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Baenas I, Camacho-Barcia L, Granero R, Razquin C, Corella D, Gómez-Martínez C, Castañer-Niño O, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem JL, Cano-Ibáñez N, Tur JA, Martín-Sánchez V, Pintó X, Gaforio JJ, Matía-Martín P, Vidal J, Vázquez C, Daimiel L, Ros E, Jiménez-Murcia S, Dalsgaard S, Garcia-Arellano A, Babio N, Sorli JV, Lassale C, García-de-la-Hera M, Gómez-García E, Zulet MA, Konieczna J, Martín-Peláez S, Tojal-Sierra L, Basterra-Gortari FJ, de Las Heras-Delgado S, Portoles O, Muñoz-Pérez MÁ, Arenas-Larriva AP, Compañ-Gabucio L, Eguaras S, Shyam S, Fitó M, Baños RM, Salas-Salvadó J, Fernández-Aranda F. Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population. J Endocrinol Invest 2024:10.1007/s40618-023-02278-y. [PMID: 38218741 DOI: 10.1007/s40618-023-02278-y] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. METHODS n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. RESULTS The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. CONCLUSIONS This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.
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Affiliation(s)
- I Baenas
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona, 08007, Barcelona, Spain
| | - L Camacho-Barcia
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
| | - R Granero
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
- Department de Psicobiologia I Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193, Barcelona, Spain
| | - C Razquin
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - D Corella
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - C Gómez-Martínez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - O Castañer-Niño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), 08003, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - J A Martínez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049, Madrid, Spain
| | - Á M Alonso-Gómez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Cardiovascular, Respiratory and Metabolic Area, Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - J Wärnberg
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), 29590, Málaga, Spain
| | - J Vioque
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain
| | - D Romaguera
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, 07120, Palma, Spain
| | - J López-Miranda
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004, Cordoba, Spain
| | - R Estruch
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036, Barcelona, Spain
| | - F J Tinahones
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29590, Málaga, Spain
| | - J Lapetra
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013, Seville, Spain
| | - J L Serra-Majem
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria and Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016, Las Palmas de Gran Canaria, Spain
| | - N Cano-Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (IBS.GRANADA), 18012, Granada, Spain
| | - J A Tur
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122, Palma, Spain
| | - V Martín-Sánchez
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, 24071, León, Spain
| | - X Pintó
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Universidad de Barcelona, 08908, Barcelona, Spain
| | - J J Gaforio
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, 23071, Jaén, Spain
| | - P Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - J Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
- Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036, Barcelona, Spain
| | - C Vázquez
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, 28024, Madrid, Spain
| | - L Daimiel
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28668, Madrid, Spain
| | - E Ros
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Lipid Clinic, Hospital Clínic, 08036, Barcelona, Spain
| | - S Jiménez-Murcia
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907, Barcelona, Spain
| | - S Dalsgaard
- NCRR-National Centre for Register-Based Research, Aarhus University, 8210, Aarhus, Denmark
- iPSYCH-The Lundbeck Foundation Initiative for Integrative Psychiatric Research, 8210, Aarhus, Denmark
- CIRRAU-Centre for Integrated Register-Based Research, Aarhus University, 8210, Aarhus, Denmark
| | - A Garcia-Arellano
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - N Babio
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - J V Sorli
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010, Valencia, Spain
| | - C Lassale
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Barcelona Institute for Global Health (ISGlobal), 08036, Barcelona, Spain
| | - M García-de-la-Hera
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain
| | - E Gómez-García
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), 29590, Málaga, Spain
| | - M A Zulet
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, 31008, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049, Madrid, Spain
| | - J Konieczna
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, 07120, Palma, Spain
| | - S Martín-Peláez
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain
| | - L Tojal-Sierra
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Cardiovascular, Respiratory and Metabolic Area, Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009, Vitoria-Gasteiz, Spain
| | - F J Basterra-Gortari
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario de Navarra, IdiSNA, Universidad Pública de Navarra, 31008, Pamplona, Spain
| | - S de Las Heras-Delgado
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - O Portoles
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - M Á Muñoz-Pérez
- Unitat de Suport a la Recerca en Atenció Primaria de Barcelona. IDIAP Jordi Gol. Primary Care Division, Institut Català de La Salut, 08007, Barcelona, Spain
| | - A P Arenas-Larriva
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004, Cordoba, Spain
| | - L Compañ-Gabucio
- CIBER de Epidemiología y Salud Pública (CIBEResp), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain
| | - S Eguaras
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008, Pamplona, Spain
| | - S Shyam
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain
| | - M Fitó
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d`Investigació Médica (IMIM), 08003, Barcelona, Spain
| | - R M Baños
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatment of the University of Valencia, 46010, Valencia, Spain
| | - J Salas-Salvadó
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Human Nutrition Unit ANUT-DSM, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili (IISPV), 43007, Reus, Spain.
| | - F Fernández-Aranda
- Eating Disorders Unit, Clinical Psychology Department, University Hospital of Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.
- Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y la Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029, Madrid, Spain.
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute-IDIBELL, 08908, Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907, Barcelona, Spain.
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Díaz-López A, Becerra-Tomás N, Ruiz V, Toledo E, Babio N, Corella D, Fitó M, Romaguera D, Vioque J, Alonso-Gómez ÁM, Wärnberg J, Martínez JA, Serra-Majem L, Estruch R, Tinahones FJ, Lapetra J, Pintó X, Tur JA, López-Miranda J, Cano Ibañez N, Delgado-Rodríguez M, Matía-Martín P, Daimiel L, de Paz JA, Vidal J, Vázquez C, Ruiz-Canela M, Bulló M, Sorlí JV, Goday A, Fiol M, García-de-la-Hera M, Tojal Sierra L, Pérez-Farinós N, Zulet MÁ, Sánchez-Villegas A, Sacanella E, Fernández-García JC, Santos-Lozano JM, Gimenez-Gracia M, Del Mar Bibiloni M, Diez-Espino J, Ortega-Azorin C, Castañer O, Morey M, Torres-Collado L, Sorto Sanchez C, Muñoz MÁ, Ros E, Martinez-Gonzalez MA, Salas-Salvadó J. Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial. Am J Nephrol 2021; 52:45-58. [PMID: 33556935 DOI: 10.1159/000513664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. METHODS Randomized controlled "PREvención con DIeta MEDiterránea-Plus" (PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55-75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (eGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired eGFR (<60 mL/min/1.73 m2) and micro- to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m2) to mildly impaired GFR (60 to <90 mL/min/1.73 m2) or micro- to macroalbuminuria. RESULTS After 1 year, eGFR declined by 0.66 and 1.25 mL/min/1.73 m2 in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2; 95% CI: 0.15-1.02). There were no between-group differences in mean UACR or micro- to macroalbuminuria changes. Moderately/severely impaired eGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44-0.82) and 92% higher (HR 1.92; 1.35-2.73), respectively, in the intervention group. CONCLUSIONS The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.
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Affiliation(s)
- Andrés Díaz-López
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Nerea Becerra-Tomás
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Verónica Ruiz
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Estefania Toledo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain
| | - Nancy Babio
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Montse Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition research group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Jesús Vioque
- ISABIAL-FISABIO, Miguel Hernandez University, Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nursing, Institute of Biomedical Research in Malaga (IBIMA), University of Málaga, Málaga, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nutrition, Food Science and Physiology, IdiSNA, University of Navarra, Pamplona, Spain
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Luís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Institutd'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Naomi Cano Ibañez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Miguel Delgado-Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Jose Antonio de Paz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Josep Vidal
- Departament of Endocrinology, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Clotilde Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain
| | - Mònica Bulló
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - José V Sorlí
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Albert Goday
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition research group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Miquel Fiol
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Manoli García-de-la-Hera
- ISABIAL-FISABIO, Miguel Hernandez University, Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucas Tojal Sierra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain
| | - Napoleón Pérez-Farinós
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Public Health, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Maria Ángeles Zulet
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nutrition, Food Science and Physiology, IdiSNA, University of Navarra, Pamplona, Spain
| | - Almudena Sánchez-Villegas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Emilio Sacanella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Institutd'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - José Carlos Fernández-García
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Miquel Gimenez-Gracia
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Del Mar Bibiloni
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Javier Diez-Espino
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain
| | - Carolina Ortega-Azorin
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Olga Castañer
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition research group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Marga Morey
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Laura Torres-Collado
- ISABIAL-FISABIO, Miguel Hernandez University, Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Sorto Sanchez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Cardiology, Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain
| | - Miguel Ángel Muñoz
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition research group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Miguel A Martinez-Gonzalez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jordi Salas-Salvadó
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Universitat Rovira i Virgili, Reus, Spain,
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain,
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain,
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3
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Gonzalez-Palacios S, Navarrete-Muñoz EM, García-de-la-Hera M, Torres-Collado L, Santa-Marina L, Amiano P, Lopez-Espinosa MJ, Tardon A, Riano-Galan I, Vrijheid M, Sunyer J, Vioque J. Sugar-Containing Beverages Consumption and Obesity in Children Aged 4-5 Years in Spain: the INMA Study. Nutrients 2019; 11:nu11081772. [PMID: 31374897 PMCID: PMC6722971 DOI: 10.3390/nu11081772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 06/24/2019] [Revised: 07/28/2019] [Accepted: 07/30/2019] [Indexed: 12/30/2022] Open
Abstract
The consumption of sugar-containing beverages (SCB) has been associated with obesity although the evidence in preschool children is scarce. Cross-sectional analyses were performed to assess the association between obesity and SCB consumption (packaged juices and sugar-sweetened soft drinks) in 1823 children at the age of 4-5 years from the INfancia y Medio Ambiente (INMA) Project. One drink was defined as a glass of 175 mL, and the consumption of SCB was categorized in <1, 1-7 drinks/week and > 1 drink/day. We used multiple logistic regression to estimate odds ratios (OR). The average SCB consumption was 79.1 mL/day, mainly from packaged juices (80.9%). The SCB consumption was lower in non-obese children than in children with obesity, 76.6 vs 118.4 mL/day (p = 0.02). After adjusting for covariates, children who consumed >1 drink/day showed elevated odds of obesity, OR = 3.23 (95% confidence interval (CI): 1.48-6.98) compared to children who consumed <1 SCB drink a week. Each additional SCB drink per day was associated with higher odds of obesity, OR = 1.55 (1.14-2.09). Higher consumption of packaged juices, but not sugar-sweetened soft drinks, was significantly associated with higher odds of obesity, OR = 1.55 (1.09-2.15) and OR = 1.59 (0.76-3.39), respectively. A higher SCB consumption is associated with obesity in preschool children, mainly due to the consumption of packaged juices.
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Affiliation(s)
- Sandra Gonzalez-Palacios
- Department of Public Health, History of Medicine and Gynecology, Miguel Hernández University and Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Eva-María Navarrete-Muñoz
- Department of Public Health, History of Medicine and Gynecology, Miguel Hernández University and Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Manoli García-de-la-Hera
- Department of Public Health, History of Medicine and Gynecology, Miguel Hernández University and Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Laura Torres-Collado
- Department of Public Health, History of Medicine and Gynecology, Miguel Hernández University and Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Subdirección de Salud Pública y Adicciones de Gipuzkoa, 20013 San Sebastian, Spain
- Biodonostia Health Research Institute, Basque Government, 20014 San Sebastián, Spain
| | - Pilar Amiano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Subdirección de Salud Pública y Adicciones de Gipuzkoa, 20013 San Sebastian, Spain
- Biodonostia Health Research Institute, Basque Government, 20014 San Sebastián, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 46020 Valencia, Spain
| | - Adonina Tardon
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- University of Oviedo, 33003 Asturias, Spain
| | - Isolina Riano-Galan
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Servicio de Pediatria. Hospital Universitario Central de Asturias-Oviedo, 33011 Asturias, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- ISGlobal, Institute for Global Health, 08036 Barcelona, Spain
- University Pompeu Fabra, 08036 Barcelona, Spain
| | - Jordi Sunyer
- ISGlobal, Institute for Global Health, 08036 Barcelona, Spain
| | - Jesus Vioque
- Department of Public Health, History of Medicine and Gynecology, Miguel Hernández University and Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain.
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
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4
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Signes-Pastor AJ, Vioque J, Navarrete-Muñoz EM, Carey M, García-Villarino M, Fernández-Somoano A, Tardón A, Santa-Marina L, Irizar A, Casas M, Guxens M, Llop S, Soler-Blasco R, García-de-la-Hera M, Karagas MR, Meharg AA. Inorganic arsenic exposure and neuropsychological development of children of 4-5 years of age living in Spain. Environ Res 2019; 174:135-142. [PMID: 31075694 PMCID: PMC6541502 DOI: 10.1016/j.envres.2019.04.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 05/18/2023]
Abstract
Early-life exposure to inorganic arsenic (iAs) may adversely impact health later in life. To date, evidence of iAs adverse effects on children's neurodevelopment comes mainly from populations highly exposed to contaminated water with conflicting results. Little is known about those effects among populations with low iAs exposure from food intake. We investigated the cross-sectional association between exposure to iAs and neurodevelopment scores among children living in Spain whose main route of exposure was diet. Arsenic species concentrations in urine from 400 children was determined, and the sum of urinary iAs, dimethylarsinic acid, and monomethylarsonic acid was used to estimate iAs exposure. The McCarthy Scales of Children's Abilities was used to assess children's neuropsychological development at about 4-5 years of age. The median (interquartile range) of children's sum of urinary iAs, MMA, and DMA was 4.85 (2.74-7.54) μg/L, and in adjusted linear regression analyses the natural logarithm transformed concentrations showed an inverse association with children's motor functions (β, [95% confidence interval]; global scores (-2.29, [-3.95, -0.63])), gross scores (-1.92, [-3.52, -0.31]) and fine scores (-1.54, [-3.06, -0.03]). In stratified analyses by sex, negative associations were observed with the scores in the quantitative index (-2.59, [-5.36, 0.17]) and working memory function (-2.56, [-5.36, 0.24]) only in boys. Our study suggests that relatively low iAs exposure may impair children's neuropsychological development and that sex-related differences may be present in susceptibility to iAs related effects; however, our findings should be interpreted with caution given the possibility of residual confounding.
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Affiliation(s)
- Antonio J Signes-Pastor
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr, 7927 Rubin Bldg, Lebanon, NH, 03756, USA; Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast BT9 5BN, Northern Ireland, UK.
| | - Jesús Vioque
- Department of Public Health, University Miguel Hernández and ISABIAL-FISABIO Foundation, Ctra. Valencia s/n, 03550, Sant Joan d'Alacant, Alicante, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Eva M Navarrete-Muñoz
- Department of Public Health, University Miguel Hernández and ISABIAL-FISABIO Foundation, Ctra. Valencia s/n, 03550, Sant Joan d'Alacant, Alicante, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Manus Carey
- Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast BT9 5BN, Northern Ireland, UK
| | - Miguel García-Villarino
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; IUOPA- Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; IUOPA- Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; IUOPA- Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Subdirección de Salud Pública de Gipuzkoa. The Basque Government's Health Department, San Sebastián, Spain; Biodonostia Health Research Institute, San Sebastián, Spain
| | - Amaia Irizar
- Biodonostia Health Research Institute, San Sebastián, Spain
| | - Maribel Casas
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Sabrina Llop
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Raquel Soler-Blasco
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Manoli García-de-la-Hera
- Department of Public Health, University Miguel Hernández and ISABIAL-FISABIO Foundation, Ctra. Valencia s/n, 03550, Sant Joan d'Alacant, Alicante, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr, 7927 Rubin Bldg, Lebanon, NH, 03756, USA
| | - Andrew A Meharg
- Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast BT9 5BN, Northern Ireland, UK
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5
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Cano-Ibáñez N, Bueno-Cavanillas A, Martínez-González MA, Corella D, Salas-Salvadó J, Zomeño MD, García-de-la-Hera M, Romaguera D, Martínez JA, Barón-López FJ, García-Ríos A, Estruch R, García-Molina L, Alonso Gómez Á, Tur JA, Tinahones F, Serra-Majem L, Cubelos-Fernández N, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Gaforio JJ, Matía P, Ros E, Diez-Espino J, Fernández-Carrión R, Basora J, Fitó M, Zazo JM, Colom A, Toledo E, Díaz-López A, Muñoz MÁ, Ruiz-Canela M, Gea A. Dietary Intake in Population with Metabolic Syndrome: Is the Prevalence of Inadequate Intake Influenced by Geographical Area? Cross-Sectional Analysis from PREDIMED-Plus Study. Nutrients 2018; 10:E1661. [PMID: 30400355 PMCID: PMC6266979 DOI: 10.3390/nu10111661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 12/30/2022] Open
Abstract
Inadequate diet influences chronic diseases such as cardiovascular disease (CVD), the leading cause of death in Spain. CVD figures vary from one geographical region to another; this could be associated with different food choices. Our aim was to analyse the influence of geographical area on nutrient intakes among the Spanish adult population with Metabolic Syndrome (MetS). We analysed cross-sectional baseline data from the PREDIMED-Plus study: 6646 Spanish adults, aged 55⁻75 years, with overweight/obesity and MetS in four geographical areas. A validated 143-item Food Frequency Questionnaire (FFQ) was used to assess energy and nutrient intakes. The prevalence of inadequate nutrient intake was estimated according to Dietary Reference Intakes (DRIs). Multivariable-adjusted logistic regression was used to assess the relationship between geographical area (North, Central, East and South areas) and inadequate nutrient intake. People in the North area consumed significantly lower amounts of vegetables and fish but more sugar and alcohol (p < 0.001) than other areas. Dietary fibre, vitamin A, E, calcium and magnesium intakes were all lower among men of North area than in the other areas (p < 0.001). Sex (women), non-smoker and physical activity were also associated to adequate nutrient intake. Geographical area influences nutrient intakes. Its effect on dietary quality should be taken into account when planning food policies.
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Grants
- FPU14/03630 Ministerio de Educación, Cultura y Deporte
- PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14-00696, PI14/01206, PI14/01919, PI14/00853 Instituto de Salud Carlos III
- Advanced Research Grant 2013-2018; 340918 European Research Council
- 2013ACUP00194 Recercaixa
- PI0458/2013 Consejería de Salud, Junta de Andalucía
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Affiliation(s)
- Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Dolores Corella
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Jordi Salas-Salvadó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain.
| | - M Dolors Zomeño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), 08003 Barcelona, Spain.
- Human Nutrition Unit, Blanquerna-Ramon Llull University, 08001 Barcelona, Spain.
| | - Manoli García-de-la-Hera
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
- Miguel Hernández University, ISABIAL-FISABIO, 03202 Alicante, Spain.
| | - Dora Romaguera
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
| | - J Alfredo Martínez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - F Javier Barón-López
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Public Health, University of Málaga-IBIMA, 29016 Málaga, Spain.
| | - Antonio García-Ríos
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain.
| | - Ramón Estruch
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
| | - Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Ángel Alonso Gómez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country (UPV/EHU), 48940 Vitoria-Gasteiz, Spain.
| | - Josep A Tur
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain.
| | - Francisco Tinahones
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, 29010 Málaga, Spain.
| | - Lluis Serra-Majem
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Institute for Biomedical Research, University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | | | - José Lapetra
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria, 41013 Sevilla, Spain.
| | - Clotilde Vázquez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Endocrinology, Fundación Jiménez-Díaz, 28040 Madrid, Spain.
| | - Xavier Pintó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - José Juan Gaforio
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
- Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaén, 23071 Jaén, Spain.
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Emilio Ros
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigació Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain.
| | - Javier Diez-Espino
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Servicio Navarro de Salud, Osasunbidea, 31002 Pamplona, Spain.
| | - Rebeca Fernández-Carrión
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Josep Basora
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain.
| | - Montse Fitó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), 08003 Barcelona, Spain.
| | - Juan Manuel Zazo
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
- Miguel Hernández University, ISABIAL-FISABIO, 03202 Alicante, Spain.
| | - Antoni Colom
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Andrés Díaz-López
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain.
| | - Miguel Ángel Muñoz
- Primary Care Division of Barcelona, Institut Català de la Salud-IDIAP Jordi Gol, 08007 Barcelona, Spain.
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
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Abstract
This article describes a bibliometric review of the publications on obesity research in PubMed over the last 20 years. We used Medline via the PubMed online service of the US National Library of Medicine from 1988 to 2007. The search strategy was: ([obesity] in MesH). A total of 58,325 references were retrieved, 25.5% in 1988-1997, and 74.5% in 1998-2007. The growth in the number of publications showed an exponential increase. The references were published in 3613 different journals, with 20 journals contributing 25% of obesity literature. The two journals contributing most were the International Journal of Obesity (5.1%), Obesity-Obesity Research (2.9%). North America and Europe were the most productive world areas with 44.1% and 37.9% of the literature, respectively. The US was the predominant country in number of publications, followed by the United Kingdom, Japan and Italy. The ranking of production changed when the number of publications was normalized by population, gross domestic product and obesity prevalence by countries. The great increase of publications on obesity during the period 1988-2007 was particularly evident in the second decade of the period which is concordant with the worldwide obesity epidemic. USA and Europe were leaders in the production of scientific articles on obesity.
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Affiliation(s)
- J Vioque
- Departamento de Salud Pública, Universidad Miguel Hernández, San Juan de Alicante, Spain.
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