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Vega-Cabello V, Struijk EA, Caballero FF, Yévenes-Briones H, Ortolá R, Calderón-Larrañaga A, Lana A, Rodríguez-Artalejo F, Lopez-Garcia E. Diet Quality and Multimorbidity in Older Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad285. [PMID: 38157322 DOI: 10.1093/gerona/glad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The role of diet quality in the accumulation of multiple chronic conditions is mostly unknown. This study examined diet quality in association with the number of chronic conditions and the rate of multimorbidity development among community-dwelling older adults. METHODS We used data from 2 784 adults aged ≥65 years from the Seniors-ENRICA 2 cohort. Diet quality was assessed at baseline (2015-17) with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Mediterranean Diet Adherence Screener (MEDAS). Information on medical diagnoses was obtained from electronic clinical records up to 2021. RESULTS Higher adherence to the AHEI-2010 was associated with a lower number of total chronic conditions (β [95% CI] quartile 4 vs 1: -0.57 [-0.86 to 0.27], p trend < .001] and cardiometabolic conditions (-0.30 [-0.44 to -0.17], p trend < .001) at baseline, while higher adherence to the MEDAS was associated with a lower number of total chronic conditions (-0.30 [-0.58 to -0.02], p trend = .01) and neuropsychiatric and neurodegenerative conditions (-0.09 [-0.17 to -0.01], p trend = .01). After a median follow-up of 5.2 years (range: 0.1-6.1 years) higher adherence to the AHEI-2010 was associated with a lower increase in chronic conditions (β [95% confidence interval] quartile 4 vs 1: -0.16 [-0.30 to -0.01], p trend = .04) and with lower rate of chronic disease accumulation. CONCLUSIONS Higher diet quality, as measured by the AHEI-2010, was associated with a lower number of chronic health conditions and a lower rate of multimorbidity development over time.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Francisco Felix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences. Universidad de Oviedo/ISPA; Oviedo, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid, Spain
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Duarte A, Martins J, Silva MJ, Augusto C, Martins SP, Rosário R. The Role of Parental Adherence to the Mediterranean Diet and Family Time Together in Children's Weight Status: The BeE-School Project. Nutrients 2024; 16:916. [PMID: 38612950 PMCID: PMC11013135 DOI: 10.3390/nu16070916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
The family context has been associated with children's weight status. This study aims to investigate the association of parents' adherence to the Mediterranean diet and family time with the weight status of children. The research is part of BeE-school, a cluster-randomized trial implemented in primary schools located in socially vulnerable contexts. A total of 735 children (380 boys and 355 girls) aged 6 to 10 participated in the study. Anthropometrics were assessed during school time, and weight status was categorized, while parents self-reported sociodemographic variables, adherence to the Mediterranean diet (MEDAS questionnaire), and family time. Children from families with higher education levels whose parents have a high adherence to the Mediterranean diet have lower odds of overweight/obesity (odds ratio (OR) 0.301, 95% CI 0.143-0.634, p = 0.002). Also, children from families with lower education levels who have more time together with their family have lower odds of overweight/obesity (OR 0.731, 95% CI 0.573-0.934, p = 0.012). The family environment, mainly family time together and adherence to the Mediterranean diet, exerts a significant influence on children's weight status. Professionals working in children's health should consider the family when fostering health-promoting behaviors.
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Affiliation(s)
- Ana Duarte
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Child Studies (CIEC-UM), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Juliana Martins
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Maria José Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Cláudia Augusto
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Silvana Peixoto Martins
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- ProChild CoLAB Against Poverty and Social Exclusion Association, Campus de Couros, Rua Vila Flor, 166, 4810-225 Guimarães, Portugal
| | - Rafaela Rosário
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Avenida Bissaya Barreto, Polo C, 3046-851 Coimbra, Portugal; (J.M.); (M.J.S.); (C.A.); (S.P.M.); (R.R.)
- School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Nursing (CiEnf), School of Nursing, University of Minho, Edifício 4, Campus de Gualtar, 4710-057 Braga, Portugal
- Research Centre on Child Studies (CIEC-UM), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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Nees J, Kiermeier S, Struewe F, Keymling M, Maatouk I, Kratz CP, Schott S. Health Behavior and Cancer Prevention among Adults with Li-Fraumeni Syndrome and Relatives in Germany-A Cohort Description. Curr Oncol 2022; 29:7768-7778. [PMID: 36290891 PMCID: PMC9600238 DOI: 10.3390/curroncol29100614] [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: 09/04/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
Abstract
Li-Fraumeni-syndrome (LFS) is a rare, highly penetrant cancer predisposition syndrome (CPS) caused by pathogenic variants (PVs) in TP53. Physical activity (PA) and a Mediterranean diet lead to cancer reduction or survival benefits and increased quality of life (QoL), but this is yet unstudied among LFS. TP53 PV carriers (PVC) and their relatives were questioned on dietary patterns (Mediterranean Diet Adherence Screener), PA (Freiburg Questionnaire), QoL (Short-form-Health-Survey-12), smoking, alcohol consumption and perception of cancer risk in a German bi-centric study from March 2020-June 2021. The study enrolled 70 PVC and 43 relatives. Women compared to men (6.49 vs. 5.38, p = 0.005) and PVC to relatives (6.59 vs. 5.51; p = 0.006) showed a healthier diet, associated with participation in surveillance (p = 0.04) and education (diet p = 0.02 smoking p = 0.0003). Women smoked less (2.91 vs. 5.91 packyears; p = 0.03), psychological well-being was higher among men (SF-12: males 48.06 vs. females 41.94; p = 0.004). PVC rated their own cancer risk statistically higher than relatives (72% vs. 38%, p < 0.001) however, cancer risk of the general population was rated lower (38% vs. 70%, p < 0.001). A relative's cancer-related death increased the estimated personal cancer risk (p = 0.01). The possibilities of reducing cancer through self-determined health behavior among PVC and relatives has not yet been exhausted. Educating families with a CPS on cancer-preventive behavior requires further investigation with regard to acceptance and real-life implementation.
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Affiliation(s)
- Juliane Nees
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
| | - Senta Kiermeier
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Farina Struewe
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Myriam Keymling
- German Cancer Research Center (DKFZ), Department of Radiology, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Imad Maatouk
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany
| | - Christian P. Kratz
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221567906
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Gregório MJ, Rodrigues AM, Salvador C, Dias SS, de Sousa RD, Mendes JM, Coelho PS, Branco JC, Lopes C, Martínez-González MA, Graça P, Canhão H. Validation of the Telephone-Administered Version of the Mediterranean Diet Adherence Screener ( MEDAS) Questionnaire. Nutrients 2020; 12:E1511. [PMID: 32455971 PMCID: PMC7284796 DOI: 10.3390/nu12051511] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 01/10/2023] Open
Abstract
A 14-Item Mediterranean Diet Adherence Screener (MEDAS) questionnaire was developed and validated in face-to-face interviews, but not via telephone. The aims of this study were to evaluate the validity and reliability of a telephone-administered version of the MEDAS as well as to validate the Portuguese version of the MEDAS questionnaire. A convenience community-based sample of adults (n = 224) participated in a three-stage survey. First, trained researchers administered MEDAS via a telephone. Second, the Portuguese version of Food Frequency Questionnaire (FFQ), and MEDAS were administered in a semi-structured face-to-face interview. Finally, MEDAS was again administered via telephone. The telephone-administered MEDAS questionnaire was compared with the face-to-face-version using several metrics. The telephone-administered MEDAS was significantly correlated with the face-to-face-administered MEDAS [r = 0.805, p < 0.001; interclass correlation coefficient (ICC) = 0.803, p < 0.001] and showed strong agreement (k = 0.60). The MEDAS scores that were obtained in the first and second telephone interviews were significantly correlated (r = 0.661, p < 0.001; ICC = 0.639, p < 0.001). The overall agreement between the Portuguese version of MEDAS and the FFQ-derived Mediterranean diet adherence score had a Cohen's k = 0.39. The telephone-administered version of MEDAS is a valid tool for assessing the adherence to the Mediterranean diet and acquiring data for large population-based studies.
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Affiliation(s)
- Maria João Gregório
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal;
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
| | - Ana M. Rodrigues
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
| | - Clara Salvador
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
| | - Sara S. Dias
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Escola Superior de Saúde do Instituto Politécnico de Leiria, Unidade de Investigação em Saúde (UI), 2411-901 Leiria, Portugal
| | - Rute D. de Sousa
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
| | - Jorge M. Mendes
- NOVA Information Management School, Universidade Nova de Lisboa, 1070-312 Lisboa, Portugal; (J.M.M.); (P.S.C.)
| | - Pedro S. Coelho
- NOVA Information Management School, Universidade Nova de Lisboa, 1070-312 Lisboa, Portugal; (J.M.M.); (P.S.C.)
| | - Jaime C. Branco
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Serviço de Reumatologia do Hospital Egas Moniz—Centro Hospitalar Lisboa Ocidental (CHLO-E.P.E.), 1349-019 Lisboa, Portugal
| | - Carla Lopes
- Instituto de Saúde Pública da Universidade do Porto, 4050-091 Porto, Portugal;
| | | | - Pedro Graça
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, 4200-465 Porto, Portugal;
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, 1049-005 Lisboa, Portugal
| | - Helena Canhão
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, UNL, 1099-085 Lisboa, Portugal; (M.J.G.); (A.M.R.); (C.S.); (R.D.d.S.); (J.C.B.)
- EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), CEDOC—Campus Sant’Ana, Pólo de Investigação, NMS, UNL, Edifício Amarelo, Rua do Instituto Bacteriológico, n 5, 1150-082 Lisboa, Portugal;
- EpiSaúde Sociedade Científica, 7005-837 Évora, Portugal
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, 1600-560 Lisboa, Portugal
- Unidade de Reumatologia—Centro Hospitalar Universitário Lisboa Central (CHULC-Hospital Curry Cabral), 1169-050 Lisboa, Portugal
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