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Carrasco-Rios M, Ortolá R, Sotos-Prieto M, Graciani A, Rodríguez-Artalejo F, Banegas JR, García-Esquinas E. Association of blood manganese concentrations with 24-h based brachial and central blood pressure, and pulse-wave velocity. Environ Res 2023; 225:115625. [PMID: 36894115 DOI: 10.1016/j.envres.2023.115625] [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] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/24/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
Potential environmental determinants of BP and hypertension in older adults are far less known than their lifestyle risk factors. Manganese (Mn) is an essential element for life that may induce changes in blood pressure (BP), but the direction of the association is unclear. We aimed to examine the association of blood manganese (bMn) with 24-h-based brachial, central BP (cBP), and pulse-wave velocity (PWV). With this purpose, we analyzed data from 1009 community-living adults aged >65 years without BP medication. bMn was measured using inductively-coupled plasma-mass spectrometry and 24-h BP with validated devices. The association of bMn (median: 6.77 μg/L; IQR: 5.59-8.27) with daytime brachial and central systolic (SBP) and with diastolic BP (DBP) was non-linear, with BP increases up to around the median of Mn and then stabilization or slight rightward decrease. Mean BP differences (95% confidence interval) comparing Mn Q2 to Q5 (vs Q1 quintile) for brachial daytime SBP were 2.56 (0.22; 4.90), 3.59 (1.22; 5.96), 3.14 (0.77; 5.51) and 1.72 (-0.68; 4.11) mmHg, respectively; and 2.22 (0.70, 3.73), 2.55 (1.01, 4.08), 2.45 (0.91; 3.98), and 1.68 (0.13; 3.24), respectively, for DBP. Daytime central-pressures showed a similar dose-response relationship with bMn as daytime brachial-pressures. The association with nighttime BP was linearly positive for brachial BPs, and only increasing for Q5 for cBP. Regarding PWV, a tendency to significant linear increase along bMn levels was observed (p-trend = 0.042). The present findings extend the scarce evidence on the association between Mn and brachial BP to 2 other vascular parameters, suggesting Mn levels as a candidate risk factor for increasing levels of both brachial and cBPs in older adults, yet further research is needed with larger cohort studies in adults at all age ranges.
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Affiliation(s)
- M Carrasco-Rios
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
| | - R Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M Sotos-Prieto
- Department of Preventive Medicine and Public Health, 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, MA, USA
| | - A Graciani
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - J R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - E García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain.
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Fernández-Rodríguez R, Ortolá R, Martínez-Vizcaíno V, Bizzozero-Peroni B, Rodríguez-Artalejo F, García-Esquinas E, López-García E, Mesas AE. Nut Consumption and Depression: Cross-Sectional and Longitudinal Analyses in Two Cohorts of Older Adults. J Nutr Health Aging 2023; 27:448-456. [PMID: 37357329 DOI: 10.1007/s12603-023-1927-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/19/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES To assess the cross-sectional and longitudinal associations between nut consumption and depression in two cohorts of older adults. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS The first cohort (Seniors-ENRICA-I or SE-I) included a representative sample of Spanish noninstitutionalized adults aged ≥65 years interviewed in 2010 and 2013. The second cohort (SE-II) included individuals from the Madrid region, Spain, aged ≥65 years interviewed in 2017 and in 2019. Nut consumption was estimated with a validated computer-based diet history. Depression was defined as self-reported physician-diagnosed depression or the use of antidepressants. Logistic regression models were adjusted for the main confounders. The DerSimonian and Laird random-effect method was used to meta-analyze the results from both studies. A participant-level pooled analysis was conducted to examine the robustness of our analyses. RESULTS The SE-I included 2278 individuals (233 prevalent cases) in the cross-sectional analysis and 1534 (108 incident cases) in the longitudinal analysis; the corresponding figures for SE-II were 2726 (407 prevalent cases) and 1566 (74 incident cases). In the meta-analysis of cross-sectional results from the two studies, compared to consuming <1 serving (30 g) of nuts/week, the odds ratio (95% confidence interval) for depression was 0.90 (0.64, 1.16) for consuming 1 to <3 servings/week and 0.92 (0.70, 1.13) for consuming ≥3 servings/week; the corresponding figures for the longitudinal results were 0.90 (0.41, 1.38) and 0.66 (0.35, 0.97). CONCLUSION Nut consumption was associated with a lower risk of depression in a pooled longitudinal analysis using data from two cohorts of older adults. Nuts should be recommended as part of a healthy diet in older adults.
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Affiliation(s)
- R Fernández-Rodríguez
- Vicente Martínez-Vizcaíno, Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain, 16071. E-mail:
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Delgado-Velandia M, Maroto-Rodríguez J, Ortolá R, García-Esquinas E, Rodríguez-Artalejo F, Sotos-Prieto M. Plant-Based Diets and All-cause and Cardiovascular Mortality in a Nationwide Cohort in Spain: The ENRICA Study. Mayo Clin Proc 2022; 97:2005-2015. [PMID: 36333014 DOI: 10.1016/j.mayocp.2022.06.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/27/2022] [Accepted: 06/03/2022] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To investigate the associations of a healthful plant-based diet index (hPDI) and an unhealthful plant-based diet index (uPDI) with all-cause and cardiovascular disease (CVD) mortality in Spanish adults. PATIENTS AND METHODS We analyzed data from 11,825 individuals 18 years of age or older, representative of the Spanish population, recruited between 2008 and 2010 and followed-up to 2020. Food consumption was collected at baseline using a validated dietary history, which served to calculate two plant-based diet indices based on 18 major food groups (range, 18-90 points). For (1) hPDI only the consumption of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea/coffee) received positive scores; whereas for (2) uPDI, only the consumption of less healthy plant foods (fruit juices, sugar-sweetened beverages, refined grains, potatoes, and sweets/desserts) received positive scores. Multivariable-adjusted Cox models were used to estimate HRs and their 95% CIs. RESULTS After a median follow-up of 10.9 and 9.8 years, 699 all-cause and 157 CVD deaths were ascertained, respectively. Each 10-point increase in hPDI was associated with 14% lower risk of all-cause death (HR, 0.86; 95% CI, 0.74 to 0.99), and 37% lower risk of CVD death (HR, 0.63; 95% CI, 0.46 to 0.85). No significant associations were found for uPDI. CONCLUSION Higher adherence to an hPDI diet, but not to a uPDI, was associated with lower all-cause and CVD mortality. This suggests that the quality of the plant food consumed is paramount to achieve diet-related benefits in mortality. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02804672.
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Affiliation(s)
- M Delgado-Velandia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain
| | - J Maroto-Rodríguez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain
| | - R Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain
| | - E García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain; National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain; Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - M Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 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, MA, USA.
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Carballo-Casla A, Stefler D, Ortolá R, Chen Y, Kubinova R, Pajak A, Malyutina S, Rodríguez-Artalejo F, Brunner EJ, Bobak M. The Southern European Atlantic Diet and depression incidence: a multicohort study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and North-Western Spain, but it may resemble that of other European countries. Higher adherence to SEAD has been associated with lower risk for myocardial infarction and all-cause mortality, but its relationship with mental health is uncertain. We examined the association between SEAD and depression incidence in Southern, Central, and Eastern Europe.
Methods
We used data from participants ≥45 years from the Seniors-ENRICA-2 and HAPIEE cohorts, who were followed for a median time of 3.6 years. SEAD comprised fresh fish, cod, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and wine. Depressive symptoms were assessed with the GDS 10 and the CES-D 10 (participants with scores ≥4 were considered depression cases). Statistical analyses were performed among the 14675 participants who were depression-free at baseline.
Results
Higher adherence to SEAD was preliminarily associated with lower depression incidence in the pooled sample (fully adjusted odds ratio [95% confidence interval] per 1-SD increment in the SEAD = 0.93 [0.89,0.98]). Results were consistent in Spain (odds ratio [95% confidence interval] 0.86 [0.68,1.08]), Czechia (0.92 [0.82,1.04]), Poland (0.94 [0.88,1.01]), and Russia (0.93 [0.87,1.00]). The association of SEAD with depression in the pooled sample was similar to that found for the Alternate Healthy Eating Index (odds ratio [95% confidence interval] per 1-SD increment = 0.94 [0.89,0.99]) and the Mediterranean Dietary Score (0.94 [0.90,0.98]).
Conclusions
Adherence to SEAD was preliminarily associated with lower depression incidence in Spain, Czechia, Poland, and Russia. These findings may support the development of mental health guidelines for Southern European Atlantic populations based on their traditional diet, and for Central and Eastern European countries based on the food components of SEAD.
Key messages
• Adherence to the Southern European Atlantic Diet (traditional diet of Northern Portugal and North-Western Spain) was associated with lower depression incidence in Spain, Czechia, Poland, and Russia.
• Mental health guidelines for Southern European Atlantic populations may reference their traditional diet, while those for Central and Eastern Europe could benefit from including its food components.
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Affiliation(s)
- A Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid , Madrid, Spain
- CIBER of Epidemiology and Public Health, CIBERESP , Madrid, Spain
| | - D Stefler
- Department of Epidemiology and Public Health, University College London , London, UK
| | - R Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid , Madrid, Spain
- CIBER of Epidemiology and Public Health, CIBERESP , Madrid, Spain
| | - Y Chen
- Department of Epidemiology and Public Health, University College London , London, UK
| | - R Kubinova
- National Institute of Public Health , Prague, Czechia
| | - A Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Collegium Medicum , Krakow, Poland
| | | | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid , Madrid, Spain
- CIBER of Epidemiology and Public Health, CIBERESP , Madrid, Spain
- IMDEA Food Institute , CEI UAM+CSIC, Madrid, Spain
| | - EJ Brunner
- Department of Epidemiology and Public Health, University College London , London, UK
| | - M Bobak
- Department of Epidemiology and Public Health, University College London , London, UK
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Mostaza JM, Salinero-Fort MA, Cardenas-Valladolid J, Rodríguez-Artalejo F, Díaz-Almirón M, Vich-Pérez P, San Andrés-Rebollo FJ, Vicente I, Lahoz C. Factores asociados con la mortalidad por SARS-CoV-2 en la población mayor de 75 años de la Comunidad de Madrid. Rev Clin Esp 2022; 222:468-478. [PMID: 35720162 PMCID: PMC9193184 DOI: 10.1016/j.rce.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/04/2022] [Indexed: 11/17/2022]
Abstract
Objetivo Pacientes y métodos Resultados Conclusión
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Affiliation(s)
- J M Mostaza
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - M A Salinero-Fort
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Instituto de Investigación del Hospital La Paz (IdIPAZ); Red de Investigación en pacientes crónicos (REDISSEC); Subdirección general de Investigación en Salud, Ministerio de Sanidad, Madrid, España
| | - J Cardenas-Valladolid
- Dirección Técnica de Sistemas de Información Sanitaria, Gerencia Adjunta de Procesos Asistenciales, Gerencia Asistencial de Atención Primaria, Madrid, España
| | - F Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid-IdIPAZ, CIBER de Epidemiología y Salud Pública (CIBERESP) e IMDEA-Alimentación, CEI UAM + CSIC, Madrid, España
| | - M Díaz-Almirón
- Unidad de Investigación, Instituto de Investigación Hospital La Paz, IdiPAZ, Madrid, España
| | - P Vich-Pérez
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Los Alpes, Madrid, España
| | - F J San Andrés-Rebollo
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Las Calesas, Madrid, España
| | - I Vicente
- Centro de Salud Monovar, Madrid, España
| | - C Lahoz
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
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Mostaza JM, Salinero-Fort MA, Cardenas-Valladolid J, Rodríguez-Artalejo F, Díaz-Almirón M, Vich-Pérez P, San Andrés-Rebollo FJ, Vicente I, Lahoz C. Factors associated with mortality due to SARS-CoV-2 in the population over 75 years of age in the Community of Madrid. Rev Clin Esp 2022; 222:468-478. [PMID: 35970758 PMCID: PMC9372797 DOI: 10.1016/j.rceng.2022.06.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/04/2022] [Indexed: 11/30/2022]
Abstract
Objective Various studies have identified factors associated with risk of mortality in patients with SARS-CoV-2 infection. However, their sample size has often been limited and their results partially contradictory. This study evaluated factors associated with COVID-19 mortality in the population of Madrid over 75 years of age, in infected patients, and in hospitalized patients up to January 2021. Patients and Methods This population-based cohort study analyzed all residents of the Community of Madrid born before January 1, 1945 who were alive as of December 31, 2019. Demographic and clinical data were obtained from primary care electronic medical records (PC-Madrid), data on hospital admissions from the Conjunto Mínimo Básico de Datos (CMBD, Minimum Data Set), and data on mortality from the Índice Nacional de Defunciones (INDEF, National Death Index). Data on SARS-CoV-2 infection, hospitalization, and death were collected from March 1, 2020 to January 31, 2021. Results A total of 587,603 subjects were included in the cohort. Of them, 41,603 (7.1%) had confirmed SARS-CoV-2 infection, of which 22,362 (53.7% of the infected individuals) were hospitalized and 11,251 (27%) died. Male sex and age were the factors most closely associated with mortality, though many comorbidities also had an influence. The associations were stronger in the analysis of the total population than in the analysis of infected or hospitalized patients. Mortality among hospitalized patients was lower during the second wave (33.4%) than during the first wave (41.2%) of the pandemic. Conclusion Age, sex, and numerous comorbidities are associated with risk of death due to COVID-19. Mortality in hospitalized patients declined notably after the first wave of the pandemic.
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Affiliation(s)
- J M Mostaza
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna. Hospital La Paz-Carlos III, Madrid, Spain.
| | - M A Salinero-Fort
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Instituto de Investigación del Hospital La Paz (IdIPAZ), Red de Investigación en pacientes crónicos (REDISSEC), Subdirección general de Investigación en Salud, Ministerios de Sanidad, Madrid, Spain
| | - J Cardenas-Valladolid
- Dirección Técnica de Sistemas de Información Sanitaria, Gerencia Adjunta de Procesos Asistenciales, Gerencia Asistencial de Atención Primaria, Madrid. Spain
| | - F Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid-IdIPAZ, CIBER de Epidemiología y Salud Pública (CIBERESP) e IMDEA-Alimentación, CEI UAM + CSIC, Madrid, Spain
| | - M Díaz-Almirón
- Unidad de Investigación, Instituto de Investigación Hospital La Paz, IdiPAZ, Madrid, Spain
| | - P Vich-Pérez
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Los Alpes, Madrid, Spain
| | - F J San Andrés-Rebollo
- Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Centro de Salud Las Calesas, Madrid, Spain
| | - I Vicente
- Centro de Salud Monovar, Madrid, Spain
| | - C Lahoz
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna. Hospital La Paz-Carlos III, Madrid, Spain
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Rodríguez-Gómez I, Sánchez-Martín C, García-García FJ, García-Esquinas E, Miret M, Jiménez-Pavón D, Guadalupe-Grau A, Mañas A, Carnicero JA, Casajus JA, Ayuso-Mateos JL, Rodríguez-Artalejo F, Rodríguez-Mañas L, Ara I. The Medium-Term Changes in Health-Related Behaviours among Spanish Older People Lifestyles during Covid-19 Lockdown. J Nutr Health Aging 2022; 26:485-494. [PMID: 35587761 PMCID: PMC9020156 DOI: 10.1007/s12603-022-1781-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/17/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim was to evaluate general changes and investigate the association between diet quality, physical activity (PA), and sedentary time (ST) during COVID-19 lockdown and the subsequent 7-month changes in health-related behaviours and lifestyles in older people. PARTICIPANTS 1092 participants (67-97y) from two Spanish cohorts were included. DESIGN Telephone-based questionaries were used to evaluate health-related behaviours and lifestyle. Multinomial logistic regression analyses with diet quality, PA, and ST during lockdown as predictors for health-related behaviours changes post-lockdown were applied. RESULTS Diet quality, PA, and ST significantly improved post-lockdown, while physical component score of the SF-12 worsened. Participants with a low diet quality during lockdown had higher worsening of post-lockdown ST and anxiety; whereas those with high diet quality showed less likelihood of remaining abstainers, worsening weight, and improving PA. Lower ST was associated with a higher likelihood of remaining abstainers, and worsening weight and improving social contact; nevertheless, higher ST was linked to improvement in sleep quality. Lower PA was more likely to decrease alcohol consumption, while higher PA showed the opposite. However, PA was more likely to be associated to remain abstainers. CONCLUSIONS Despite improvements in lifestyle after lockdown, it had health consequences for older people. Particularly, lower ST during lockdown seemed to provide the most medium-term remarkable lifestyle improvements.
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Affiliation(s)
- I Rodríguez-Gómez
- Ignacio Ara Royo, PhD, GENUD-Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III, s/n, 45071, Toledo, Spain, Tel: +34 925268800 (Ext.5543); E-mail: ; @iara_royo
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Estrada-deLeón D, Struijk E, Caballero F, Prieto MS, Rodríguez-Artalejo F, Lopez-Garcia E. Time-restricted feeding and lower-extremity functioning in community-dwelling older adults. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Carballo-Casla A, García-Esquinas E, Lopez-Garcia E, Sotos-Prieto M, Struijk E, Caballero F, Rodríguez-Artalejo F, Ortolá R. Consumption of food fried in olive oil and unhealthy aging in a Mediterranean country. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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García-Esquinas E, Carrasco-Rios M, Ortolá R, Sotos Prieto M, Pérez-Gómez B, Gutiérrez-González E, Banegas JR, Queipo R, Olmedo P, Gil F, Tellez-Plaza M, Navas-Acien A, Pastor-Barriuso R, Rodríguez-Artalejo F. Selenium and impaired physical function in US and Spanish older adults. Redox Biol 2020; 38:101819. [PMID: 33316745 PMCID: PMC7744768 DOI: 10.1016/j.redox.2020.101819] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023] Open
Abstract
Background Selenium (Se) is a trace element with a narrow safety margin. Objectives To evaluate the cross-sectional and longitudinal dose-response association between Se exposure and measures of impaired physical function and disability in older adults. Design NHANES 2011–2014 cross-sectional (US, n = 1733, age ≥60 years) and Seniors-ENRICA-2 2017–2019 cross-sectional and longitudinal (Spain, n = 2548 and 1741, respectively, age ≥65 years) data were analyzed. Whole blood and serum Se levels were measured using inductively coupled plasma-mass spectrometry. Lower-extremity performance was assessed with the Short Physical Performance Battery, and muscle weakness with a dynamometer. Incident mobility and agility limitations, and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including physical activity. Results across studies were pooled using random-effects meta-analysis. Results Meta-analyzed odds ratios (95% confidence interval) per log2 increase in whole blood Se were 0.54 (0.32; 0.76) for weakness, 0.59 (0.34; 0.83) for impaired lower-extremity performance, 0.48 (0.31; 0.68) for mobility limitations, 0.71 (0.45; 0.97) for agility limitations, and 0.34 (0.12; 0.56) for disability in at least one IADL. Analyses for serum Se in NHANES showed similar results. Findings suggest the inverse association with grip strength is progressive below 140 μg/L (p-value for non-linear trend in the Seniors-ENRICA-2 study = 0.13), and above 140 μg/L (p-value for non-linear trend in NHANES = 0.11). In the Seniors-ENRICA-2 cohort, with a 2.2 year follow-up period, a doubling in baseline Se levels were associated with a lower incidence of weakness [odds ratio (95% confidence interval): 0.45 (0.22; 0.91)], impaired lower-extremity performance [0.63 (0.32; 1.23)], mobility [0.43 (0.21; 0.91)] and agility [0.38 (0.18; 0.78)] limitations. Discussion In US and Spanish older adults, Se concentrations were inversely associated with physical function limitations. Further studies are needed to elucidate underlying mechanisms.
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Affiliation(s)
- E García-Esquinas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - M Carrasco-Rios
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain
| | - R Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; 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
| | - M Sotos Prieto
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - B Pérez-Gómez
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; National Center of Epidemiology. Carlos III Health Institute, Madrid, Spain
| | | | - J R Banegas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - R Queipo
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; Department of Medicine. School of Biomedical Sciences. Universidad Europea. Madrid, Spain
| | - P Olmedo
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - F Gil
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - M Tellez-Plaza
- National Center of Epidemiology. Carlos III Health Institute, Madrid, Spain; Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Spain
| | - A Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - R Pastor-Barriuso
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; National Center of Epidemiology. Carlos III Health Institute, Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA Research Institute on Food and Health Sciences. Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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11
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García-Esquinas E, Carrasco-Rios M, Navas-Acien A, Ortolá R, Rodríguez-Artalejo F. Cadmium exposure is associated with reduced grip strength in US adults. Environ Res 2020; 180:108819. [PMID: 31654908 DOI: 10.1016/j.envres.2019.108819] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/09/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Muscle strength is a strong predictor of all-cause mortality in the general population. Recent studies have shown an association between environmental pollution and declined grip strength. No previous research has evaluated the specific association between cadmium exposure, a well-known risk factor of several chronic diseases, and muscle strength. METHODS Cross-sectional study among 4,197 individuals aged ≥40 years, who participated in the National Health and Nutrition Examination Survey (NHANES) 2011-2014, provided data on grip strength, and had either blood or urine cadmium determinations. Grip strength was measured using a Takei digital handgrip dynamometer, and combined grip strength was calculated as the sum of the largest reading from each hand. RESULTS Median (interquartile range) concentrations of blood (BCd) and creatinine-corrected urine cadmium (Cr-UCd) were 0.32 μg/L (0.20-4.56) and 0.27 μg/g (0.15-0.46), respectively. After adjusting for sociodemographic, anthropometric, health-related behavioral, and clinical risk factors, and serum creatine phosphokinase concentrations, the highest (vs lowest) quartile of BCd was associated with a reduction in combined grip strength of 1.93 kg (95% confidence interval [CI]: -3.51, -0.34), p-trend <0.001. The corresponding values comparing Cr-UCd quartiles 4 vs 1 were -3.24 kg (95% CI: -5.68, -0.79), p-trend <0.001. These results were consistent across socio-demographic and clinical subgroups. CONCLUSIONS In the US adult population, higher cadmium exposure was associated with decreased grip strength. These results may have important public health implications given the widespread cadmium exposure.
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Affiliation(s)
- E García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - M Carrasco-Rios
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain
| | - A Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - R Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPAZ, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
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12
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Higueras-Fresnillo S, de la Cámara MA, Esteban-Cornejo I, Rodríguez-Artalejo F, Martinez-Gomez D. Concurrent Criterion Validity of a Test of Usual Gait Speed in Older Adults. Percept Mot Skills 2018; 125:908-922. [PMID: 30089427 DOI: 10.1177/0031512518780594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Usual gait speed has been shown to have very good reliability and convincing predictive validity for evaluating older adults' gait skills, but its criterion validity is unknown. We examined the criterion validity of the 8-feet (i.e., 2.44 meters) test in a laboratory environment to assess usual gait speed by comparing its results with the Intelligent Device for Energy Expenditure and Activity (IDEEA) monitor. Participants were 200 well-functioning community-dwelling adults aged 65 and older (113 women; 87 men; mean [M] age = 71.8, standard deviation [ SD] = 5.6 years). Participants wore the IDEEA monitor for 48 consecutive hours, and we used the participants' average usual gait speed for the analysis. The Spearman correlation of usual gait speed using both the 8-feet test and IDEEA monitor was moderate and statistically significant (ρ = .364, p < .001). The mean difference between both methods was 0.20 ( SD = 0.27) meters/second, and the corresponding limits of agreement were 0.73 and -0.33 meters/second. There was a small systematic bias when the difference between the two methods was correlated with usual gait speed as measured by the IDEEA (ρ = -.20, p = .011). The perfect agreement (weighted kappa) of both instruments for classifying usual gait speed into tertiles, quartiles, and quintiles was 48.3% ( k = 0.17), 30.9% ( k = 0.23), and 25.4% ( k = 0.29), respectively. Our results indicate that the 8-feet test showed moderate criterion-related validity for evaluating and assessing usual gait speed test in older adults.
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Affiliation(s)
- S Higueras-Fresnillo
- 1 Department of Physical Education, Sport, and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - M A de la Cámara
- 1 Department of Physical Education, Sport, and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - I Esteban-Cornejo
- 2 PROFITH Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - F Rodríguez-Artalejo
- 3 Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Spain.,4 IdiPaz and CIBER of Epidemiology and Public Health, Madrid, Spain
| | - D Martinez-Gomez
- 1 Department of Physical Education, Sport, and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
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13
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Ortolá R, García-Esquinas E, Galán I, Guallar-Castillón P, López-García E, Banegas JR, Rodríguez-Artalejo F. Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study. Osteoporos Int 2017; 28:3143-3152. [PMID: 28725986 DOI: 10.1007/s00198-017-4157-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 05/23/2017] [Accepted: 07/10/2017] [Indexed: 01/29/2023]
Abstract
UNLABELLED Falls are a major health problem in older adults, but their relationship with alcohol consumption in this population remains unclear. In a cohort with 2170 older adults followed up for 3.3 years, both moderate drinking and the Mediterranean drinking pattern were associated with a lower risk of falls and injurious falls. INTRODUCTION This study aims to examine the association between certain patterns of alcohol consumption, including the Mediterranean drinking pattern (MDP), and the risk of falls in older adults. METHODS A prospective cohort with 2170 community-dwelling individuals aged ≥60 years was recruited in Spain in 2008-2010 and followed up through 2012. At baseline, participants reported alcohol consumption and, at the end of follow-up, their falls during the previous year. The MDP was defined as moderate alcohol consumption (threshold between moderate and heavy intake was 40 g/day for men and 24 g/day for women) with preference for wine and drinking only with meals. Analyses were conducted with negative binomial or logistic regression, as appropriate, and adjusted for the main confounders. RESULTS Compared with never drinkers, the number of falls was lower in moderate drinkers (incidence rate ratio (95% confidence interval), 0.79 (0.63-0.99)) and drinkers with MDP (0.73 (0.56-0.96)). Also, moderate drinkers and those with MDP showed a lower risk of ≥2 falls (odds ratio (95% confidence interval), 0.58 (0.38-0.88) and 0.56 (0.34-0.93), respectively) and of falls requiring medical care (0.67 (0.46-0.96) and 0.61 (0.39-0.96), respectively). CONCLUSION Both moderate drinking and the MDP were associated with a lower risk of falls and injurious falls in older adults. However, sound advice on alcohol consumption should balance risks and benefits.
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Affiliation(s)
- R Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.
| | - E García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and 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
| | - I Galán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and Idipaz, Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain
- National Centre for Epidemiology, Instituto de Salud Carlos III, Calle de Sinesio Delgado 4, 28029, Madrid, Spain
| | - P Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and 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, Ctra. de Canto Blanco 8, 28049, Madrid, Spain
| | - E López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and 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, Ctra. de Canto Blanco 8, 28049, Madrid, Spain
| | - J R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and 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
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and 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, Ctra. de Canto Blanco 8, 28049, Madrid, Spain.
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Chaparro M, Ramas M, Benítez JM, López-García A, Juan A, Guardiola J, Mínguez M, Calvet X, Márquez L, Fernández Salazar LI, Bujanda L, García C, Zabana Y, Lorente R, Barrio J, Hinojosa E, Iborra M, Cajal MD, Van Domselaar M, García-Sepulcre MF, Gomollón F, Piqueras M, Alcaín G, García-Sánchez V, Panés J, Domènech E, García-Esquinas E, Rodríguez-Artalejo F, Gisbert JP. Extracolonic Cancer in Inflammatory Bowel Disease: Data from the GETECCU Eneida Registry. Am J Gastroenterol 2017; 112:1135-1143. [PMID: 28534520 DOI: 10.1038/ajg.2017.96] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 12/29/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objective of this study was (a) To know the prevalence and distribution of extracolonic cancer (EC) in patients with inflammatory bowel disease (IBD); (b) To estimate the incidence rate of EC; (c) To evaluate the association between EC and treatment with immunosuppressants and anti-tumor necrosis factor (TNF) agents. METHODS This was an observational cohort study. INCLUSION CRITERIA IBD and inclusion in the ENEIDA Project (a prospectively maintained registry) from GETECCU. EXCLUSION CRITERIA Patients with EC before the diagnosis of IBD, lack of relevant data for this study, and previous treatment with immunosuppressants other than corticosteroids, thiopurines, methotrexate, or anti-TNF agents. The Kaplan-Meier method was used to evaluate the impact of several variables on the risk of EC, and any differences between survival curves were evaluated using the log-rank test. Stepwise multivariate Cox regression analysis was used to investigate factors potentially associated with the development of EC, including drugs for the treatment of IBD, during follow-up. RESULTS A total of 11,011 patients met the inclusion criteria and were followed for a median of 98 months. Forty-eight percent of patients (5,303) had been exposed to immunosuppressants or anti-TNF drugs, 45.8% had been exposed to thiopurines, 4.7% to methotrexate, and 21.6% to anti-TNF drugs. The prevalence of EC was 3.6%. In the multivariate analysis, age (HR=1.05, 95% CI=1.04-1.06) and having smoked (hazards ratio (HR)=1.47, 95% confidence interval (CI)=1.10-1.80) were the only variables associated with a higher risk of EC. CONCLUSIONS Neither immunosuppressants nor anti-TNF drugs seem to increase the risk of EC. Older age and smoking were associated with a higher prevalence of EC.
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Affiliation(s)
- María Chaparro
- Hospital de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - M Ramas
- Hospital de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - J M Benítez
- Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | | | - A Juan
- Hospital Germans Trias i Pujol (CIBERehd), Badalona, Spain
| | - J Guardiola
- Badalona, Hospital Bellvitge, Barcelona, Spain
| | - M Mínguez
- Hospital Clínico de Valencia, Valencia, Spain
| | - X Calvet
- Hospital Parc Taulí, Barcelona, Spain
| | | | | | - L Bujanda
- Hospital Donostia (CIBERehd), Universidad del País Vasco (UPV/EHU), San Sebastián, Spain
| | - C García
- Hospital Ramón y Cajal, Madrid, Spain
| | - Y Zabana
- Hospital Mutua de Terrassa (CIBERehd), Terrassa, Spain
| | - R Lorente
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - J Barrio
- Hospital Universitario Río Hortega, Valladolid, Spain
| | | | - M Iborra
- Hospital La Fe (CIBERehd), Valencia, Spain
| | | | | | | | - F Gomollón
- ISS Aragón, Hospital Clínico "Lozano Blesa" (CIBERehd), Zaragoza, Spain
| | | | - G Alcaín
- Hospital Clínico Universitario de Málaga, Málaga, Spain
| | - V García-Sánchez
- Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - J Panés
- Hospital Clinic (CIBERehd), Barcelona, Spain
| | - E Domènech
- Hospital Germans Trias i Pujol (CIBERehd), Badalona, Spain
| | - E García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - J P Gisbert
- Hospital de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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15
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Lopez-Garcia E, Guallar-Castillón P, Garcia-Esquinas E, Rodríguez-Artalejo F. Metabolically healthy obesity and health-related quality of life: A prospective cohort study. Clin Nutr 2017; 36:853-860. [DOI: 10.1016/j.clnu.2016.04.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 02/08/2016] [Accepted: 04/28/2016] [Indexed: 12/27/2022]
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16
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Christofaro DGD, Andrade SM, Fernandes RA, Cabrera MAS, Rodríguez-Artalejo F, Mesas AE. Overweight parents are twice as likely to underestimate the weight of their teenage children, regardless of their sociodemographic characteristics. Acta Paediatr 2016; 105:e474-9. [PMID: 26809020 DOI: 10.1111/apa.13342] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/18/2015] [Accepted: 01/20/2016] [Indexed: 11/29/2022]
Abstract
AIM It is unclear whether parents' weight affects their ability to recognise whether their teenage children are overweight. This study analysed whether overweight parents assessed their child's weight as well as normal weight parents. METHODS This cross-sectional study was carried out in Londrina, Brazil, in 2011 and included teenagers between 14 and 17 years of age and their parents or guardians. We recorded the weight and height of the teenagers and asked the parents or guardians to fill in a questionnaire that included how they perceived their child's weight and demographic information. RESULTS We studied 1231 teenagers - 58.2% girls - and 19.4% were overweight or obese. In 842 (68.4%) of cases both parents replied to the questionnaire. We found that 8.7% of the 1202 mothers and 10.0% of the 871 fathers underestimated how overweight their child was. The adjusted analyses confirmed they were twice as likely to underestimate their child's weight if they were overweight themselves, with an odds ratio of 1.96 for the mothers and 2.04 for the fathers. Sociodemographic characteristics did not affect the results. CONCLUSION Overweight parents were twice as likely to underestimate the weight of their teenage children, regardless of the sociodemographic characteristics.
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Affiliation(s)
- DGD Christofaro
- Department of Physical Education; Universidade Estadual Paulista; Presidente Prudente SP Brazil
| | - SM Andrade
- Department of Public Health; Universidade Estadual de Londrina; Londrina PR Brazil
| | - RA Fernandes
- Department of Physical Education; Universidade Estadual Paulista; Presidente Prudente SP Brazil
| | - MAS Cabrera
- Department of Public Health; Universidade Estadual de Londrina; Londrina PR Brazil
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health; Universidad Autónoma de Madrid; Madrid Spain
| | - AE Mesas
- Department of Public Health; Universidade Estadual de Londrina; Londrina PR Brazil
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17
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Cavero-Redondo I, Peleteiro B, Álvarez-Bueno C, Rodríguez-Artalejo F, Martínez-Vizcaíno V. Glycosylated haemoglobin as a predictor of cardiovascular events and mortality: a protocol for a systematic review and meta-analysis. BMJ Open 2016; 6:e012229. [PMID: 27401368 PMCID: PMC4947717 DOI: 10.1136/bmjopen-2016-012229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Glycosylated haemoglobin level (HbA1c) is an indicator of the average blood glucose concentrations over the preceding 2-3 months and is used as a convenient and well-known biomarker in clinical practice. Currently, epidemiological evidence suggests that HbA1c level is an independent risk factor for cardiovascular events such as myocardial infarction, stroke, coronary heart disease and heart failure. This protocol aim is to conduct a systematic review and meta-analysis to determine relationships of HbA1c levels with cardiovascular outcomes and cause of death, and to analyse the range of HbA1c levels that is a predictor of cardiovascular disease and/or mortality based on data from published observational studies. METHODS AND ANALYSIS The search will be conducted using Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases from their inception. Observational studies written in Portuguese, Spanish or English will be included. The Quality In Prognosis Studies tool will be used to assess the risk of bias for the studies included in the systematic review or meta-analysis. HRs for cardiovascular outcomes and causes of death with 95% CIs will be determined as primary outcomes. Subgroup analyses will be performed based on cardiovascular outcomes, cause of death studied, and type of population included in the studies. ETHICS AND DISSEMINATION This systematic review will synthesise evidence on the potential of using HbA1c level as a prognostic marker for cardiovascular disease outcomes and/or mortality. The results will be disseminated by publication in a peer-reviewed journal. Ethics approval will not be needed because the data used for this systematic review will be obtained from published studies and there will be no concerns about privacy. TRIAL REGISTRATION NUMBER PROSPERO CRD42015032552.
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Affiliation(s)
- I Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - B Peleteiro
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - C Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - F Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública. Facultad de Medicina Universidad Autónoma de Madrid/IdiPaz and Ciberesp
| | - V Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Lana A, Lopez-Garcia E, Rodríguez-Artalejo F. Consumption of soft drinks and health-related quality of life in the adult population. Eur J Clin Nutr 2015; 69:1226-32. [PMID: 26130297 DOI: 10.1038/ejcn.2015.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 02/17/2015] [Accepted: 05/05/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND/OBJECTIVES Despite the accumulated evidence on the health risks associated with sugar-sweetened beverages (SSB), the industry has funded mass communication strategies promoting the idea that soft drinks, including SSB, may represent a source of well-being. This study assessed the association between consumption of soft drinks and health-related quality of life (HRQL), as a proxy of well-being, in the adult population of Spain. SUBJECTS/METHODS The cohort was established in 2008-2010 with 8417 individuals representative of the Spanish population aged 18-60 years. Habitual soft drink consumption was assessed with a validated diet history at baseline. HRQL was measured using the SF-12 questionnaire at baseline and in a subsample of 2132 study participants in 2012. The analyses were performed using linear regression and adjusted for the main confounders. RESULTS In cross-sectional analyses at baseline, those who drank ⩾1 serving/day of SSB had a lower (worse) score on the physical composite summary (PCS) of the SF-12 (adjusted linear regression coefficient: -1.08; 95% confidence interval (CI): -1.60 to -0.54) than those who drank <1 serving/week. Results were similar among individuals younger than 35 years (-1.06; 95% CI: -1.79 to -0.32), those who were not dieting (-1.21; 95% CI: -1.80 to -0.62), those who did not lose >5 kg in the previous 4 years (-0.79; 95% CI: -1.87 to 0.29), and in those without morbidity (-1.18; 95% CI: -1.91 to -0.46). Neither SSBs nor artificially sweetened beverages (ASBs) showed an association with the mental composite summary (MCS) of the SF-12. In the prospective analyses, no association was observed between baseline consumption of SSBs or ASBs and the changes in the PCS and MCS score from 2008/2010 to 2012. CONCLUSIONS No evidence was found that soft drink consumption has a beneficial effect on either the physical or mental dimensions of HRQL.
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Affiliation(s)
- A Lana
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPAZ (Instituto de Investigación Sanitaria del Hospital Universitario La Paz), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Oviedo, Spain
| | - E Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPAZ (Instituto de Investigación Sanitaria del Hospital Universitario La Paz), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPAZ (Instituto de Investigación Sanitaria del Hospital Universitario La Paz), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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León-Muñoz LM, Galán I, Valencia-Martín JL, López-García E, Guallar-Castillón P, Rodríguez-Artalejo F. Is a specific drinking pattern a consistent feature of the Mediterranean diet in Spain in the XXI century? Nutr Metab Cardiovasc Dis 2014; 24:1074-1081. [PMID: 24954423 DOI: 10.1016/j.numecd.2014.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 01/21/2014] [Revised: 03/31/2014] [Accepted: 04/04/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Over the last 50 years, people in Spain have increasingly been eating their main meal away from home and are shifting from the typical Mediterranean diet (MD). In addition, wine consumption has decreased whereas beer intake has risen. Consequently, it is uncertain if the Mediterranean drinking pattern (MDP; moderate alcohol intake mainly from wine and during meals) is a habitual feature of the MD today. METHODS AND RESULTS Cross-sectional study conducted from 2008 to 2010 among 8894 individuals representative of the Spanish population aged 18-64 years. Consumption of alcoholic beverages and food was collected with a validated diet history. Accordance with the MD was defined as a score ≥8 on the Mediterranean Diet Adherence Screener (MEDAS) or ≥5 in the Trichopoulou index (after excluding alcohol intake from both indices). Among individuals with MEDAS-based MD accordance, only 17.1% had a MDP. After adjustment for potential confounders, this drinking pattern showed a weak association with higher MD accordance (odds ratio (OR) 1.32; 95% confidence interval (CI) 1.12-1.57). Only 14.7% of those with Trichopoulou-based MD accordance had a MDP; this pattern showed an even weaker association with higher MD accordance (OR 1.17; 95% CI 1.01-1.36). Similar results were obtained when this drinking pattern was redefined to include persons who drank wine with or outside of meals, as well as those who were primarily beer drinkers. CONCLUSIONS The MDP is not a habitual feature of the MD in the early XXI century in Spain.
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Affiliation(s)
- L M León-Muñoz
- CIBERESP, Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, 28049 Madrid, Spain
| | - I Galán
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, 28049 Madrid, Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, Spain
| | - J L Valencia-Martín
- CIBERESP, Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, 28049 Madrid, Spain; Department of Preventive Medicine, Móstoles University Hospital, Móstoles, Spain
| | - E López-García
- CIBERESP, Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, 28049 Madrid, Spain
| | - P Guallar-Castillón
- CIBERESP, Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, 28049 Madrid, Spain
| | - F Rodríguez-Artalejo
- CIBERESP, Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, 28049 Madrid, Spain.
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Galán I, Valencia-Martín JL, Guallar-Castillón P, Rodríguez-Artalejo F. Alcohol drinking patterns and biomarkers of coronary risk in the Spanish population. Nutr Metab Cardiovasc Dis 2014; 24:189-197. [PMID: 24418385 DOI: 10.1016/j.numecd.2013.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 04/26/2013] [Revised: 06/18/2013] [Accepted: 07/01/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS To estimate the association between patterns of alcohol consumption and biomarkers of coronary heart disease (CHD) risk. METHODS AND RESULTS Cross-sectional study among 10,793 individuals representative of the Spanish population aged ≥ 18 years. The threshold between moderate and heavy drinking was 40 g of alcohol/day in men and 24 g/day in women. Binge drinking was defined as intake of ≥ 80 g of alcohol in men and ≥ 60 g in women at any drinking occasion in the preceding 30 days. Analyses were performed with generalized linear models with adjustment for the main confounders, and results were expressed as the percentage change in the geometric mean (PCGM). Compared to non-drinkers, moderate and heavy drinkers had progressively higher serum HDL-cholesterol, with a PCGM ranging from 4.8% (95% CI: 3.7-6.0%) in moderate drinkers without binge drinking (MNB) to 9.6% (5.1-14.2%) in heavy drinkers with binge drinking (HB). Fibrinogen decreased progressively with alcohol intake, from -2.2% (-3.1 to -1.3%) in MNB to -5.8% (-9.4 to -2.0%) in HB. Leptin, glycated hemoglobin and the HOMA-index also decreased with increasing alcohol intake, and particularly with binge drinking. CONCLUSIONS Moderate alcohol intake is associated with improved HDL-cholesterol, fibrinogen and markers of glucose metabolism, which is consistent with the reduced CHD risk of moderate drinkers in many studies. Heavy and binge drinking were also associated with favorable levels of CHD biomarkers; since these drinking patterns produce substantial health harms, our results should not be used to promote alcohol consumption.
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Affiliation(s)
- I Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.
| | - J L Valencia-Martín
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain; CIBERESP, Madrid, Spain
| | - P Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain; CIBERESP, Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain; CIBERESP, Madrid, Spain
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Valdés J, Rodríguez-Artalejo F, Aguilar L, Jaén-Casquero MB, Royo-Bordonada MÁ. Frequency of family meals and childhood overweight: a systematic review. Pediatr Obes 2013; 8:e1-e13. [PMID: 23239547 DOI: 10.1111/j.2047-6310.2012.00104.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 08/15/2012] [Accepted: 08/30/2012] [Indexed: 12/22/2022]
Abstract
Energy balance is influenced by understudied genetic, social and other environmental factors. The frequency of family meals (FFM) may be one of these factors since it is associated with a healthier dietary pattern in children and adolescents. The objective of this review is to evaluate the scientific evidence on the association between FFM and the risk of childhood and adolescent overweight. The electronic literature search identified 394 articles published during 2005-2012. Of these, 15 studies gave precise information of the studied association, of which four were longitudinal. We found great variability regarding the measurement of FFM. Six out of 11 cross-sectional studies and 1 out of 4 longitudinal studies found statistically significant inverse associations between FFM and being overweight, mainly in children, with odds ratios ranging from 0.11 to 0.93. Of those, only one adjusted for all the potential confounding factors considering socio-demographic, physical activity- and diet-related variables. Therefore, this review found inconsistent and weak evidence of an inverse association between FFM and risk of childhood overweight. In conclusion, further research is needed to establish whether family meals have an effect on childhood overweight. These studies ideally should have longitudinal or experimental designs, a clear and standardized definition of the exposure under study, a measure of the exposure based on direct observation or validated questionnaires and an adequate adjustment for potential confounders.
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Affiliation(s)
- J Valdés
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain.
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22
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Mesas AE, León-Muñoz LM, Guallar-Castillón P, Graciani A, Gutiérrez-Fisac JL, López-García E, Aguilera MT, Banegas JR, Rodríguez-Artalejo F. Obesity-related eating behaviours in the adult population of Spain, 2008-2010. Obes Rev 2012; 13:858-67. [PMID: 22577840 DOI: 10.1111/j.1467-789x.2012.01005.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Knowledge of the socio-demographic distribution of eating behaviours can aid our understanding of their contribution to the obesity epidemic and help to address healthy eating interventions to those who can benefit most. This cross-sectional study assessed the frequency of self-reported eating behaviours among 11,603 individuals representative of the non-institutionalized Spanish population aged ≥ 18 years in the period 2008-2010. In the adult population of Spain, 24.3% had lunch and 18.2% had dinner away from home >3 times per month. About three-fourths of adults did not plan the amount of food to be eaten, and did not choose light foods and/or skim dairy products. Also, 26% did not trim visible fat from meat, and 74.7% usually ate while watching television. Compared with individuals with primary or less education, those with university studies were more likely to remove fat from meat (age- and sex-adjusted odds ratio [aOR] 1.25; 95% confidence interval [CI] 1.08-1.44), and to choose light food and/or skim dairy (aOR 1.50; 95% CI 1.30-1.77), and less likely to eat while watching television (aOR 0.54; 95% CI 0.47-0.63). In conclusion, the prevalence of several obesity-related eating behaviours is high in Spain, which indicates a deficient implementation of dietary guidelines. Socioeconomic inequalities in eating behaviours should also be addressed.
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Affiliation(s)
- A E Mesas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ - CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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23
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Gutiérrez-Fisac JL, Guallar-Castillón P, León-Muñoz LM, Graciani A, Banegas JR, Rodríguez-Artalejo F. Prevalence of general and abdominal obesity in the adult population of Spain, 2008-2010: the ENRICA study. Obes Rev 2012; 13:388-92. [PMID: 22151906 DOI: 10.1111/j.1467-789x.2011.00964.x] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This is the first study to report the prevalence of general obesity and abdominal obesity (AO) in the adult population of Spain based on measurements of weight, height and waist circumference. The data are taken from the ENRICA study, a cross-sectional study carried out between June 2008 and October 2010 in 12,883 individuals representative of the non-institutionalized population on Spain aged 18 years and older. Anthropometry was performed under standardized conditions in the households by trained interviewers. Overweight was considered as body mass index (BMI) 25-29.9 kg m(-2) , and obesity as BMI ≥ 30 kg m(-2) . AO was defined as waist circumference >102 cm in men and >88 cm in women. The prevalence of obesity was 22.9% (24.4% in men and 21.4% in women). About 36% of adults had AO (32% of men and 39% of women). The frequency of obesity and of AO increased with age and affected, respectively, 35 and 62% of persons aged 65 and over. The frequency of obesity and AO decreased with increasing educational level. For example, 29% of women with primary education or less had obesity vs. only 11% of those with university studies. The prevalence of obesity was very high in the Canary Islands and in the south of Spain.
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Affiliation(s)
- J L Gutiérrez-Fisac
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP), C/ Arzobispo Morcillo 2,Madrid, Spain.
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Guallar-Castillón P, Rodríguez-Artalejo F, Tormo MJ, Sánchez MJ, Rodríguez L, Quirós JR, Navarro C, Molina E, Martínez C, Marín P, Lopez-Garcia E, Larrañaga N, Huerta JM, Dorronsoro M, Chirlaque MD, Buckland G, Barricarte A, Banegas JR, Arriola L, Ardanaz E, González CA, Moreno-Iribas C. Major dietary patterns and risk of coronary heart disease in middle-aged persons from a Mediterranean country: the EPIC-Spain cohort study. Nutr Metab Cardiovasc Dis 2012; 22:192-199. [PMID: 20708394 DOI: 10.1016/j.numecd.2010.06.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [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: 02/23/2010] [Revised: 05/11/2010] [Accepted: 06/10/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIM No previous study has assessed the association between major dietary patterns and the risk of coronary heart disease (CHD) in a large cohort from a Mediterranean country. METHODS AND RESULTS We studied prospectively 40,757 persons, aged 29-69 years, participating in the Spanish cohort of the EPIC study. Food consumption was collected between 1992 and 1996 with a validated history method. Individuals were followed-up until 2004 through record linkage with hospital discharge registers, population-based registers of myocardial infarction, and mortality registers to ascertain CHD events (fatal and non-fatal acute myocardial infarction or angina requiring revascularization). Two major dietary patterns were identified from factor analysis. The first pattern was labeled as Westernized, because of the frequent consumption of refined cereals and red meat; the second was called the evolved Mediterranean pattern, because of the frequent intake of plant-based foods and olive oil. During a median follow-up of 11 years, 606 CHD events were ascertained. No association was found between the Westernized pattern and CHD risk. In contrast, the score for the evolved Mediterranean pattern was inversely associated with CHD risk (p for trend = 0.0013); when compared with the lowest quintile of the evolved Mediterranean pattern score, the multivariable hazard ratios for CHD were 0.77 (95% confidence interval 0.61-0.98) for the second quintile, 0.64 (95% CI 0.50-0.83) for the third quintile, 0.56 (95% CI 0.43-0.73) for the fourth quintile, and 0.73 (95% CI 0.57-0.94) for the fifth quintile. CONCLUSION A Mediterranean diet, as consumed in this study population, was associated with a lower risk of CHD.
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Affiliation(s)
- P Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine. Universidad Autónoma de Madrid, IdiPAZ, Avda. Arzobispo Morcillo, 28029 Madrid. Spain.
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Abstract
The relationship between obesity and the intake of macronutrients and specific foods is uncertain. Thus, there is growing interest in some eating behaviours because they may reflect the joint effect of several foods and nutrients and, thus, increase the likelihood of finding a link to obesity. This study examined the association between selected eating behaviours and excess weight in the general population throughout a systematic review of publications written in English, Spanish or Portuguese identified in a PubMed search up to 31 December 2010. We included 153 articles, 73 of which have been published since 2008. Only 30 studies had a prospective design; of these, 15 adjusted for sociodemographic variables, physical activity and energy or food intake. Moreover, definitions of eating behaviours varied substantially across studies. We found only small or inconsistent evidence of a relationship between excess weight and skipping breakfast, daily eating frequency, snacking, irregular meals, eating away from home, consumption of fast food, takeaway food intake, consumption of large food portions, eating until full and eating quickly. In conclusion, this review highlights the difficulty in measuring human behaviour, and suggests that a more systematic approach is needed for capturing the effects of eating behaviours on body weight.
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Affiliation(s)
- A E Mesas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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26
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Oliveira A, Lopes C, Severo M, Rodríguez-Artalejo F, Barros H. Body fat distribution and C-reactive protein--a principal component analysis. Nutr Metab Cardiovasc Dis 2011; 21:347-354. [PMID: 20153616 DOI: 10.1016/j.numecd.2009.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 06/02/2009] [Revised: 08/31/2009] [Accepted: 10/26/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS To assess, using principal component analysis, the independent associations of general, central and peripheral subcutaneous fat with high-sensitivity C-reactive protein (hs-CRP), in men and women from the general population. METHODS AND RESULTS We studied 833 women and 486 men, randomly selected from the non-institutionalized population of Porto, Portugal, with information on hs-CRP (≤10 mg/l) and anthropometrics (1999-2003). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a skinfold composite index to estimate the proportion of arm subcutaneous fat (PSFA), were ascertained by trained personnel. Beta regression coefficients were obtained from generalized linear models with adjustment for the main confounders. Direct associations were found between BMI, WC, WHR and hs-CRP. PSFA was inversely associated with hs-CRP in women (β=-0.080, p-trend=0.010). Since the anthropometric measures were strongly correlated, we used principal component analysis to identify new independent anthropometric factors. The first one, representing a generalized fat distribution (high BMI and WC), was directly associated with hs-CRP (β=0.226, p-trend<0.001 in women; β=0.138, p-trend=0.002 in men). The second factor, characterized by a high PSFA, showed an inverse association with hs-CRP in women (β=-0.071, p-trend=0.048). The third factor, representing a central pattern of fat distribution (low BMI, but high WC and high WHR), was directly associated with hs-CRP in men (β=0.090, p-trend=0.005). CONCLUSION A central pattern of fat distribution is directly associated with hs-CRP levels in men, while a high proportion of peripheral subcutaneous fat seems to be inversely associated with hs-CRP, but only in women.
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Affiliation(s)
- A Oliveira
- Department of Hygiene and Epidemiology and Cardiovascular Research & Development Unit, University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
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Rey E, Alvarez-Sánchez A, Rodríguez-Artalejo F, Moreno Elola-Olaso C, Almansa C, Díaz-Rubio M. Onset and disappearance rates of gastroesophageal reflux symptoms in the Spanish population, and their impact on quality of life. Rev Esp Enferm Dig 2009; 101:477-82. [PMID: 19642839 DOI: 10.4321/s1130-01082009000700005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND few studies have reported the onset and disappearance rates of gastroesophageal reflux symptoms (GERS) in the population. AIM to assess the occurrence and disappearance rates of GERS in Spain, and their impact on health-related quality of life (HRQL). PARTICIPANTS AND METHODS participants were selected at random from the general population of Madrid in age and sex strata. They were interviewed at home twice, 6 months apart. Heartburn, acid regurgitation and consultation were assessed with the gastroesophageal reflux questionnaire, and HRQL with the SF-36. RESULTS 709 individuals were included, and 451 (63.6%) were re-interviewed 6 months later. Among the 325 individuals without GERS, 9 developed weekly symptoms (2.2% [95% CI: 0.8, 3.4%]); 2 (22%) consulted because of GERS. Among the 34 subjects reporting weekly GERS initially, 26 did not report them at 6-months. Onset of GERS was associated with worsening scores in the physical summary of SF-36 (delta = -6.6 [95% CI: -11.8, -1.42]), while disappearance with an improved score (delta = -3.0 [95% CI: 0.0, 5.9]). CONCLUSION despite the lower prevalence of GERS in Spain, the occurrence rate is 2.2% in 6 months; however symptoms disappeared in more than half of subjects six months later. Developing GERS was associated with reduced HRQL, and their disappearance with improvement.
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Affiliation(s)
- E Rey
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBER of Edpidemiology and Public Helath (CIBERESP), Spain.
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Banegas J, de la Sierra A, Segura J, Gorostidi M, de la Cruz J, Rodríguez-Artalejo F, Ruilope L. Control of hypertension in coronary heart disease. Int J Cardiol 2009; 134:245-7. [DOI: 10.1016/j.ijcard.2007.12.073] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Accepted: 12/26/2007] [Indexed: 10/22/2022]
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Royo-Bordonada MA, Garcés C, Gorgojo L, Martín-Moreno JM, Lasunción MA, Rodríguez-Artalejo F, Fernández O, de Oya M. Saturated fat in the diet of Spanish children: relationship with anthropometric, alimentary, nutritional and lipid profiles. Public Health Nutr 2007; 9:429-35. [PMID: 16870014 DOI: 10.1079/phn2005870] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectiveTo compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake.DesignThis was a cross-sectional study. Food data were collected using a food-frequency questionnaire.Subjects and methodsThe sample included 1112 children of both sexes, aged between 6 and 7 years, selected by means of random cluster sampling in schools. The plasma lipid profile included measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Global diet quality was evaluated by the Dietary Variety Index (DVI) and the Healthy Eating Index (HEI).ResultsEnergy intake, DVI and HEI of children from the lower quartile of saturated fat intake (LL) were higher (P < 001) than in the remaining children (UL). However, there were no significant differences in average height or weight between groups. The UL children had lower intakes of meat, fish, vegetables, fruits and olive oil and a higher intake of dairy products (P < 0.001). The intakes of fibre, vitamins C, D, B6, E and folic acid were higher in the LL children, who had lower intakes of vitamin A and calcium. The ratios LDL-C/HDL-C and apoB/apoA1 were lower (P = 0.04) in the LL children (1.87 and 0.52, respectively) than in the UL children (2.02 and 0.54, respectively).ConclusionsThe growth rate of children does not seem to be affected by the level of saturated fat intake. Furthermore, at the levels of intake observed in this study, diets with less saturated fat are associated with better alimentary, nutritional and plasma lipid profiles.
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Affiliation(s)
- M A Royo-Bordonada
- Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain.
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Rey E, Elola-Olaso CM, Rodríguez-Artalejo F, Locke GR, Diaz-Rubio M. Use of antisecretory drugs among consumers of non-steroidal anti-inflammatory drugs in the general population. Aliment Pharmacol Ther 2006; 24:1585-92. [PMID: 17206946 DOI: 10.1111/j.1365-2036.2006.03173.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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] [Indexed: 01/10/2023]
Abstract
BACKGROUND Overall success of prophylactic strategies against non-steroidal anti-inflammatory drug (NSAID) complications depends on the use of gastroprotective drugs. AIM We examined the use of antisecretory drugs in NSAID users in the general population of Spain. PARTICIPANTS AND METHODS In 2002, a phone interview was conducted with 2500 persons representative of the general population of Spain. Using a validated questionnaire, we asked about the use of NSAID, aspirin and antisecretory drugs, and history of digestive diseases. We estimated the use of antisecretory drugs in NSAID users, according to risk factors for gastrointestinal (GI) lesions associated with NSAID. RESULTS In total, 425 persons [17.0% (95% CI 15.5-18.5%)] were NSAID users. Of them, 69 persons (16.2%; 95% CI 12.7-19.7%) used antisecretory drugs [proton pump inhibitor (PPI) 11.8% and H2-blocker 4.9%]. Forty-four of the 224 NSAID users (19.6%) with one risk factor for GI lesions were antisecretory drug users (PPI 16%; H2-blocker 4%), compared with 24 of the 197 NSAID users (12.7%) without risk factors (PPI 6.6%; H2-blocker 6.1%). NSAID users with risk factors for GI lesions but without upper GI (UGI) symptoms did not consume more antisecretory drugs than equivalent non-NSAID users (12.9% vs. 10.7%). CONCLUSION Current strategies to prevent GI lesions in NSAID users are not effective from a population perspective, especially in subjects without UGI symptoms.
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Affiliation(s)
- E Rey
- Digestive Disease Service, Hospital Clinico San Carlos, Complutense University, Madrid, Spain.
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31
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León-Muñoz LM, Guallar-Castillón P, Banegas JR, Gutiérrez-Fisac JL, López-García E, Jiménez FJ, Rodríguez-Artalejo F. Changes in body weight and health-related quality-of-life in the older adult population. Int J Obes (Lond) 2006; 29:1385-91. [PMID: 16103894 DOI: 10.1038/sj.ijo.0803049] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND No other study has ascertained the short-term impact of weight change on health-related quality-of-life (HRQL) on a national sample of older adults. OBJECTIVE To examine the relationship between change in body weight and HRQL among the older adult population. METHODS We carried out a prospective study from 2001 to 2003 of a cohort of 2364 persons, representative of the noninstitutionalized Spanish population aged 60 y and over. Weight changes during the period 2001-2003 were self-reported, and HRQL in 2003 was measured with the SF-36 questionnaire. Analyses adjusted for the principal confounders. RESULTS Among nonobese women (body mass index (BMI) 18.5-29.9 kg/m(2)), and compared to those who underwent no important weight change, weight loss was associated with a clinically significant worsening in the role-physical, vitality, and social functioning SF-36 scales. Among obese women (BMI> or =30 kg/m(2)), weight gain led to a reduction in HRQL for four of the eight SF-36 scales, while weight loss was associated with worse scores in role-emotional and mental health scales. Results were usually similar for men, though of lower magnitude. In both sexes, weight change was associated with a reduction of over 5 points on several physical and mental scales of the SF-36, which indicates a clinically relevant worsening in HRQL. CONCLUSION Weight change is associated with worse HRQL among the older adults, principally women. From the stance of HRQL, it is desirable to prevent weight gain, especially among the obese, and weight loss, especially among the nonobese.
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Affiliation(s)
- L M León-Muñoz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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Brotons C, Royo-Bordonada M, Álvarez-Sala L, Armario P, Artigao R, Conthe P, de Álvaro F, de Santiago A, Gil A, Lobos J, Maiques A, Marrugat J, Mauricio D, Rodríguez-Artalejo F, Sans S, Suárez C. Adaptación española de la Guía Europea de Prevención Cardiovascular. Rev Clin Esp 2006. [DOI: 10.1157/13084762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Suárez B, Lope V, Pérez-Gómez B, Aragonés N, Rodríguez-Artalejo F, Marqués F, Guzmán A, Viloria LJ, Carrasco JM, Martín-Moreno JM, López-Abente G, Pollán M. Acute health problems among subjects involved in the cleanup operation following the Prestige oil spill in Asturias and Cantabria (Spain). Environ Res 2005; 99:413-24. [PMID: 16307984 DOI: 10.1016/j.envres.2004.12.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2004] [Revised: 12/07/2004] [Accepted: 12/13/2004] [Indexed: 05/05/2023]
Abstract
The purpose of this study was to evaluate exposure conditions and acute health effects in subjects participating in the Prestige oil spill cleanup activities and the association between these and the nature of the work and use of protection devices in the regions of Asturias and Cantabria (Spain). The sample comprised 400 subjects in each region, selected from a random sampling of all persons involved in cleanup activities, stratified by type of worker and number of working days. Data were obtained via a structured questionnaire and included information on specific tasks, number of working days, use of protective materials, and acute health effects. These effects were classified into two broad groups: injuries and toxic effects. Data analysis was performed using complex survey methods. Significant differences between groups were evaluated using Pearson's chi(2) test. Unconditional logistic regression was used to compute odds ratios and 95% confidence intervals. Bird cleaners accounted for the highest prevalence of injuries (19% presented with lesions). Working more than 20 days in highly polluted areas was associated with increased risk of injury in all workers. Occurrence of toxic effects was higher among seamen, possibly due to higher exposure to fuel oil and its components. Toxic effects were more frequent among those working longer than 20 days in highly polluted areas, performing three or more different cleaning activities, having skin contact with fuel oil on head/neck or upper limbs, and eating while in contact with fuel or perceiving disturbing odors. No severe disorders were identified among individuals who performed these tasks. However, potential health impact should be considered when organizing cleanup activities in similar environmental disasters.
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Affiliation(s)
- B Suárez
- National Centre for Epidemiology, Carlos III Institute of Public Health, Madrid 28039, Spain
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Regidor E, Banegas JR, Gutiérrez-Fisac JL, Domínguez V, Rodríguez-Artalejo F. Influence of childhood socioeconomic circumstances, height, and obesity on pulse pressure and systolic and diastolic blood pressure in older people. J Hum Hypertens 2005; 20:73-82. [PMID: 16121198 DOI: 10.1038/sj.jhh.1001925] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study assesses the association of childhood socioeconomic circumstances, height, and obesity with components of blood pressure. We selected 4009 people representative of the Spanish population aged 60 years and older, and estimated systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) according to childhood social class, height, and obesity. No association was found between childhood social class and blood pressure. SBP showed an inverse gradient and DBP a direct gradient with height, although an independent association between height and DBP was found only in women. Stature was independently associated with increased DBP in women with central obesity, but there was no association between height and DBP in women without central obesity. Short stature was independently associated with increased PP. Body mass index and waist-to-hip ratio were independently associated with increased DBP in women, and waist-to-hip ratio was independently associated with increased PP in men, while waist circumference was independently associated with increased DBP and increased PP in women. These results do not support the assumed effect of socioeconomic circumstances in early life on blood pressure, which may depend on the context and/or study population. The relations observed between height and blood pressure support the hypothesis that PP could be a mediator of the association between short stature and increased cardiovascular risk. The relationship between obesity measures and components of blood pressure reinforces the recommendation to reduce body weight in order to reduce blood pressure.
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Affiliation(s)
- E Regidor
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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García EL, Banegas JR, Pérez-Regadera AG, Cabrera RH, Rodríguez-Artalejo F. Social network and health-related quality of life in older adults: a population-based study in Spain. Qual Life Res 2005; 14:511-20. [PMID: 15892440 DOI: 10.1007/s11136-004-5329-z] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined the association between social network and health-related quality of life (HRQL) in older adults and compared this against the association between HRQL and a disabling disease such as osteoarthritis. A cross-sectional survey was done on 3600 subjects representative of the Spanish non-institutionalised population aged 60 years and over. Data were collected through home-based personal interview and physical examination. HRQL was measured with the SF-36 health questionnaire. Data analysis was performed with multiple linear regression models with adjustment for the main confounders. Of the total sample, 38.6% of subjects were unmarried, 17.6% were living alone, 4.7% saw their family seldom or never, and 2.9% saw their friends seldom or never. Unmarried status and living alone were associated with lower scores in the social and mental quality-of-life components, though statistical significance was not in general attained (p > 0.05). Seeing family members seldom or never was associated (p < 0.05) with worse scores in the following scales of SF-36 questionnaire: role-physical, body pain, general health and mental health. HRQL was lower among those who saw friends seldom or never, and the reduction in HRQL proved similar to that associated with osteoarthritis, on the physical functioning (coefficients -8.4 vs. -8.1) and general health scales (-7.8 vs. -6.6); the reduction in HRQL was even greater than that associated with osteoarthritis for other scales, such as vitality (-9.6 vs. -6.7; p > 0.05) and social functioning (-14.5 vs. -3.7; p < 0.05). We conclude that only a small proportion of Spain's elderly population lack frequent social relationships, yet low frequency of relationships with friends is associated with a decline in quality of life similar to or greater than that associated with osteoarthritis.
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Affiliation(s)
- E López García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
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36
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Brotons C, Royo-Bordonada MA, Alvarez-Sala L, Armario P, Artigao R, Conthe P, de Alvaro F, de Santiago A, Gil A, Lobos J, Maiques A, Marrugat J, Mauricio D, Rodríguez-Artalejo F, Sans S, Suárez C. [Spanish adaptation of the European Guide to Cardiovascular Prevention (I)]. Aten Primaria 2005; 34:427-32. [PMID: 15546541 PMCID: PMC7668924 DOI: 10.1016/s0212-6567(04)78927-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Regidor E, Gutiérrez-Fisac JL, Banegas JR, López-García E, Rodríguez-Artalejo F. Obesity and socioeconomic position measured at three stages of the life course in the elderly. Eur J Clin Nutr 2004; 58:488-94. [PMID: 14985688 DOI: 10.1038/sj.ejcn.1601835] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the association between socioeconomic position, measured at three stages of the life course, and obesity in the elderly. DESIGN Cross-sectional study carried out in 2000-2001. SUBJECTS In total, 4009 subjects aged 60 y and older, representative of the Spanish noninstitutionalised population. RESEARCH METHODS AND PROCEDURES We estimated body mass index (BMI) and waist circumference (WC) by social class in childhood, by educational level and by adult social class, as well as the association between these two obesity measures and each socioeconomic characteristic after adjusting for the other two. RESULTS In men, no relation was found between the two measures of obesity studied and socioeconomic circumstances throughout the life course. Nor was any relation found in women between social class in childhood and the two measures of obesity after adjusting for the other two socioeconomic variables. In contrast, BMI and WC in women showed a statistically significant inverse gradient with educational level and with adult social class after adjusting for age and the rest of the socioeconomic variables. CONCLUSIONS In general, these results support the small amount of existing evidence on the association between obesity and abdominal obesity and socioeconomic position by educational level and adult social class. The results for social class in childhood do not support the existing evidence, and suggest that this association may depend on specific historic and cultural circumstances.
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Affiliation(s)
- E Regidor
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Complutense de Madrid, Spain
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Affiliation(s)
- F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Spain.
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Brotons C, Royo-Bordonada M, Álvarez-Sala L, Armario P, Artigao R, Conthe P, Álvaro FD, Santiago AD, Gil A, Lobos J, Maiques A, Marrugat J, Mauricio D, Rodríguez-Artalejo F, Sans S, Suárez C. Adaptación Española de la Guía Europea de Prevención Cardiovascular. Semergen 2004. [DOI: 10.1016/s1138-3593(04)74350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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40
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Royo-Bordonada MA, Gorgojo L, Ortega H, Martín-Moreno JM, Lasunción MA, Garcés C, Gil A, Rodríguez-Artalejo F, de Oya M. Greater dietary variety is associated with better biochemical nutritional status in Spanish children: the Four Provinces Study. Nutr Metab Cardiovasc Dis 2003; 13:357-364. [PMID: 14979682 DOI: 10.1016/s0939-4753(03)80004-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Although dietary variety has been associated with a better nutritional profile, its possible role in obesity raises doubts about its overall health benefits. In this study, we examined the association between dietary variety and anthropometric variables, food intake and various food intake biomarkers in Spanish children. METHODS AND RESULTS This was a cross-sectional study of 1112 children aged 6-7 years from Cadiz, Murcia, Orense and Madrid, who were selected by means of the random cluster-sampling of schools. Information concerning food and nutrient intake was obtained using a food frequency questionnaire, and a dietary variety index (DVI) was calculated on the basis of the number of different foods consumed more than once a month. The anthropometric variables (weight and height), and plasma lipid and vitamin levels were determined using standardised methods. Our results show that the body mass index (BMI) did not vary substantially as a function of DVI: it was 16.9 in the lowest DVI tertile and 17.2 in the highest (p=0.20). Unlike BMI, the DVI positively correlated (p<0.05) with the plasma levels of alpha and beta-carotene, lycopene, retinol, alpha-tocopherol and vitamin E, with energy intake, and with most of the foods, particularly vegetables, fruit and sausages (respective correlation coefficients of 0.43, 0.26 and 0.23). CONCLUSIONS Dietary variety is associated with a better food and nutritional profile in Spanish children. Nevertheless, the presence of a positive association between the DVI and energy intake, and the consumption of sausages and pre-cooked products calls for the recommendation of a varied diet of healthy foods, such as cereals (especially whole grains), fruits and vegetables.
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Affiliation(s)
- M A Royo-Bordonada
- Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain.
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Abstract
OBJECTIVE To present the current burden of mortality attributable to some of the main cardiovascular risk factors in adults in Spain. METHODS Mortality attributable to risk factors was calculated by combining their prevalence, the relative risks for death, and the number of deaths in Spain. Prevalence of hypertension (>/=140/90 mmHg), tobacco smoking, excess weight (body mass index >/=25 kg/m(2)), and self-reported diabetes were based on representative samples of the Spanish population in the 1990s. The relative risks came from valid international studies. RESULTS About 14 000 total deaths (25% of all deaths) were attributable to hypertension in Spain's middle-aged population. A quarter of them were cardiovascular deaths. About 56 000 deaths were attributable to tobacco use in adults >/=35 y (16% of all deaths). Two-thirds of them were deaths for: lung cancer (26.5%), chronic obstructive pulmonary disease (20.9%), coronary heart disease (12.8%), and stroke (9.2%). About 28 000 deaths (8.5% of all deaths) were attributable to excess weight in adults. Two-thirds of them were cardiovascular deaths. About 2800 cardiovascular deaths were attributable to diabetes in adults >/=35 y (6% of all cardiovascular deaths). CONCLUSIONS Mortality attributable to the risk factors studied is a major avoidable public health problem in Spain. The results presented are only illustrative but clearly show that there is considerable scope for prevention.
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Affiliation(s)
- J R Banegas
- Department of Preventive Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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42
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Royo-Bordonada MA, Gorgojo L, Martín-Moreno JM, Garcés C, Rodríguez-Artalejo F, Benavente M, Mangas A, de Oya M. Spanish children's diet: compliance with nutrient and food intake guidelines. Eur J Clin Nutr 2003; 57:930-9. [PMID: 12879087 DOI: 10.1038/sj.ejcn.1601627] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare the diet of Spanish children against the nutrient and food intake guidelines. To calculate an index of overall diet quality and check its validity against nutrient intake. DESIGN AND SETTING Cross-sectional study in four cities in Spain, where information on food and nutrient intake was obtained from schoolchildren through a food frequency questionnaire. PARTICIPANTS The sample included 1112 children (overall response rate of 85%) attending public and private schools and aged 6-7 y. Children were selected through random cluster sampling in schools, and stratified by sex and socioeconomic level. MAIN OUTCOME MEASURES Mean nutrient intake, number of food servings, and the percentage of children who meet recommended nutrient and food-serving intake levels. The overall dietary quality was assessed using the Healthy Eating Index (HEI). RESULTS Mean micronutrient intake exceeded 100% of the recommended dietary allowances, except for vitamin B6, which registered a mean intake of 77.1%. For almost all children, intake of saturated fat was above, and that of carbohydrate below, the recommended level, in contrast to the relatively high compliance with the recommendations for poly- and monounsaturated fatty acid, salt and fiber intake (69.7, 43.7, 40.7, and 30.1%, respectively). Consumption of food servings for each of the five American pyramid food groups came close to or exceeded USDA guidelines, with the exception of cereals, with 5.4 servings per day. The mean score obtained in the HEI was 64.6. Children who complied with all the food guide pyramid recommendations registered a higher dietary variety and a healthier nutritional profile. CONCLUSIONS Children aged 6-7 y show scant compliance with the macronutrient goals for healthy eating. Micronutrient intake is adequate in general, yet there are small groups of children with risk of deficient intake of vitamins B6 and D. While Spanish children's eating habits are reasonably in line with American food guide pyramid guidelines, consumptions of cereals and fruit should be improved.
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Affiliation(s)
- M A Royo-Bordonada
- Carlos III Institute of Public Health, Ministerio de Sanidad y Consumo, Madrid, Spain.
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López-García E, Banegas Banegas JR, Gutiérrez-Fisac JL, Pérez-Regadera AG, Gañán LD, Rodríguez-Artalejo F. Relation between body weight and health-related quality of life among the elderly in Spain. Int J Obes (Lond) 2003; 27:701-9. [PMID: 12833114 DOI: 10.1038/sj.ijo.0802275] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.0] [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] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study examines the relation between body weight and the physical and mental components of health-related quality of life (HRQL) in the population aged 60 y and over in Spain. RESEARCH METHODS AND PROCEDURES Cross-sectional study covering 3605 subjects, representative of the noninstitutionalised Spanish population aged 60 y and over. Information was collected through home-based personal interview and measurement of blood pressure and anthropometric variables. Logistic regression was used to examine the relation of suboptimal HRQL (score<100) on each SF-36 questionnaire scale with body mass index (BMI) and waist circumference. Separate regression models were constructed for each sex and adjusted for sociodemographic variables, tobacco and alcohol consumption, physical activity, arterial hypertension and diagnosed chronic disease. RESULTS Mean age of the study population was 70.9 y for men and 72.2 y for women. The percentage of overweight subjects was 48.5% in men and 39.8% in women, and of obese subjects, 31.9 and 41.1% respectively. Men registered a better HRQL than women on most of the SF-36 scales. Compared to normal-weight subjects (BMI: 18.5-24.9 kg/m(2)), frequency of suboptimal physical functioning was higher among obese subjects (BMI>or=30 kg/m(2)), both male (OR: 1.91; 95% CI: 1.22-3.00) and female (OR: 2.58; 95% CI: 1.59-4.19). The aspects of physical functioning most affected were bending, kneeling or stooping, climbing stairs and strenuous effort. Male, though not female, obesity was nonetheless associated with a better HRQL on the SF-36 mental scales. Frequencies of suboptimal scores for overweight persons (BMI: 25-29.9 kg/m(2)) were similar to those for normal-weight subjects on most of the SF-36 scales. Results proved similar for subjects in both the 60-74 and 75-and-over age groups, and also when waist circumference was used as the measure of obesity (>102 cm in men and >88 cm in women). CONCLUSIONS Obese men and women showed worse physical functioning than normal-weight persons. This occurred irrespective of whether subjects were over or under 74 y of age, or whether obesity was measured by BMI or waist circumference, and was not explained by unhealthy lifestyles or obesity-related chronic disease.
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Affiliation(s)
- E López-García
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
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Rodríguez-Artalejo F, Lafuente Urdinguio P, Guallar-Castillón P, Garteizaurrekoa Dublang P, Sáinz Martínez O, Díez Azcárate JI, Foj Alemán M, Banegas JR. One year effectiveness of an individualised smoking cessation intervention at the workplace: a randomised controlled trial. Occup Environ Med 2003; 60:358-63. [PMID: 12709522 PMCID: PMC1740534 DOI: 10.1136/oem.60.5.358] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To assess the effectiveness of a smoking cessation intervention at the workplace. The intervention was adapted to smokers' tobacco dependence, and included minimal structured counselling at the first visit (5-8 minutes), nicotine patches for three months, and three sessions of counselling for reinforcement of abstinence (2-3 minutes) over a three month period. METHODS Open randomised trial with two groups: the intervention group, and the control group which was subjected to standard clinical practice, consisting of short (30 seconds to one minute) sporadic sessions of unstructured medical antismoking advice. The trial was carried out among 217 smokers of both sexes, aged 20-63 years, motivated to quit smoking and without contraindications for nicotine patches, who were employees at a public transport company and at two worksites of an electric company. The main outcome measure was self reported tobacco abstinence confirmed by carbon monoxide in expired air </=10 ppm. Analysis was performed according to intention-to-treat. RESULTS The rate of continuous abstinence at 12 months was 20.2% for the intervention versus 8.7% for the control group (OR: 2.58; 95% CI: 1.13 to 5.90; p = 0.025). In subgroup analyses, effectiveness of the intervention did not vary substantially with age, tobacco dependence, number of cigarettes smoked per day, number of years of tobacco consumption, degree of desire to quit smoking, time spent with smokers, subjective health, and presence of tobacco related symptoms. Weight gain at 12 months was similar for both groups (1.69 kg in the intervention v 2.01 kg in the control group; p = 0.21). CONCLUSIONS A simple and easily generalisable intervention at the workplace is effective to achieve long term smoking cessation. In a setting similar to ours, nine subjects would have to be treated for three months for one to achieve continuous abstinence for 12 months.
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Affiliation(s)
- F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Spain.
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Banegas JR, López-García E, Gutiérrez-Fisac JL, Guallar-Castillón P, Rodríguez-Artalejo F. A simple estimate of mortality attributable to excess weight in the European Union. Eur J Clin Nutr 2003; 57:201-8. [PMID: 12571650 DOI: 10.1038/sj.ejcn.1601538] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2002] [Revised: 05/09/2002] [Accepted: 05/27/2002] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the current burden of mortality attributable to excess weight in the European Union (EU). METHODS Prevalence of overweight (body mass index, BMI 25-29.9 kg/m(2)) and obesity (BMI >or=30 kg/m(2)) were based on self-reported data from a survey with samples representative of the 15 EU Member States in 1997. Primary source of relative risk (RR) of death by BMI was the first American Cancer Prevention Study (CPS I). Additional calculations were performed to account for effect of smoking (using CPS I data for non- or never-smokers), for pre-existing illness (using the second CPS, CPS II, data for healthy never-smokers) and using RRs derived from European rather than US data (using data from a meta-analysis of prospective studies). Mortality attributable to excess weight was calculated by combining the prevalences of overweight and obesity, the RRs, and the number of deaths in the EU countries. RESULTS Annual deaths attributable to overweight and obesity totalled approximately 279 000 when RRs for all subjects were used. When RRs for nonsmokers only were applied to the entire population, about 304 000 deaths were attributable to excess weight. In analyses using RRs which controlled for both smoking and history of disease, the number of deaths attributable to excess weight was estimated at about 337 000 based on European data and at about 401 000 based on US data. In the EU, therefore, a minimum of 279 000 deaths were attributable to excess weight (7.7% of all deaths, varying from 5.8% for France through 8.7% for the UK). More attributable deaths occurred among the obese (175 000) than among the overweight (104 000). Around 70% were cardiovascular disease deaths (195 000) and 20% cancer deaths (53 000). CONCLUSION Mortality attributable to excess weight is a major public health problem in the EU. At least one in 13 annual deaths in the EU are likely to be related to excess weight.
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Affiliation(s)
- J R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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Royo-Bordonada MA, Gorgojo L, de Oya M, Garcés C, Rodríguez-Artalejo F, Rubio R, del Barrio JL, Martín-Moreno JM. Food sources of nutrients in the diet of Spanish children: the Four Provinces Study. Br J Nutr 2003; 89:105-14. [PMID: 12568670 DOI: 10.1079/bjn2002754] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of the present study was to assess the principal food sources of energy and nutrients among Spanish children. We used a cross-sectional study design, based on results obtained from a food-frequency questionnaire. The sample included 1112 children, aged 6-7 years, from Cadiz, Madrid, Orense and Murcia, Spain. Children were selected through random cluster-sampling in schools. We analysed the percentage contributed by each food item to total energy and nutrient intake. The most important food sources were: white bread in the case of carbohydrate (13.4 %); olive oil in the case of total lipids (18.3 %) and monounsaturated fatty acids (29.2 %); whole milk in the case of protein (10.2 %) and saturated fatty acids (14.9 %); chips (French fried potatoes) in the case of polyunsaturated fatty acids (30.4 %). The greatest proportion of Na, consumed in excess, came from salt added to meals. Ham ranked second as a source of saturated fats. Fruits and green leafy vegetables proved to have great relevance as sources of fibre and vitamins, though with regard to the latter, it was observed that fortified foods (breakfast cereals, dairy products, fruit juices, etc.) had come to play a relevant role in many cases. In conclusion, the nutritional profile of Spanish school-aged children aged 6-7 years could be improved by nutritional policies targeted at limiting their consumption of ham (cured or cooked) and of salt added to meals, replacing whole milk with semi-skimmed milk, encouraging the consumption of products rich in complex carbohydrates already present in children's diets (bread, pasta, rice) and promoting less fatty ways of cooking food.
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Affiliation(s)
- M A Royo-Bordonada
- Institute of Health Carlos III, Ministry of Health & Consumer Affairs, Madrid, Spain.
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Moreno Elola-Olaso C, Rey E, Rodríguez-Artalejo F, Locke GR, Díaz-Rubio M. Adaptation and validation of a gastroesophageal reflux questionnaire for use on a Spanish population. Rev Esp Enferm Dig 2002; 94:745-58. [PMID: 12733333] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To produce and validate for telephone use in Spain a cross-cultural adaptation of the gastroesophageal reflux questionnaire (GERQ) developed by Locke et al. MATERIAL AND METHOD The Spanish version of the questionnaire was developed through translation, assessment of comprehensibility, back translation, and appraisal of applicability. Subsequently, reproducibility was measured by a test-retest procedure in 125 patients, and concurrent validity was evaluated by comparing self-reported questionnaire data against a gastroenterologist's findings from clinical interviews with 50 patients. RESULTS The Spanish version showed itself to be easily understandable and widely applicable. Reproducibility for the two cardinal symptoms of gastroesophageal reflux disease (heartburn and acid regurgitation) as measured by the kappa index (95% confidence interval), was 0.85 (0.73-0.97) and 0.81 (0.70-0.92), respectively. With respect to the process of concurrent validation, kappa values (95% confidence interval) for heartburn and acid regurgitation were 0.85 (0.68-1) and 0.91 (0.79-1), respectively. Median kappa for all questions on the questionnaire was 0.75 (range: 0.42 a 1) in the reproducibility analysis and 0.83 (range: 0.44 a 1) in the concurrent validity analysis. CONCLUSIONS The reproducibility and concurrent validity of the Spanish version of the GERQ is excellent and comparable to that of the original English version.
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Affiliation(s)
- C Moreno Elola-Olaso
- Service of Digestive Diseases, Hospital Clínico San Carlos, Complutense University, Madrid, Spain
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Banegas JR, de la Cruz JJ, Rodríguez-Artalejo F, Graciani A, Guallar-Castillón P, Herruzo R. Systolic vs diastolic blood pressure: community burden and impact on blood pressure staging. J Hum Hypertens 2002; 16:163-7. [PMID: 11896505 DOI: 10.1038/sj.jhh.1001310] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2001] [Revised: 09/22/2001] [Accepted: 09/28/2001] [Indexed: 11/09/2022]
Abstract
Systolic blood pressure (SBP) is a more frequent cardiovascular risk factor than diastolic blood pressure (DBP), and has a greater impact on blood pressure staging, though this can vary with age, sex and country. Therefore this paper compares SBP and DBP in terms of community burden and impact on blood pressure staging, among Spain's middle-aged population. Data were drawn from a cross-sectional study on a representative sample of the Spanish population aged 35-64 years. Blood pressure was determined under standardised conditions, and was classified as per WHO-ISH and JNC-VI criteria. Prevalence of SBP > or =140 mm Hg was 34.1%, and that of DBP > or =90 mm Hg, 30.9%. A total of 12% of subjects had isolated systolic hypertension (ISH) and 8.7% had isolated diastolic hypertension (IDH). Of treated hypertensives, 31% had their SBP controlled and 34% their DBP controlled. Of subjects not undergoing antihypertensive drug therapy, 60.8% had congruent SBP and DBP levels, 22.5% were up-staged on the basis of their SBP, and 16.7% were up-staged on the basis of their DBP. SBP alone thus correctly classified JNC-VI staging in 83.3% of subjects vs 77.5% for DBP alone. It was solely among the population >50 years of age, in both sexes, that systolic proved more frequent than diastolic hypertension, ISH greater than IDH prevalence, SBP worse than DBP control, and the percentage of SBP higher than that of DBP up-staged subjects. SBP constitutes a greater community burden than does DBP, and has a greater impact on blood pressure staging in Spain's middle-aged population. However, the differential impact of SBP and DBP upon blood pressure burden and staging is favourable to SBP only among subjects >50 years old. These findings are in accordance with recent guidelines on hypertension management.
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Affiliation(s)
- J R Banegas
- Department of Preventive Medicine and Public Health. Universidad Autónoma de Madrid. Madrid, Spain.
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Rodríguez-Artalejo F, Garcés C, Gorgojo L, López García E, Martín-Moreno JM, Benavente M, del Barrio JL, Rubio R, Ortega H, Fernández O, de Oya M. Dietary patterns among children aged 6-7 y in four Spanish cities with widely differing cardiovascular mortality. Eur J Clin Nutr 2002; 56:141-8. [PMID: 11857047 DOI: 10.1038/sj.ejcn.1601296] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2001] [Revised: 06/22/2001] [Accepted: 06/25/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Classic cardiovascular risk factors, such as smoking, arterial hypertension and hypercholesterolaemia, cannot explain a substantial part of the geographic differences in cardiovascular mortality. Anthropometric and nutritional factors in early stages of life may contribute to adult cardiovascular disease. Therefore, this work examines certain anthropometric variables and diet among children aged 6-7 y, living in four Spanish cities with widely differing ischaemic heart disease (IHD) mortality. DESIGN AND SETTING Cross-sectional anthropometric and dietary survey in four cities in Spain. SUBJECTS A total of 1112 children (50.1% males, 49.9% females) attending public and private schools in Cadiz and Murcia, cities with a relatively high IHD mortality, and Madrid and Orense, cities with a relatively low IHD mortality. A standardized method was used to measure anthropometric variables, and a food-frequency questionnaire completed by subjects' mothers, to measure diet. OUTCOME MEASURES Body mass index (BMI), overweight (BMI>17.6 kg/m(2)), obesity (BMI>20.1 kg/m(2)) and intake of food and nutrients. RESULTS Children in the four cities showed a high prevalence of overweight (range across cities, 28.9-34.5%) and obesity (8.5-15.7%). They also had a moderately hypercaloric diet (range, 2078-2218 kcal/day), marked by an excessive intake of lipids (45.0-47.3% kcal), particularly saturated fats (16.6-16.9% kcal), proteins (17.0-17.3% kcal), sugars (20.0-21.9% kcal) and cholesterol (161.6-182.9 mg/1000 kcal/day), and a low intake of complex carbohydrates (17.5-18.1% kcal) and fibre (19.6-19.9 g/day). Compared with children in the two low-IHD-mortality cities, those in the two high-IHD-mortality cities had a greater BMI (mean difference, 0.61 kg/m(2); P=0.0001) and ponderal index (0.58 kg/m(3); P=0.0001) and a higher intake of energy (104 kcal/day; P=0.007), cholesterol (16.00 mg/1000 kcal/day; P=0.0001) and sodium (321 mg/day; P=0.0001). Inter-city differences in anthropometric variables remained after adjustment for birthweight. CONCLUSIONS Intake of fats, especially saturated fats, and cholesterol should be reduced among Spanish children. It could contribute to a needed reduction of the high prevalence of overweight and obesity in children. If the differences in anthropometric variables and diet between children from the cities with high and low coronary mortality are maintained in future or continue into adulthood, this could contribute to consolidate or even increase the IHD mortality gradient across cities. The finding that differences in anthropometric variables are independent of birthweight suggests that the childhood, rather than intrauterine environment, is involved in the development of such differences. SPONSORSHIP This study was partly funded by grants from the International Olive Oil Board (Consejo Oleícola Internacional), Comunidad Autónoma de Madrid, Fundación Pedro Barrié de la Maza, and Fundación Eugenio Rodríguez Pascual.
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Affiliation(s)
- F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
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Banegas Banegas J, García EL, Rodríguez-Artalejo F. Riesgo cardiovascular. Semergen 2002. [DOI: 10.1016/s1138-3593(02)74061-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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