertile were associated with a higher degree of frailty [1.40, 95% confidence interval (0.01-2.81) and 1.62, (0.18-3.06), respectively. P trend: 0.03]. Additionally, the medium and highest dp-ucMGP tertile had a higher odds ratio of frailty [1.75 (1.11-2.77) and 1.63 (1.04-2.57), respectively]. The degree of frailty increased over time, but the differences by dp-ucMGP tertiles existed since baseline and remained stable during follow-up. CONCLUSIONS Baseline plasma low vitamin K status was associated with a greater degree of frailty and frailty risk in this cohort of older adults, which highlights the importance of ensuring an optimal nutritional status of this vitamin to prevent frailty in later life.
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Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, and the Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, The Netherlands
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, and the Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, The Netherlands
| | - Adriana J van Ballegooijen
- Department of Epidemiology and Biostatistics, and the Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, The Netherlands
- Department of Nephrology, and Amsterdam Cardiovascular Science, Amsterdam UMC-Location VU University Medical Center, Amsterdam, The Netherlands
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Struijk EA, Hagan KA, Fung TT, Hu FB, Rodríguez-Artalejo F, Lopez-Garcia E. Diet quality and risk of frailty among older women in the Nurses' Health Study. Am J Clin Nutr 2020; 111:877-883. [PMID: 32091575 PMCID: PMC7138663 DOI: 10.1093/ajcn/nqaa028] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/31/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The frailty syndrome is associated with higher risk of disability and death after accounting for multimorbidity. Therefore, the determinants of frailty need to be identified to ensure older adults live not only longer but also healthier lives. However, the effect of diet quality on frailty is mostly unknown. OBJECTIVES We aimed to evaluate the alternate Mediterranean diet (AMED), the Dietary Approaches to Stop Hypertension (DASH) diet, and the alternate Healthy Eating Index-2010 (AHEI-2010) in association with frailty risk among older women. METHODS We analyzed data from 71,941 women aged ≥60 y participating in the Nurses' Health Study. The AMED, DASH, and AHEI-2010 were computed from validated FFQs in 1990 and repeated every 4 y until 2010. Frailty was defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, reduced resistance, reduced aerobic capacity, having ≥5 illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every 4 y. RESULTS During follow-up we identified 11,564 incident cases of frailty. After adjusting for potential confounders, the RRs (95% CIs) of frailty per 1-SD increase in the AMED, DASH, and AHEI-2010 scores were 0.87 (0.85, 0.90), 0.93 (0.91, 0.95), and 0.90 (0.88, 0.92), respectively. All diet quality scores were associated with lower risk of the individual frailty criteria fatigue, reduced resistance, reduced aerobic capacity, and weight loss. Lower consumption of red and processed meat, a lower sodium intake, a higher ratio of monounsaturated to saturated fat, vegetables, and moderate alcohol intake were components of the diet quality scores independently associated with lower risk of frailty. CONCLUSIONS Adherence to a healthy diet, as defined by the AMED, DASH, and AHEI-2010 scores, was associated with reduced risk of frailty in older women.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Kaitlin A Hagan
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain,Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain,Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain,Address correspondence to EAS (e-mail: )
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Arias-Fernández L, Struijk EA, Rodríguez-Artalejo F, Lopez-Garcia E, Lana A. Habitual dietary fat intake and risk of muscle weakness and lower-extremity functional impairment in older adults: A prospective cohort study. Clin Nutr 2020; 39:3663-3670. [PMID: 32273201 DOI: 10.1016/j.clnu.2020.03.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/04/2020] [Accepted: 03/20/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND & AIMS Fatty acid supplementation increases muscle mass and function in older adults, but the effect of habitual dietary intake is uncertain. Therefore, the objective of this study was to examine the association between habitual dietary fat intake and risk of muscle weakness and lower-extremity functional impairment (LEFI) in older adults. METHODS Prospective study with 1873 individuals aged ≥60 years from the Seniors-ENRICA cohort. In 2008-10 and 2012, a validated face-to-face diet history was used to record the one-year consumption of up to 880 foods. Then, fatty acids, other nutrients and energy intake were estimated using standard food composition tables. Means of intake between these years were calculated to represent cumulative consumption over the follow-up. Study participants were followed up through 2015 to assess incident muscle weakness (lowest quintile of grip strength) and incident LEFI (Short Physical Performance Battery score ≤6). Analyses were performed with Cox regression and adjusted for the main confounders, including other types of fatty acids. RESULTS Over a median follow-up of 5.2 years, 331 participants developed muscle weakness and 397 LEFI. Intake of saturated fatty acids (SFA) did not show an association with muscle weakness but was associated with higher risk of LEFI (multivariable hazard ratio (HR) for tertile 3 vs. tertile 1: 1.15; 95% confidence interval: 1.05-2.01; p-trend = 0.02). This association was mostly due to consumption of Spanish cold cuts and pastry and, to a lesser extent, dairy. Monounsaturated fatty acids (MUFA) intake was associated with lower risk of muscle weakness (HR t3 vs. t1: 0.73; 0.54-0.99; p trend = 0.04), and intake of n-3 polyunsaturated fatty acids (PUFA) was associated with reduced risk of both muscle weakness (0.70; 0.52-0.95; p-trend = 0.02) and LEFI (0.49; 0.35-0.68; p-trend <0.001). Olive oil and blue fish, the main sources of MUFA and PUFA, were also associated with lower risk of muscle weakness and LEFI. CONCLUSIONS Habitual intake of SFA was associated with increased risk of LEFI. By contrast, habitual intake of MUFA and PUFA were associated with lower risk of physical performance impairment.
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Affiliation(s)
- Lucía Arias-Fernández
- Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo /ISPA, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
| | - Alberto Lana
- Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo /ISPA, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Machado-Fragua MD, Struijk EA, Caballero FF, Ortolá R, Lana A, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Dairy consumption and risk of falls in 2 European cohorts of older adults. Clin Nutr 2020; 39:3140-3146. [PMID: 32075745 DOI: 10.1016/j.clnu.2020.01.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/25/2020] [Accepted: 01/28/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS Some previous evidence have linked dairy products with greater muscle mass, bone mineral density and lower risk of osteoporosis. However, there is also evidence of a detrimental effect of milk on the risk of hip fracture. The aim of this study was to assess the prospective association between dairy consumption and risk of falls in older adults. METHODS We used data from 2 cohorts of community-dwellers aged ≥60y: the Seniors-ENRICA cohort with 2981 individuals, and the UK Biobank cohort with 8927 participants. In the Seniors-ENRICA, dairy consumption was assessed with a validated diet history in 2008-10, and falls were ascertained up to 2015. In the UK Biobank study, dairy consumption was obtained with 3-5 multiple-pass 24-h food records in 2006-10, and falls were assessed up to 2016. RESULTS A total of 801 individuals in the Seniors-ENRICA and 201 in the UK Biobank experienced ≥1 fall. After adjustment for potential confounders, dairy products were not associated with risk of falls in the Seniors-ENRICA [hazard ratio (95% confidence interval) per 1-serving increment in total dairy consumption: 1.02 (0.93-1.11), milk: 0.93 (0.85-1.01), yogurt: 1.05 (0.96-1.15), and cheese: 0.96 (0.88-1.05)]. Corresponding figures in the UK Biobank were: total dairy: 1.19 (1.00-1.41), milk: 1.53 (1.13-2.08), yogurt: 1.10 (0.90-1.31), and cheese: 1.02 (0.87-1.22). CONCLUSIONS These results suggest a null association between habitual dairy consumption and the risk of falling in older adults. Whether milk consumption may increase the risk of falls, as observed in the UK Biobank cohort, merits further study.
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Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo / ISPA, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz) CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Ortolá R, Struijk EA, García-Esquinas E, Rodríguez-Artalejo F, Lopez-Garcia E. Changes in Dietary Intake of Animal and Vegetable Protein and Unhealthy Aging. Am J Med 2020; 133:231-239.e7. [PMID: 31369726 DOI: 10.1016/j.amjmed.2019.06.051] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/19/2019] [Accepted: 06/19/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Animal and vegetable-based proteins differ on their effect on many health outcomes, but their relationship with unhealthy aging is uncertain. Thus, we examined the association between changes in animal and vegetable protein intake and unhealthy aging in older adults. METHODS Data came from 1951 individuals aged ≥60 years recruited in the Seniors-ENRICA cohort in 2008-2010 (wave 0) and followed-up in 2012 (wave 1), 2015 (wave 2), and 2017 (wave 3). Dietary protein intake was measured with a validated diet history at waves 0 and 1, and unhealthy aging was measured with a 52-item health deficit accumulation index at each wave. RESULTS Compared with participants with a >2% decrease in energy intake from vegetable protein from wave 0 to wave 1, those with a >2% increase showed less deficit accumulation over 3.2 years (multivariable β [95% confidence interval (CI)]: -1.05 [-2.03, -0.06]), 6 years (-1.28 [-2.51, -0.03]), and 8.2 years of follow-up (-1.68 [-3.27, -0.09]). No associations were found for animal protein. Less deficit accumulation over 8.2 years was observed when substituting 1% of energy from vegetable protein for an equal amount of carbohydrate or fat (-0.50 [-0.93, -0.07]), animal protein (-0.44 [-0.81, -0.07]), dairy protein (-0.51 [-0.91, -0.12]), or meat protein (-0.44 [-0.84, -0.04]). CONCLUSIONS Increasing dietary intake of vegetable protein may delay unhealthy aging when replacing carbohydrates, fats, or animal protein, especially from meat and dairy.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz. Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz. Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz. Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz. Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz. Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Ortolá R, García-Esquinas E, García-Varela G, Struijk EA, Rodríguez-Artalejo F, López-García E. Influence of Changes in Diet Quality on Unhealthy Aging: The Seniors-ENRICA Cohort. Am J Med 2019; 132:1091-1102.e9. [PMID: 30981558 DOI: 10.1016/j.amjmed.2019.03.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/20/2019] [Accepted: 03/22/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Whether adopting a better diet in late life influences the aging process is still uncertain. Thus, we examined the association between changes in diet quality and unhealthy aging. METHODS Data came from 2042 individuals aged ≥60 years recruited in the Seniors-ENRICA cohort in 2008-2010 (wave 0) and followed-up in 2012 (wave 1) and 2015 (wave 2). Diet quality was assessed with the Mediterranean Diet Adherence Screener (MEDAS), the Mediterranean Diet Score (MDS), and the Alternate Healthy Eating Index-2010 (AHEI-2010) at waves 0 and 1. Unhealthy aging was measured using a 52-item health deficit accumulation index with 4 domains (functional, self-rated health/vitality, mental health, and morbidity/health services use) at each wave. An increase in dietary indices represents a diet improvement, and a lower deficit accumulation index indicates a health improvement. RESULTS Compared with participants with a >1-point decrease in MEDAS or MDS, those with a >1-point increase showed lower deficit accumulation from wave 0 to wave 2 (multivariate β, -1.49 [95% confidence interval (CI), -2.88 to -0.10], P-trend = .04 for MEDAS; and -2.20 [95% CI, -3.56 to -0.84], P-trend = .002 for MDS) and from wave 1 to wave 2 (-1.34 [95% CI, -2.60 to -0.09], P-trend = .04 for MEDAS). Also, participants with a >5-point increase in AHEI-2010 showed lower deficit accumulation from wave 0 to wave 1 (-1.15 [95% CI, -2.01 to -0.28], P-trend = .009) and from wave 0 to wave 2 (-1.21 [95% CI, -2.31 to -0.10], P-trend = .03) than those with a >5-point decrease. These results were mostly due to a strong association between improved diet quality and less functional deterioration. CONCLUSIONS In older adults, adopting a better diet was associated with less deficit accumulation, particularly functional deterioration. Improving dietary habits may delay unhealthy aging. Our results have clinical relevance because we have observed that the deficit accumulation index decreases an average of 0.74 annually.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giselle García-Varela
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
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Machado-Fragua MD, Struijk EA, Ballesteros JM, Ortolá R, Rodriguez-Artalejo F, Lopez-Garcia E. Habitual coffee consumption and risk of falls in 2 European cohorts of older adults. Am J Clin Nutr 2019; 109:1431-1438. [PMID: 31005970 DOI: 10.1093/ajcn/nqy369] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 10/03/2018] [Accepted: 12/04/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Habitual coffee consumption has been associated with lower risk of type 2 diabetes, cardiovascular disease, and sarcopenia, which are strong risk factors of falls. In addition, caffeine intake stimulates attention and vigilance, and reduces reaction time. Therefore, a protective effect of coffee on the risk of falling can be hypothesized. OBJECTIVES The aim of this study was to examine the association between habitual coffee consumption and the risk of ≥1 falls, injurious falls, and falls with fracture in older people. METHODS Data were taken from 2964 participants aged ≥60 y from the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk in Spain) cohort and 8999 participants aged ≥60 y from the UK Biobank cohort. In the Seniors-ENRICA study, habitual coffee consumption was assessed with a validated diet history in 2008-2010, and falls were ascertained up to 2015. In the UK Biobank study, coffee was measured with 3-5 multiple-pass 24-h food records starting in 2006, and falls were assessed up to 2016. RESULTS A total of 793 individuals in Seniors-ENRICA and 199 in UK Biobank experienced ≥1 fall during follow-up. After multivariable adjustment for major lifestyle and dietary risk factors and compared with daily consumption of <1 cup of coffee, the pooled HR for ≥1 fall was 0.75 (95% CI: 0.52, 1.07) for total coffee consumption of 1 cup/d and 0.74 (95% CI: 0.62, 0.90) for ≥2 cups/d (P-trend = 0.001). The corresponding figures for caffeinated coffee were 0.67 (95% CI: 0.42, 1.07) and 0.70 (95% CI: 0.56, 0.87) (P-trend < 0.001). Decaffeinated coffee was not associated with risk of falling in the analyzed cohorts. In Seniors-ENRICA, there was a tendency to lower risk of injurious falls among those consuming caffeinated coffee (HR: 0.83; 95% CI: 0.68, 1.00 for 1 cup/d; HR: 0.83; 95% CI: 0.64, 1.09 for ≥2 cups/d; P-trend = 0.09). No association was observed between caffeinated or decaffeinated coffee consumption and risk of falls with fracture. CONCLUSIONS Habitual coffee consumption was associated with lower risk of falling in older adults in Spain and the United Kingdom.
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Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Juan-Manuel Ballesteros
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Lana A, Struijk EA, Arias-Fernandez L, Graciani A, Mesas AE, Rodriguez-Artalejo F, Lopez-Garcia E. Habitual Meat Consumption and Changes in Sleep Duration and Quality in Older Adults. Aging Dis 2019; 10:267-277. [PMID: 31011478 PMCID: PMC6457059 DOI: 10.14336/ad.2018.0503] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/03/2018] [Indexed: 12/15/2022] Open
Abstract
Dietary proteins are sources of some amino acid precursors of two neurotransmitters relevant for biological rhythms, serotonin and melatonin, which are involved in sleep and alertness. Meat is the main source of proteins in many countries. Furthermore, meat consumption is of special interest because it provides high-quality protein as well as saturated and trans fatty acids. However, its effect on sleep patterns is unclear. Thereby, the aim was to examine the association of habitual meat consumption with changes in sleep duration and with sleep quality in older adults. We used data from 1,341 participants in the Seniors-ENRICA cohort aged ≥60 years, followed from 2012 through 2015. Habitual meat consumption was assessed at baseline with a validated diet history. Sleep duration and quality were ascertained both in 2012 and 2015. Analyses were performed with logistic regression and adjusted for socio-demographic variables, lifestyle, morbidity, sleep duration and poor sleep indicators at baseline. During follow-up, 9.0% of individuals increased and 7.9% decreased their sleep duration by ≥2 hours/night. Compared with individuals in the lowest tertile of meat consumption (<87 g/d), those in the highest tertile (≥128 g/d) showed increased incidence of a large decrease (≥2 h) in sleep duration (OR: 1.93; 95% CI:1.01-3.72; p-trend:0.04). Higher consumption of meat was also associated with incidence of snoring (OR:2.06; 95% CI:1.17-3.60; p-trend:0.01) and poor general sleep quality (OR:1.71; 95% CI:1.04-2.82; p-trend:0.03). Each 100 g/d increment in meat intake was associated with a 60% higher risk of both large sleep duration changes and poor sleep quality (OR:1.60; 95% CI:1.07-2.40). Results were in the same direction for red and processed meat and for white meat separately, and among individuals with physical impairment. Higher meat consumption (≥128 g/d) was associated with changes in sleep duration and with poor sleep in older adults.
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Affiliation(s)
- Alberto Lana
- 1Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Spain.,2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ellen A Struijk
- 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Lucía Arias-Fernandez
- 1Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Spain.,2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Auxiliadora Graciani
- 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Arthur E Mesas
- 4Department of Public Health, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Fernando Rodriguez-Artalejo
- 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,3IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain /IdiPAZ, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,3IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Struijk EA, Guallar-Castillón P, Rodríguez-Artalejo F, López-García E. Mediterranean Dietary Patterns and Impaired Physical Function in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 73:333-339. [PMID: 28329809 DOI: 10.1093/gerona/glw208] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/26/2016] [Indexed: 11/14/2022] Open
Abstract
Background Information about nutritional risk factors of functional limitation is scarce. The aim of this study was to examine the association between the Mediterranean diet and risk of physical function impairment in older adults. Methods We used data from 1,630 participants in the Seniors-ENRICA cohort aged ≥60 years. In 2008-2010, adherence to the Mediterranean diet pattern was measured with the Mediterranean Diet Score (MDS) and the Mediterranean Diet Adherence Screener (MEDAS). Study participants were followed up through 2012 to assess incident impairment in agility and mobility as well as impairment in overall physical functioning, defined as a ≥5-point decrease from baseline to follow-up in the physical component summary of the 12-Item Short-Form Health Survey. Results Over a median follow-up of 3.5 years, we identified 343 individuals with agility limitation, 212 with mobility limitation, and 457 with decreased overall physical functioning. No association was found between the MDS score and the likelihood of impaired agility or mobility, although a 2-point increment in the MDS score was marginally associated with lower likelihood for decreased overall physical function. Compared to individuals in the lowest tertile of the MEDAS score, those in the highest tertile showed a lower odds of agility limitation (odds ratio: 0.67, 95% confidence interval: 0.48; 0.94, p trend = .02), mobility limitation (odds ratio: 0.69, 95% confidence interval: 0.40; 0.88, p trend = .01), and decreased overall physical functioning (odds ratio: 0.60, 95% confidence interval: 0.45; 0.79, p trend < .001). Conclusions In this prospective cohort study, a Mediterranean-style dietary pattern, especially when measured with the MEDAS, was associated with a lower likelihood of physical function impairment in older adults.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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Ballesteros JM, Struijk EA, Rodríguez-Artalejo F, López-García E. Mediterranean diet and risk of falling in community-dwelling older adults. Clin Nutr 2019; 39:276-281. [PMID: 30824269 DOI: 10.1016/j.clnu.2019.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 01/21/2019] [Accepted: 02/04/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although the association between nutrition and muscle and bone health has been widely studied, the role of adequate nutrition in the prevention of falls remains uncertain. Therefore, this study examined the association between a Mediterranean-style dietary pattern and the risk of falling in older adults. METHODS We performed a prospective cohort study with 2,071 participants aged ≥60 y from the Seniors-ENRICA study. In 2008-2010, adherence to the Mediterranean diet was assessed with the MEDAS score, and study participants were followed-up through 2012 to assess incident falls during the previous year. RESULTS Over a median follow-up of 3.5 years, 402 (19.4%) people reported at least one fall (69.2% of them fell once and 30.8% ≥ 2 times). After adjustment for potential confounders, participants in the highest tertile of the MEDAS score showed a lower frequency of falling compared with those in the lowest tertile (OR: 0.72; 95% confidence interval 0.53-0.98; P-trend: 0.04). Consuming ≥2 servings/day of vegetables was the individual target of the MEDAS score that showed a significant association with a lower risk of falling (OR: 0.63; 95% CI 0.44-0.89). Targets for consumption of fruit, red and process meat, butter and margarine, wine, fish and nuts also showed some tendency to a slightly lower risk of falls. CONCLUSION The Mediterranean diet was associated with lower risk of falling among older Spanish adults. These findings suggest that the total benefit from the Mediterranean diet is due to the accumulated or synergic impact of several foods rather than a single one.
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Affiliation(s)
- Juan-Manuel Ballesteros
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomus University of Madrid, IdiPaz (Health Research Institute, University Hospital La Paz), CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomus University of Madrid, IdiPaz (Health Research Institute, University Hospital La Paz), CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomus University of Madrid, IdiPaz (Health Research Institute, University Hospital La Paz), CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomus University of Madrid, IdiPaz (Health Research Institute, University Hospital La Paz), CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Balboa-Castillo T, Struijk EA, Lopez-Garcia E, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillon P. Low vitamin intake is associated with risk of frailty in older adults. Age Ageing 2018; 47:872-879. [PMID: 30052701 DOI: 10.1093/ageing/afy105] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/03/2018] [Indexed: 01/07/2023] Open
Abstract
Background the association between vitamin intake and frailty has hardly been studied. The objective was to assess the association of dietary vitamin intake with incident frailty in older adults from Spain. Methods data came from a cohort of 1,643 community-dwelling individuals aged ≥65, recruited in 2008-10 and followed up prospectively throughout 2012. At baseline, 10 vitamins were assessed (vitamin A, thiamine, riboflavin, niacin, vitamins B6, B12, C, D, E and folates) using a validated face-to-face diet history. Incident frailty was identified using Fried's definition as having ≥3 of the following five criteria: unintentional weight loss of ≥4.5 kg, exhaustion, weakness, slow walking speed and low physical activity. Nonadherence to the recommended dietary allowances (RDA) was considered when the intake of a vitamin was below the recommendation. Analyses were performed with logistic regression and adjusted for main confounders. Results during a 3.5-year follow-up, 89 (5.4%) participants developed frailty. The odds ratios (95% confidence interval) of frailty for those in the lowest versus the highest tertile of vitamin intake were 2.80 (1.38-5.67), P-trend: 0.004, for vitamin B6; 1.65 (0.93-2.95), P-trend: 0.007, for vitamin C; 1.93 (0.99-3.83), P-trend: 0.06, for vitamin E and 2.34 (1.21-4.52), P-trend: 0.01, for folates. Nonadherence to the RDAs of vitamins was related to frailty for thiamine odds ratio (OR): 2.09 (1.03-4.23); niacin OR: 2.80 (1.46-5.38) and vitamin B6; 2.23 (1.30-3.83). When considering tertiles of RDAs for the 10 vitamins those who met <5 RDAs had a higher risk of frailty, OR: 2.84 (1.34-6.03); P-trend: <0.001, compared to those who met >7. Conclusion a lower intake of vitamins B6, C, E and folates was associated with a higher risk of frailty. Not meeting RDAs for vitamins was also strongly associated.
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Affiliation(s)
- Teresa Balboa-Castillo
- Department of Public Health—EPICYN Research Center, School of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Pilar Guallar-Castillon
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
- Johns Hopkins Bloomerg School of Public Health, Baltimore, USA
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Struijk EA, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Consumption of meat in relation to physical functioning in the Seniors-ENRICA cohort. BMC Med 2018; 16:50. [PMID: 29622014 PMCID: PMC5887175 DOI: 10.1186/s12916-018-1036-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/13/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meat is an important source of high-quality protein and vitamin B but also has a relatively high content of saturated and trans fatty acids. Although protein and vitamin B intake seems to protect people from functional limitations, little is known about the effect of habitual meat consumption on physical function. The objective of this study was to examine the prospective association between the intake of meat (processed meat, red meat, and poultry) and physical function impairment in older adults. METHODS Data were collected for 2982 participants in the Seniors-ENRICA cohort, who were aged ≥60 years and free of physical function impairment. In 2008-2010, their habitual diet was assessed through a validated computer-assisted face-to-face diet history. Study participants were followed up through 2015 to assess self-reported incident impairment in agility, mobility, and performance-based lower-extremity function. RESULTS Over a median follow-up of 5.2 years, we identified 625 participants with impaired agility, 455 with impaired mobility, and 446 with impaired lower-extremity function. After adjustment for potential confounders, processed meat intake was associated with a higher risk of impaired agility (hazard ratio [HR] for highest vs. lowest tertile: 1.33; 95% confidence interval [CI]: 1.08-1.64; p trend = 0.01) and of impaired lower-extremity function (HR for highest vs. lowest tertile: 1.31; 95% CI: 1.02-1.68; p trend = 0.04). No significant associations were found for red meat and poultry. Replacing one serving per day of processed meat with one serving per day of red meat, poultry, or with other important protein sources (fish, legumes, dairy, and nuts) was associated with lower risk of impaired agility and lower-extremity function. CONCLUSIONS A higher consumption of processed meat was associated with a higher risk of impairment in agility and lower-extremity function. Replacing processed meat by other protein sources may slow the decline in physical functioning in older adults.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain. .,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
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48
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Machado-Fragua MD, Struijk EA, Graciani A, Guallar-Castillon P, Rodríguez-Artalejo F, Lopez-Garcia E. Coffee consumption and risk of physical function impairment, frailty and disability in older adults. Eur J Nutr 2018; 58:1415-1427. [PMID: 29549497 DOI: 10.1007/s00394-018-1664-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/09/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Habitual coffee consumption has been associated with lower risk of type 2 diabetes and cardiovascular disease. Since these diseases are main determinants of functional limitations, we have tested the hypothesis that coffee intake is associated with lower risk of physical function impairment, frailty and disability in older adults. We focused on women and those with obesity, hypertension or type 2 diabetes because they are at higher risk of functional limitations. METHODS Prospective study with 3289 individuals ≥ 60 years from the Seniors-ENRICA cohort. In 2008-2010 coffee consumption was measured through a validated dietary history. Participants were followed up until 2015 to ascertain incident impaired physical function, frailty and disability, assessed by both self-report and objective measures. RESULTS Compared with non-drinking coffee, consumption of ≥ 2 cups of coffee/day was associated with lower risk of impaired agility in women (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.51-0.97, P trend 0.04) and in those with obesity (HR 0.60; 95% CI 0.40-0.90, P trend 0.04). Intake of ≥ 2 cups of coffee/day was also linked to reduced risk of impaired mobility in women (HR 0.66; 95% CI 0.46-0.95, P trend 0.02) and among individuals with hypertension (HR 0.70, 95% CI 0.48-1.00, P trend 0.05). Moreover, among subjects with diabetes, those who consumed ≥ 2 cups/day had lower risk of disability in activities of daily living (HR 0.30, 95% CI 0.11-0.76, P trend 0.01). CONCLUSIONS In older people, habitual coffee consumption was not associated with increased risk of functional impairment, and it might even be beneficial in women and those with hypertension, obesity or diabetes.
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Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain. .,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain. .,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pilar Guallar-Castillon
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, s/n, 28029, Madrid, Spain. .,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain. .,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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49
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Muller DC, Murphy N, Johansson M, Ferrari P, Tsilidis KK, Boutron-Ruault MC, Clavel F, Dartois L, Li K, Kaaks R, Weikert C, Bergmann M, Boeing H, Tjønneland A, Overvad K, Redondo ML, Agudo A, Molina-Portillo E, Altzibar JM, Cirera L, Ardanaz E, Khaw KT, Wareham NJ, Key TJ, Travis RC, Bamia C, Orfanos P, Trichopoulou A, Palli D, Pala V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Verschuren WMM, Struijk EA, Peeters PH, Engström G, Melander O, Sund M, Weiderpass E, Skeie G, Lund E, Norat T, Gunter M, Riboli E, Brennan P. Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study. BMC Med 2016; 14:87. [PMID: 27296932 PMCID: PMC4907105 DOI: 10.1186/s12916-016-0630-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/27/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. METHODS We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. RESULTS We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers. CONCLUSIONS While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.
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Affiliation(s)
- David C Muller
- International Agency for Research on Cancer, 69008, Lyon, France
| | - Neil Murphy
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | | | - Pietro Ferrari
- International Agency for Research on Cancer, 69008, Lyon, France
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Marie-Christine Boutron-Ruault
- Centre for Research in Epidemiology and Population Health (CESP), 94805, Villejuif, France
- Université Paris Sud, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Francoise Clavel
- Université Paris Sud, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), 94805, Villejuif, France
| | - Laureen Dartois
- Université Paris Sud, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), 94805, Villejuif, France
| | - Kuanrong Li
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), DE-69120, Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), DE-69120, Heidelberg, Germany
| | - Cornelia Weikert
- German Institute of Human Nutrition Potsdam-Rehbrücke (DifE), DE-14558, Nuthetal, Germany
| | - Manuela Bergmann
- German Institute of Human Nutrition Potsdam-Rehbrücke (DifE), DE-14558, Nuthetal, Germany
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbrücke (DifE), DE-14558, Nuthetal, Germany
| | - Anne Tjønneland
- Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, DK-8000, Aarhus, Denmark
| | | | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, 08908, Barcelona, Spain
| | - Elena Molina-Portillo
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, 18012, Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Jone M Altzibar
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Public Health Division of Gipuzkoa-BIODONOSTIA, Basque Regional Health Department, 20014, Donostia - San Sebastián, Spain
| | - Lluís Cirera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, 30003, Murcia, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - Eva Ardanaz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Navarra Public Health Institute, 31003, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Pamplona, Spain
| | - Kay-Tee Khaw
- School of Clinical Medicine, University of Cambridge, Cambridge, CB2 2QQ, UK
| | | | - Timothy J Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, OX3 7LF, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, OX3 7LF, UK
| | - Christina Bamia
- Hellenic Health Foundation, GR-115 27, Athens, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Philippos Orfanos
- Hellenic Health Foundation, GR-115 27, Athens, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Antonia Trichopoulou
- Hellenic Health Foundation, GR-115 27, Athens, Greece
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), 50134, Florence, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M. P. Arezzo" Hospital, ASP Ragusa, Ragusa, 97100, Italy
| | - Paolo Vineis
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Human Genetics Foundation (HuGeF), Torino, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Sperimentale, Federico II University, 80138, Naples, Italy
| | - H Bas Bueno-de-Mesquita
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), 3720 BA, Bilthoven, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - W M Monique Verschuren
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), 3720 BA, Bilthoven, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ellen A Struijk
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra H Peeters
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gunnar Engström
- Department of Clinical Science, Malmö Lund University, Lund, SE-205 02, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Hypertension & Cardiovascular Disease, Clinical Research Centre, Malmö University Hospital, SE-20502, Malmö, Sweden
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umea University, 901 85, Umea, Sweden
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, 9037, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Samfundet Folkhälsan, Helsinki, Finland
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, 9037, Tromsø, Norway
- The Arctic University of Norway, Tromsø, Norway
| | - Eiliv Lund
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, 9037, Tromsø, Norway
- The Arctic University of Norway, Tromsø, Norway
| | - Teresa Norat
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Marc Gunter
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Elio Riboli
- School of Public Health, Imperial College London, London, SW7 2AZ, UK
| | - Paul Brennan
- International Agency for Research on Cancer, 69008, Lyon, France.
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50
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Jankovic N, Geelen A, Streppel MT, de Groot LC, Kiefte-de Jong JC, Orfanos P, Bamia C, Trichopoulou A, Boffetta P, Bobak M, Pikhart H, Kee F, O'Doherty MG, Buckland G, Woodside J, Franco OH, Ikram MA, Struijk EA, Pajak A, Malyutina S, Kubinova R, Wennberg M, Park Y, Bueno-de-Mesquita HB, Kampman E, Feskens EJ. WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project. Am J Clin Nutr 2015; 102:745-56. [PMID: 26354545 PMCID: PMC4588736 DOI: 10.3945/ajcn.114.095117] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 07/23/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly. OBJECTIVE The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y. DESIGN We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model. RESULTS During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable). CONCLUSION Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.
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Affiliation(s)
- Nicole Jankovic
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands; Centre of Clinical Epidemiology, Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | | | | | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands; Global Public Health, Leiden University College, the Hague, Netherlands
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Christina Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Antonia Trichopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; Hellenic Health Foundation, Athens, Greece
| | - Paolo Boffetta
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Medical School, Athens, Greece; The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Hynek Pikhart
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Mark G O'Doherty
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Genevieve Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | - Jayne Woodside
- UKCRC Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Ellen A Struijk
- Department of Epidemiology, Julius Centre, Utrecht, Netherlands
| | - Andrzej Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University, Krakow, Poland
| | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia; Novosibirsk State Medical University, Novosibirsk, Russia
| | | | - Maria Wennberg
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Yikyung Park
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - H Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom; and Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Edith J Feskens
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands;
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