Epidemiología y Salud Pública

Autores: Arredondo Montero, J. (Autor de correspondencia); Pérez Riveros, B. P.; Bueso Asfura, O. E.; et al.

Título: Leucine-Rich Alpha-2-Glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis

Revista: EUROPEAN JOURNAL OF PEDIATRICS

ISSN: 0340-6199 Vol.182 N° 7 2023 págs. 3033 - 3044

Resumen

The aim of this study was to analyze the diagnostic performance of Leucine-Rich Alpha-2-Glycoprotein (LRG1) in pediatric acute appendicitis (PAA). We conducted a systematic review of the literature in the main databases of medical bibliography. Two independent reviewers selected the articles and extracted relevant data. Methodological quality was assessed using the QUADAS2 index. A synthesis of the results, standardization of the metrics and 4 random-effect meta-analyses were performed. Eight studies with data from 712 participants (305 patients with confirmed diagnosis of PAA and 407 controls) were included in this review. The random-effect meta-analysis of serum LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 46.76 ¿g/mL (29.26-64.26). The random-effect meta-analysis for unadjusted urinary LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 0.61 ¿g/mL (0.30-0.93). The random-effect meta-analysis (PAA vs control) for urinary LRG1 adjusted for urinary creatinine resulted in a significant mean difference (95% CI) of 0.89 g/mol (0.11-1.66). Conlusion: Urinary LRG1 emerges as a potential non-invasive biomarker for the diagnosis of PAA. On the other hand, due to the high between-study heterogeneity, the results on serum LRG1 should be interpreted with caution. The only study that analyzed salivary LRG1 showed promising results. Further prospective studies are needed to confirm these findings. What is Known: ¿ Pediatric acute appendicitis continues to be a pathology with a high rate of diagnostic error. ¿ Invasive tests, although useful, are a source of stress for patients and their parents. What is New: ¿ LRG1 emerges as a promising urinary and salivary biomarker for the noninvasive diagnosis of pediatric acute appendicitis.
Autores: Domínguez, L. J. (Autor de correspondencia); Donat Vargas, Carolina Luisa; Sayon Orea, María del Carmen; et al.

Título: Rationale of the association between Mediterranean diet and the risk of frailty in older adults and systematic review and meta-analysis

Revista: EXPERIMENTAL GERONTOLOGY

ISSN: 0531-5565 Vol.177 2023 págs. 112180

Resumen

Frailty is a geriatric syndrome whose frequency is increasing in parallel with population aging and is of great interest due to its dire consequences: increased disability, hospitalizations, falls and fractures, institutionalization, and mortality. Frailty is multifactorial but nutritional factors, which are modifiable, play a crucial role in its pathogenesis. Epidemiologic evidence supports that high-quality dietary patterns can prevent, delay or even reverse the occurrence of frailty. In order to add new knowledge bridging the gap as the main purpose of the present article we performed a comprehensive review of the rationale behind the association of MedDiet with frailty and a systematic review and meta-analysis updating the latest ones published in 2018 specifically examining the relationship of Mediterranean diet (MedDiet) and incident frailty. Adding the updated information, our results confirmed a robust association of a higher adherence to MedDiet with reduced incident frailty. Key components of the MedDiet, i.e., abundant consumption of vegetables and fruit as well as the use of olive oil as the main source of fat, all of which have been associated with a lower incidence of frailty, may help explain the observed benefit. Future well-designed and sufficiently large intervention studies are needed to confirm the encouraging findings of the current observational evidence. Meanwhile, based on the existing evidence, the promotion of MedDiet, a high-quality dietary pattern, adapted to the conditions and traditions of each region, and considering lifelong and person-tailored strategies, is an open opportunity to reduced incident frailty. This could also help counteract the worrying trend towards the spread of unhealthy eating and lifestyle models such as those of Western diets that greatly contribute to the genesis of chronic non-communicable diseases and disability.
Autores: Arredondo Montero, J.; Bardaji Pascual, C.; Antona, G.; et al.

Título: Diagnostic performance of calprotectin and APPY-1 test in pediatric acute appendicitis: a systematic review and a meta-analysis

Revista: EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY

ISSN: 1863-9933 Vol.49 N° 2 2023 págs. 763 - 773

Resumen

Background Pediatric acute appendicitis (AA) is a challenging pathology to diagnose. In the last decades, multiple biomarkers have been evaluated in different human biological samples to improve diagnostic performance. This study aimed to examine the diagnostic performance of serum, fecal and urinary calprotectin as well as the role of the APPY-1 biomarker panel in pediatric acute appendicitis. Methods We conducted a systematic review of the literature that involved an extensive search in the main databases of medical bibliography (Medline, PubMed, Web of Science and SciELO). Two independent reviewers selected the relevant articles based on the previously defined inclusion and exclusion criteria. Methodological quality of the selected article was rated using the QUADAS2 index. Data extraction was performed by two independent reviewers. A synthesis of the results, a standardization of the metrics and two random-effect meta-analyses, one for serum calprotectin and one for APPY-1, were performed. Results The research resulted in 173 articles. Thirty-eight duplicates were removed. Among the remaining 135 articles, we excluded 125 following the inclusion and exclusion criteria, resulting in the 10 studies included in this review. This systematic review included data from of 3901 participants (1276 patients with confirmed diagnosis of AA and 2625 controls). The age of the participants ranged from 0 to 21 years. Four of the studies compared serum calprotectin values and reported significant differences between groups, but inconsistent results regarding cutoff points, sensitivity and specificity. Two publications compared urinary values of calprotectin and presented inconsistent results regarding sensitivity and specificity as well. One publication evaluated the diagnostic performance of fecal calprotectin, but it did not provide data on measured values. Four studies evaluated the diagnostic performance of APPY-1 test in pediatric acute appendicitis. The calculated pooled sensitivity and specificity of those studies were 97.37 (95% CI 95.60-98.44) and 36.74 (95% CI 32.28-41.44), respectively, and the calculated pooled NLR, 0.0714 (95% CI 0.041-0.115). Conclusion Serum calprotectin has limited diagnostic yield in pediatric acute appendicitis. Its performance seems to increase with the hours of clinical evolution and in advanced AA, although the evidence is limited. There is not enough evidence on the usefulness of urinary or fecal calprotectin in the diagnosis of pediatric acute appendicitis. On the other hand, the APPY-1 is a reliable test to exclude the diagnosis of AA in patients at low or moderate risk according to PAS and Alvarado Score.
Autores: Royo-Bordonada, M. Á. (Autor de correspondencia); Bes Rastrollo, Maira

Título: El valor del concepto de alimento ultraprocesado en salud pública

Revista: GACETA SANITARIA

ISSN: 0213-9111 Vol.37 2023 págs. 102270
Autores: Arredondo-Montero, J. (Autor de correspondencia); Antona, G.; Bronte-Anaut, M.; et al.

Título: Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study (vol 39, 27, 2023)

Revista: PEDIATRIC SURGERY INTERNATIONAL

ISSN: 0179-0358 Vol.39 N° 1 2023 págs. 49
Autores: Arredondo Montero, J. (Autor de correspondencia); Pérez Riveros, B. P.; Bueso Asfura, O. E.; et al.

Título: Correction to: Leucine-rich alpha-2-glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis

Revista: EUROPEAN JOURNAL OF PEDIATRICS

ISSN: 0340-6199 Vol.182 N° 7 2023 págs. 3045 - 3047
Autores: Arredondo Montero, J.; Bardaji Pascual, C.; Antona, G.; et al.

Título: Correction to: diagnostic performance of calprotectin and APPY-1 test in pediatric acute appendicitis: a systematic review and a meta-analysis

Revista: EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY

ISSN: 1863-9933 Vol.49 N° 2 2023 págs. 775
Autores: Martínez-Urbistondo, D. (Autor de correspondencia); San-Cristóbal, R.; Villares, P.; et al.

Título: Corrigendum: Role of NAFLD on the health related QoL response to lifestyle in patients with metabolic syndrome: the PREDIMED plus cohort

Revista: FRONTIERS IN ENDOCRINOLOGY

ISSN: 1664-2392 Vol.13 2023 págs. 1113532
Autores: Arredondo Montero, J.; Hernández-Martín, S.; Martín Calvo, Nerea; et al.

Título: Development and clinical application of a new sternal zenithal traction system in video-assisted percutaneous thoracoplasty

Revista: CIRUGÍA ESPAÑOLA

ISSN: 2173-5077 Vol.101 N° 5 2023 págs. 319 - 324

Resumen

Introduction: Video-assisted percutaneous thoracoplasty involves a complex surgical access with risk of damaging vital structures during the procedure. Historically, different traction and sternal elevation systems have been applied during the intervention to minimize the risk associated with the passage of the instruments between the sternum and the pericardium. Material and methods: A new sternal traction system is presented by means of an illustrated description. Clinical and sociodemographic data were extracted from the 36 patients operated in our center for Pectus Excavatum between July 2017 and August 2021. The Haller index was not applied as a criterion to determine the use or not of the sternal traction system. Patients were classified according to whether the sternal traction system (TE) or not (ST) had been employed. Statistical analysis of the data collected was performed with STATA, version 15.0 (StataCorp). Results: Both groups were comparable. Haller's Index was 4.19 ± 0.7 for the sternal traction (TE) group and 3.79 ± 0.3 for the no sternal traction (ST) group. In 25 of the patients the described traction system was used, and in 11 no traction system was used. All patients were operated on by the same surgeon. The mean operative time in minutes was 97.73 ± 46.2 for the ST group and 88.13 ± 18.1 for the TE group (p = 0.87). The mean total days of admission was 7.67 ± 0.82 (TE) and 7.73 ± 1.35 (ST). Mean days of intravenous PCA was 6.08 ± 0.72 (TE) and 5.89 ± 1.45 (ST). The mean number of epidural PCA days was 3.79 ± 0.5 (TE) and 3.36 ± 0.5 (ST) (p = 0.01). All patients presented a favorable postoperative evolution. None of the patients presented discomfort at the level of the sternal wounds during hospitalization. Cosmetic evolution was favorable in all patients. Conclusions: The sternal traction system presented provides safety when performing retrosternal dissection and placement of the thoracoplasty bar, leading to a decrease in surgical time in cases with a Haller Index higher than 3.5. There have been no complications associated with its use, nor has there been an increase in the number of days of hospitalization or analgesic requirements. There are no aesthetic sequelae for the patients.
Autores: Pano, O.; Sayon Orea, María del Carmen (Autor de correspondencia); Hershey, M. S.; et al.

Título: The risk of incident depression when assessed with the Lifestyle and Well-Being index

Revista: PUBLIC HEALTH

ISSN: 0033-3506 Vol.220 2023 págs. 165 - 171

Resumen

Objectives: Novel findings indicate links between unhealthy lifestyles and depression based on active inflammatory processes. Thus, identifying participants with poor habits could reveal differences in trends of incident depression. This study aimed to examine the association between an objective lifestyle assessment, as measured by the Lifestyle and Well-Being Index (LWB-I), and incident depression in healthy participants of a Spanish cohort. Study design: This was a longitudinal analysis of a subsample of 10,063 participants from the Seguimiento Universidad de Navarra cohort study. Methods: Group comparisons and Cox proportional hazard models were conducted using the LWB-I, which categorizes the sample into groups with healthy and unhealthy lifestyles and well-being. The main outcome was incident depression as well as secondary outcomes. Results: Those classified to the transition category of LWB-I were associated with a hazard ratio of 0.67 (95% confidence interval: 0.52-0.87), and those in the excellent category showed a hazard ratio of 0.44 (95% confidence interval: 0.33-0.58), which in both groups reflects a significantly lower risk of incident depression compared with the group including those classified in the poor LWB-I level. Moreover, the available sensitivity analyses concerning time of depression diagnosis or antidepressant treatment further supported the role of nutrition and physical activity on incident depression. Interestingly, throughout the follow-up, incident depression was inversely related to healthier daily habits as measured by the LWB-I. Conclusions: A global assessment of lifestyles such as the LWB-I provides valuable insight into the complex relationship between lifestyle factors and their link to depression risk.
Autores: Santos Martín, José Luis; Ruiz-Canela, Miguel (Autor de correspondencia); Razquin Burillo, Cristina; et al.

Título: Circulating citric acid cycle metabolites and risk of cardiovascular disease in the PREDIMED study

Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES

ISSN: 0939-4753 Vol.33 N° 4 2023 págs. 835 - 843

Resumen

Background and aim: Plasma citric acid cycle (CAC) metabolites might be likely related to cardiovascular disease (CVD). However, studies assessing the longitudinal associations between circulating CAC-related metabolites and CVD risk are lacking. The aim of this study was to evaluate the association of baseline and 1-year levels of plasma CAC-related metabolites with CVD incidence (a composite of myocardial infarction, stroke or cardiovascular death), and their interaction with Mediterranean diet interventions. Methods and results: Case-cohort study from the PREDIMED trial involving participants aged 55-80 years at high cardiovascular risk, allocated to MedDiets or control diet. A subcohort of 791 participants was selected at baseline, and a total of 231 cases were identified after a median follow-up of 4.8 years. Nine plasma CAC-related metabolites (pyruvate, lactate, citrate, aconitate, isocitrate, 2-hydroxyglutarate, fumarate, malate and succinate) were measured using liquid chromatography-tandem mass spectrometry. Weighted Cox multiple regression was used to calculate hazard ratios (HRs). Baseline fasting plasma levels of 3 metabolites were associated with higher CVD risk, with HRs (for each standard deviation, 1-SD) of 1.46 (95%CI:1.20-1.78) for 2-hydroxyglutarate, 1.33 (95%CI:1.12-1.58) for fumarate and 1.47 (95%CI:1.21-1.78) for malate (p of linear trend <0.001 for all). A higher risk of CVD was also found for a 1-SD increment of a combined score of these 3 metabolites (HR = 1.60; 95%CI: 1.32-1.94, p trend <0.001). This result was replicated using plasma measurements after one-year. No interactions were detected with the nutritional intervention. Conclusion: Plasma 2-hydroxyglutarate, fumarate and malate levels were prospectively associated with increased cardiovascular risk. Clinical trial number: ISRCTN35739639.
Autores: Bullon Vela, Maria Vanessa (Autor de correspondencia); Xu, Y.F.; Razquin Burillo, Cristina; et al.

Título: Health associations of liver enzymes and inflammatory scores with urinary citrus flavonoid metabolites

Revista: FOOD & FUNCTION

ISSN: 2042-6496 Vol.14 N° 2 2023 págs. 1011 - 1023

Resumen

Background: Dietary flavonoid intake is associated with a reduced risk of some cardiometabolic disorders, attributed in part to their claimed anti-inflammatory activity. Our aim was to investigate the potential association between specific urine flavonoid metabolites, liver enzymes, and inflammatory status in individuals with metabolic syndrome (MetS). Methods: In this cross-sectional study, clinical and dietary data from 267 participants, aged 55 to 75 years, participating in the PREDIMED Plus study (PREvencion con DIeta MEDiterranea) were analyzed. At the baseline, spot urine samples were collected and seven urinary flavonoid metabolites were quantified using ultra-performance liquid chromatography coupled to triple quadrupole mass spectrometry (UPLC-Q-q-Q MS). Liver enzymes, inflammatory scores, and urinary flavonoid concentrations were inverse normally transformed. Results: Adjusted linear regression models showed an inverse association between urinary citrus flavanone concentrations and gamma-glutamyl transferase (GGT) (all p-values <0.05). Naringenin 7 '-GlcUA was significantly associated with a lower aggregate index of systemic inflammation (AISI) (B-per 1SD = -0.14; 95% CI: -0.27 to -0.02; p-value = 0.025) and systemic inflammation index (SII) (B-per 1SD = -0.14; 95% CI: -0.27 to -0.02; p-value = 0.028). To investigate the relationship between flavanone subclasses and GGT levels, we fitted a score of citrus-flavanones, and subjects were stratified into quartiles. The highest values of the citrus-flavanone score (per 1-SD increase) were associated with lower GGT levels (B-per 1SD = -0.41; 95% CI: -0.74 to -0.07), exhibiting a linear trend across quartiles (p-trend = 0.015). Conclusion: This cross-sectional study showed that higher urinary excretion of citrus-flavanone metabolites was associated with lower GGT levels in subjects diagnosed with MetS and obesity.
Autores: Arredondo Montero, J.; Recreo Baquedano, A. C.; Bronte Anaut, M.; et al.

Título: Metastasis of spindle cell malignant melanoma in gallbladder

Revista: INDIAN JOURNAL OF SURGERY

ISSN: 0972-2068 Vol.85 N° 2 2023 págs. 433 - 435

Resumen

Malignant melanoma is an aggressive neoplasm with a high tendency to metastasize. Gastrointestinal metastases, although described in the literature, are infrequent. We present the case of a 51-year-old male patient with a surficial spreading melanoma stage IIIc with BRAF mutation who presented a gallbladder outgrowth lesion, compatible with a polyp. A significant growth of the lesion was observed in subsequent TC studies and a laparoscopic cholecystectomy was performed. The anatomopathological study of the specimen confirmed the diagnosis of gallbladder metastasis due to epithelioid and spindle cell malignant melanoma. The presence of a gallbladder lesion in the context of a patient diagnosed with melanoma should establish the diagnostic suspicion of metastasis, and an early extension study and laparoscopic cholecystectomy should be considered. The palliative surgical approach to avoid hepatobiliary symptomatology can be considered.
Autores: Romanos-Nanclares, A. (Autor de correspondencia); Guasch-Ferré, M.; Willett, W. C.; et al.

Título: Consumption of olive oil and risk of breast cancer in US women: results from the Nurses' Health Studies

Revista: BRITISH JOURNAL OF CANCER

ISSN: 0007-0920 Vol.129 N° 3 2023 págs. 416 - 425

Resumen

BackgroundOlive oil consumption may reduce breast cancer risk, but it is unclear whether olive oil is beneficial for breast cancer prevention in populations outside of Mediterranean regions, namely in the U.S., where the average consumption of olive oil is low compared with Mediterranean populations. We examined whether olive oil intake was associated with breast cancer risk in two prospective cohorts of U.S. women.MethodsWe used multivariable-adjusted time-varying Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence interval (CI) for breast cancer among 71,330 (Nurses' Health Study, 1990-2016) and 93,295 women (Nurses' Health Study II, 1991-2017) who were free of cancer at baseline. Diet was assessed by a validated semi-quantitative food frequency questionnaire every 4 years.ResultsDuring 3,744,068 person-years of follow-up, 9,638 women developed invasive breast cancer. The multivariable-adjusted HR (95% CI) for breast cancer among women who had the highest consumption of olive oil (>1/2 tablespoon/d or >7 g/d) compared with those who never or rarely consumed olive oil, was 1.01 (0.93, 1.09). Higher olive oil consumption was not associated with any subtype of breast cancer.ConclusionWe did not observe an association between higher olive oil intake and breast cancer risk in two large prospective cohorts of U.S. women, whose average olive oil consumption was low. Prospective studies are needed to confirm these findings and to further investigate whether different varieties of olive oil (e.g., virgin and extra virgin olive oil) may play a role in breast cancer risk.
Autores: Domínguez-López, I.; Lozano-Castellón, J.; Vallverdú-Queralt, A.; et al.

Título: Urinary metabolomics of phenolic compounds reveals biomarkers of type-2 diabetes within the PREDIMED trial

Revista: BIOMEDICINE AND PHARMACOTHERAPY

ISSN: 0753-3322 Vol.162 2023 págs. 114703

Resumen

Background: Phenolic compounds have been associated with protective effects against type-2 diabetes (T2D). We used a metabolomics approach to determine urinary phenolic metabolites associated with T2D and fasting plasma glucose.Methods: This case-control study within the PREDIMED trial included 200 participants at high cardiovascular risk, 102 of whom were diagnosed with T2D. A panel of urinary phenolic compounds were analysed using a novel method based on liquid chromatography coupled to mass spectrometry. Multivariate statistics and adjusted logistic regressions were applied to determine the most discriminant compounds and their association with T2D. The relationship between the discriminant phenolic compounds and plasma glucose was assessed using multi - variable linear regressions.Results: A total of 41 phenolic compounds were modeled in the orthogonal projection to latent structures discriminant analysis, and after applying adjusted logistic regressions two were selected as discriminant: dihy- drocaffeic acid (OR=0.22 (CI 95 %: 0.09; 0.52) per 1-SD, p-value=0.021) and genistein diglucuronide (OR=0.72 (CI 95%: 0.59; 0.88) per 1-SD, p-value=0.021). Both metabolites were associated with a lower risk of suffering from T2D, but only dihydrocaffeic acid was inversely associated with plasma glucose (beta=-17.12 (95 % CI:-29.92;-4.32) mg/dL per 1-SD, p-value=0.009). Conclusions: A novel method using a metabolomics approach was developed to analyse a panel of urinary phenolic compounds for potential associations with T2D, and two metabolites, dihydrocaffeic acid and genistein diglucuronide, were found to be associated with a lower risk of this condition.
Autores: Khoury, N.; Martínez, M. Á. (Autor de correspondencia); Paz-Graniel, I.; et al.

Título: Dietary intake of polychlorinated dibenzo-p-dioxins and furans, adiposity and obesity status

Revista: ENVIRONMENTAL RESEARCH

ISSN: 0013-9351 Vol.227 2023 págs. 115697

Resumen

Introduction: The principal source of exposure to Polychlorinated dibenzo-p-dioxins and polychlorinated dibenzo-p-furans (PCDD/Fs) in humans comes from food intake. PCDD/Fs, are a family of potential endocrine disruptors and have been associated with different chronic diseases such as diabetes and hypertension. However, studies assessing the relationship between dietary exposure to PCDD/Fs and adiposity or obesity status in a middle-aged population are limited.Objective: To assess cross-sectionally and longitudinally the associations between estimated dietary intake (DI) of PCDD/Fs and body mass index (BMI), waist circumference, and the prevalence/incidence of obesity and abdominal obesity in a middle-aged population.Methods: In 5899 participants aged 55-75 years (48% women) living with overweight/obesity from the PREDIMED-plus cohort, PCDD/Fs DI was estimated using a 143-item validated food-frequency questionnaire, and the levels of food PCDD/F expressed as Toxic Equivalents (TEQ). Consequently, cross-sectional and pro-spective associations between baseline PCDD/Fs DI (in pgTEQ/week) and adiposity or obesity status were assessed at baseline and after 1-year follow-up using multivariable cox, logistic or linear regression models.Results: Compared to participants in the first PCDD/F DI tertile, those in the highest tertile presented a higher BMI (beta-coefficient [confidence interval]) (0.43kg/m2 [0.22; 0.64]; P-trend <0.001), a higher waist circumfer-ence (1.11 cm [0.55; 1.66]; P-trend <0.001), and a higher prevalence of obesity and abdominal obesity (1.05 [1.01; 1.09] and 1.02 [1.00; 1.03]; P-trend = 0.09 and 0.027, respectively). In the prospective analysis, par-ticipants in the top PCDD/F DI baseline tertile showed an increase in waist circumference compared with those in the first tertile after 1-year of follow-up (beta-coefficient 0.37 cm [0.06; 0.70]; P-trend = 0.015).Conclusion: Higher DI of PCDD/Fs was positively associated with adiposity parameters and obesity status at baseline and with changes in waist circumference after 1-year of follow-up in subjects living with overweight/ obesity. Further large prospective studies using a different population with longer follow-up periods are war-ranted in the future to strengthen our results.
Autores: Hernández Hernández, Aitor; Oliver, D.; Martínez González, Miguel Ángel; et al.

Título: Mediterranean Alcohol-Drinking Pattern and Arterial Hypertension in the "Seguimiento Universidad de Navarra" (SUN) Prospective Cohort Study

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.15 N° 2 2023 págs. 1 - 13

Resumen

Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the ¿Seguimiento Universidad de Navarra¿ (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score < 2) to the Mediterranean alcohol-drinking pattern was significantly associated with a higher incidence of hypertension (multivariable-adjusted hazard ratio 1.81, 95% confidence interval 1.09¿2.99) as compared to the high-adherence (score > 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk.
Autores: García-Blanco, L.; de la O, V.; Santiago Neri, Susana; et al.

Título: High consumption of ultra-processed foods is associated with increased risk of micronutrient inadequacy in children: the SENDO project

Revista: EUROPEAN JOURNAL OF PEDIATRICS

ISSN: 0340-6199 Vol.182 N° 8 2023 págs. 3537 - 3547

Resumen

Due to its rising prevalence, which parallels that of ultraprocessed food (UPF) consumption, inadequate micronutrient intake in childhood is a public health concern. This study aimed to evaluate the association between UPF consumption and inadequate intake of 20 micronutrients in a sample of children from the Mediterranean area. Cross-sectional information from participants in the "Seguimiento del Niño para un Desarrollo Óptimo" (SENDO) project 2015-2021 was used. Dietary information was gathered with a previously validated 147-item semi-quantitative food frequency questionnaire and the NOVA system was used to classify food items. Children were classified by tertiles of energy intake from UPF. Twenty micronutrients were evaluated, and inadequate intake was defined using the estimated average requirement as a cutoff. Crude and multivariable adjusted OR (95% CI) for the inadequacy of ¿ 3 micronutrients associated with UPF consumption were calculated fitting hierarchical models to take into account intra-cluster correlation between siblings. Analyses were adjusted for individual and family confounders. This study included 806 participants (51% boys) with a mean age of 5 years old (SD: 0.90) and an average energy intake from UPF of 37.64% (SD: 9.59). An inverse association between UPF consumption and the intake of 15 out of the 20 micronutrients evaluated was found (p < 0.01). After the adjustment for individual and family confounders, compared with children in the first tertile of UPF consumption, those in the third tertile showed higher odds of inadequate intake of ¿ 3 micronutrients (OR 2.57; 95%CI [1.51-4.40]). Conclusion: High UPF consumption is associated with increased odds of inadequate intake of micronutrients in childhood. What is Known: ¿ Micronutrient deficiency is among the 20 most important risk factors for disease and affect around two billion people worldwide. ¿ UPF are rich in total fat, carbohydrates and added sugar, but poor in vitamins and minerals. What is New: ¿ Compared with children in the 1st tertile of UPF consumption, those in the 3rd tertile had 2.57 times higher odds (95% CI: 1.51-4.40) of inadequate intake of ¿ 3 micronutrients after adjusting for potential confounders. ¿ The adjusted proportions of children with inadequate intake of ¿ 3 micronutrients were 23%, 27% and 35% in the 1st, 2nd, and 3rd tertiles of UPF consumption respectively.
Autores: Pérez Araluce, Rafael María; Bes Rastrollo, Maira (Autor de correspondencia); Martínez González, Miguel Ángel; et al.

Título: Effect of binge-drinking on quality of life in the 'Seguimiento Universidad de Navarra' (SUN) cohort

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.15 N° 5 2023 págs. 1072

Resumen

Background: Binge-drinking is one of the alcohol drinking patterns with the worst health consequences. Nonetheless, binge-drinking is highly prevalent. The perceived benefits that motivate it are ultimately related to subjective well-being. In this context, we analyzed the relationship between binge-drinking and quality of life. Methods: We evaluated 8992 participants of the SUN cohort. We classified as binge-drinkers those who reported consuming six or more drinks on at least one occasion the year before recruitment (n = 3075). We fitted multivariable logistic regression models to calculate the odds ratios (ORs) of a worse physical and mental quality of life, measured with the validated SF-36 questionnaire at 8 years of follow-up (cut-off point = P75 or highest score). Results: Binge-drinking was associated with greater odds of having a worse mental quality of life, even adjusting for quality of life at 4 years of follow-up, used as an approximation to a baseline measure (OR = 1.22 (1.07-1.38)). This value was mainly due to the effects on vitality (OR = 1.17 (1.01-1.34)) and mental health (OR = 1.22 (1.07-1.39)). Conclusions: Binge-drinking may lead to poorer mental quality of life; therefore, binge-drinking for enhancement purposes does not seem to be justified by this effect.
Autores: Paz-Graniel, I.; Fito, M.; Ros, E.; et al.

Título: Impact of COVID-19 pandemic on the PREDIMED-Plus randomized clinical trial: effects on the interventions, participants follow-up, and adiposity

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2023 págs. 1098269

Resumen

Background: The COVID-19 pandemic has affected the implementation of most ongoing clinical trials worldwide including the PREDIMED-Plus study. The PREDIMED-Plus is an ongoing, multicenter, controlled intervention trial, aimed at weight-loss and cardiovascular disease prevention, in which participants were randomized (1:1 ratio) to an intervention group (energy-reduced Mediterranean diet, promotion of physical activity, and behavioral support) or to a control group (Mediterranean diet with usual care advice). When the pandemic began, the trial was in the midst of the planned intervention. The objective of this report was to examine the effects of the pandemic on the delivery of the intervention and to describe the strategies established to mitigate the possible adverse effects of the pandemic lockdown on data collection and adiposity. Methods: We assessed the integrity of the PREDIMED-Plus trial during 5 identified periods of the COVID-19 pandemic determined according to restrictions dictated by the Spanish government authorities. A standardized questionnaire was delivered to each of the 23 PREDIMED-Plus recruiting centers to collected data regarding the trial integrity. The effect of the restrictions on intervention components (diet, physical activity) was evaluated with data obtained in the three identified lockdown phases: pre lockdown, lockdown proper, and post lockdown. Results: During the lockdown (March/2020-June/2021), 4,612 participants (48% women, mean age 65y) attended pre-specified yearly follow-up visits to receive lifestyle recommendations and obtain adiposity measures. The overall mean (SD) of the proportions reported by each center showed that 40.4% (25.4) participants had in-person visits, 39.8% (18.2) participants were contacted by telephone and 35% (26.3) by electronic means. Participants' follow-up and data collection rates increased across lockdown periods (from approximate to 10% at onset to approximate to 80% at the end). Compared to pre-lockdown, waist circumference increased during (0.75 cm [95% CI: 0.60-0.91]) and after (0.72 cm [95% CI: 0.56-0.89]) lockdown. Body weight did not change during lockdown (0.01 kg [95% CI: -0.10 to 0.13) and decreased after lockdown (-0.17 kg [95% CI: -0.30 to -0.04]). Conclusion: Mitigating strategies to enforce the intervention and patient's follow-up during lockdown have been successful in preserving the integrity of the trial and ensuring its continuation, with minor effects on adiposity.
Autores: López-Gil, J. F. (Autor de correspondencia); García-Hermoso, A.; Smith, L.; et al.

Título: A Cluster Randomized Controlled Trial of the Archena Infancia Saludable Project on 24-h Movement Behaviors and Adherence to the Mediterranean Diet among Schoolchildren: a Pilot Study Protocol

Revista: CHILDREN

ISSN: 2227-9067 Vol.10 N° 4 2023 págs. 738

Resumen

Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention's halo effect on parents'/guardians' 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6-13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.
Autores: Gayoso, L.; Goñi Mateos, Leticia; De la O Pascual, Víctor; et al.

Título: An intensive culinary intervention programme to empower type 2 diabetic patients in cooking skills: The SUKALMENA pilot study

Revista: INTERNATIONAL JOURNAL OF GASTRONOMY AND FOOD SCIENCE

ISSN: 1878-450X Vol.32 2023 págs. 100721

Resumen

An inverse association has been shown between healthy dietary habits and the risk of Type 2 Diabetes (T2D). However, there is a limited knowledge on the benefits that a culinary and nutritional training may have in patients with T2D. The objective of this study was to analyse the effect of a culinary intervention on health parameters and dietary-culinary habits among T2D patients. Fifty-three volunteers with T2D were randomly (1:1) assigned to an intensive culinary intervention group (CIG) or a nutritional intervention group (NIG). The CIG received 8 online cooking lessons and the NIG received written material with nutritional information to follow the Mediterranean Diet (MedDiet). Anthropometric parameters, biochemical determinations, advanced glycation end products (AGEs) and dietary-culinary related questionnaires were collected at baseline and after 3month follow-up. At 1-year follow-up, self-reported anthropometric measurements and dietary-culinary related questionnaires were collected by telephone. Fifty-one volunteers completed the intervention. No statistically significant differences were observed between groups for changes on MedDiet adherence, anthropometry, biochemical determinations, and AGEs. A significant increase in blood glucose (p = 0.017) and low-density lipoprotein cholesterol (LDL-c) (p = 0.024) levels was observed in the NIG after the 3-month follow-up period. Participants from the CIG showed a significant reduction in the C reactive protein (p = 0.007) and a significant increase in total cholesterol (p = 0.001), high density lipoprotein cholesterol (p = 0.001) and LDL-c levels (p = 0.001) after 3 months. The CIG also showed a significant reduction in weight (p = 0.008, p = 0.002), body mass index (p = 0.007, p = 0.001), and waist circumference (p = 0.047, p = 0.004) after 3-month and 1-year followup, respectively. Participants from the CIG increased the use of boiling, compared to participants from the NIG (p = 0.034). Likewise, when analysing the CIG only, a significant increase in the use of steaming (p = 0.015) and in the consumption of raw vegetables (p = 0.039) was found after 3-month follow-up, but these changes were not maintained after 1-year follow-up. These findings suggest that a culinary intervention based on MedDiet is a promising approach to promote healthy dietary-culinary habits in patients with T2D. To explore the potential effect of this culinary programme on glycemic parameters, larger randomized controlled trials would be necessary.
Autores: Arredondo-Montero, J. (Autor de correspondencia); Bardaji-Pascual, C.; Bronte-Anaut, M.; et al.

Título: Coagulation profile: alterations and diagnostic yield in pediatric acute appendicitis: a prospective validation study

Revista: SURGICAL INFECTIONS

ISSN: 1096-2964 Vol.24 N° 4 2023 págs. 335 - 343

Resumen

Background: The literature regarding alterations in the coagulation profile in pediatric acute appendicitis (PAA) is scarce and mainly limited to retrospective studies. Evidence on the diagnostic yield of coagulation parameters is limited to fibrinogen.Patients and Methods: This is a prospective study with 151 patients divided into two groups: patients with nonsurgical abdominal pain (NSAP) in whom the diagnosis of PAA was excluded (n = 53) and patients with a confirmed diagnosis of PAA (n = 98). In 93 patients (62%), a coagulation study was obtained at the time of diagnosis and international normalized ratio (INR), activated partial thromboplastin time (aPTT), d-dimer, platelets, mean platelet volume, and platelet-to-lymphocyte ratio were analyzed. The PAA group was further classified into complicated (n = 19) and non-complicated PAA (n = 40). Quantitative variables were compared between groups using the Mann-Whitney U test. Diagnostic performance of the coagulation profile was evaluated with the area under the receiver operating characteristic (ROC) curves. Results: Patients with NSAP had lower median levels of INR, fibrinogen and d-dimer than those with PAA. Moreover, patients with complicated PAA had higher median values of INR and fibrinogen. None of the patients needed specific treatment for the correction of coagulopathy. Fibrinogen was the parameter with the highest diagnostic yield for distinguishing between NSAP and PAA (area under the curve [AUC], 0.74; 95% confidence interval [CI], 0.65-0.85), as well as between complicated versus non-complicated PAA (AUC, 0.71; 95% CI, 0.57-0.86).Conclusions: This study found a moderate extrinsic pathway coagulopathy in patients with PAA, especially in complicated PAA. Fibrinogen is a parameter with moderate diagnostic yield for the diagnosis of PAA.
Autores: Talavera Rodríguez, Irene; Fernández Lázaro, Cesar Ignacio; Hernández-Ruiz, Á.; et al.

Título: Association between an oxidative balance score and mortality: a prospective analysis in the SUN cohort

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.62 N° 4 2023 págs. 1667 - 1680

Resumen

Purpose We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specific mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates. Methods Using baseline information on 12 a priori selected dietary and non-dietary lifestyle pro- and antioxidants exposures-vitamins C and E, beta-carotenes, selenium, zinc, heme iron, polyphenols, total antioxidant capacity, body mass index, alcohol, smoking, and physical activity-we constructed an equally weighted OBS categorized into quartiles, with higher scores representing greater antioxidant balance. Cox proportional hazards models were fitted to evaluate the association between the OBS and mortality. Results A total of 18,561 participants (mean [SD] age, 38.5 [12.4] years; 40.8% males) were included in the analysis. During a median follow-up of 12.2 years (interquartile range 8.3-14.9), 421 deaths were identified, including 80 deaths from cardiovascular disease (CVD), 215 from cancer, and 126 from other causes. After adjustment for potential confounders, the hazard ratios and 95% confidence interval (CIs) between the highest quartile (predominance of antioxidants) vs. the lowest quartile (reference category) were 0.35 (95% CI 0.22-0.54, P-trend < 0.001) for all-cause mortality, 0.18 (95% CI 0.06-0.51, P-trend = 0.001) for CVD mortality, 0.35 (95% CI 0.19-0.65, P-trend = 0.002) for cancer mortality, and 0.45 (95% CI 0.20-1.02, P-trend = 0.054) for other-cause mortality. Conclusion Our findings suggest a strong inverse association between the OBS and all-cause, CVD, and cancer mortality. Individuals exposed to both antioxidant dietary and lifestyle factors may potentially experience the lowest mortality risk.
Autores: Arredondo-Montero, J. (Autor de correspondencia); Antona, G.; Bronte-Anaut, M.; et al.

Título: Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study

Revista: PEDIATRIC SURGERY INTERNATIONAL

ISSN: 0179-0358 Vol.39 N° 1 2023 págs. 27

Resumen

Introduction Pediatric acute appendicitis (PAA) is a pathology with a high rate of diagnostic error. The search for new diagnostic tools is justified by the high morbidity and healthcare costs associated with diagnostic error. Methods We designed a prospective study to validate serum pentraxin-3 (PTX3) as a diagnostic tool in PAA. Participants were divided into three groups: (1) patients with no underlying pathology (2) patients with non-surgical abdominal pain and (3) patients with a confirmed diagnosis of PAA. For further analyses, patients in group 3 were divided into complicated or uncomplicated PAA. Quantitative variables were expressed as medians and interquartile ranges and categorical variables as percentages. Quantitative variables were compared using the Kruskal-Wallis test and the Mann-Whitney U test. Diagnostic performance was evaluated with ROC curves. Results This study included 215 patients divided into group 1 (n = 63), group 2 (n = 53) and group 3 (n = 99). Median serum PTX3 values were 2.54 (1.70-2.95) ng/mL, 3.29 (2.19-7.64) ng/mL and 8.94 (6.16-14.05) in groups 1, 2 and 3, respectively (p = 0.001). Patients with complicated PAA showed significantly higher values than patients with uncomplicated PAA (p = 0.04). The AUC (group 2 vs. 3) was 0.77 (95% CI 0.69-0.85) and the best cut-off point was at 7.28 ng/mL, with a sensitivity of 61.3% and a specificity of 73.1%. The AUC (complicated vs. uncomplicated PAA) was 0.65 (95% CI 0.54-0.77) and the best cut-off point was 12.33 ng/mL, with a sensitivity of 51.72% and a specificity of 72.73%. Conclusions The diagnostic ability of serum PTX3 in PAA is only moderate and therefore it cannot be considered a definitive diagnostic test. The discriminatory ability of PTX3 between complicated and uncomplicated PAA is poor. These findings, which contrast with those reported to date, should be validated with future properly designed prospective studies.
Autores: Pérez-Vega, K.A.; Castaner, O.; Sanllorente, A.; et al.

Título: Mediterranean diet, energy restriction, physical activity, and atherogenicity of very-low density lipoproteins: Findings from two randomized controlled trials

Revista: MOLECULAR NUTRITION AND FOOD RESEARCH

ISSN: 1613-4125 Vol.67 N° 1 2023 págs. 2200338

Resumen

ScopeSome very-low density lipoprotein (VLDL) properties may render them more pro-atherogenic. We aimed to assess whether a Mediterranean diet (MedDiet) or an energy-reduced MedDiet with increased physical activity improves them. Methods and resultsIn a sample of the PREvencion con DIeta MEDiterranea (PREDIMED) study, a 1-year intervention with MedDiet with extra-virgin olive oil (n = 89) or nuts (MedDiet-Nuts; n = 79) is compared with a low-fat diet (n = 90). In the PREDIMED-Plus study, a 1-year intervention with energy-reduced MedDiet and physical activity (n = 103) is compared with an ad libitum MedDiet (n = 101). VLDL levels of apolipoprotein C-I, C-III, triglycerides, and cholesterol; the apolipoprotein E-/C-I ratio; and VLDL ex-vivo triglyceride transfer are measured. In PREDIMED participants in both MedDiet groups combined, VLDL apolipoprotein C-III levels are nominally reduced (-0.023 SD units, 95% CI -0.44 to -0.014, p = 0.037). VLDL triglyceride transfer is nominally increased in the MedDiet-Nuts group (+0.39 SD units, 95% CI 0.012-0.78, p = 0.045). In PREDIMED-Plus, no inter-group differences are detected. ConclusionsIn older adults at high cardiovascular risk, MedDiet is associated with lower VLDL atherogenicity versus a low-fat diet. No differences are seen after an energy-reduced MedDiet with physical activity.
Autores: Razquin Burillo, Cristina; Ruiz-Canela, Miguel; Wernitz, A.; et al.

Título: Effects of supplemented Mediterranean diets on plasma-phospholipid fatty acid profiles and risk of cardiovascular disease after 1 year of intervention in the PREDIMED trial

Revista: CLINICAL CHEMISTRY

ISSN: 0009-9147 Vol.69 N° 3 2023 págs. 283 -294

Resumen

Background Plasma fatty acids (FAs) have been associated with cardiovascular disease (CVD) risk. Diet and endogenous metabolism influence the FA profile of the plasma phospholipid (PL) fraction. In the PREDIMED trial, we examined 1-year changes in the FA profile of plasma PL according to a nutritional intervention with Mediterranean diets, either supplemented with extra-virgin olive oil (MedDiet + EVOO) or mixed nuts (MedDiet + nuts), in a high cardiovascular risk population. We also analyzed if 1-year changes in PL FAs were associated with subsequent cardiovascular risk. Methods We included 779 participants in our case-cohort study: 185 incident cases and 594 participants in the subcohort (including 31 overlapping cases). The end point was the incidence of CVD. We measured the FAs of plasma PL at baseline and after 1 year of intervention. Results MedDiet + EVOO increased C17:0 and C20:3n9 in linear regression models [beta coefficient(perSD) : 0.215 (95% CI, 0.032-0.399) and 0.271 (0.107-0.434), respectively] and decreased 16:1n7 and C22:4n6 [beta(perSD): -0.239 (95% CI, -0.416 to -0.061) and -0.287 (95% CI, -0.460 to -0.113), respectively] vs the control group. MedDiet + nuts increased C18:3n3 [beta(perSD): 0.382 (95% CI, 0.225 - 0.539)], C18:2n6 [beta(per SD): 0.250 (95% CI, 0.073 - 0.428)], C18:0 [beta(perSD): 0.268 (95% CI, 0.085-0.452)], and C22:0 [beta(per SD): 0.216 (95% CI, 0.031-0.402)]; and decreased the sum of six n6 FAs [beta(per SD): -0.147 (95% CI, -0.268 to -0.027)] vs the control group. The 1-year increase in C18:2n6 was inversely associated with the subsequent CVD risk (HRperSD: 0.64 (95% CI, 0.44-0.92)). Conclusions MedDiet interventions changed n6 FAs and C16:1n7c; other changes were specific for each group: MedDiet + EVOO increased C17:0 and C20:3n9, and MedDiet + Nuts C18:3n3, C18:2n6, C18:0, and C22:0 FAs.
Autores: López Iracheta, Roberto; Moreno Galarraga, Laura; Moreno Villares, José Manuel (Autor de correspondencia); et al.

Título: The Effects of COVID-19 Lockdown on the Sleep Quality of Children

Revista: CHILDREN

ISSN: 2227-9067 Vol.10 N° 6 2023 págs. 944

Resumen

Introduction: The COVID-19 lockdown has caused important changes in children's routines, especially in terms of nutrition, physical activity, screen time, social activity, and school time. Regarding these changes, recent studies show that the COVID-19 lockdown is associated with higher levels of anxiety and depression in children. The objective of this study was to assess changes in sleep quality in Spanish children during the lockdown decreed by the Spanish government between March and June 2020. Methodology: We compared the BEAR (bedtime, excessive daytime sleepiness, awakening during the night, and regularity and duration of sleep) scores of 478 participants (median age = 7.5 years; 48% girls) in the SENDO project during the periods before, during, and after lockdown. The questionnaires were filled out by one of the parents. We used hierarchical models with two levels of clustering to account for the intra-cluster correlation between siblings. The interaction of time with a set of a priori selected variables was assessed by introducing the interaction term into the model and calculating the likelihood ratio test. Results: The mean scores in the BEAR questionnaire referred to the periods before, during, and after lockdown were 0.52 (sd 1.25), 1.43 (sd 1.99), and 1.07 (sd 1.55), respectively. These findings indicate a deterioration in sleep quality during the period of confinement. Parental level of education was found to be an effect modifier (p for interaction = 0.004). Children whose parents had higher education (university graduates or higher) showed a smaller worsening than those without. Conclusion: Our study shows that the COVID-19 lockdown was associated with a significant worsening of sleep quality. Moreover, although the end of the lockdown brought about a slight improvement, mean scores on the BEAR scale remained significantly higher than before the lockdown, suggesting that the consequences for sleep quality could persist over time. This worsening was higher in children whose parents had lower educational degrees. Helping children maintain healthy sleeping habits despite the circumstances and providing early psychological support when needed is important to prevent negative psycho-physical symptoms due to lockdown that could persist over the years.
Autores: Martinez-Steele, E.; Khandpur, N.; Batis, C.; et al.

Título: Best practices for applying the Nova food classification system

Revista: NATURE FOOD

ISSN: 2662-1355 Vol.4 N° 6 2023 págs. 445 - 448

Resumen

The assignment of foods to one of four categories proposed by the Nova framework may be challenging in the absence of information on how these foods were prepared and their specific composition. A three-step iterative approach can make the categorization process more efficient and transparent, thereby increasing the accuracy of Nova estimates.
Autores: Bouzas, C.; Pastor, R.; García, S.; et al.

Título: Comparative effects of glucagon-like peptide-1 receptors agonists, 4-dipeptidyl peptidase inhibitors, and metformin on metabolic syndrome

Revista: BIOMEDICINE AND PHARMACOTHERAPY

ISSN: 0753-3322 Vol.161 2023 págs. 114561

Resumen

Aims: To assess the comparative effects of glucagon-like peptide-1 receptor agonists (GLP-1RA), 4-dipeptidyl peptidase inhibitors (DPP-4I), and metformin treatment during one year on metabolic syndrome (MetS) com-ponents and severity in MetS patients. Methods: Prospective study (n = 6165 adults) within the frame of PREDIMED-Plus trial. The major end-point was changes on MetS components and severity after one-year treatment of GLP-1RA, DPP-4I, and metformin. Anthropometric measurements (weight, height and waist circumference), body mass index (BM), and blood pressure were registered. Blood samples were collected after overnight fasting. Plasma glucose, glycosylated hemoglobin (HbA1c), plasma triglycerides and cholesterol were measured. Dietary intakes as well as physical activity were assessed through validated questionnaires.Results: MetS parameters improved through time. The treated groups improved glycaemia compared with un-treated (glycaemia Delta untreated:-1.7 mg/dL(+/- 13.5); Delta metformin: -2.5(+/- 23.9) mg/dL; Delta DPP-4I: -4.5(+/- 42.6); mg/dL Delta GLP-1RA: -4.3(+/- 50.9) mg/dL; and HbA1c: Delta untreated: 0.0(+/- 0.3) %; Delta metformin: -0.1(+/- 0.7) %; Delta DPP-4I: -0.1(+/- 1.0) %; Delta GLP-1RA: -0.2(+/- 1.2) %. Participants decreased BMI and waist circumference. GLP-1RA and DPP-4I participants registered the lowest decrease in BMI (Delta untreated:-0.8(+/- 1.6) kg/m2; Delta metformin: -0.8(+/- 1.5) kg/m2; Delta DPP-4I: -0.6(+/- 1.3) kg/m2; Delta GLP-1RA: -0.5(+/- 1.2) kg/m2. and their waist circumference (Delta untreated:-2.8(+/- 5.2) cm; Delta metformin: -2.6(+/- 15.2) cm; Delta DPP-4I: -2.1(+/- 4.8) cm; Delta GLP-1RA: -2.4(+/- 4.1) cm.Conclusion: In patients with MetS and healthy lifestyle intervention, those treated with GLP-1RA and DPP-4I obtained better glycemic profile. Anthropometric improvements were modest.
Autores: Olid, A. O.; Moreno Galarraga, Laura (Autor de correspondencia); Moreno Villares, José Manuel; et al.

Título: Breastfeeding is associated with higher adherence to the Mediterranean diet in a Spanish population of preschoolers: the SENDO project

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.15 N° 5 2023 págs. 1278

Resumen

Objective: To assess whether breastfeeding during the first months of life is associated with adherence to the Mediterranean dietary (MedDiet) pattern in preschool children. Design: The Seguimiento del Nino para un Desarrollo & Oacute; ptimo (SENDO) project is an ongoing pediatric cohort with open recruitment, started in 2015 in Spain. Participants, recruited when they are 4 to 5 years old at their primary local health center or school, are followed annually through online questionnaires. For this study, 941 SENDO participants with full data on study variables were included. Breastfeeding history was collected retrospectively at baseline. Adherence to the Mediterranean diet was assessed with the KIDMED index (range -3 to 12). Results: After accounting for multiple sociodemographic and lifestyle confounders, including parental attitudes and knowledge about dietary recommendations for children, breastfeeding was independently associated with a higher adherence to the MedDiet. Compared with children who were never breastfed, children breastfed for >= 6 months had a one-point increase on their mean KIDMED score (Mean difference +0.93, 95%confidence interval [CI]. 0.52-1.34, p for trend <0.001). The odds ratio of high adherence to the MedDiet (KIDMED index >= 8) was 2.94 (95%CI 1.50-5.36) in children who were breastfed for at least 6 months, as compared to their peers who were never breastfeed. Children who were breastfed for less than 6 months exhibited intermediate levels of adherence (p for trend <0.01). Conclusion: Breastfeeding for 6 months or longer is associated with a higher adherence to the Mediterranean diet during the preschool years.
Autores: Cano-Ibanez, N. (Autor de correspondencia); Serra-Majem, L.; Martin-Pelaez, S.; et al.

Título: Dietary diversity and depression: cross-sectional and longitudinal analyses in Spanish adult population with metabolic syndrome. Findings from PREDIMED-Plus trial

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.26 N° 3 2023 págs. 598 - 610

Resumen

Objective: To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms. Design: An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used. Setting: Spanish older adults with metabolic syndrome (MetS). Participants: A total of 6625 adults aged 55-75 years from the PREDIMED-Plus study with overweight or obesity and MetS. Results: Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0 center dot 76 (95 % CI (0 center dot 64, 0 center dot 90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0 center dot 75, 95 % CI (0 center dot 57, 0 center dot 93)), cereals (OR = 0 center dot 72 (95 % CI (0 center dot 56, 0 center dot 94)) and proteins (OR = 0 center dot 27, 95 % CI (0 center dot 11, 0 center dot 62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (beta = 0 center dot 70, 95 % CI (0 center dot 05, 1 center dot 35)). Conclusions: According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.
Autores: Aguilera-Buenosvinos, I.; Martínez González, Miguel Ángel; Zazpe García, Itzíar; et al.

Título: Associations between overall, healthful, and unhealthful low-fat dietary patterns and breast cancer risk in a Mediterranean cohort: The SUN project

Revista: NUTRITION

ISSN: 0899-9007 Vol.109 2023 págs. 111967

Resumen

Objectives: Dietary patterns may have a greater influence on human health than individual foods or nutrients, and they are also of substantial interest in the field of breast cancer prevention. Beyond the adequate balance of macronutrients, evidence indicates that the quality of macronutrient sources may play an important role in health outcomes. We sought to examine the relationship between healthful and unhealthful low-fat dietary patterns in relation to breast cancer. Methods: We used observational data from a Mediterranean cohort study (the Seguimiento Universidad de Navarra project). We prospectively followed 10 930 middle-aged women initially free of breast cancer during a median follow-up of 12.1 y. We calculated an overall, an unhealthful, and a healthful low-fat diet score, based on a previously validated 136-item food frequency questionnaire and grouped participants into ter -tiles. Incident breast cancer-overall and stratified by menopausal status-was the primary outcome. It was self-reported by participants and confirmed based on medical reports or consultation of the National Death Index. We used multivariable Cox regression models adjusted for potential confounders. Results: During 123 297 person-years of follow-up, 150 cases of incident breast cancer were confirmed. No signifi-cant associations were observed for overall or premenopausal breast cancer. For postmenopausal women, we observed a significant association for moderate adherence to the unhealthful low-fat dietary score and postmeno-pausal breast cancer (comparing tertile 2 to tertile 1; hazard ratio = 2.18; 95% confidence interval, 1.15-4.13). Conclusions: In conclusion, no clear associations were observed, although more research is needed to address the association between an unhealthful dietary pattern and postmenopausal breast cancer risk. (c) 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Autores: Asfura-Carrasco, D.; Santiago Neri, Susana; Zazpe García, Itzíar; et al.

Título: Healthful and unhealthful provegetarian food patterns and micronutrient intake adequacy in the SUN cohort

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.26 N° 3 2023 págs. 563 - 574

Resumen

Objective: To investigate the association between different versions of a provegetarian food pattern (FP) and micronutrient inadequacy. Design: Cross-sectional analysis. Dietary intake was assessed at baseline through a validated 136-item FFQ. Participants were classified according to groups of different versions of a provegetarian FP: overall, healthful and unhealthful. The prevalence of inadequate intake of vitamins B-1, B-2, B-3, B-6, B-12, C, A, D, E, folic acid, Zn, I, Se, Fe, Ca, K, P, Mg and Cr was evaluated using the estimated average requirement (EAR) cut-point method and the probabilistic approach. Logistic regression analyses were conducted to estimate the probability of failing to meet EAR for either >= 3 or >= 6 micronutrients. Setting: Seguimiento Universidad de Navarra (SUN) cohort. Participants: 17 825 Spanish adults. Results: Overall, subjects in the highest group of the unhealthful provegetarian FP had the highest prevalence of inadequate dietary intake for every vitamin and mineral, compared to those in the lowest group. The adjusted OR of failing to meet >= 3 EAR (highest v. lowest group) was 0 center dot 65 (0 center dot 54, 0 center dot 69) for the overall, 0 center dot 27 (0 center dot 24, 0 center dot 31) for the healthful and 9 center dot 04 (7 center dot 57, 10 center dot 4) for the unhealthful provegetarian FP. Conclusion: A higher adherence to an overall and healthful provegetarian FP was inversely associated with the risk of failing to meet EAR values, whereas the unhealthful version was directly associated with micronutrient inadequacy. Provegetarian FP should be well planned, prioritising nutrient-dense plant foods and minimising ultra-processed and unhealthy ones.
Autores: Barbería Latasa, María; Martínez González, Miguel Ángel (Autor de correspondencia); de la Fuente Arrillaga, María del Carmen; et al.

Título: Predictors of total mortality and their differential association on premature or late mortality in the SUN cohort

Revista: EXPERIMENTAL GERONTOLOGY

ISSN: 0531-5565 Vol.172 2023 págs. 112048

Resumen

Several studies have tried to analyse the association between all-cause mortality and different risk factors, (especially those which are modifiable, such as smoking, diet or exercise), to develop public health preventive strategies. However, a specific analysis of predictors of premature and late mortality is needed to give more precise recommendations. Considering that there are risk factors which exert an influence on some diseases and not on others, we expect that, similarly, they may have a different impact depending on the timing of mortality, separating premature (<65 years) from late mortality (>65 years). Thus, we prospectively followed-up during a median of 12 years a cohort of 20,272 university graduates comprising an ample range of ages at inception. Time-dependent, covariate-adjusted Cox models were used to estimate adjusted hazard ratios (HR) and their 95 % confidence intervals (CI) for each predictor. The strongest independent predictor of mortality at any age was physical activity which was associated with reduced risk of total, premature and late mortality (range of HRs when comparing the highest vs. the lowest level: 0.24 to 0.48). Specific strong predictors for premature mortality were smoking, HR: 4.22 (95 % CI: 2.42-7.38), and the concurrence of >2 metabolic conditions at baseline, HR: 1.97 (1.10-3.51). The habit of sleeping a long nap (>30 min/d), with HR: 2.53 (1.30-4.91), and poor adherence to the Mediterranean Diet (<3 points in a 0 to 8 score vs. >6 points), with HR: 2.27 (1.08-4.76), were the strongest specific predictors for late mortality. Smoking, diet quality or lifestyles, probably should be differen-tially assessed as specific predictors for early and late mortality. In the era of precision medicine, this approach will allow tailored recommendations appropriate to each person's age and baseline condition.
Autores: Arredondo-Montero, J. (Autor de correspondencia); Bronte-Anaut, M.; Bardaji-Pascual, C.; et al.

Título: Alterations and diagnostic performance of capillary ketonemia in pediatric acute appendicitis: a pilot study

Revista: PEDIATRIC SURGERY INTERNATIONAL

ISSN: 0179-0358 Vol.39 N° 1 2023 págs. 44

Resumen

Introduction The diagnostic performance of capillary ketonemia (CK) has been previously evaluated in context of pediatric acute gastroenteritis. To our knowledge, there is no literature on its performance in the setting of pediatric acute appendicitis (PAA).Materials and methods In this study, 151 patients were prospectively included and divided into two groups: (1) patients with non-surgical abdominal pain in whom the diagnosis of PAA was excluded (n = 53) and (2) patients with a confirmed diagnosis of PAA (n = 98). In 80 patients (Group 1, n = 23 and group 2, n = 57) a CK was measured at the time of diagnosis. The PAA group was further classified into complicated (n = 18) and uncomplicated PAA (n = 39). Quantitative variables were compared between groups using the Mann-Whitney U test. Diagnostic performance of CK was evaluated with ROC curves.Results CK values were 0.3 [0.1-0.9] mmol/L in group 1 and 0.7 [0.4-1.4] mmol/L in group 2 (p = 0.01). Regarding the type of PAA, CK values were 0.6 [0.4-0.9] mmol/L in uncomplicated PAA and 1.2 [0.8-1.4] mmol/L in complicated PAA (p = 0.02). The AUC for the discrimination between groups 1 and 2 was 0.68 (95% IC 0.53-0.82) (p = 0.24) and the AUC for the discrimination between uncomplicated PAA and complicated PAA was 0.69 (95% IC 0.54-0.85) (p = 0.04). The best cut-off point (group 1 vs group 2) resulted in 0.4 mmol/L, with a sensitivity of 80.7% and a specificity of 52.2%. The best cut-off point (non-complicated vs complicated PAA) resulted in 1.1 mmol/L, with a sensitivity of 61.1% and a specificity of 76.9%.Conclusions This study found significantly higher levels of CK in patients with PAA than in those with NSAP. Similarly, significantly higher levels were observed in patients with complicated than in those with uncomplicated PAA. Nevertheless, the diagnostic performance of CK was only moderate in the two settings analyzed. The potential usefulness of CK determination as a tool to guide the preoperative rehydration regimen of patients with PAA to prevent postoperative hyporexia and vomiting is a promising line of research and should be evaluated in future studies.
Autores: Arredondo Montero, J. (Autor de correspondencia); Bronte Anaut, M.; Martín Calvo, Nerea; et al.

Título: Cooperation and scientific contribution: the search for a common nexus

Revista: CLINICAL PEDIATRICS

ISSN: 0009-9228 Vol.62 N° 8 2023 págs. 937 - 941

Resumen

International cooperation in pediatrics and pediatric surgery entails important barriers such as sociocultural differences, language difficulties, lack of infrastructure and resources, and short duration of campaigns. In this work, we share our personal experience in relation to the scientific publication of works carried out in pediatric international cooperation, and we make a critical reflection on the aspects to be considered for this field to develop in the future.
Autores: De la O Pascual, Víctor; Zazpe García, Itzíar (Autor de correspondencia); de la Fuente Arrillaga, María del Carmen; et al.

Título: Association between a new dietary protein quality index and micronutrient intake adequacy: a cross-sectional study in a young adult Spanish Mediterranean cohort

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.62 2023 págs. 419 - 432

Resumen

Purpose There is no evidence of a dietary index that measures not only the quantity but also the quality of protein. The aim is to investigate the association between a new dietary protein quality index (PQI) and micronutrient intake adequacy in a Mediterranean cohort. Design We assessed 17,535 participants' diet at baseline using a semi-quantitative FFQ. The PQI was calculated according to the ratio of protein (g/d) sources: [fish, seafood, lean meat, pulses, eggs, nuts, low-fat dairy, and whole grains]/[red and ultra-processed meats, whole-fat or semi-skimmed dairy, potatoes and refined grains]. Participants were classified into quintiles of PQI. We evaluated the intakes of Fe, Cr, I, K, Mg, Ca, P, Na, Se, Zn and vitamins A, B1, B2, B3, B6, B12, C, E and folic acid. Micronutrient adequacy was evaluated using DRIs. Logistic regression analysis was used to assess the micronutrient adequacy according to quintiles of PQI. Results In this cross-sectional analysis, a total of 24.2% and 4.3% participants did not to meet DRIs in >= 4 and >= 8 micronutrients, respectively. The odds of failing to meet >= 4 and >= 8 DRI were lower in participants in the highest quintile of protein quality (OR = 0.22; IC 95% = 0.18, 0.26; P-trend < 0.001; and OR = 0.08; IC 95% = 0.05, 0.14; P-trend < 0.001, respectively) as compared to participants in the lowest quintile. Conclusion Higher PQI was found to be strongly associated with better micronutrient intake adequacy in this Mediterranean cohort. The promotion of high-quality protein intake may be helpful for a more adequate intake of micronutrients. The odds of failing to meet certain numbers of DRIs were lower rather than saying lower risk.
Autores: Garcia, S.; Pastor, R.; Monserrat-Mesquida, M.; et al.

Título: Ultra-processed foods consumption as a promoting factor of greenhouse gas emissions, water, energy, and land use: A longitudinal assessment

Revista: SCIENCE OF THE TOTAL ENVIRONMENT

ISSN: 0048-9697 Vol.891 2023 págs. 164417

Resumen

Background: Dietary patterns can produce an environmental impact. Changes in people's diet, such as the increased consumption of ultra-processed food (UPF) can not only influence human health but also environment sustainability. Objectives: Assessment of the impact of 2-year changes in UPF consumption on greenhouse gas emissions and water, energy and land use. Design: A 2-year longitudinal study after a dietary intervention including 5879 participants from a Southern European population between the ages of 55-75 years with metabolic syndrome. Methods: Food intake was assessed using a validated 143-item food frequency questionnaire, which allowed classifying foods according to the NOVA system. In addition, sociodemographic data, Mediterranean diet adherence, and physical activity were obtained from validated questionnaires. Greenhouse gas emissions, water, energy and land use were cal-culated by means of the Agribalyse & REG; 3.0.1 database of environmental impact indicators for food items. Changes in UPF consumption during a 2-year period were analyzed. Statistical analyses were conducted using computed General Lin-ear Models. Results: Participants with major reductions in their UPF consumption reduced their impact by -0.6 kg of CO2eq and -5.3 MJ of energy. Water use was the only factor that increased as the percentage of UPF was reduced. Conclusions: Low consumption of ultra-processed foods may contribute to environmental sustainability. The processing level of the consumed food should be considered not only for nutritional advice on health but also for environmental protection. Trial registration: ISRCTN, ISRCTN89898870. Registered 05 September 2013, http://www.isrctn.com/ ISRCTN89898870.
Autores: Donat-Vargas, C. (Autor de correspondencia); López-García, E.; Banegas, J. R.; et al.

Título: Only virgin type of olive oil consumption reduces the risk of mortality. Results from a Mediterranean population-based cohort

Revista: EUROPEAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0954-3007 Vol.77 N° 2 2023 págs. 226 - 234

Resumen

Background Evidence on the association between virgin olive oil (OO) and mortality is limited since no attempt has previously been made to discern about main OO varieties. Objective We examined the association between OO consumption (differentiating by common and virgin varieties) and total as well as cause-specific long-term mortality Methods 12,161 individuals, representative of the Spanish population >= 18 years old, were recruited between 2008 and 2010 and followed up through 2019. Habitual food consumption was collected at baseline with a validated computerized dietary history. The association between tertiles of OO main varieties and all-cause, cardiovascular and cancer mortality were analyzed using Cox models. Results After a mean follow-up of 10.7 years (129,272 person-years), 143 cardiovascular deaths, and 146 cancer deaths occurred. The hazard ratio (HR) (95% confidence interval) for all-cause mortality in the highest tertile of common and virgin OO consumption were 0.96 (0.75-1.23; P-trend 0.891) and 0.66 (0.49-0.90; P-trend 0.040). The HR for all-cause mortality per a 10 g/day increase in virgin OO was 0.91 (0.83-1.00). Virgin OO consumption was also inversely associated with cardiovascular mortality, with a HR of 0.43 (0.20-0.91; P-trend 0.017), but common OO was not, with a HR of 0.88 (0.49-1.60; P-trend 0.242). No variety of OO was associated with cancer mortality. Conclusion Daily moderate consumption of virgin OO (1 and 1/2 tablespoons) was associated with a one-third lower risk of all-cause as well as half the risk of cardiovascular mortality. These effects were not seen for common OO. These findings may be useful to reappraise dietary guidelines.
Autores: García Blanco, Lorena; De la O Pascual, Víctor; Berasaluce, A.; et al.

Título: Individual and family predictors of ultra-processed food consumption in Spanish children. The SENDO project

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.26 N° 2 2023 págs. 437 - 445

Resumen

Background: Ultra-processed food (UPF) consumption is increasing exponentially, becoming a matter of concern for Public Health, given its adverse health effects. Objective: To identify individual and faGmily factors predicting UPF consumption in childhood. Design: The SENDO project is an ongoing prospective dynamic cohort of Spanish children. In this study, we used baseline information of participants recruited between January 2015 and June 2021. Dietary information was collected with a validated semi-quantitative FFQ, and food items were classified using the NOVA classification. Individual and family factors associated with UPF consumption (P < 0 center dot 20) in univariate analyses were introduced in a model of generalised estimating equations which accounted for intra-cluster correlations between siblings. Setting: The SENDO project (Spain), 2015-2021. Participants: Spanish children are recruited at the age of 4-5 years and followed yearly through online questionnaires completed by parents. Results: In this sample of 806 participants (49 % girls; mean age 5 years (sd: 0 center dot 90)), the mean UPF consumption was 37 center dot 64 % of total energy intake (sd: 9 center dot 59). Large family size and longer exposure to screens predicted higher consumption of UPF. On the other hand, better knowledge of children's dietary recommendations, healthy dietary attitudes towards child's eating habits and longer breastfeeding were associated with lower consumption of UPF. All these factors accounted for approximately 16 % of the variability on the consumption of UPF in childhood. Conclusion: Since most of the factors identified in this study are modifiable, they should be considered in public health strategies aimed at promoting healthy dietary habits in early life.
Autores: Vázquez Ruiz, Zenaida; Martínez González, Miguel Ángel; Vitelli-Storelli, F.; et al.

Título: Effect of dietary phenolic compounds on incidence of type 2 diabetes in the "Seguimiento Universidad de Navarra" (SUN) cohort

Revista: ANTIOXIDANTS

ISSN: 2076-3921 Vol.12 N° 2 2023 págs. 507

Resumen

The global incidence of type 2 diabetes (T2D) has been steadily increasing in recent decades. The Mediterranean dietary pattern has shown a preventive effect on the risk of T2D. Evaluating the association between bioactive compounds such as phenolic compounds (PC) in a Mediterranean cohort could help to better understand the mechanisms implicated in this protection. We evaluated the association between dietary intake of PC and the risk of T2D in a relatively young cohort of 17,821 Spanish participants initially free of T2D, through the University of Navarra Follow-up Project (Seguimiento Universidad de Navarra or SUN cohort) after 10 years of median follow-up using time-dependent Cox models. Intake of PC was estimated at baseline and repeatedly at 10-year follow-up using a 136-item validated food frequency and the Phenol-Explorer database. The incidence of T2D was identified by a biennial follow-up, and only medically confirmed cases were included. During 224,751 person-years of follow-up, 186 cases of T2D were confirmed. A suboptimal intake of stilbenes was independently associated with a higher risk of T2D in subjects over 50 years (HR: 1.75, 95% CI: 1.06-2.90, p value < 0.05) after adjusting for potential confounders. Our results suggest that a moderate-high intake of stilbenes can decrease the risk of developing T2D in subjects over 50 years in our cohort.
Autores: Castro-Barquero, S.; Casas, R.; Rimm, E. B.; et al.

Título: Loss of visceral fat is associated with a reduction in inflammatory status in patients with metabolic syndrome

Revista: MOLECULAR NUTRITION AND FOOD RESEARCH

ISSN: 1613-4125 Vol.67 N° 4 2023 págs. e2200264

Resumen

ScopeExcessive visceral adipose tissue (VAT) is associated with higher secretion of pro-inflammatory molecules, contributing to systemic inflammation and obesity-related metabolic disturbances. Methods and resultsThis prospective analysis includes 117 overweight/obese adults (55-75 years) from the PREDIMED-Plus study. Fourteen inflammatory markers and adipokines are measured using a Bio-Plex assay with multiplex technology: insulin, glucagon, IL-6, visfatin, ghrelin, GLP-1, TNF-alpha, MCP-1, PAI-1, resistin, C-peptide, leptin, adipsin, and adiponectin. Participants are categorized into tertiles according to changes in VAT after 1-year of follow-up, determined by dual-energy X-Ray absorptiometry. Participants allocate in tertile 3, which represent an increase of VAT content after 1-year of follow-up compared to tertile 1, show significant differences in insulin (T3 vs T1, fully adjusted model: p = 0.037, p for trend 0.042), PAI-1 (fully adjusted model: p = 0.05, p for trend 0.06), c-peptide (fully adjusted model: p = 0.037, p for trend 0.042), and TNF-alpha (fully adjusted model p = 0.037, p for trend 0.042). ConclusionThe results evidence that a reduction in VAT is associated with clinical improvements in several inflammatory and adiposity markers, mainly in insulin, c-peptide, and PAI-1 levels, and these improvements may contribute to a reduction in cardiometabolic disturbances observe in obesity.
Autores: Martín Calvo, Nerea (Autor de correspondencia); Gómez, B.; Díez Goñi, María de las Nieves; et al.

Título: Development and validation of a low-cost laparoscopic simulation box

Revista: CIRUGIA ESPAÑOLA

ISSN: 0009-739X Vol.101 N° 7 2023 págs. 482 - 489

Resumen

Introduction: The acquisition of laparoscopic technique skills in an operating room is conditioned by the expertise of the tutor and the number of training interventions by the trainee. For students and surgeons to use a laparoscopic simulator to train their skills, it must be validated beforehand. Methods: A laparoscopic simulator box was designed, along with 6 interchangeable training games. The simulator was validated by a group of 19 experts, physicians with an experience from at least 100 laparoscopic surgeries, and 20 students of 4th to 6th grades of medical school (non-experts). To evaluate its construct validity, time-to-completion and the number of successfully completed games were assessed. We used 11 and 9-item questionnaires to gather information on content and face validity respectively. In both questionnaires, answers were collected through Likert-type scales, scored from 1 to 5. Results: The group of experts required less time and successfully completed more games than the group of non-experts (p < 0.01). The group of non-experts gave a score ¿4 points on each of the questions regarding the content validity of the tool, however, the experts rated with a significant lower mean score the need for the simulator to learn the surgical technique (3.68 points; p < 0.01). Regarding the face validity, all items were graded with a score ¿4 points except for the question relating to the spatial realism (3.82 points). Conclusion: The laparoscopy simulation box and the games were valid means for training surgeons and medical students to develop the skills required for the laparoscopic technique.
Autores: Amer, F.; Gil Conesa, Mario; Carlos Chillerón, Silvia; et al.

Título: Behavioral and personal characteristics associated with risk of SARS-CoV-2 infection in a Spanish university cohort

Revista: AMERICAN JOURNAL OF EPIDEMIOLOGY

ISSN: 0002-9262 Vol.192 N° 9 2023 págs. 1463 - 1474

Resumen

The aim of this study was to analyze the life habits and personal factors associated with increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) risk in a university environment with in-person lectures during the coronavirus disease 2019 (COVID-19) pandemic. To our knowledge, there are no previous longitudinal studies that have analyzed associations of behavioral and personal factors with the risk of SARS-CoV-2 infection on an entire university population. A cohort study was conducted in the 3 campuses of the University of Navarra between August 24, 2020, and May 30, 2021, including 14,496 students and employees; the final sample included 10,959. Descriptive and multivariate-adjusted models were fitted using Cox regression. A total of 1,032 (9.4%) participants were diagnosed with COVID-19 (879 students and 153 employees), almost 50% living with their families. COVID-19 was associated with living in college or residence (hazard ratio (HR) = 1.96, 95% CI: 1.45, 2.64), motor transportation (HR = 1.35, 95% CI: 1.14, 1.61), South American origin (HR = 1.43, 95% CI: 1.20, 1.72), and belonging to Madrid's campus (HR = 3.11, 95% CI: 2.47, 3.92). International students, especially from Latin America, mostly lived in university apartments or shared flats and cohabited with 4-11 people. Living in a big city (Madrid), was a significant risk factor.
Autores: Diaz-Gutierrez, J.; Martínez González, Miguel Ángel; Alonso, A.; et al.

Título: American Heart Association's life simple 7 and the risk of atrial fibrillation in the PREDIMED study cohort

Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES

ISSN: 0939-4753 Vol.33 N° 6 2023 págs. 1144 - 1148

Resumen

Background and aims: The American Heart Association proposed 7 ideal cardiovascular health metrics (Life's Simple 7 [LS7]) namely, not smoking, body mass index <25 kg/m2, healthy diet, moderate physical activity & GE;150 min/week, total blood cholesterol <200 mg/dL, blood pressure <120/80 mmHg and fasting blood glucose <100 mg/dL. Our objective was to assess the association between these LS7 metrics and the incidence of atrial fibrillation (AF).Methods and results: A total of 6,479 participants of the PREDIMED study were included. We calculated the participants' baseline LS7 index ranging 0-7 points to categorize them according to their adherence to these LS7 health metrics. Multivariable Cox regression models were used to estimate Hazard Ratios (HR) and their 95% Confidence Intervals (95% CI). After a median followup of 4.8 years, we identified 250 incident cases of AF. After adjusting for potential confounders, adherence to LS7 index was not associated with the incidence of AF (adjusted HR 0.90 [95% CI: health metric individually associated with a lower risk of AF (HR 0.36 [95% CI: 0.16-0.78]).Conclusions: In a high cardiovascular risk Spanish population, adherence to American Heart As-sociation's LS7 metrics was not associated with the risk of incident AF. Clinical Trials number: ISRCTN35739639.& COPY; 2023 The Author(s). Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Autores: Razquin Burillo, Cristina; Ruiz-Canela, Miguel; Toledo Atucha, Estefanía; et al.

Título: Circulating amino acids and risk of peripheral artery disease in the PREDIMED trial

Revista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES

ISSN: 1422-0067 Vol.24 N° 1 2023 págs. 270

Resumen

Effective prevention and risk prediction are important for peripheral artery disease (PAD) due to its poor prognosis and the huge disease burden it produces. Circulating amino acids (AA) and their metabolites may serve as biomarkers of PAD risk, but they have been scarcely investigated. The objective was to prospectively analyze the associations of baseline levels of plasma AA (and their pathways) with subsequent risk of PAD and the potential effect modification by a nutritional intervention with the Mediterranean diet (MedDiet). A matched case-control study was nested in the PREDIMED trial, in which participants were randomized to three arms: MedDiet with tree nut supplementation group, MedDiet with extra-virgin olive oil (EVOO) supplementation group or control group (low-fat diet). One hundred and sixty-seven PAD cases were matched with 250 controls. Plasma AA was measured with liquid chromatography/mass spectrometry at the Broad Institute. Baseline tryptophan, serine and threonine were inversely associated with PAD (ORfor 1 SD increase = 0.78 (0.61-0.99); 0.67 (0.51-0.86) and 0.75 (0.59-0.95), respectively) in a multivariable-adjusted conditional logistic regression model. The kynurenine/tryptophan ratio was directly associated with PAD (ORfor 1 SD increase = 1.50 (1.14-1.98)). The nutritional intervention with the MedDiet+nuts modified the association between threonine and PAD (p-value interaction = 0.018) compared with the control group. However, subjects allocated to the MedDiet+EVOO group were protected against PAD independently of baseline threonine. Plasma tryptophan, kynurenine/tryptophan ratio, serine and threonine might serve as early biomarkers of future PAD in subjects at a high risk of cardiovascular disease. The MedDiet supplemented with EVOO exerted a protective effect, regardless of baseline levels of threonine.
Autores: Hernández Hernández, Aitor; Oliver, D.; Martínez González, Miguel Ángel; et al.

Título: Mediterranean alcohol-drinking pattern and arterial hypertension in the "Seguimiento Universidad de Navarra" (SUN) prospective cohort study

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.15 N° 2 2023 págs. 307

Resumen

Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the Seguimiento Universidad de Navarra (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score < 2) to the Mediterranean alcohol-drinking pattern was significantly associated with a higher incidence of hypertension (multivariable-adjusted hazard ratio 1.81, 95% confidence interval 1.09-2.99) as compared to the high-adherence (score > 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk.
Autores: García, S.; Bouzas, C.; Mateos, D.; et al.

Título: Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index

Revista: ENVIRONMENTAL HEALTH

ISSN: 1476-069X Vol.22 N° 1 2023 págs. 1

Resumen

Background Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment. Aim To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population. Design and population Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed. Methods Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expressed in kg/day: Q1 (<= 2.01 kg CO2), Q2 (2.02-2.34 kg CO2), Q3 (2.35-2.79 kg CO2) and Q4 (>= 2.80 kg CO2). Results More men than women induced higher dietary levels of CO2 emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO2 through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO2 emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference). Conclusions The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO2 emissions. Mediterranean Diet index may be used as a pollution level index.
Autores: Fernández-González, E.; Martínez González, Miguel Ángel; Bes Rastrollo, Maira; et al.

Título: Association between pre-conceptional carbohydrate quality index and the incidence of gestational diabetes: the SUN cohort study

Revista: BRITISH JOURNAL OF NUTRITION

ISSN: 0007-1145 Vol.129 2023 págs. 704 - 714

Resumen

The aim of the study was to investigate the association between pre-gestational carbohydrate quality index (CQI) and the incidence of gestational diabetes mellitus (GDM). Data from the 'Seguimiento Universidad de Navarra' (SUN) cohort were used, which includes 3827 women who notified at least one pregnancy between December 1999 and December 2019. We used a validated semi-quantitative 136-item FFQ to evaluate dietary exposures at baseline and at 10-year follow-up. The CQI was defined by four criteria: glycaemic index, whole-grain/total-grain carbohydrate, dietary fibre intake and solid/total carbohydrate ratio. We fitted generalised estimating equations with repeated measurements of the CQI to assess its relationship with incident GDM. A total of 6869 pregnancies and 202 new cases of incident GDM were identified. The inverse association between the global quality of carbohydrate and the development of GDM was not statistically significant: OR the highest v. the lowest CQI category: 0 center dot 67, 95 % CI (0 center dot 40, 1 center dot 10), P-for trend = 0 center dot 10. Participants at the highest CQI category and with daily carbohydrate amounts >= 50 % of total energy intake had the lowest incidence of GDM (OR = 0 center dot 29 (95 % CI (0 center dot 09, 0 center dot 89)) compared with those with the lowest quality (lowest CQI) and quantity (<= 40 %). Further studies are needed to overcome the limitations of our study. Those studies should jointly consider the quality and the quantity of dietary carbohydrates, as the quality might be of importance, especially in women with a higher intake of carbohydrates.
Autores: Henn, Matthias Christoph (Autor de correspondencia); Babio, N.; Romaguera, D.; et al.

Título: Increase from low to moderate, but not high, caffeinated coffee consumption is associated with favorable changes in body fat

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.42 N° 4 2023 págs. 477 - 485

Resumen

Background & aims: Higher consumption of coffee and caffeine has been linked to less weight gain and lower body mass index in prospective cohort studies. The aim of the study was to longitudinally assess the association of changes in coffee and caffeine intake with changes in fat tissue, in particular, visceral adipose tissue (VAT) using dual x-ray absorptiometry (DXA). Methods: In the setting of a large, randomized trial of Mediterranean diet and physical activity intervention, we evaluated 1483 participants with metabolic syndrome (MetS). Repeated measurements of coffee consumption from validated food frequency questionnaires (FFQ) and DXA measurements of adipose tissue were collected at baseline, 6 months, 12 months and 3 years of follow-up. DXA-derived measurements of total and regional adipose tissue expressed as % of total body weight were transformed into sex-specific z-scores. Linear multilevel mixed-effect models were used to investigate the relationship between changes in coffee consumption and corresponding concurrent changes in fat tissue during a 3-year follow-up. Results: After adjustment for intervention group, and other potential confounders, an increase in caffeinated coffee consumption from no or infrequent consumption (¿3 cups/month) to moderate consumption (1-7 cups/week) was associated with reductions in total body fat (¿ z-score: -0.06; 95% CI: -0.11 to -0.02), trunk fat (¿ z-score: -0.07; 95% CI: -0.12 to -0.02), and VAT (¿ z-score: -0.07; 95% CI: -0.13 to -0.01). Neither changes from no or infrequent consumption to high levels of caffeinated coffee consumption (>1 cup/day) nor any changes in decaffeinated coffee consumption showed significant associations with changes in DXA measures. Conclusions: Moderate changes in the consumption of caffeinated coffee, but not changes to high consumption, were associated with reductions in total body fat, trunk fat and VAT in a Mediterranean cohort with MetS. Decaffeinated coffee was not linked to adiposity indicators. Moderate consumption of caffeinated coffee may be part of a weight management strategy. Trial registration: The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
Autores: Arancibia-Riveros, C.; Dominguez-López, I.; Tresserra-Rimbau, A.; et al.

Título: Total urinary polyphenol excretion: a biomarker of an anti-inflammatory diet and metabolic syndrome status

Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0002-9165 Vol.117 N° 4 2023 págs. 814 - 822

Resumen

Background: Chronic inflammation is associated with noncommunicable diseases, including obesity, metabolic syndrome (MetS), and CVDs. The Mediterranean diet has been shown to have strong anti-inflammatory effects, attributed in part to the polyphenol richness of many of its components. Objectives: This study aimed to assess the value of polyphenols as a urinary biomarker of an anti-inflammatory diet and their influence on MetS status. Methods: A longitudinal analysis was performed in Spain considering 543 participants with high CVD risk in a PREDIMED study. Approximately 52% of the participants were women and 48% were men with a mean age of 67.5 (5.9) y. Total polyphenol excretion (TPE) in urine was determined at baseline and 5 y of intervention using a validated Folin-Ciocalteu spectrophotometric method, and the dietary inflammatory index (DII) was calculated from a validated 137-item food-frequency questionnaire. Three categories were built according to tertiles of change in the DII score. Multivariable linear regression analyses were performed to assess the association of changes in TPE with changes in the DII scores and with MetS status at 5 y. Results: Tertiles 2 and 3 compared with tertile 1 presented a lower anti-inflammatory potential of the diet and were inversely associated with TPE in women [-0.30 mg gallic acid equivalent (GAE)/g creatinine; 95% CI: -0.46, -0.15; P value = 0.006 and -0.29 mg GAE/g creatinine; 95% CI: -0.43, -0.15; P value = 0.005], respectively. The mean changes in TPE were 7.9 (56.1) mg GAE/g creatinine in women and 7.7 (48.2) mg GAE/g creatinine in men. In addition, TPE was inversely associated with changes in MetS status [-0.06 (-0.09; -0.02), P value = 0.009] in both men and women. Conclusions: Urinary polyphenols may be a potential biomarker of anti-inflammatory diet consumption in women and are prospectively associated with improvement in MetS.
Autores: Montero, J. A. (Autor de correspondencia); Bardají-Pascual, C.; Bronte-Anaut, M. ; et al.

Título: Diagnostic performance of serum interleukin-6 in pediatric acute appendicitis: a systematic review

Revista: WORLD JOURNAL OF PEDIATRICS

ISSN: 1708-8569 Vol.18 N° 2 2022 págs. 91 - 99

Resumen

Background Despite the radiological and analytical advances of the last decades, there is still a significant rate of diagnostic error in pediatric acute appendicitis. In recent years, multiple biomarkers have emerged as potential diagnostic tools. This study aimed to examine the diagnostic performance of serum interleukin-6 in pediatric acute appendicitis. Methods We conducted a systematic review of the literature that involved an extensive search in the main databases of medical bibliography (Medline, PubMed, Web of Science and SciELO). Two independent reviewers selected the relevant articles based on the previously defined inclusion and exclusion criteria. Methodological quality of the selected article was rated using the QUADAS2 index. Data extraction was performed by two independent reviewers. Results The research in the medical bibliography databases resulted in 68 articles. We removed 26 duplicates. Among the remaining 42 articles, we excluded 33 following the inclusion and exclusion criteria. Of the final 9 studies included in this review, 8 provided measured serum interleukin-6 values, and all of them reported significant differences between groups, but inconsistent results regarding sensitivity and specificity. Conclusions The diagnostic performance of interleukine-6 alone for the diagnosis of acute appendicitis in children is limited. The sensitivity and specificity of interleukine-6 for the diagnosis of non-complicated acute appendicitis in the pediatric population are moderate but increased in complicated appendicitis. There seems to be a direct relationship between serum level of interleukin-6 and the hours of evolution of abdominal pain in children with acute appendicitis. The increasingly widespread use of non-operative management of acute appendicitis warrants further exploration of the classificatory potential of this marker between complicated and uncomplicated appendicitis. We consider that this may be an avenue of research to explore in the future.
Autores: Romero-Cabrera, J. L.; Ankeny, J.; Fernández Montero, Alejandro; et al.

Título: A Systematic Review and Meta-Analysis of Advanced Biomarkers for Predicting Incident Cardiovascular Disease among Asymptomatic Middle-Aged Adults

Revista: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES

ISSN: 1422-0067 Vol.23 N° 21 2022 págs. 13540

Resumen

Cardiovascular disease (CVD) continues as the most important cause of mortality. Better risk screening and prediction are needed to reduce the cardiovascular disease burden. The aim of the study was to assess the role of serum biomarkers in the prediction of CVD among asymptomatic middle-aged adults with no prior CVD history. A systematic review and meta-analysis were carried out using literature from PubMed and following PRISMA reporting guidelines. Twenty-five studies met our inclusion criteria and were included in the systematic review. The most commonly studied biomarker was high-sensitivity C reactive protein (hs-CRP) (10 studies), which showed that higher hs-CRP levels are associated with an increased risk of subsequent CVD events and mortality. In addition, several less-studied biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), fibrinogen, gamma-glutamyl transferase (GGT), and others) also showed significant associations with greater future risk of CVD. A meta-analysis was possible to perform for hs-CRP and NT-proBNP, which showed statistically significant results for the ability of hs-CRP (hazard ratio (HR) 1.19, (95% CI: 1.09-1.30), p < 0.05) and NT-proBNP (HR 1.22, (1.13-1.32), p < 0.05) to predict incident CVD among middle-aged adults without a prior CVD history or symptoms. Several serum biomarkers, particularly hs-CRP and NT-proBNP, have the potential to improve primary CVD risk prevention among asymptomatic middle-aged adults.
Autores: Barbería Latasa, María; Gea Sánchez, Alfredo (Autor de correspondencia); Martínez González, Miguel Ángel

Título: Alcohol, Drinking Pattern, and Chronic Disease

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.14 N° 9 2022 págs. 1954

Resumen

This review discusses the inconsistent recommendations on alcohol consumption and its association with chronic disease, highlighting the need for an evidence-based consensus. Alcohol is an addictive substance consumed worldwide, especially in European countries. Recommendations on alcohol consumption are controversial. On one hand, many nonrandomized studies defend that moderate consumption has a beneficial cardiovascular effect or a lower risk of all-cause mortality. On the other hand, alcohol is associated with an increased risk of cancer, neurological diseases, or injuries, among others. For years, efforts have been made to answer the question regarding the safe amount of alcohol intake, but controversies remain. Observational studies advocate moderate alcohol consumption following a Mediterranean pattern (red wine with meals avoiding binge drinking) as the best option for current drinkers. However, agencies such as the IARC recommend abstention from alcohol as it is a potent carcinogen. In this context, more randomized trial with larger sample size and hard clinical endpoints should be conducted to clarify the available evidence and provide clinicians with support for their clinical practice.
Autores: Pano Espínola, Octavio (Autor de correspondencia); Gamba, M.; Bullon Vela, Maria Vanessa; et al.

Título: Eating behaviors and health-related quality of life: a scoping review

Revista: MATURITAS

ISSN: 0378-5122 Vol.165 2022 págs. 58 - 71

Resumen

Discrepancies between total life expectancy and healthy life expectancy are in part due to unhealthy lifestyles, in which diet plays an important role. Despite this knowledge, observational studies and randomized trials have yet to show consistent improvements in health and well-being, also known as health-related quality of life (HRQoL), given the variety of elements that conform a healthy diet aside from its content. As such, we aimed to describe the evidence and common topics concerning the effects of modifiable eating behaviors and HRQoL in patients with non-communicable diseases (NCD). This scoping review of six electronic databases included 174 reports (69 % were experimental studies, 10 % longitudinal studies, and 21 % cross-sectional studies). Using VOSviewer, a bibliometric tool with text mining functionalities, we identified relevant aspects of dietary assessments and interventions. Commonly observed topics in experimental studies were those related to diet quality (micro-and macronutrients, food items, and dietary patterns). In contrast, less was found regarding eating schedules, eating locations, culturally accepted food items, and the role of food insecurity in HRQoL. Disregarding these aspects of diets may be limiting the full potential of nutrition as a key element of health and well-being in order to ensure lengthy and fulfilling lives.
Autores: Arredondo Montero, J. (Autor de correspondencia); Rico Jiménez, M.; Martín Calvo, Nerea

Título: Discriminatory capacity of serum total bilirubin between complicated and uncomplicated acute appendicitis in children: a systematic review and a diagnostic test accuracy meta-analysis

Revista: PEDIATRIC SURGERY INTERNATIONAL

ISSN: 0179-0358 Vol.39 N° 1 2022 págs. 64

Resumen

This study aimed to examine the ability of serum total bilirubin (STB) to discriminate between complicated and uncomplicated paediatric acute appendicitis (PAA). We conducted a systematic review of the literature that involved an extensive search in the main databases of medical bibliography (Medline, PubMed, Web of Science, OVID, Scopus, Cochrane Library). Two independent reviewers selected the relevant articles based on the previously defined inclusion and exclusion criteria. Methodological quality of the selected articles was assessed using the QUADAS2 index. Data extraction was performed by two independent reviewers. A synthesis of the results, a standardization of the metrics and a random-effect meta-analysis were performed. Between-study heterogeneity was assessed in subgroup analysis by study design. In addition, a diagnostic test accuracy (DTA) meta-analysis was performed. This review included 8 studies with data from 3634 participants aged between 0 and 18 years (2230 with uncomplicated PAA and 1404 with complicated PAA). The random-effects meta-analysis showed significantly higher mean STB in the complicated PAA group than in the uncomplicated PAA group (difference = 0.27; 95% CI 0.06-0.48) and high heterogeneity (I2 = 96%). In subgroup analyses by study design, the difference remained significant in prospective studies. The DTA meta-analysis resulted in an AUC of 0.83 (95% CI 0.79-0.86) and pooled sensitivity and specificity of 68.53% (95% CI 48.35%-83.51%) and 81.12% (95% CI 67.76%-89.78%), respectively. Mean values of STB are higher in children with complicated than uncomplicated acute appendicitis, and the diagnostic yield of STB seems to be high. Due to the high heterogeneity between studies, these results must be interpreted with caution.
Autores: Fernández-Lázaro, D. (Autor de correspondencia); Fernández Lázaro, Cesar Ignacio (Autor de correspondencia); Seco-Calvo, J.; et al.

Título: Effects of Tribulus terrestris L. on sport and health biomarkers in physically active adult males: a systematic review

Revista: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH

ISSN: 1660-4601 Vol.19 N° 15 2022 págs. 9533

Resumen

Tribulus terrestris L. (TT) is a plant used in traditional Chinese medicine, Ayurvedic medicine, and sports nutrition to improve health and performance. However, no conclusive evidence exists about the potential beneficial effects of TT on sport and health biomarkers in physically active adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the modified McMaster Critical Review Form for methodological quality assessment, we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed, to assess the effects of TT on immunological, hematological, biochemical, renal, lipidic, hormonal behavior, and anti-inflammatory response in physically active adult males. Among 340 records identified in the search, a total of 7 studies met the inclusion and exclusion criteria. Overall, participants supplemented with TT displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no TT-induced toxicity was reported. In conclusion, there was no clear evidence of the beneficial effects of TT supplementation on muscle damage markers and hormonal behavior. More studies are needed to confirm the benefits of TT due to the limited number of studies available in the current literature.
Autores: Rabassa, M. (Autor de correspondencia); Hernández Ponce, Y.; García-Ribera, S.; et al.

Título: Food-based dietary guidelines in Spain: an assessment of their methodological quality

Revista: EUROPEAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0954-3007 Vol.76 N° 3 2022 págs. 350 - 359

Resumen

Background & objectives Food-based dietary guidelines (FBDGs) have been developed to promote healthy diets and prevent chronic diseases. However, the methodological quality of Spanish FBDGs has not been systematically assessed yet. The objective of this review is to identify and assess the methodological quality of Spanish FBDGs, as well as to describe their food guides and key recommendations. Methods We conducted a systematic search to identify Spanish FBDGs targeted at the general population using multiple sources. Two authors independently screened the references, extracted data, and assessed the quality of the FBDGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Recommendation Excellence (AGREE-REX) instruments. We performed a descriptive analysis of the FBDGs. Results We included 19 FBDGs, published between 2007 and 2019. The median scores for each AGREE II domain were: scope and purpose 44% (Q1-Q3: 33-61%); Stakeholder involvement 31% (11-44%), rigor of development 3% (1-14%); clarity of presentation 42% (33-47%), applicability 0% (0-6%); and editorial independence 0% (0-8%). Six FBDGs (32%; 6/19) were categorized as recommended with modifications, and the rest (68%; 13/19) as not recommended. None of the FBDGs scored >= 60% in three or more domains, including the rigor of development domain. FBDGs indexed in literature databases scored significantly higher in overall rating than those not indexed (P = 0.023). The majority of FBDGs (74%; 14/19) used the pyramid as a food guide representation with a larger number of food levels (3-7 levels). The majority of FBDGs recommended a daily intake of cereals and grains, vegetables, fruits, olive oil and dairy products; a weekly intake of vegetable and animal proteins; and the occasional and limited intake of other food groups (e.g., ultraprocessed foods). Conclusions Overall, the methodological quality of FBDGs is poor showing that only 32% of FBDGs are recommended for use with modifications. Our results highlight the need to revise, systematize and improve FBDG development processes in Spain.
Autores: Babio, N. (Autor de correspondencia); Becerra-Tomás, N.; Nishi, S. K. (Autor de correspondencia); et al.

Título: Total dairy consumption in relation to overweight and obesity in children and adolescents: a systematic review and meta-analysis

Revista: OBESITY REVIEWS

ISSN: 1467-7881 Vol.23 N° Supl. 1 2022 págs. e13400

Resumen

A systematic review and meta-analysis of cross-sectional and prospective cohort studies was conducted to assess the associations between total dairy consumption and its different subtypes with the prevalence and incidence of overweight, obesity, and overweight/obesity in children and adolescents. A literature search was conducted in Medline through PUBMED and Cochrane Library databases until October 18, 2021. Articles reporting the risk estimates as odd ratios (OR), risk ratios (RR), or hazard ratios and their corresponding 95% confidence interval (CI) for the association between dairy product consumption and the risk of overweight and/or obesity were included. In the meta-analysis from cross-sectional studies, results showed an inverse association between total dairy consumption and obesity prevalence (OR (95% CI): 0.66 (0.48-0.91). No significant associations were found between milk or yogurt and obesity prevalence risk. Regarding prospective studies, total milk consumption was positively associated with overweight prevalence (OR (95% CI): 1.13 (1.01-1.26)) and incidence (RR (95%CI): 1.17 (1.01-1.35)) risk. Evidence from pooled analysis of cross-sectional studies suggested an inverse association between total dairy consumption and obesity. However, there is limited and no conclusive evidence to confirm an inverse relationship from pooled analysis of prospective studies in children and adolescents.
Autores: Martín Calvo, Nerea (Autor de correspondencia); Goñi Mateos, Leticia; Tur, J. A.; et al.

Título: Low birth weight and small for gestational age are associated with complications of childhood and adolescence obesity: systematic review and meta-analysis

Revista: OBESITY REVIEWS

ISSN: 1467-7881 Vol.23 N° Supl. 1 2022 págs. e13380

Resumen

In recent decades, the incidence of type 2 diabetes (T2D) has increased dramatically in children and adolescents, posing a real public health problem. Beyond unhealthy diets and sedentary lifestyles, growing evidence suggests that some perinatal factors, such as low birth weight (LBW), are associated with higher risk of T2D in adulthood. In this regard, it remains unclear whether the increased risk is already present in childhood and adolescence. We conducted a systematic review and meta-analysis to clarify the association of LBW or being small for gestational age (SGA) with insulin resistance in childhood and adolescence. The systematic review resulted in 28 individual studies, and those with the same outcome were included within two random-effects meta-analyses. Compared with children or adolescents born with adequate size for gestational age, those SGA had 2.33-fold higher risk of T2D (95% confidence interval [CI]: 1.05-5.17). Furthermore, LBW and being SGA were associated with 0.20 higher mean homeostasis model assessment of insulin resistance (HOMA-IR) values (95% CI: 0.02-0.38). Given the high prevalence of preterm babies, from a population perspective, these results may be of great importance as they point to the existence of a potentially vulnerable subgroup of children and adolescents that could benefit from screening tests and early preventive strategies.
Autores: Donat-Vargas, C. (Autor de correspondencia); Sandoval-Insausti, H.; Penalvo, J. L.; et al.

Título: Reply-Letter to the editor - Association between olive oil consumption and the risk of cardiovascular disease and stroke YCLNU-D-21-02208

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.41 N° 3 2022 págs. 784 - 785
Autores: Arredondo-Montero, J. (Autor de correspondencia); Román-Moleón, M.; Martín Calvo, Nerea; et al.

Título: Pseudoaneurismas postraumáticos pediátricos: nuestra experiencia

Revista: ANALES DE PEDIATRIA

ISSN: 1695-4033 Vol.97 N° 3 2022 págs. 208 - 211
Autores: Arredondo Montero, J. (Autor de correspondencia); Bronte Anaut, M.; López-Andrés, N.; et al.

Título: A tumor at the base of the tongue

Revista: JOURNAL OF PEDIATRICS

ISSN: 0022-3476 Vol.242 2022 págs. 256 - 257
Autores: Visioli, F. (Autor de correspondencia); Franco, M.; Martínez González, Miguel Ángel

Título: Front of package labels and olive oil: a call for caution

Revista: EUROPEAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0954-3007 Vol.76 N° 4 2022 págs. 502 - 504
Autores: Martín Calvo, Nerea; Santiago Neri, Susana; Segura, G.; et al.

Título: Pregestational BMI and higher offspring's risk of overweight/obesity in smoker and non-smoker mothers - Corrigendum

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.25 N° 6 2022 págs. 1733
Autores: Fernández Lázaro, Cesar Ignacio; Zazpe García, Itzíar; Santiago Neri, Susana; et al.

Título: Corrigendum to "Association of carbohydrate quality and all-cause mortality in the Sun Project: A prospective cohort study" [Clinical Nutrition 40 (4) (2021) 2364-2372]

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.41 N° 6 2022 págs. 1465
Autores: Henríquez-Sánchez, P. (Autor de correspondencia); Sánchez-Villegas, A.; Ruano-Rodríguez, C.; et al.

Título: Correction to: Dietary total antioxidant capacity and mortality in the PREDIMED study

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 1 2022 págs. 569 - 571
Autores: Hershey de la Cruz, María Soledad; Sánchez-Villegas, A.; Sotos-Prieto, M.; et al.

Título: The Mediterranean lifestyle and the risk of depression in middle-aged adults

Revista: JOURNAL OF NUTRITION

ISSN: 0022-3166 Vol.152 N° 1 2022 págs. 227 - 234

Resumen

Background: Recent evidence has indicated a greater number of protective factors are associated with a greater decreased risk for depression and depressive symptoms compared with individual factors alone. Moreover, adherence to healthy modifiable lifestyle behaviors may lower the risk of depression regardless of underlying genetic risk. Objectives: We longitudinally evaluated the association of the Mediterranean lifestyle (MEDLIFE) with the risk of depression. Methods: We prospectively analyzed data from 15,279 participants (6089 men and 9190 women, mean age 37 y) in the Seguimiento Universidad de Navarra cohort. The MEDLIFE index is composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, each of which was assigned 0 or 1 point. Final scores ranged from 0 to 28 points and were categorized into quartiles of MEDLIFE adherence. Cox proportional regression models determined the association of total MEDLIFE adherence, each item, and block with incident depression. Results: After a mean follow-up of 11.7 y, 912 (6%) incident cases of depression were reported. The mean +/- SD final score for MEDLIFE adherence was 11.9 +/- 2.7 points. The multivariable model showed that compared with the first quartile, the second and third quartiles of MEDLIFE adherence were significantly associated with a decreased relative risk for incident depression (HR: 0.82; 95% CI: 0.69, 0.96 and HR: 0.74; 95% CI: 0.61, 0.89, respectively). The fourth quartile did not show a statistically significant association with incident depression (HR: 0.89; 95% CI: 0.73, 1.09). Conclusions: MEDLIFE adherence may decrease the risk of depression in a Spanish cohort of university graduates. Given no clear association was observed among the highest MEDLIFE adherence, future studies are warranted to better understand the nature of this association. Evidence on MEDLIFE, beyond the Mediterranean diet, may contribute toward more effective prevention strategies for depression.
Autores: Pérez Araluce, Rafael María (Autor de correspondencia); Martínez González, Miguel Ángel; Gea Sánchez, Alfredo; et al.

Título: Components of the Mediterranean Diet and risk of COVID-19

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.8 2022 págs. 805533

Resumen

Adherence to the traditional Mediterranean diet has been customarily assessed with the Mediterranean diet score (MDS or Trichopolou Index), with values of 0 or 1 assigned to each of the nine elements, and with the use of the sex-specific median as the cutoff. The value of persons whose consumption of the six beneficial items (ratio of monounsaturated to saturated fatty acids, vegetables, legumes, fruits and nuts, cereal, and fish) is at or above the median and is assigned a value of 1. Otherwise they receive 0 points. For detrimental elements (meats and dairy products) persons whose consumption is below the median are assigned a value of 1. An additional ninth point is assigned to moderate ethanol intake. We assessed the effect of each of the nine components of the MDS (replacing the fats ratio with olive oil, the main source of monounsaturated fats in the Mediterranean diet) on the risk of COVID-19 infection, symptomatic and severe COVID-19. From March to December 2020, 9,699 participants of the "Seguimiento Universidad de Navarra" (SUN) cohort answered a COVID-19 questionnaire. After excluding doctors and nurses, 5,194 participants were included in the main statistical analyses. Among them, we observed 382 cases of COVID-19 based on symptoms and clinical diagnosis; 167 of them with test confirmation. For the two COVID-19 definitions used, we found a significant decrease in risk for a higher adherence to the Mediterranean diet (OR = 0.64, 95% CI: 0.42-0.98, p for trend = 0.040; and OR = 0.44, 95% CI: 0.22-0.88, p for trend = 0.020, for test-diagnosed cases). A protective effect was also found for symptomatic COVID-19 (OR = 0.64, 95% CI: 0.41-1.00, p for trend = 0.050). Among the different individual food groups, only the consumption of whole dairy products showed a harmful direct association. The Mediterranean diet as a whole seems more important than each of its components in preventing the infection and symptoms of COVID-19.
Autores: Muralidharan, J.; Papandreou, C.; Soria-Florido, M. T.; et al.

Título: Cross-sectional associations between HDL structure or function, cell membrane fatty acid composition, and inflammation in elderly adults

Revista: JOURNAL OF NUTRITION

ISSN: 0022-3166 Vol.152 N° 3 2022 págs. 789 - 795

Resumen

Background: Cell membrane fatty acid composition has been related to inflammation and cardiovascular disease (CVD) risk. Dysregulation of HDL function is also considered a CVD risk factor. Objectives: We aimed to investigate whether the content of cell membrane fatty acids and HDL functionality are linked to each other as well as to inflammation. Methods: This cross-sectional analysis involved 259 participants (mean age: 67.9 y) with overweight/obesity (mean BMI: 29.5 kg/m(2)) from a coronary artery disease case-control study nested within the PREDIMED (PREvencion con Dleta MEDiterranea) trial for which HDL functional parameters [apoA-I, apoA-IV, and apoC-III; cholesterol efflux capacity (CEC); HDL oxidative inflammatory index (HOII); sphingosine-1-phosphate (S1P); serum amyloid A (SAA); and complement-3 (C3) protein] were quantified. We also assessed 22 fatty acids in blood cell membranes using GC and inflammatory markers (IFN-gamma and IL-1b, IL-6, IL-8, and IL-10) in serum. Associations of HDL-related variables with cell membrane fatty acids and with inflammatory markers were assessed using multivariable linear regression analyses with elastic net penalty. Results: ApoA-I, apoC-III, CEC, HOII, S1P and SAA, but not apoA-IV and C3 protein, were associated with membrane fatty acids. S1P and SAA were directly associated with IL-6, whereas apoA-I and C3 protein showed inverse associations with IL-6. Specific fatty acids including myristic acid (14:0) and long-chain n-6 fatty acids being negatively and positively associated with IL-8, respectively, were also found to be positively associated with SAA. Conclusions: This study suggests interrelations between indicators of inflammation and both blood cell membrane fatty acid composition and HDL structure/functional parameters in a Mediterranean population at high CVD risk.
Autores: Ni, J.; Nishi, S. K.; Babio, N.; et al.

Título: Dairy product consumption and changes in cognitive performance: two-year analysis of the PREDIMED-Plus cohort

Revista: MOLECULAR NUTRITION AND FOOD RESEARCH

ISSN: 1613-4125 Vol.66 N° 14 2022 págs. e2101058

Resumen

Scope Dairy consumption has been suggested to impact cognition; however, evidence is limited and inconsistent. This study aims to longitudinally assess the association between dairy consumption with cognitive changes in an older Spanish population at high cardiovascular disease risk. Methods and results Four thousand six hundred sixty eight participants aged 55-75 years, completed a validated food frequency questionnaire at baseline and a neuropsychological battery of tests at baseline and 2-year follow-up. Multivariable linear regression models are used, scaled by 100 (i.e., the units of beta correspond to 1 SD/100), to assess associations between baseline tertile daily consumption and 2-year changes in cognitive performance. Participants in the highest tertile of total milk and whole-fat milk consumption have a greater decline in global cognitive function (beta: -4.71, 95% CI: -8.74 to -0.69, p-trend = 0.020 and beta: -6.64, 95% CI: -10.81 to -2.47, p-trend = 0.002, respectively) compared to those in the lowest tertile. No associations are observed between low fat milk, yogurt, cheese or fermented dairy consumption, and changes in cognitive performance. Conclusion Results suggest there are no clear prospective associations between consumption of most commonly consumed dairy products and cognition, although there may be an association with a greater rate of cognitive decline over a 2-year period in older adults at high cardiovascular disease risk for whole-fat milk.
Autores: Hernández-Ruiz, A. (Autor de correspondencia); López-Trigo, J. A.; Muñoz-Ruiz, M. A.; et al.

Título: Descripción de un indicador de calidad de la dieta para su aplicación en residencias de ancianos: Quality Index For Nutrition In Nursing Homes - QUINN

Revista: REVISTA ESPAÑOLA DE NUTRICION HUMANA Y DIETETICA

ISSN: 2173-1292 Vol.26 N° 2 2022 págs. 156 - 161

Resumen

Introducción: Los indicadores de calidad de la dieta (Diet Quality Indicators, DQIns) son herramientas para evaluar las características de patrones de dieta basados en el conocimiento de la relación entre los factores dietéticos, los estilos de vida y resultados de salud. El objetivo de este artículo fue proponer un nuevo índice de calidad de la dieta utilizando un enfoque a priori para su aplicación en residencias de ancianos, Quality Index for Nutrition in Nursing Homes, índice QUINN. Metodología: La elección de los componentes se basó en una revisión rápida realizada sobre índices previamente publicados y los principales grupos de alimentos relacionados con la prevención de síndromes geriátricos y de las enfermedades crónicas de alta prevalencia en población geriátrica. El índice QUINN se basó en 15 componentes dietéticos-alimentos, 12 de los cuales se referían a alimentos básicos de una dieta saludable (verduras, frutas, legumbres, aceite de oliva ¿ preferiblemente virgen extra-, cereales, lácteos, pescados blancos y mariscos, carnes blancas y huevos, componentes positivos); otras grasas, carnes rojas y procesadas y dulces, componentes negativos), junto con otros 3 componentes adicionales positivos (variedad de verduras y frutas, pescado azul y cereales integrales). Cada componente se clasificó en 4 categorías (0, 1, 2 o 3 puntos), con un rango final de 0 a 45 puntos. Conclusiones: Desde nuestro conocimiento el índice QUINN es el primer índice de calidad de la dieta a priori desarrollado específicamente para evaluar los menús ofertados en las residencias de ancianos. Esta herramienta proporcionará información sobre la calidad de la dieta para el diseño de los menús. El índice QUINN podría ser un instrumento útil para implementar estrategias de intervención para mejorar de forma sencilla la dieta ofertada en las instituciones y que redunde en una mejora del estado nutricional y de la salud de la población geriátrica institucionalizada.
Autores: Moreno Montañés, Javier; Gándara Rodríguez de Campoamor, Elsa Pilar; Gutiérrez-Ruiz, I.; et al.

Título: Healthy lifestyle score and incidence of glaucoma: the Sun project

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.14 N° 4 2022 págs. 779

Resumen

Background: The relationship between modifiable risk factors, such as diet and lifestyle, and glaucoma remains controversial. We analyse the effect of the Mediterranean lifestyle (ML) on glaucoma incidence in the Seguimiento Universidad de Navarra (SUN) Project. Methods: The SUN Healthy Lifestyle Score (SHLS) includes 10 healthy habits: never having smoked, moderate to high physical activity, Mediterranean diet adherence, moderate alcohol consumption, low television exposure, no binge drinking, short afternoon napping, meeting up with friends, working at least 40 h/wk, and low body mass index. The information was collected biennially through self-reported questionnaires. The relationship between new glaucoma cases and the SHLS was assessed by Cox regression using hazard ratios. Crude, multi-adjusted, and sensitivity analyses were performed. Results: During a median of 12 years of follow-up, 261 (1.42%) new cases of glaucoma were identified among 18,420 participants. After adjusting for potential confounders, participants in the healthiest SHLS category showed a significantly reduced risk of glaucoma compared to those in the lowest SHLS category (adjusted HR = 0.51, 95% CI = 0.28-0.93). For each point added to the SHLS, the risk of glaucoma relatively dropped 5%. Conclusions: Higher adherence to a ML, measured by the SHLS, was significantly associated with a lower risk of developing glaucoma. Based on our study, the ML is a protective factor for glaucoma incidence.
Autores: López, L.; Rossello, X. (Autor de correspondencia); Romaguera, D.; et al.

Título: The Palma Echo Platform: rationale and design of an echocardiography core lab

Revista: FRONTIERS IN CARDIOVASCULAR MEDICINE

ISSN: 2297-055X Vol.9 2022 págs. 909347

Resumen

Background: The metabolic syndrome (MetS) is associated with increased cardiovascular morbidity and mortality. Characterization of cardiac structural and functional abnormalities due to the MetS can help recognize individuals who would benefit the most from preventive interventions. Transthoracic echocardiography (TTE) provides an opportunity to identify those abnormalities in a reproducible and cost-efficient manner. In research settings, implementation of protocols for the acquisition and analysis of TTE images are key to ensure validity and reproducibility, thus facilitating answering relevant questions about the association of the MetS with cardiac alterations. Methods and Results: The Palma Echo Platform (PEP) is a coordinated network that is built up to evaluate the underlying structural and functional cardiac substrate of participants with MetS. Repeated TTE will be used to evaluate 5-year changes in the cardiac structure and function in a group of 565 individuals participating in a randomized trial of a lifestyle intervention for the primary prevention of cardiovascular disease. The echocardiographic studies will be performed at three study sites, and will be centrally evaluated at the PEP core laboratory. Planned analyses will involve evaluating the effect of the lifestyle intervention on cardiac structure and function, and the association of the MetS and its components with changes in cardiac structure and function. Particular emphasis will be placed on evaluating parameters of left atrial structure and function, which have received more limited attention in past investigations. This PEP will be available for future studies addressing comparable questions. Conclusion: In this article we describe the protocol of a central echocardiography laboratory for the study of functional and structural alterations of the MetS.
Autores: Hershey de la Cruz, María Soledad; Martínez González, Miguel Ángel; Álvarez-Álvarez, I.; et al.

Título: The Mediterranean diet and physical activity: better together than apart for the prevention of premature mortality

Revista: BRITISH JOURNAL OF NUTRITION

ISSN: 0007-1145 Vol.128 N° 7 2022 págs. 1413 - 1424

Resumen

Diet and physical activity (PA) have been studied extensively in epidemiology as single or combined lifestyle factors; however, their interaction has not been studied thoroughly. Studying potential synergisms between lifestyle components with a comprehensive interaction analysis, including additive measures of interaction, provides key insights into the nature of their joint effect and helps target interventions more effectively. First, a comprehensive review was conducted to assess the potential research gap regarding reported interaction analyses conducted in studies assessing the Mediterranean diet (MedDiet) in combination with PA on all-cause mortality. Thereafter, we prospectively assessed the joint association of the MedDiet with PA on all-cause mortality in the Seguimiento Universidad de Navarra (SUN) cohort, followed by both multiplicative and additive interaction analyses. The conjoint effect of low adherence to the MedDiet and low PA observed an increased risk greater than the individual risk factors, suggesting a potential additive interaction or synergism between both exposures, with relative risk due to interaction (RERI) and (95 % confidence interval (95 % CI)) = 0.46 (-0.83 to 1.75) and attributable proportion (95 % CI) due to interaction of 36 % (-0.62, 1.34). No multiplicative interaction was detected. Studying interactions between lifestyle factors, such as the MedDiet and PA, is particularly relevant given the current research gaps in studying the complexities of combined aspects of lifestyle in comparison with isolated behaviours. Our findings underline the important public health message of adhering to both the MedDiet and PA for the prevention of premature mortality.
Autores: Barbería Latasa, María; Bes Rastrollo, Maira; Pérez Araluce, Rafael María; et al.

Título: Mediterranean alcohol-drinking patterns and all-cause mortality in women more than 55 years old and men more than 50 years old in the "Seguimiento Universidad de Navarra" (SUN) Cohort

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.14 N° 24 2022 págs. 5310

Resumen

Background: Most of the available epidemiological evidence on alcohol and chronic disease agrees on recommending alcohol abstention to young people, but some controversy exists about the most appropriate recommendation for alcohol abstention for people of older ages. A growing body of evidence suggests that the pattern of alcohol consumption is likely to be a strong effect modifier. The Mediterranean Alcohol Drinking Pattern (MADP) represents a score integrating several dimensions of drinking patterns (moderation, preference for red wine, drinking with meals, and avoiding binge drinking). Our aim was to clarify this issue and provide more precise recommendations on alcohol consumption. Methods: We prospectively followed-up 2226 participants (men older than 50 years and women older than 55 years at baseline) in the Seguimiento Universidad de Navarra (SUN) cohort. We classified participants into three categories of adherence to the MADP score (low, moderate, and high), and we added a fourth category for abstainers. Cox regression models estimated multivariable-adjusted hazard ratios (HR) of all-cause death and 95% confidence intervals (CI) using low MADP adherence as the reference category. Results: The strongest reduction in risk of mortality was observed for those with high adherence to the MADP, with an HR of 0.54 (95% CI: 0.37-0.80). The moderate adherence group (HR = 0.65, 95% CI: 0.44-0.96) and the abstention group (HR = 0.60, 95% CI: 0.36-0.98) also exhibited lower risks of mortality than the low MADP adherence group. Conclusions: based on the available evidence, a public health message can be provided to people older than 50 years as follows: among those who drink alcohol, high adherence to the MADP score could substantially reduce their risk of all-cause mortality.
Autores: Hernández-Ruiz, A. (Autor de correspondencia); García-Villanova, B.; Ruiz-Canela, Miguel; et al.

Título: El papel de la vitamina K: un estudio transversal de la ingesta de los menús ofertados en un centro geriátrico

Revista: REVISTA ESPAÑOLA DE NUTRICION HUMANA Y DIETETICA

ISSN: 2173-1292 Vol.26 N° 1 2022 págs. 19 - 29

Resumen

Introduction: The aims of the present study were to estimate the vitamin K-1 content of the menu offered in a nursing home and its adequacy to the recommendations, to determine its dietary sources and to classify the dishes on the menu. Methodology: Cross-sectional descriptive study. The dietary intake of vitamin K1 from the dietary menu offered in a public nursing home (Valladolid, Spain) was studied. The dietary study was performed by estimating the theoretical dietary intake of the basal menu offered during 14 consecutive days consumed by 138 elderly individuals. Vitamin Ki intake was estimated using data from the food composition table of Ortega-Anta et al, 2010. Results: The mean vitamin K-1 intake was 224 (standard deviation, 128 mu g/day) with a very similar amount between weeks and a great variation between days (97-586 mu g/day). The main source of this micronutrient was vegetables, especially green leafy vegetables (chard, cabbage, lettuce). The vitamin K-1 content of the menu offered was more than three times higher (320%) than the adequate intake recommended by EFSA and more than double (249-280%) the AESAN dietary intakes. The food groups that contributed most vitamin K-1 to the diet were vegetables (41.7%) and fruits (28.6%). Based on the Nutrition Care Manual classification, dishes were categorised into 4 free of vitamin K-1, 23 with low, 13 with moderate and 4 with a high amount of this micronutrient. Conclusions: In the menu offered in this nursing home, the estimated dietary intake of vitamin K-1 was between two and three times higher than recommended (AESAN and EFSA). In the long term, high intakes of vitamin K-1 could have health benefits associated with age-related diseases.
Autores: Vázquez Ruiz, Zenaida; Toledo Atucha, Estefanía; Vitelli-Storelli, F.; et al.

Título: Effect of dietary phenolic compounds on incidence of cardiovascular disease in the SUN project; 10 years of follow-up

Revista: ANTIOXIDANTS

ISSN: 2076-3921 Vol.11 N° 4 2022 págs. 783

Resumen

The health benefits of plant-based diets have been reported. Plant-based diets found in Spain and other Mediterranean countries differ from typical diets in other countries. In the Mediterranean diet, a high intake of phenolic compounds through olives, olive oil, and red wine may play an important role in cardiovascular prevention. Prospective studies carried out in Mediterranean countries may provide interesting insights. A relatively young Mediterranean cohort of 16,147 Spanish participants free of cardiovascular disease (CVD) was followed (61% women, mean (SD) age 37(12) years at baseline) for a median of 12.2 years. Dietary intake was repeatedly assessed using a 136-item validated food frequency questionnaire, and (poly)phenol intake was obtained using the Phenol-Explorer database. Participants were classified as incident cases of CVD if a medical diagnosis of myocardial infarction, stroke, or cardiovascular death was medically confirmed. Time-dependent Cox regression models were used to assess the relationship between (poly)phenol intake and the incidence of major CVD. A suboptimal intake of phenolic compounds was independently associated with a higher risk of CVD, multivariable-adjusted hazard ratio for the lowest versus top 4 quintiles: 1.85 (95% CI: 1.09-3.16). A moderate-to-high dietary intake of phenolic compounds, especially flavonoids, is likely to reduce CVD incidence in the context of a Mediterranean dietary pattern.
Autores: Camacho-Barcia, L.; García-Gavilán, J.; Martínez González, Miguel Ángel; et al.

Título: Vitamin K dietary intake is associated with cognitive function in an older adult Mediterranean population

Revista: AGE AND AGEING

ISSN: 0002-0729 Vol.51 N° 2 2022 págs. afab246

Resumen

Background In the last years, evidence that dietary vitamin K could have a role in the cognitive domain has increased. However, data from large trials are limited. The objective of this study was to assess the association of 2 year changes in the dietary intake of vitamin K with cognitive function measured through neuropsychological performance tests. Methods In 5,533 participants of the multicentre PREDIMED-Plus study (48.1% women, age 65.1 +/- 4.9 years with overweight/obesity and metabolic syndrome), we assessed the adjusted odds ratios of cognitive function decline according to 2 year changes in vitamin K intake. Participants answered a battery of cognitive function tests and Food Frequency Questionnaires (FFQs) in order to estimate the vitamin K dietary intake. Results After adjusting for potential cofounders, the highest tertile of change of dietary vitamin K intake (median [IQR]; 194.4 mu g/d [120.9, 373.1]) was inversely associated with a Mini-Mental State Examination (MMSE) score <= 24 (OR [95% CI]; 0.53 [0.35, 0.79] P for trend = 0.002) compared with a decrease in the intake of vitamin K (median [IQR]; -97.8 mu g/d [-292.8, -51.5]). A significant positive association between changes in dietary vitamin K intake and the semantic verbal fluency test scores (OR [95% CI]; 0.69 [0.51, 0.94] P for trend = 0.019) was found. Conclusions An increase of the intake of dietary vitamin K was associated with better cognitive function scores, independently of recognised risk factors for cognitive decline, in an older adult Mediterranean population with high cardiovascular risk.
Autores: Arias Colinas, Mónica; Gea Sánchez, Alfredo (Autor de correspondencia); Khattab, A.; et al.

Título: The association between inflammatory biomarkers and cardiovascular autonomic dysfunction after bacterial infection

Revista: APPLIED SCIENCES

ISSN: 2076-3417 Vol.12 N° 7 2022 págs. 3484

Resumen

Heart rate variability (HRV) is a known measure of cardiac autonomic function. A cardiovascular autonomic dysfunction (CAD), measured as changes in HRV, is usually presented after an infectious process. The aim of the present study is to assess the association between serum inflammatory markers and CAD. For this purpose, 50 volunteers (13 of them recovering from an infection) were recruited and followed-up for 6 weeks. Their serum inflammatory biomarkers (CRP, IL1, IL4, IL6, IL10, and TNFalpha) were quantified throughout those weeks, along with their HRV resting, in response to the Valsalva maneuver, metronome breathing, standing and sustained handgrip. The correlation of within-subject changes in both HRV and inflammatory biomarkers was assessed to evaluate the concurrent changes. An inverse within-subject correlation was found between CRP and HRV in response to the Valsalva maneuver (rho (95% CI): -0.517 (-0.877 to -0.001); p = 0.032) and HRV standing (rho (95% CI): -0.490 (-0.943 to -0.036); p = 0.034). At the beginning, increased values of CRP are found along with reduced levels of HRV. Then, the CRP was reduced, accompanied by an improvement (increase) in HRV. These results suggest that CRP is a potential marker of CAD. Whether it is the cause, the consequence or a risk indicator non-causally associated is still to be determined.
Autores: Ruiz-Canela, Miguel (Autor de correspondencia); Guasch-Ferre, M.; Razquin Burillo, Cristina; et al.

Título: Plasma acylcarnitines and risk of incident heart failure and atrial fibrillation: the Prevencion con dieta mediterranea study

Revista: REVISTA ESPAÑOLA DE CARDIOLOGÍA (ENGLISH ED.)

ISSN: 1885-5857 Vol.75 N° 8 2022 págs. 649 - 658

Resumen

Introduction and objectives: Fatty acid metabolic dysregulation in mitochondria is a common mechanism involved in the development of heart failure (HF) and atrial fibrillation (AF). We evaluated the association between plasma acylcarnitine levels and the incidence of HF or AF, and whether the mediterranean diet (MedDiet) may attenuate the association between acylcarnitines and HF or AF risk. Methods: Two case-control studies nested within the Prevencion con dieta mediterranea (PREDIMED) trial. High cardiovascular risk participants were recruited in Spain: 326 incident HF and 509 AF cases individually matched to 1 to 3 controls. Plasma acylcarnitines were measured with high-throughput liquid chromatography-tandem mass spectrometry. Conditional logistic regression models were fitted to estimate multivariable OR and 95%CI. Additive and multiplicative interactions were assessed by intervention group, obesity (body mass index >= 30 kg/m(2)), and type 2 diabetes. Results: Elevated levels of medium- and long-chain acylcarnitines were associated with increased HF risk (adjusted ORper DE, 1.28; 95%CI, 1.09-1.51 and adjusted ORper DE, 1.21; 95%CI, 1.04-1.42, respectively). A significant association was observed for AF risk with long-chain acylcarnitines: 1.20 (1.06-1.36). Additive interaction of the association between long-chain acylcarnitines and AF by the MediDiet supplemented with extra virgin olive oil (P for additive interaction = .036) and by obesity (P = .022) was observed in an inverse and direct manner, respectively. Conclusions: Among individuals at high cardiovascular risk, elevated long-chain acylcarnitines were associated with a higher risk of incident HF and AF. An intervention with MedDiet + extra-virgin olive oil may reduce AF risk associated with long-chain acylcarnitines.
Autores: Muñoz-García, M. I.; Martínez González, Miguel Ángel; Razquin Burillo, Cristina; et al.

Título: Exploratory dietary patterns and cognitive function in the Seguimiento Universidad de Navarra (SUN) prospective cohort

Revista: EUROPEAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0954-3007 Vol.76 N° 1 2022 págs. 48 - 55

Resumen

Background Dementia is projected to affect 135 million by 2050. Diet is a pertinent target for primary prevention, but firm recommendations for dementia prevention are not available yet. Our aim was to address the association between exploratory (empirically derived) dietary patterns (DP) and changes in the Spanish Telephone Interview for Cognitive Status (STICS-m, maximum score = 41 points) over 6 years. Method Information on diet was collected with a validated 136-item food-frequency questionnaire from 803 participants in the Mediterranean cohort Seguimiento Universidad de Navarra. We used principal component analysis to derive exploratory DP. The derived DP were associated with change in STICS-m scores over 6 years, through adjusted multiple linear regression models. Results Two main DP were identified. The first DP resembled a Western dietary pattern (WDP)-high in sugar, fat, processed foods, and red meat-and the second DP resembled a Mediterranean dietary pattern (MDP)-high in vegetables, fruits, nuts, fish, and olive oil. Adherence to the WDP (tertile 3 vs tertile 1) was significantly associated with negative STICS-m changes after 6 years (between-tertile difference in changes: -0.80 points; 95% confidence interval [CI] -1.51, -0.08, p value = 0.03). Meanwhile, the MDP showed a positive +0.71 point (95% CI 0.15, 1.26, p value = 0.01) between-tertile difference in changes in the STICS-m score. Conclusions A healthy, prudent, MDP was associated with less decline in cognitive function and, thus, could help to lower dementia incidence. Western-type diets were associated with a greater decline in cognitive performance and could increase dementia incidence.
Autores: Lan, F. Y.; Scheibler, C.; Hershey, M. S.; et al.

Título: Effects of a healthy lifestyle intervention and COVID-19-adjusted training curriculum on firefighter recruits

Revista: SCIENTIFIC REPORTS

ISSN: 2045-2322 Vol.12 N° 1 2022 págs. 10607

Resumen

There are knowledge gaps regarding healthy lifestyle (HLS) interventions in fire academy settings and also concerning the impacts of the pandemic on training. We enrolled fire recruits from two fire academies (A and B) in New England in early 2019 as the historical control group, and recruits from academies in New England (B) and Florida (C), respectively, during the pandemic as the intervention group. The three academies have similar training environments and curricula. The exposures of interest were a combination of (1) an HLS intervention and (2) impacts of the pandemic on training curricula and environs (i.e. social distancing, masking, reduced class size, etc.). We examined the health/fitness changes throughout training. The follow-up rate was 78%, leaving 92 recruits in the historical control group and 55 in the intervention group. The results show an HLS intervention improved the effects of fire academy training on recruits healthy behaviors (MEDI-lifestyle score, 0.5 +/- 1.4 vs. - 0.3 +/- 1.7), systolic blood pressure (- 7.2 +/- 10.0 vs. 2.9 +/- 12.9 mmHg), and mental health (Beck Depression score, - 0.45 +/- 1.14 vs. - 0.01 +/- 1.05) (all P < 0.05). The associations remained significant after multivariable adjustments. Moreover, a 1-point MEDI-lifestyle increment during academy training is associated with about 2% decrement in blood pressures over time, after multivariable adjustments (P < 0.05). Nonetheless, the impacts of pandemic restrictions on academy procedures compromised physical fitness training, namely in percent body fat, push-ups, and pull-ups.
Autores: Martínez González, Miguel Ángel; Martín Calvo, Nerea (Autor de correspondencia); Bretos-Azcona, T.; et al.

Título: Mediterranean diet and cardiovascular prevention: why analytical observational designs do support causality and not only associationsciations

Revista: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH

ISSN: 1660-4601 Vol.19 N° 20 2022 págs. 13653

Resumen

Causal reductions in cardiovascular disease (CVD) with the Mediterranean diet (MedDiet) are supported by randomized trials, but the ability of nonrandomized studies to provide causal inferences in nutritional epidemiology is questioned. The "Seguimiento Universidad de Navarra" (SUN) project, conducted during 1999-2019 with 18,419 participants, was used to try to refute non-causal explanations for the inverse association found between adherence to the MedDiet and reduced CVD risk. A framework of different analytical strategies is proposed: alternative definitions of the exposure, exploration of residual confounding, resampling methods, depiction of absolute risks across the follow-up period, trial emulation, and negative controls. Additionally, we calculated the rate advancement period (RAP). We found that one standard deviation increase in the most frequently used MedDiet score was associated with a 29% relative reduction in CVD risk (95% Confidence Interval [CI] 14-41%), which is almost identical to that found in 2 randomized trials. The RAP of CVD would be postponed by an average of 7.9 years (95% CI: 1.6 to 14.2 years) by switching from low (MDS = 0 to2) to high (MDS = 7 to 9) adherence to the MedDiet in the fully adjusted model. Sensitivity analyses, graphical representations of absolute risks, trial emulation, and negative controls also supported causality. In conclusion, a framework of analytical approaches supported the causal effect of the MedDiet on CVD prevention using observational data. Similar methodology could be applied for causal inferences regarding other hypotheses.
Autores: Tresserra-Rimbau, A. (Autor de correspondencia); Castro-Barquero, S.; Becerra-Tomas, N.; et al.

Título: Adopting a high-polyphenolic diet is associated with an improved glucose profile: Prospective analysis within the PREDIMED-Plus Trial

Revista: ANTIOXIDANTS

ISSN: 2076-3921 Vol.11 N° 2 2022 págs. 316

Resumen

Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with better glucose levels and HbA1c after one year of follow-up. These associations were modified when the analyses were run considering diabetes status separately. To our knowledge, this is the first study to assess the relationship between changes in the intake of all polyphenolic groups and T2D-related parameters in a senior population with T2D or at high-risk of developing T2D.
Autores: Álvarez-Mon, M. A. (Autor de correspondencia); Fernández Lázaro, Cesar Ignacio (Autor de correspondencia); Llavero-Valero, M.; et al.

Título: Mediterranean diet social network impact along 11 years in the major US media outlets: thematic and quantitative analysis using Twitter

Revista: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH

ISSN: 1660-4601 Vol.19 N° 2 2022 págs. 784

Resumen

Background: Media outlets influence social attitudes toward health. Thus, it is important that they share contents which promote healthy habits. The Mediterranean diet (MedDiet) is associated with lower cardiovascular disease risk. Analysis of tweets has become a tool for understanding perceptions on health issues. Methods: We investigated tweets posted between January 2009 and December 2019 by 25 major US media outlets about MedDiet and its components as well as the retweets and likes generated. In addition, we measured the sentiment analysis of these tweets and their dissemination. Results: In total, 1608 tweets, 123,363 likes and 48,946 retweets about MedDiet or its components were analyzed. Dairy (inversely weighted in MedDiet scores) accounted for 45.0% of the tweets (723/1608), followed by nuts 19.7% (317/1608). MedDiet, as an overall dietary pattern, generated only 9.8% (157/1608) of the total tweets, while olive oil generated the least number of tweets. Twitter users' response was quantitatively related to the number of tweets posted by these US media outlets, except for tweets on olive oil and MedDiet. None of the MedDiet components analyzed was more likely to be liked or retweeted than the MedDiet itself. Conclusions: The US media outlets analyzed showed reduced interest in MedDiet as a whole, while Twitter users showed greater interest in the overall dietary pattern than in its particular components.
Autores: Casas, R.; Ribó-Coll, M.; Ros, E.; et al.

Título: Change to a healthy diet in people over 70 years old: the PREDIMED experience

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 3 2022 págs. 1429 - 1444

Resumen

Purpose: It is difficult to change dietary habits and maintain them in the long run, particularly in elderly people. We aimed to assess whether adherence to the Mediterranean diet (MedDiet) and cardiovascular risk factor were similar in the middle-aged and oldest participants in the PREDIMED study. Methods: We analyzed participants belonging to the first and fourth quartiles of age (Q1 and Q4, respectively) to compare between-group differences in adherence to the nutritional intervention and cardiovascular risk factor (CRF) control during a 3-year follow-up. All participants underwent yearly clinical, nutritional, and laboratory assessments during the following. Results: A total of 2278 patients were included (1091 and 1187 in Q1 and Q4, respectively). At baseline, mean ages were 59.6 ± 2.1 years in Q1 and 74.2 ± 2.6 years in Q4. In Q4, there were more women, greater prevalence of hypertension and diabetes, and lower obesity and smoking rates than the younger cohort (P ¿ 0.001, all). Adherence to the MedDiet was similar in Q1 and Q4 at baseline (mean 8.7 of 14 points for both) and improved significantly (P < 0.01) and to a similar extent (mean 10.2 and 10.0 points, respectively) during follow-up. Systolic blood pressure, low density-lipoprotein cholesterol, and body weight were similarly reduced at 3 years in Q1 and Q4 participants. Conclusion: The youngest and oldest participants showed improved dietary habits and CRFs to a similar extent after 3 years' intervention. Therefore, it is never too late to improve dietary habits and ameliorate CRF in high-risk individuals, even those of advanced age. Registration: The trial is registered in the London-based Current Controlled Trials Registry (ISRCTN number 35739639).
Autores: Gil Conesa, Mario; Amer, F.; Carlos Chillerón, Silvia; et al.

Título: Control of SARS-CoV-2 infection rates at a Spanish university with in-person class attendance

Revista: AMERICAN JOURNAL OF PUBLIC HEALTH

ISSN: 0090-0036 Vol.112 N° 4 2022 págs. 570 - 573

Resumen

The "Safe Campus Program," implemented in 2020 through 2021 at the University of Navarra (Spain), aimed to guarantee a safe return to university campus and prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks, avoiding university-wide lockdown. It included COVID-19 education, campus adaptation, and polymerase chain reaction (PCR) testing. We describe the main characteristics of the program and analyze the SARS-CoV-2 cumulative incidence among 14 496 university members. The 14-day cumulative incidence in the university was 415.2 versus 447.7 in the region. The program, sustainable in the long term, achieved low SARS-CoV-2 in-campus rates.
Autores: Hernando-Redondo, J.; Toloba, A.; Benaiges, D.; et al.

Título: Mid- and long-term changes in satiety-related hormones, lipid and glucose metabolism, and inflammation after a Mediterranean diet intervention with the goal of losing weight: a randomized, clinical trial

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 950900

Resumen

BackgroundObesity is produced by the enlargement of the adipose tissue. Functioning as an endocrine organ, it releases and receives information through a complex network of cytokines, hormones, and substrates contributing to a low-chronic inflammation environment. Diet and healthy habits play key roles in the prevention of obesity and its related pathologies. In this regard, there is a need to switch to healthier and more appetizing diets, such as the Mediterranean one. ObjectiveTo compare the mid-and long-term effects of two Mediterranean diet (MedDiet) interventions, one energy-reduced plus physical activity promotion versus a non-restrictive diet, on peripheral satiety-related hormones, weight loss, glucose/lipid metabolism, and pro-inflammatory markers in subjects with obesity/overweight and metabolic syndrome. Materials and methodsA randomized, lifestyle intervention was conducted in 23 Spanish centers, with a large cohort of patients presenting metabolic syndrome. Our study is a subproject set in IMIM (Hospital del Mar Research Institute). Participants were men and women, aged 55-75 and 60-75, respectively, who at baseline met at least three metabolic syndrome components. Subjects were assigned to two intervention groups: (1) an intensive lifestyle intervention with an energy-reduced MedDiet and physical activity promotion (intervention group) with the aim of weight loss; and (2) a normocaloric MedDiet (control). We quantified in a subsample of 300 volunteers from Hospital del Mar Research Institute (Barcelona), following analytes at baseline, 6 months, and 1 year: glucose, HbA1c, triglycerides, total cholesterol, high-density lipoprotein cholesterol, LDL cholesterol, C-peptide, ghrelin, GLP-1, glucagon, insulin, leptin, PAI-1, resistin, and visfatin. Anthropometric and classical cardiovascular risk factors were also determined. A multivariate statistical model was employed to compare the two groups. Linear mixed-effect models were performed to compare changes in risk factors and biomarkers between intervention groups and over time. ResultsCompared to participants in the control group, those in intervention one showed greater improvements in weight, waist circumference, insulin (P < 0.001), glucose metabolism-related compounds (P < 0.05), triglyceride-related lipid profile (P < 0.05), leptin, blood pressure, and pro-inflammatory markers such as PAI-1 (P < 0.001) at mid-and/or long-term. High-sensitivity C-reactive protein, resistin, and vifastin also decreased in both groups. ConclusionA weight loss intervention employing a hypocaloric MedDiet and physical activity promotion has beneficial effects on adiposity, glucose metabolism, lipid profile, leptin, and pro-inflammatory markers, such as PAI-1 in both mid-and long-term.
Autores: Valle-Hita, C.; Becerra-Tomás, N.; Díaz-López, A. (Autor de correspondencia); et al.

Título: Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 986190

Resumen

BackgroundDiets high in acid load may contribute to kidney function impairment. This study aimed to investigate the association between dietary acid load and 1-year changes in glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (UACR). MethodsOlder adults with overweight/obesity and metabolic syndrome (mean age 65 +/- 5 years, 48% women) from the PREDIMED-Plus study who had available data on eGFR (n = 5,874) or UACR (n = 3,639) at baseline and after 1 year of follow-up were included in this prospective analysis. Dietary acid load was estimated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) at baseline from a food frequency questionnaire. Linear and logistic regression models were fitted to evaluate the associations between baseline tertiles of dietary acid load and kidney function outcomes. One year-changes in eGFR and UACR were set as the primary outcomes. We secondarily assessed >= 10% eGFR decline or >= 10% UACR increase. ResultsAfter multiple adjustments, individuals in the highest tertile of PRAL or NEAP showed higher one-year changes in eGFR (PRAL, beta: -0.64 ml/min/1.73 m(2); 95% CI: -1.21 to -0.08 and NEAP, beta: -0.56 ml/min/1.73 m(2); 95% CI: -1.13 to 0.01) compared to those in the lowest category. No associations with changes in UACR were found. Participants with higher levels of PRAL and NEAP had significantly higher odds of developing >= 10% eGFR decline (PRAL, OR: 1.28; 95% CI: 1.07-1.54 and NEAP, OR: 1.24; 95% CI: 1.03-1.50) and >= 10 % UACR increase (PRAL, OR: 1.23; 95% CI: 1.04-1.46) compared to individuals with lower dietary acid load. ConclusionsHigher PRAL and NEAP were associated with worse kidney function after 1 year of follow-up as measured by eGFR and UACR markers in an older Spanish population with overweight/obesity and metabolic syndrome.
Autores: Goñi Mateos, Leticia; Razquin Burillo, Cristina; Toledo Atucha, Estefanía; et al.

Título: Arginine catabolism metabolites and atrial fibrillation or heart failure risk: 2 case-control studies within the Prevencion con Dieta Mediterranea (PREDIMED) trial

Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0002-9165 Vol.116 N° 3 2022 págs. 653 - 662

Resumen

Background: Arginine-derived metabolites are involved in oxidative and inflammatory processes related to endothelial functions and cardiovascular risks. Objectives: We prospectively examined the associations of arginine catabolism metabolites with the risks of atrial fibrillation (AF) or heart failure (HF), and evaluated the potential modifications of these associations through Mediterranean diet (MedDiet) interventions in a large, primary-prevention trial. Methods: Two nested, matched, case-control studies were designed within the Prevencion con Dieta Mediterranea (PREDIMED) trial. We selected 509 incident cases and 547 matched controls for the AF case-control study and 326 cases and 402 matched controls for the HF case-control study using incidence density sampling. Fasting blood samples were collected at baseline and arginine catabolism metabolites were measured using LC-tandem MS. Multivariable conditional logistic regression models were applied to test the associations between the metabolites and incident AF or HF. Interactions between metabolites and intervention groups (MedDiet groups compared with control group) were analyzed with the likelihood ratio test. Results: Inverse association with incident AF was observed for arginine (OR per 1 SD, 0.83; 95% CI: 0.73-0.94), whereas a positive association was found for N1-acetylspermidine (OR for Q4 compared with Q1 1.58; 95% CI: 1.13-2.25). For HF, inverse associations were found for arginine (OR per 1 SD, 0.82; 95% CI: 0.69-0.97) and homoarginine (OR per 1 SD, 0.81; 95% CI: 0.68-0.96), and positive associations were found for the asymmetric dimethylarginine (ADMA) and symmetric dimethlyarginine (SDMA) ratio (OR per 1 SD, 1.19; 95% CI: 1.02-1.41), N1 - acetylspermidine (OR per 1 SD, 1.34; 95% CI: 1.12-1.60), and diacetylspermine (OR per 1 SD, 1.20; 95% CI: 1.02-1.41). In the stratified analysis according to the dietary intervention, the lower HF risk associated with arginine was restricted to participants in the MedDiet groups (P-interaction = 0.044). Conclusions: Our results suggest that arginine catabolism metabolites could be involved in AF and HF. Interventions with the MedDiet may contribute to strengthen the inverse association between arginine and the risk of HF.
Autores: Hernández-Ruiz, Á. (Autor de correspondencia); Muñoz-Ruiz, M.; Ruiz-Canela, Miguel; et al.

Título: The Quality Index for Nutrition in Nursing Homes (QUINN): A new tool for evaluating diet quality in long-term care homes

Revista: NUTRICION HOSPITALARIA

ISSN: 0212-1611 Vol.39 N° 6 2022 págs. 1237 - 1255

Resumen

Background: the assessment of diet quality (DQ) is fundamental to the study of disease-diet associations, and it is necesary to implement an easy to-apply tool in nursing homes (NHs). Our objective was to propose and apply a novel diet quality indicator (DQIn) using an a priori approach for NHs. Methods: the QUality Index for Nutrition in Nursing homes (QUINN) was implemented in a public NH located in Valladolid, Spain, during a 5-week period (n = 137 subjects). The choice of the QUINN components was based on a rapid review. The QUINN was based on 15 dietary components ¿ 12 were basic (vegetables, fruits, legumes, olive oil, cereals, dairy, white fish and seafood, white-meat, eggs/positive; other fats, red and processed meat, and sweets/negative), and 3 were supplementary (fruits and vegetables variety, oily-fish, and whole-grains/positive). Each component was classified into 4-categories (0, 1, 2 o 3 points; range: 0-45 points). Results: the QUINN was tested on a menu offered by a NH giving a result of 34 points (good diet). The components with the highest scores were related to the Mediterranean diet (high consumption of legumes, olive oil, white fish and shellfish; low intake of other fats; and a wide variety of fruits and vegetables), together with cereals, white meat, dairy, and eggs. The components that required a major change were red- and processed-meats, sweets, and whole grains. Conclusion: the menu of this Spanish NH showed a good DQ according to the QUINN. The assessment of the DQ in NHs using QUINN will allow the proposal of interventions aimed at improving their diet.
Autores: Pérez Araluce, Rafael María; Martínez González, Miguel Ángel; Fernández Lázaro, Cesar Ignacio; et al.

Título: Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.41 N° 12 2022 págs. 3061 - 3068

Resumen

Background & aims: A potential protection against COVID-19 by a high-quality dietary pattern is to be expected given the biological plausibility supporting the beneficial effects of an adequate dietary intake on the immune system. However, knowledge on the relationship between long-term maintained healthy dietary patterns, such as the Mediterranean diet, and the risk of SARS-CoV-2 infection is still sparse. We longitudinally assessed this association in a well-known Mediterranean cohort. Methods: We assessed 9,677 participants from the SUN Project, a prospective cohort of middle-aged university graduates in Spain. We inquired about a positive result in a COVID-19 diagnostic test during the months of February to December 2020. After excluding health professionals (HP), 5,194 participants were included in the statistical analyses (mean age: 52.6, SD: 12.4; 55.2% women). Food habits were assessed at baseline using a previously validated semiquantitative 136-item food frequency questionnaire. Adherence to the Mediterranean diet (cumulative average of 2 repeated measurements 10 years apart) was assessed using the 0-to-9 Mediterranean Diet Score (MDS). We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident COVID-19 according to the MDS. Results: Among 5,194 non-HP participants, 122 reported to have received a positive COVID-19 diagnostic test. Participants with intermediate adherence to the Mediterranean diet (3 < MDS ¿ 6) had a significantly lower odds of developing COVID-19 (multivariable-adjusted OR = 0.50, 95% CI: 0.34-0.73), and those with the highest adherence (MDS > 6) exhibited the lowest risk (multivariable-adjusted OR = 0.36, 95% CI: 0.16-0.84, p for trend < 0.001) as compared with participants with MDS ¿ 3. This inverse association remained robust within subgroups and in sensitivity analyses. Notwithstanding, no significant associations were observed for health professionals (p for interaction = 0.06). Conclusion: In conclusion, better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19. Our results are applicable only to persons who are not health professionals.
Autores: Fernández Ciriza, Leire; González Hernández, Álvaro; del Pozo León, José Luis; et al.

Título: Humoral and cellular immune response over 9 months of mRNA-1273, BNT162b2 and ChAdOx1 vaccination in a University Hospital in Spain

Revista: SCIENTIFIC REPORTS

ISSN: 2045-2322 Vol.12 N° 1 2022 págs. 15606

Resumen

Scarce data have been reported about cellular immunity and longevity for different COVID-19 vaccination schedules. We carried out a prospective study enrolling 709 healthcare workers receiving two doses of mRNA-1273, BNT162b2, ChAdOx1, ChAdOx1/BNT162b2 or ChAdOx1 single dose to compare humoral and cellular immunogenicity across 9 months. Higher SARS-CoV-2 spike antibody levels were observed among individuals with hybrid immunity with one dose of any vaccine in comparison to uninfected individuals receiving two doses (mRNA-1273: 20,145 vs 4295 U/mL; BNT162b2: 15,659 vs 1959 U/mL; ChAdOx1: 5344 vs 2230 U/mL), except for ChAdOx1/BNT162b2 heterologous schedule (12,380 U/mL). Naturally infected individuals did not increase substantially the titers after the second dose and showed higher levels throughout the 9 months follow-up. The mean elimination half-life of antibodies among COVID-19 naive participants was 98, 111, 60 and 36 days, for mRNA-1273, BNT162b2, ChAdOx1/ChAdOx1 and ChAdOx1/BNT162b2, respectively. Cellular immunity was preserved in 96%, 98%, 88% and 92% of uninfected individuals who received mRNA-1273, BNT162b2, ChAdOx1/ChAdOx1 and ChAdOx1/BNT162b2 after 6/9 months. Individuals with specific T cells showed robust long lasting protection, especially when m-RNA based vaccines are inoculated. These data may influence the validity of the vaccination passport and the need for booster vaccinations.
Autores: Marhuenda-Muñoz, M.; Domínguez-López, I.; Laveriano-Santos, E. P.; et al.

Título: One-year changes in urinary microbial phenolic metabolites and the risk of type 2 diabetes-A case-control study

Revista: ANTIOXIDANTS

ISSN: 2076-3921 Vol.11 N° 8 2022 págs. 1540

Resumen

The intake of polyphenols has been associated with a risk reduction of type 2 diabetes. Nevertheless, to the best of our knowledge, the molecules that might be metabolically active after ingestion are only starting to be investigated regarding this metabolic disease. To investigate the association between one-year changes in urinary microbial phenolic metabolites (MPM) and the incidence of type 2 diabetes, we performed a case-control study using data and samples of the PREDIMED trial including 46 incident type 2 diabetes cases of 172 randomly selected participants. Eight urinary MPMs were quantified in urine by liquid chromatography coupled to mass spectrometry and used to assess their associations with type 2 diabetes risk by multivariable logistic regression models. Compared to participants in the lowest tertile of one-year changes in hydroxybenzoic acid glucuronide, those in the highest tertile had a significantly lowered probability of developing type 2 diabetes (OR [95% CI], 0.39 [0.23-0.64]; p < 0.001 for trend). However, when additionally adjusting for fasting plasma glucose, the statistical significance was lost. Changes in the dietary pattern can increase the concentrations of this compound, derived from many (poly)phenol-rich foods, and might be changing the gut microbial population as well, promoting the production of the metabolite.
Autores: Oncina-Canovas, A.; Vioque, J. (Autor de correspondencia); González-Palacios, S.; et al.

Título: Pro-vegetarian food patterns and cardiometabolic risk in the PREDIMED-Plus study: a cross-sectional baseline analysis

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 1 2022 págs. 357 - 372

Resumen

Purpose We explored the cross-sectional association between the adherence to three different provegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), and the cardiometabolic risk in adults with metabolic syndrome (MetS) of the PREDIMED-Plus randomized intervention study. Methods We performed a cross-sectional analysis of baseline data from 6439 participants of the PREDIMED-Plus randomized intervention study. The gPVG food pattern was built by positively scoring plant foods (vegetables/fruits/legumes/grains/potatoes/nuts/olive oil) and negatively scoring, animal foods (meat and meat products/animal fats/eggs/fish and seafood/dairy products). The hPVG and uPVG were generated from the gPVG by adding four new food groups (tea and coffee/fruit juices/sugar-sweetened beverages/sweets and desserts), splitting grains and potatoes and scoring them differently. Multivariable-adjusted robust linear regression using MM-type estimator was used to assess the association between PVG food patterns and the standardized Metabolic Syndrome score (MetS z-score), a composed index that has been previously used to ascertain the cardiometabolic risk, adjusting for potential confounders. Results A higher adherence to the gPVG and hPVG was associated with lower cardiometabolic risk in multivariable models. The regression coefficients for 5th vs. 1st quintile were - 0.16 (95% CI: - 0.33 to 0.01) for gPVG (p trend: 0.015), and - 0.23 (95% CI: - 0.41 to - 0.05) for hPVG (p trend: 0.016). In contrast, a higher adherence to the uPVG was associated with higher cardiometabolic risk, 0.21 (95% CI: 0.04 to 0.38) (p trend: 0.019). Conclusion Higher adherence to gPVG and hPVG food patterns was generally associated with lower cardiovascular risk, whereas higher adherence to uPVG was associated to higher cardiovascular risk.
Autores: Sayon Orea, María del Carmen; Carlos Chillerón, Silvia (Autor de correspondencia); Rico-Campa, A.; et al.

Título: Physicians' characteristics and practices associated with the provision of cancer screening advice to their patients: the Spanish SUN cohort study

Revista: BMJ OPEN

ISSN: 2044-6055 Vol.12 N° 1 2022 págs. e048498

Resumen

Objectives To evaluate the association between cancer screening counselling provided by medical doctors to their patients and each doctor's own anthropometrics, lifestyle, cancer screening practices, and personal and family history of cancer. Design Prospective cohort study. Setting Substudy including physicians participating in a Spanish cohort study with open enrolment. Participants Among 22 800 participants in the cohort as of May 2018, there were 2371 physicians who had replied to the cohort baseline questionnaire, had an email account and were younger than 65 years (retirement age in Spain). From this subsample, 890 replied to an online questionnaire focused on their clinical practices related to the counselling provided to their patients and to their prescription practices of preventive medications. Their mean age was 51.7 (SD 9.4) years and 48% were women. Outcome measures Frequency of counselling given to their patients on specific practices of breast, colorectal and prostate cancer screenings. Results Counselling on cancer screening to their patients was provided by 65% of physicians in a scenario of colorectal cancer, 59% for prostate cancer and 58% for breast cancer. More frequent cancer screening counselling was associated with the specialties of family medicine (OR=9.4, 95% CI 5.1 to 17.1) and internal medicine (OR=2.9, 95% CI 1.5 to 5.7) as compared with other specialties. Recommending cancer screening was associated with more frequent counselling on smoking cessation (OR=3.7, 95% CI 2.6 to 5.4), having personally attended colorectal cancer screening (OR=2.2, 95% CI 1.1 to 4.7) and prescribing blood pressure medication more often than their colleagues (OR=2.1, 95% CI 1.2 to 3.7). Conclusions Among medical doctors, cancer screening counselling was provided to their patients more frequently for doctors with family medicine or internal medicine specialties and for physicians who regularly offered counselling on certain lifestyle behaviours, and those having personally attended colorectal cancer screening. Doctors' own personal practices and knowledge of healthy lifestyles may help doctors to more frequently provide counselling on cancer screening to their patients.
Autores: Martínez González, Miguel Ángel (Autor de correspondencia); Barbería Latasa, María; Pérez de Rojas, J.; et al.

Título: Alcohol and early mortality (before 65 years) in the 'Seguimiento Universidad de Navarra' (SUN) cohort: does any level reduce mortality?

Revista: BRITISH JOURNAL OF NUTRITION

ISSN: 0007-1145 Vol.127 N° 9 2022 págs. 1415 - 1425

Resumen

The aim of this study was to assess the association between alcohol intake and premature mortality (younger than 65 years) and to explore the effect of potential alcohol underreporting by heavy drinkers. We followed-up 20 272 university graduates. Four categories of alcohol intake were considered (abstainer, light, moderate and heavy consumption). Repeated measurements of alcohol intake and updated information on confounders were used in time-dependent Cox models. Potential underreporting of alcohol intake by some heavy drinkers (likely misclassified as light or moderate drinkers) was explicitly addressed in an attempt to correct potential underreporting by using indirect information. During 12 center dot 3 years of median follow-up (interquartile range: 6 center dot 8-15 center dot 0), 226 participants died before their 65th birthday. A higher risk of early mortality was found for the highest category of alcohol intake (>= 50 g/d) in comparison with abstention (multivariable-adjusted hazard ratio (HR) = 2 center dot 82, 95 % CI 1 center dot 38, 5 center dot 79). In analyses of alcohol as a continuous variable, the multivariable-adjusted HR was 1 center dot 17 (95 % CI 1 center dot 08, 1 center dot 26), for each 10 g/d of alcohol. This harmful linear association was present both in uncorrected models and in models corrected for potential underreporting. No significant inverse association between light or moderate alcohol intake and premature mortality was observed, even after correcting for potential misclassification. Alcohol intake exhibited a harmful linear dose-response association with premature mortality (<65 years) in this young and highly educated Mediterranean cohort. Our attempts to correct for potential misclassification did not substantially change these results.
Autores: Gabaldón-Figueira, J. C. (Autor de correspondencia); Keen, E.; Giménez, G.; et al.

Título: Acoustic surveillance of cough for detecting respiratory disease using artificial intelligence

Revista: ERJ OPEN RESEARCH

ISSN: 2312-0541 Vol.8 N° 2 2022 págs. 053

Resumen

Research question Can smartphones be used to detect individual and population-level changes in cough frequency that correlate with the incidence of coronavirus disease 2019 (COVID-19) and other respiratory infections? Methods This was a prospective cohort study carried out in Pamplona (Spain) between 2020 and 2021 using artificial intelligence cough detection software. Changes in cough frequency around the time of medical consultation were evaluated using a randomisation routine; significance was tested by comparing the distribution of cough frequencies to that obtained from a model of no difference. The correlation between changes of cough frequency and COVID-19 incidence was studied using an autoregressive moving average analysis, and its strength determined by calculating its autocorrelation function (ACF). Predictors for the regular use of the system were studied using a linear regression. Overall user experience was evaluated using a satisfaction questionnaire and through focused group discussions. Results We followed-up 616 participants and collected >62 000 coughs. Coughs per hour surged around the time cohort subjects sought medical care (difference +0.77 coughs.h(-1); p=0.00001). There was a weak temporal correlation between aggregated coughs and the incidence of COVID-19 in the local population (ACF 0.43). Technical issues affected uptake and regular use of the system. Interpretation Artificial intelligence systems can detect changes in cough frequency that temporarily correlate with the onset of clinical disease at the individual level. A clearer correlation with population-level COVID-19 incidence, or other respiratory conditions, could be achieved with better penetration and compliance with cough monitoring.
Autores: Moreno Montañés, Javier; Gutiérrez-Ruiz, I.; Gándara Rodríguez de Campoamor, Elsa Pilar; et al.

Título: Carbohydrate intake and risk of glaucoma in the sun cohort

Revista: EUROPEAN JOURNAL OF OPHTHALMOLOGY

ISSN: 1120-6721 Vol.32 N° 2 2022 págs. 999 - 1008

Resumen

Purpose: To assess the association between carbohydrates (CH) intake and glaucoma incidence. Methods: 18,247 volunteer participants (183,067 person-years at risk) with 10-year of median follow-up were included in this prospective dynamic cohort. Baseline total CH intake (g/d) was categorised in quartiles and classified in nine different CH food sources. Self-reported diagnosis of glaucoma was collected at baseline and on biennial follow-up questionnaires. CH intake and glaucoma diagnosis were validated in a subsample of participants. We studied potential confounders and effect modificators, including diabetes. The relationship between CH intake and glaucoma incidence was analysed using multivariable Cox proportional hazards ratio (HR) models to adjust for potential confounding factors. Results: During 10 years of median follow-up, a total of 242 new cases of glaucoma were identified. Participants in the highest quartile of baseline CH intake had a significantly higher risk of glaucoma as compared to participants in the lowest quartile [HR 1.50 (95% Confidence interval (CI): 1.01-2.25), p for trend = 0.042]. None of the nine CH food groups was individually related to glaucoma. In stratified analyses, after excluding all cases of diabetes, the HR comparing extreme quartiles of CH intake was 1.77 (95% CI: 1.15-2.74). Conclusions: Our results suggest that a higher intake of total carbohydrates is associated with a higher risk of incident glaucoma. The total amount of CH, rather than the specific food sources of CH, seems to play a major role, and this association does not seem to be confounded or modified by diabetic status.
Autores: Soldevila-Domenech, N.; Pastor, A.; Sala-Vila, A.; et al.

Título: Sex differences in endocannabinoids during 3 years of Mediterranean diet intervention: association with insulin resistance and weight loss in a population with metabolic syndrome

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 1076677

Resumen

BackgroundExcess circulating endocannabinoids (eCBs) and imbalanced N-acylethanolamines (NAEs) related eCBs abundance could influence dietary weight loss success. We aimed to examine sex differences in the impact of a 3-years Mediterranean diet (MedDiet) intervention on circulating eCBs, NAEs and their precursor fatty acids, and to analyze the interplay between changes in eCBs or NAEs ratios, insulin resistance and the achievement of clinically meaningful weight reductions. MethodsProspective cohort study in a subsample of N = 105 participants (54.3% women; 65.6 +/- 4.6 years) with overweight or obesity and metabolic syndrome that underwent a 3-years MedDiet intervention (PREDIMED-Plus study). Plasma eCBs and NAEs, including 2-arachidonoylglycerol (2-AG), anandamide (AEA), oleoylethanolamide (OEA) and palmitoylethanolamide (PEA), fatty acids, diet, glycemic homeostasis (including the assessment of insulin resistance-HOMA-IR), and cardiovascular risk markers were monitored (at 0-6-12-36 months). ResultsMediterranean diet adherence increased in both sexes and remained high during the 3 years of follow-up. Reductions in body weight, glycemic and cardiovascular parameters were larger in men than in women. Women presented higher concentrations of NAEs than men throughout the study. In both sexes, AEA and other NAEs (including OEA, and PEA) decreased after 6 months (for AEA: -4.9%), whereas the ratio OEA/AEA increased after 1 year (+5.8%). Changes in 2-AG (-3.9%) and the ratio OEA/PEA (+8.2%) persisted over the 3 years of follow-up. In women, 6-months changes in AEA (OR = 0.65) and the ratio OEA/AEA (OR = 3.28) were associated with the achievement of 8% weight reductions and correlated with HOMA-IR changes (r = 0.29 and r = -0.34). In men, OEA/PEA changes were associated with 8% weight reductions (OR = 2.62) and correlated with HOMA-IR changes (r = -0.32). ConclusionA 3-years MedDiet intervention modulated plasma concentrations of eCBs and NAEs. Changes in AEA and in the relative abundance of NAEs were associated with clinically meaningful weight reductions. However, marked sex differences were identified in eCBs and NAEs, as well as in the efficacy of the intervention in terms of glycemic and cardiovascular parameters, which could be related to post-menopause alterations in glucose metabolism. These findings support a sex-balanced research strategy for a better understanding of the mechanisms underlying the regulation of body weight loss.
Autores: Rubín-García, M.; Vitelli-Storelli, F.; Álvarez-Álvarez, L. (Autor de correspondencia); et al.

Título: Association Among Polyphenol Intake, Uric Acid, and Hyperuricemia: A Cross-Sectional Analysis in a Population at High Cardiovascular Risk

Revista: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE

ISSN: 2047-9980 Vol.11 N° 20 2022 págs. e026053

Resumen

Background Dietary polyphenol intake has been associated with a decreased risk of hyperuricemia, but most of this knowledge comes from preclinical studies. The aim of the present study was to assess the association of the intake of different classes of polyphenols with serum uric acid and hyperuricemia. Methods and Results This cross-sectional analysis involved baseline data of 6332 participants. Food polyphenol content was estimated by a validated semiquantitative food frequency questionnaire and from the Phenol-Explorer database. Multivariable-adjusted linear regression models with serum uric acid (milligrams per deciliter) as the outcome and polyphenol intake (quintiles) as the main independent variable were fitted. Cox regression models with constant follow-up time (t=1) were performed to estimate the prevalence ratios (PRs) of hyperuricemia (>= 7 mg/dL in men and >= 6 mg/dL in women). An inverse association between the intake of the phenolic acid class (beta coefficient, -0.17 mg/dL for quintile 5 versus quintile 1 [95% CI, -0.27 to -0.06]) and hydroxycinnamic acids (beta coefficient, -0.19 [95% CI, -0.3 to -0.09]), alkylmethoxyphenols (beta coefficient, -0.2 [95% CI, -0.31 to -0.1]), and methoxyphenols (beta coefficient, -0.24 [95% CI, -0.34 to -0.13]) subclasses with serum uric acid levels and hyperuricemia (PR, 0.82 [95% CI, 0.71-0.95]; PR, 0.82 [95% CI, 0.71-0.95]; PR, 0.80 [95% CI, 0.70-0.92]; and PR, 0.79 [95% CI, 0.69-0.91]; respectively) was found. The intake of hydroxybenzoic acids was directly and significantly associated with mean serum uric acid levels (beta coefficient, 0.14 for quintile 5 versus quintile 1 [95% CI, 0.02-0.26]) but not with hyperuricemia. Conclusions In individuals with metabolic syndrome, a higher intake of some polyphenol subclasses (hydroxycinnamic acids, alkylmethoxyphenol, and methoxyphenol) was inversely associated with serum uric acid levels and hyperuricemia. Nevertheless, our findings warrant further research.
Autores: Atzeni, A.; Martínez, M.A.; Babio, N.; et al.

Título: Association between ultra-processed food consumption and gut microbiota in senior subjects with overweight/obesity and metabolic syndrome

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 976547

Resumen

The production and consumption of ultra-processed foods (UPF) has increased considerably during the last years worldwide. Collective evidence shows the association between UPF consumption and adverse health outcomes, including inflammatory gastro-intestinal disorders and obesity. The gut microbiota has been suggested as potential mediator of the effects of UPF consumption on metabolism and health. However, few studies have been conducted in order to elucidate these aspects. Therefore, the aim of the present study was to assess the cross-sectional associations between UPF consumption and gut microbiota in a population of senior subjects (n = 645) within the frame of the PREDIMED-Plus trial. Eligible participants were men and women (aged 55-75 years), without documented history of cardiovascular disease at enrollment, with overweight/obesity (body mass index <= 27 and <40 kg/m(2)) and metabolic syndrome. Using the information of food frequency questionnaires, the consumption of UPF, expressed as a percentage of total dietary energy intake in kcal/day, was calculated considering those food items classified in group 4 of NOVA system. Population was categorized according to tertiles of UPF consumption. Taxonomic fecal microbiota information, along with blood biochemical parameters, anthropometric measurements and clinical data were obtained. Bioinformatics analysis was performed to study the association between fecal microbiota composition and UPF consumption. We observed that subjects allocated in the highest tertile of UPF consumption (21.4 +/- 5.0 % kcal/day) presented lower adherence to MedDiet (p < 0.001) and higher total energy intake (p < 0.001). The taxonomic analysis of the fecal microbiota revealed a significant (Benjamini-Hochberg adjusted p < 0.2) positive association between specific taxa and tertiles (T) of UPF consumption: Alloprevotella (p = 0.041 vs. T2; p = 0.065 vs. T3), Negativibacillus (p = 0.096 vs. T3), Prevotella (p = 0.116 vs. T3), and Sutterella (p = 0.116 vs. T2). UPF consumption was positively associated with lower adherence to MedDiet and higher total energy intake in senior subjects with overweight obesity and metabolic syndrome. In addition, positive association with specific fecal microbiota taxa related to inflammatory gastro-intestinal diseases and low consumption of fruits and vegetables, was observed.
Autores: Vanegas, P.; Zazpe García, Itzíar; Santiago Neri, Susana; et al.

Título: Macronutrient quality index and cardiovascular disease risk in the Seguimiento Universidad de Navarra (SUN) cohort

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 7 2022 págs. 3517 - 3530

Resumen

Purpose To assess the association between a multi-dimensional Macronutrient Quality Index (MQI) and the risk of cardiovascular disease (CVD) in a Mediterranean cohort. Methods Prospective analyses among 18,418 participants (mean age 36 years, 60.8% women) of the Seguimiento Universidad de Navarra (SUN) cohort. Dietary intake information was obtained through a validated semi-quantitative food-frequency questionnaire (FFQ). The MQI (expressing high-quality macronutrient intake) was calculated based on three previously reported quality indices: the Carbohydrate Quality Index (CQI), the Fat Quality Index (FQI), and the Healthy Plate Protein source Quality Index (HPPQI). Adherence to the Mediterranean diet (MedDiet) and Provegetarian Diet was evaluated using the Trichopoulou index and the score proposed by Martinez-Gonzalez, respectively. CVD was defined as new-onset stroke, myocardial infarction, or CVD death. Results After a median follow-up time of 14 years (211,744 person-years), 171 cases of CVD were identified. A significant inverse association was found between the MQI and CVD risk with multivariable-adjusted HR for the highest vs. the lowest quartile of 0.60 (95% IC, 0.38-0.96; P-trend = 0.024). Conclusion In this Mediterranean cohort, we found a significant inverse relationship between a multidimensional MQI (expressing high-quality macronutrient intake) and a lower risk of CVD.
Autores: Moreno Montañés, Javier; Gándara Rodríguez de Campoamor, Elsa Pilar; Moreno-Galarraga, L.; et al.

Título: ACE-Vitamin Index and Risk of Glaucoma: the SUN Project

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.14 N° 23 2022 págs. 5129

Resumen

Background: Previous studies regarding antioxidant consumption and glaucoma have shown contradictory results. The aim of this study was to analyze the combined effect of the consumption of three vitamins (A, C and E) on the incidence of glaucoma in the SUN Project. Methods: For this study, 18,669 participants were included. The mean follow-up was 11.5 years. An index including vitamins A, C and E (ACE-Vitamin Index) was calculated. Vitamin intake was extracted from participants' dietary data and vitamin supplements, if taken. Information on glaucoma incidence was collected by previously validated self-reported questionnaires. The association between glaucoma and vitamin intake was assessed by repeated-measures Cox regression using multi-adjusted hazard ratios. Results: A total of 251 (1.3%) cases of glaucoma were detected. Participants with a higher ACE-Vitamin Index presented a reduced risk of glaucoma compared to participants with lower consumption (adjusted HR = 0.73; 95% CI, (0.55-0.98)). When each vitamin was analyzed individually, none of them had a significant protective effect. The protective effect of the ACE-Vitamin Index was higher in men and older participants (>= 55 year). Conclusions: The consumption of vitamins A, C and E considered separately do not seem to exert a protective effect against glaucoma, but when these vitamins are considered together, they are associated with a lower risk of glaucoma.
Autores: Jannasch, F. (Autor de correspondencia); Dietrich, S.; Bishop, T. R. P.; et al.

Título: Associations between exploratory dietary patterns and incident type 2 diabetes: a federated meta-analysis of individual participant data from 25 cohort studies

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 7 2022 págs. 3649 - 3667

Resumen

Purpose In several studies, exploratory dietary patterns (DP), derived by principal component analysis, were inversely or positively associated with incident type 2 diabetes (T2D). However, findings remained study-specific, inconsistent and rarely replicated. This study aimed to investigate the associations between DPs and T2D in multiple cohorts across the world. Methods This federated meta-analysis of individual participant data was based on 25 prospective cohort studies from 5 continents including a total of 390,664 participants with a follow-up for T2D (3.8-25.0 years). After data harmonization across cohorts we evaluated 15 previously identified T2D-related DPs for association with incident T2D estimating pooled incidence rate ratios (IRR) and confidence intervals (CI) by Piecewise Poisson regression and random-effects meta-analysis. Results 29,386 participants developed T2D during follow-up. Five DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, were associated with higher incidence of T2D. The strongest association was observed for a DP comprising these food groups besides others (IRRpooled per 1 SD = 1.104, 95% CI 1.059-1.151). Although heterogeneity was present (I-2 = 85%), IRR exceeded 1 in 18 of the 20 meta-analyzed studies. Original DPs associated with lower T2D risk were not confirmed. Instead, a healthy DP (HDP1) was associated with higher T2D risk (IRRpooled per 1 SD = 1.057, 95% CI 1.027-1.088). Conclusion Our findings from various cohorts revealed positive associations for several DPs, characterized by higher intake of red meat, processed meat, French fries and refined grains, adding to the evidence-base that links DPs to higher T2D risk. However, no inverse DP-T2D associations were confirmed.
Autores: Gomez-Martinez, C.; Babio, N. (Autor de correspondencia); Julvez, J.; et al.

Título: Impulsivity is longitudinally associated with healthy and unhealthy dietary patterns in individuals with overweight or obesity and metabolic syndrome within the framework of the PREDIMED-Plus trial

Revista: INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY

ISSN: 1479-5868 Vol.19 N° 1 2022 págs. 101

Resumen

Background: Few studies have analyzed the associations between impulsivity and dietary patterns. Some of them have shown a cross-sectional inverse relationship between impulsivity and healthy diet scores, whereas others reported a positive association with unhealthy dietary assessments. We aimed to examine longitudinal associations of impulsivity trait with adherence to healthy and unhealthy dietary patterns in older participants at high risk of cardiovascular disease over 3 years of follow-up. Methods: A 3-year prospective cohort analysis within the PRED-IMED-Plus-Cognition study conducted in 4 PREDIMED-Plus study centers was performed. The PREDIMED-Plus study aimed to test the beneficial effect of a lifestyle intervention on the primary prevention of cardiovascular disease. The participants with overweight or obesity and metabolic syndrome included in the present study (n = 462; mean age of 65.3 years; 51.5% female) completed both the UPPS-P Impulsive Behavior Scale (range: 0-236 points) and the 143-item Food Frequency Questionnaire at baseline, 1-year and 3-years of follow-up. Ten diet scores assessing healthy and unhealthy dietary patterns were evaluated. Linear mixed models were performed adjusting by several confounders to study the longitudinal associations between impulsivity trait and adherence to dietary pattern scores over 3 years of follow-up (also assessing interactions by sex, age, and intervention group). Results: Impulsivity were negatively associated with adherence to the Healthy Plant-Based [beta=-0.92 (95%CI -1.67, -0.16)], Mediterranean [beta= -0.43 (95%CI -0.79, -0.07)], Energy-Restricted Mediterranean [beta = -0.76 (95%CI -1.16, -0.37)], Alternative Healthy Eating Index [beta = -0.88 (95%CI -1.52, -0.23)], Portfolio [beta = -0.57 (95%CI -0.91, -0.22)], and DASH [beta = -0.50 (95%CI -0.79, -0.22)] diet scores over 3 years of follow-up, whereas impulsivity was positively related with adherence to the unhealthy Western diet [beta = 1.59 (95%CI 0.59, 2.58)] over time. An interaction by intervention group was found, with those participants in the intervention group with high impulsivity levels having lower adherence to several healthy dietary patterns. Conclusions: Heightened impulsivity was longitudinally associated with lower adherence to healthy dietary patterns and higher adherence to the Western diet over 3 years of follow-up. Furthermore, nutritional intervention programs should consider impulsivity as a relevant factor for the intervention success.
Autores: Pano Espínola, Octavio; Sayon Orea, María del Carmen (Autor de correspondencia); Hershey de la Cruz, María Soledad; et al.

Título: Development of a general health score based on 12 objective metabolic and lifestyle items: the lifestyle and well-being index

Revista: HEALTHCARE

ISSN: 2227-9032 Vol.10 N° 6 2022 págs. 1088

Resumen

Healthy and unhealthy lifestyles are tightly linked to general health and well-being. However, measurements of well-being have failed to include elements of health and easy to interpret information for patients seeking to improve lifestyles. Therefore, this study aimed to create an index for the assessment of general health and well-being along with two cut-off points: the lifestyle and well-being index (LWB-I). This was a cross-sectional analysis of 15,168 individuals. Internally valid multivariate linear models were constructed using key lifestyle features predicting a modified Short Form 36 questionnaire (SF-36) and used to score the LWB-I. Categorization of the LWB-I was based on self-perceived health (SPH) and analyzed using receiver operating characteristic curve analysis. Optimal cut-points identified individuals with poor and excellent SPH. Lifestyle and well-being were adequately accounted for using 12 lifestyle items. SPH groups had increasingly healthier lifestyle features and LWB-I scores; optimal cut-point for poor SPH were scores below 80 points (AUC: 0.80 (0.79, 0.82); sensitivity 75.7%, specificity 72.3%)) and above 86 points for excellent SPH (AUC: 0.67 (0.66, 0.69); sensitivity 61.4%, specificity 63.3%). Lifestyle and well-being were quantitatively scored based on their associations with a general health measure in order to create the LWB-I along with two cut points.
Autores: Bullon Vela, Maria Vanessa; Sayon Orea, María del Carmen; Gómez-Donoso, C.; et al.

Título: Mortality prediction of the nutrient profile of the Chilean front-of-pack warning labels: Results from the Seguimiento Universidad de Navarra prospective cohort study

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 951738

Resumen

Background and aimsFront-of-Pack (FoP) nutrition labelling has been established as a policy, empowering consumers to choose healthy food options for preventing diet-related non-communicable diseases. This study aimed to evaluate the association between the nutrient profile underlying the Chilean warning label score and all-cause mortality and to conduct a calibration with the Nutri-Score in a large cohort of Spanish university graduates. Materials and methodsThis prospective cohort study analysed 20,666 participants (8,068 men and 12,598 women) with a mean (standard deviation) age of 38 years (+/- 12.4) from the SUN cohort. Dietary food intake was assessed by a validated semi-quantitative food-frequency questionnaire at baseline and after 10 years of follow-up. The warning label score was calculated by considering the threshold of nutrients (sugar, saturated fat, and sodium) and energy density per 100 g/ml of product, as established by Chilean Legislation. Participants were classified according to quartiles of consumption of daily label score: Q1 (<= 5.0), Q2 (>5.0-7.1), Q3 (>7.1-9.8), and Q4 (>9.8). Time-dependent, multivariable-adjusted Cox models were applied. To compare the performance of the warning label score and Nutri-Score to predict mortality, we used the Akaike information criterion (AIC) and Bayesian information criterion (BIC) methods. ResultsDuring a median of 12.2 years of follow-up, 467 deaths were identified. A higher score in the warning label values (lower nutritional quality) was associated with an increased risk of all-cause mortality [HR (95% CI) Q4 vs. Q1: 1.51 (1.07-2.13); p-trend = 0.010] and cancer mortality [HR (95% CI) Q4 vs. Q1: 1.91 (1.18-3.10); p-trend = 0.006]. However, no statistically significant association was found for cardiovascular mortality. Furthermore, the warning label score and Nutri-Score exhibited comparable AIC and BIC values, showing similar power of prediction for mortality. ConclusionA diet with a higher warning label score (>9.8 per day) was a good predictor of all cases and cancer mortality in a large Spanish cohort of university graduates. Also, the warning label score was capable to predict mortality as well as the Nutri-Score. Our findings support the validity of the warning label score as a FoP nutrition labelling policy since it can highlight less healthy food products.
Autores: Fernández-García, J. C. (Autor de correspondencia); Barrios-Rodríguez, R.; Asenjo-Plaza, M.; et al.

Título: Metformin, testosterone, or both in men with obesity and low testosterone: a double-blind, parallel-group, randomized controlled trial

Revista: METABOLISM-CLINICAL AND EXPERIMENTAL

ISSN: 0026-0495 Vol.136 2022 págs. 155290

Resumen

Background: Men with obesity tend to be insulin resistant and often have low-normal testosterone concentrations. We conducted a clinical trial aimed to evaluate potential therapeutic strategies for low testosterone in men with obesity.Methods: We did a 1-year, parallel, randomized, double-blind, placebo-controlled trial, where we evaluated the independent and combined effects of metformin and testosterone in 106 men with obesity, aged 18-50 years, who had low levels of testosterone and no diabetes mellitus. The primary outcome was change in insulin resistance, measured as Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index. Secondary outcomes included changes in total and free serum testosterone, body composition, metabolic variables, erectile function, and health-related quality of life (HRQoL).Results: In the intention-to-treat analysis, the HOMA-IR index decreased significantly in all active groups compared to placebo (metformin-2.4, 95 % CI-4.1 to-0.8, p = 0.004; testosterone-2.7, 95 % CI-4.3 to-1.1, p = 0.001; combination-3.4, 95 % CI-5.0 to-1.8, p < 0.001). Combination therapy was not superior to testosterone alone in decreasing insulin resistance (-0.7, 95 % CI-2.3 to 0.9, p = 0.383). Only the combination of metformin plus testosterone significantly increased total and free testosterone concentrations, compared to placebo. No significant changes in body composition (except for a higher decrease in fat mass in the metformin and combination group), metabolic variables, erectile function, or HRQoL were found with any treatment.Conclusions: Among men with obesity and low testosterone concentrations, the combination of metformin plus testosterone, metformin only, and testosterone only, compared to placebo, reduced insulin resistance with no evidence of additive benefit.
Autores: García-Gavilán, J. F.; Paz-Graniel, I.; Babio, N.; et al.

Título: Inflammatory potential of diet and bone mineral density in a senior Mediterranean population: a cross-sectional analysis of PREDIMED-Plus study

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 3 2022 págs. 1445 - 1455

Resumen

Purpose Inflammation could play a key role in tissue damage and bone metabolism. The modified dietary inflammatory score (M-DIS) is a validated tool to estimate the inflammatory potential of the diet. In the present study, we evaluate the associations between the M-DIS and bone mineral density (BMD) in a senior Mediterranean population with overweight/obesity and metabolic syndrome. Methods Baseline cross-sectional association between the M-DIS and bone mineral density was assessed in 1134 participants of the multicenter PREDIMED-Plus trial (aged 55-75 with overweight/obesity and metabolic syndrome). BMD was measured using Dual-energy X-ray Absorptiometry scans and participants answered a food frequency questionnaire to determine the M-DIS. BMD was categorized as low BMD when T score was equal or lower than -1 and normal BMD in another case. Associations between BMD and M-DIS were evaluated by using linear and logistic regressions adjusted by other co-variates. Results Participants in the top tertile of the M-DIS had a lower BMD at total femur [beta (95% CI) - 0.02 (- 0.04, - 0.01)], trochanter areas [beta (95% CI) - 0.03 (- 0.05, - 0.01)] and lumbar spine area [beta (95% CI) - 0.03 (- 0.07, 0.01)] (but in the last case, measures were less precise and hence not statistically significant) compared to those in the lower M-DIS tertile. Multiple logistic regression analyses showed that the odds of the total femur and femoral trochanter osteopenia/osteoporosis were higher in participants in the top tertile compared to those in the lowest tertile of M-DIS [OR (95% CI) 1.71 (1.12, 2.64), P for trend 0.015; 2.02 (1.29, 3.21), P for trend 0.002, respectively]. Conclusion A high pro-inflammatory diet, measured by the M-DIS, is associated with lower BMD in a senior Mediterranean population with metabolic syndrome.
Autores: De la O Pascual, Víctor; Zazpe García, Itzíar; Goñi Mateos, Leticia; et al.

Título: A score appraising Paleolithic diet and the risk of cardiovascular disease in a Mediterranean prospective cohort

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 2 2022 págs. 957 - 971

Resumen

Purpose: To assess the association between a score appraising adherence to the PaleoDiet and the risk of cardiovascular disease (CVD) in a Mediterranean cohort. Methods: We included 18,210 participants from the Seguimiento Universidad de Navarra (SUN) cohort study. The PaleoDiet score comprised six food groups promoted within this diet (fruit, nuts, vegetables, eggs, meat and fish) and five food groups whose consumption is discouraged (cereals and grains, dairy products, legumes, culinary ingredients, and processed/ultra-processed foods). CVD was defined as acute myocardial infarction with or without ST elevation, non-fatal stroke and cardiovascular death. Cox proportional hazards models adjusted for potential confounders were fitted to assess the association between the PaleoDiet score and CVD risk, and the PaleoDiet and MedDiet indices to explore differences between both diets. Results: During 12.2 years of follow-up, 165 incident CVD cases were confirmed. A significant inverse association was found between the PaleoDiet score and CVD (HR Q5 vs. Q1: 0.45, 95% CI 0.27-0.76, P for trend = 0.007). A weaker association that became non-significant was observed when the item for low consumption of ultra-processed foods was removed from the score. Joint analysis of PaleoDiet and MedDiet Trichopoulou scores suggested that the inverse association between PaleoDiet and CVD was mainly present when adherence to the MedDiet was also high (HR for high adherence vs low adherence to both diet scores: 0.22, 95% CI 0.08-0.64). Conclusions: Our findings suggest that the PaleoDiet may have cardiovascular benefits in participants from a Mediterranean country. Avoidance of ultra-processed foods seems to play a key role in this inverse association.
Autores: Guasch-Ferre, M. (Autor de correspondencia); Li, Y.; Willett, W. C.; et al.

Título: Consumption of olive oil and risk of total and cause-specific mortality among US adults

Revista: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

ISSN: 0735-1097 Vol.79 N° 2 2022 págs. 101 - 112

Resumen

BACKGROUND Olive oil consumption has been shown to tower cardiovascular disease risk, but its associations with total and cause-specific mortality are unclear. OBJECTIVES The purpose of this study was to evaluate whether olive oil intake is associated with total and cause-specific mortality in 2 prospective cohorts of U.S. men and women. METHODS The authors used multivariable-adjusted Cox proportional-hazards models to estimate HRs for total and cause-specific mortality among 60,582 women (Nurses' Health Study, 1990-2018) and 31,801 men (Health Professionals Follow-up Study, 1990-2018) who were free of cardiovascular disease or cancer at baseline. Diet was assessed by a semiquantitative food frequency questionnaire every 4 years. RESULTS During 28 years of follow-up, 36,856 deaths occurred. The multivariable-adjusted pooled HR for all-cause mortality among participants who had the highest consumption of olive oil (>0.5 tablespoon/day or >7 g/d) was 0.81 (95% 0: 0.78-0.84) compared with those who never or rarely consumed olive oil. Higher olive oil intake was associated with 19% tower risk of cardiovascular disease mortality (HR: 0.81; 95% CI: 0.75-0.87), 17% tower risk of cancer mortality (HR: 0.83; 95% CI: 0.78-0.89), 29% lower risk of neurodegenerative disease mortality (HR: 0.71; 95% CI: 0.64-0.78), and 18% lower risk of respiratory disease mortality (HR: 0.82; 95% CI: 0.72-0.93). In substitution analyses, replacing 10 g/d of margarine, butter, mayonnaise, and dairy fat with the equivalent amount of olive oil was associated with 8%-34% lower risk of total and cause-specific mortality. No significant associations were observed when olive oil was compared with other vegetable oils combined. CONCLUSIONS Higher olive oil intake was associated with tower risk of total and cause-specific mortality. Replacing margarine, butter, mayonnaise, and dairy fat with olive oil was associated with lower risk of mortality. (C) 2022 by the American College of Cardiology Foundation.
Autores: Qi, Q. (Autor de correspondencia); Li, J.; Yu, B.; et al.

Título: Host and gut microbial tryptophan metabolism and type 2 diabetes: an integrative analysis of host genetics, diet, gut microbiome and circulating metabolites in cohort studies

Revista: GUT

ISSN: 0017-5749 Vol.71 N° 6 2022 págs. 1095 - 1105

Resumen

Objective Tryptophan can be catabolised to various metabolites through host kynurenine and microbial indole pathways. We aimed to examine relationships of host and microbial tryptophan metabolites with incident type 2 diabetes (T2D), host genetics, diet and gut microbiota. Method We analysed associations between circulating levels of 11 tryptophan metabolites and incident T2D in 9180 participants of diverse racial/ethnic backgrounds from five cohorts. We examined host genome-wide variants, dietary intake and gut microbiome associated with these metabolites. Results Tryptophan, four kynurenine-pathway metabolites (kynurenine, kynurenate, xanthurenate and quinolinate) and indolelactate were positively associated with T2D risk, while indolepropionate was inversely associated with T2D risk. We identified multiple host genetic variants, dietary factors, gut bacteria and their potential interplay associated with these T2D-relaetd metabolites. Intakes of fibre-rich foods, but not protein/tryptophan-rich foods, were the dietary factors most strongly associated with tryptophan metabolites. The fibre-indolepropionate association was partially explained by indolepropionate-associated gut bacteria, mostly fibre-using Firmicutes. We identified a novel association between a host functional LCT variant (determining lactase persistence) and serum indolepropionate, which might be related to a host gene-diet interaction on gut Bifidobacterium, a probiotic bacterium significantly associated with indolepropionate independent of other fibre-related bacteria. Higher milk intake was associated with higher levels of gut Bifidobacterium and serum indolepropionate only among genetically lactase non-persistent individuals. Conclusion Higher milk intake among lactase non-persistent individuals, and higher fibre intake were associated with a favourable profile of circulating tryptophan metabolites for T2D, potentially through the host-microbial cross-talk shifting tryptophan metabolism toward gut microbial indolepropionate production.
Autores: Donat-Vargas, C. (Autor de correspondencia); Sandoval-Insausti, H.; Peñalvo, J. L.; et al.

Título: Olive oil consumption is associated with a lower risk of cardiovascular disease and stroke

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.41 N° 1 2022 págs. 122 - 130

Resumen

Background & aims: The specific association of olive oil consumption with coronary heart disease (CHD) or stroke has not been totally established. Objective: to examine whether olive oil consumption is associated with subclinical atherosclerosis, the risk of total cardiovascular disease (CVD), CHD, and stroke. Methods: Three cohorts were included: AWHS (2318 men), SUN Project (18,266 men and women), and EPIC-Spain (39,393 men and women). Olive oil consumption was measured at baseline using validated questionnaires. Results: In the AWHS, 747 participants had a positive coronary artery calcium score (CACS>0), and the OR (95% CI) was 0.89 (0.72, 1.10) in those with virgin olive oil consumption >30 g/day (v. <10 g/day). In the SUN Project (follow-up 10.8 years) 261 total CVD cases occurred, and the HR was 0.57 (0.34, 0.96) for consumptions >30 g/day (v. <10 g/day). In the EPIC-Spain (follow-up 22.8 years) 1300 CHD cases and 938 stroke cases occurred; the HRs for stroke according, 0 to <10 (ref), 10 to <20, 20 to <30, and >30 g/day of olive oil consumption, were 0.84 (0.70, 1.02), 0.80 (0.66, 0.96), 0.89 (0.74, 1.07). A weaker association was observed for CHD. The association was stronger among those consuming virgin olive oil, instead of common (refined). Conclusions: Olive oil is associated with lower risk of CVD and stroke. The maximum benefit could be obtained with a consumption between 20 and 30 g/day. The association could be stronger for virgin olive oil and might operate from the early stages of the disease.
Autores: Arredondo Montero, J. (Autor de correspondencia); Antona, G.; Bardaji Pascual, C.; et al.

Título: Serum neutrophil gelatinase-associated lipocalin (NGAL) as a diagnostic tool in pediatric acute appendicitis: a prospective validation study

Revista: PEDIATRIC SURGERY INTERNATIONAL

ISSN: 0179-0358 Vol.38 N° 11 2022 págs. 1569 - 1576

Resumen

Introduction NGAL has recently been studied as a biomarker in the diagnostic context of pediatric acute appendicitis (PAA), although existing series are scarce and have limited sample sizes. Materials and methods A prospective observational study was designed to validate serum NGAL as a diagnostic tool in PAA. This study included 215 patients, divided into 3 groups: (1) patients undergoing major outpatient surgery (n = 63), (2) patients with non-surgical abdominal pain in whom a diagnosis of PAA was excluded (n = 53) and (3) patients with a confirmed diagnosis of PAA (n = 99). Patients in group 3 were divided into complicated or uncomplicated appendicitis. In 201 patients, a serum sample was obtained at the time of diagnosis and NGAL concentration was determined by ELISA. The Kolmogorov-Smirnov test was used to assess normality. Comparative statistical analyses were performed using the Mann-Whitney U test, the Kruskal-Wallis test and the Fisher's exact test. To calculate the discriminative ability of the molecule, the area under the receiver-operating characteristic curves (AUC) was calculated. A p value < 0.05 established statistical significance. Results Median (interquartile range) of serum NGAL values were 38.88 (27.15-48.04) ng/mL (group 1), 51.84 (37.33-69.80) ng/mL (group 2) and 65.06 (50.50-86.60) ng/mL (group 3). The AUC (group 2 vs 3) was 0.642 (95% CI 0.542-0.741) (p < 0.001) and the best cutoff point was found to be at 40.97 ng/mL, with a sensitivity of 89% and a specificity of 34.6%. No statistically significant differences in serum NGAL values were found between patients with uncomplicated PAA and those with complicated PAA. Conclusions This prospective validation study with a large sample size confirms that the diagnostic yield of NGAL in the context of PAA is only moderate, and therefore, it should not be used as a unique diagnostic tool. Furthermore, NGAL is not a valid biomarker to discern between uncomplicated and complicated PAA.
Autores: Melero Bermejo, Ignacio; Villalba Esparza, María; Recalde Zamacona, Borja; et al.

Título: Neutrophil extracellular traps, local IL-8 expression, and cytotoxic T-lymphocyte response in the lungs of patients with fatal COVID-19

Revista: CHEST

ISSN: 0012-3692 Vol.162 N° 5 2022 págs. 1006 - 1016

Resumen

BACKGROUND: Excessive inflammation is pathogenic in the pneumonitis associated with severe COVID-19. Neutrophils are among the most abundantly present leukocytes in the inflammatory infiltrates and may form neutrophil extracellular traps (NETs) under the local influence of cytokines. NETs constitute a defense mechanism against bacteria, but have also been shown to mediate tissue damage in a number of diseases. RESEARCH QUESTION: Could NETs and their tissue-damaging properties inherent to neutrophil- associated functions play a role in the respiratory failure seen in patients with severe COVID-19, and how does this relate to the SARS-CoV-2 viral loads, IL-8 (CXCL8) chemokine expression, and cytotoxic T-lymphocyte infiltrates? STUDY DESIGN AND METHODS: Sixteen lung biopsy samples obtained immediately after death were analyzed methodically as exploratory and validation cohorts. NETs were analyzed quantitatively by multiplexed immunofluorescence and were correlated with local levels of IL-8 messenger RNA (mRNA) and the density of CD8+ T-cell infiltration. SARS-CoV-2 presence in tissue was quantified by reverse-transcriptase polymerase chain reaction and immunohistochemistry analysis. RESULTS: NETs were found in the lung interstitium and surrounding the bronchiolar epithelium with interindividual and spatial heterogeneity. NET density did not correlate with SARS-CoV-2 tissue viral load. NETs were associated with local IL-8 mRNA levels. NETs were also detected in pulmonary thrombi and in only one of eight liver tissues. NET focal presence correlated negatively with CD8+ T-cell infiltration in the lungs. INTERPRETATION: Abundant neutrophils undergoing NETosis are found in the lungs of patients with fatal COVID-19, but no correlation was found with viral loads. The strong association between NETs and IL-8 points to this chemokine as a potentially causative factor. The function of cytotoxic T-lymphocytes in the immune responses against SARS-CoV-2 may be interfered with by the presence of NETs.
Autores: Pimenta, A. M. (Autor de correspondencia); Mendonca, R. D.; Lahortiga Ramos, Francisca; et al.

Título: Sedentary behaviors and risk of depression in the Seguimiento Universidad de Navarra cohort: the SUN Project

Revista: CADERNOS DE SAUDE PUBLICA

ISSN: 0102-311X Vol.38 N° 2 2022 págs. e00076621

Resumen

The study aimed to prospectively examine the association between different sedentary behaviors and the risk of depression. We included 12,691 Spanish university graduates (mean age: 36.7 year; SD: 11.5), participants of the Seguimiento Universidad de Navarra cohort (the SUN Project), initially free of depression who were followed-up fir a median of 10.9 years. Based on items presented in our baseline questionnaire, time spent in four sedentary behaviors (hours/day) were evaluated: overall sitting time; TV-viewing; computer use; and driving. Participants were classified as incident cases of depression if they reported a physician diagnosis of depression in at least one of the followup assessments conducted after the first two years offollow-up. Cox regression models were used to assess the relationship between sedentary behaviors and depression. A total of 560 incident cases of depression were identified during follow-up. We found no significant association between overall sitting time, TV-viewing or driving and risk of depression. On the other hand, computer use was directly associated with the risk of developing depression during the follow-up (p-value for trend = 0.020), with the participants in the highest quartile of computer use (3.64 to 10 hours/week) having a higher risk of developing depression (HR = 1.33; 95%CI: 1.05-1.70) than those in the lowest quartile (0 to 0.25 hours/week) after adjusting for potential confounders. Prolonged use of computer was independently associated with an increased risk of developing depression among young middle-aged adult university graduates from a Spanish cohort.
Autores: Rubín-García, M.; Vitelli-Storelli, F. (Autor de correspondencia); Toledo Atucha, Estefanía; et al.

Título: Polyphenol intake and cardiovascular risk in the PREDIMED-Plus trial. A comparison of different risk equations

Revista: REVISTA ESPAÑOLA DE CARDIOLOGIA

ISSN: 0300-8932 Vol.75 N° 5 2022 págs. 401 - 411

Resumen

Introduction and objectives: Quantification of cardiovascular risk has been based on scores such as Framingham, Framingham-REGICOR, SCORE or Life's Simple 7 (LS7). In vitro, animal, and randomized clinical studies have shown that polyphenols may provide benefits to the vascular system and reduce the inflammatory response. However, some clinical-epidemiological studies have yielded inconsistent results. Our aim was to assess the possible association between intake of the various polyphenol classes and established cardiovascular scores. Methods: This cross-sectional analysis involved 6633 PREDIMED-Plus study participants. Food polyphenol content was estimated by a semi-quantitative food frequency questionnaire, adjusted for total energy intake according to the residual method. The association between polyphenol intake and cardiovascular risk was tested using linear regression analyses. Results: Total polyphenol and flavonoid intake were directly and significantly associated only with the LS7 scale. Intake of lignans was directly and significantly associated with SCORE and LS7 scales, stilbene intake with SCORE, and phenolic acid intake with Framingham and Framingham-REGICOR scores. Other polyphenol classes were associated in a protective and significant manner in Framingham, SCORE and LS7 scores. In women, intake of all the polyphenol classes, except phenolic acids, showed a protective trend in the results of the Framingham, Framingham-REGICOR scores and LS7 scale. Conclusions: An inverse association was found between consumption of the 'other polyphenols' class and, especially among women, with estimated cardiovascular risk. The results were similar to those of Framingham, Framingham-REGICOR and LS7 (after eliminating the diet component) and differed from those of SCORE, but the predictors included were limited in the latter case.
Autores: Almanza-Aguilera, E.; Hernáez, A.; Corella, D.; et al.

Título: Transcriptional response to a Mediterranean diet intervention exerts a modulatory effect on neuroinflammation signaling pathway

Revista: NUTRITIONAL NEUROSCIENCE

ISSN: 1028-415X Vol.25 N° 2 2022 págs. 256 - 265

Resumen

Background: The Traditional Mediterranean Diet (TMD) is known to have beneficial effects on several chronic diseases. However, data concerning the whole transcriptome modulation of the TMD are scarce. Objective: We aimed to explore the effects of the TMD on the whole transcriptome of individuals at high cardiovascular risk. Methods: Thirty-four participants at high cardiovascular risk were randomly assigned to a TMD enriched with extra-virgin olive oil (TMD + VOO), mixed nuts (TMD + Nuts), or a control diet based on low-fat diet recommendations. A microarray analysis in circulating peripheral blood mononuclear cells of the participants was conducted before and after 3 months of the intervention. The association of changes in gene expression was modeled into canonical pathways by conducting an untargeted functional analysis with the Ingenuity Pathway Analysis(R)(IPA). Effects were considered significant when the absolutez-score values were >= 2.0 and the logarithmP(adjusted by the Benjamini-Hochberg procedure [BH]) values were >= 1.30. Results: According to IPA, interventions with TMD + Nuts, TMD + VOO, and control diet downregulated neuroinflammation, triggering receptor expressed on myeloid cells 1 , and cholecystokinin/gastrin-mediated signaling pathways, respectively. The gene expression among these pathways included cytokines, T-cell activation receptors, nuclear factor kappa beta/inflammasome components, pro-inflammatory enzymes and cell cycle regulators. Conclusion: The current findings suggest that the TMD enriched with mixed nuts or VOO downregulate transcriptomic pathways, including those related to neuroinflammation, which could influence development of neurodegenerative diseases. Our data should be corroborated in other tissue cells, such as neurons and glial cells.
Autores: Diez-Ricote, L.; San-Cristóbal, R.; Concejo, M. J.; et al.

Título: One-year longitudinal association between changes in dietary choline or betaine intake and cardiometabolic variables in the PREvencion con DIeta MEDiterránea-Plus (PREDIMED-Plus) trial

Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION

ISSN: 0002-9165 Vol.116 N° 6 2022 págs. 1565 - 1579

Resumen

Background: Choline and betaine intakes have been related to cardiovascular health. Objectives: We aimed to explore the relation between 1-y changes in dietary intake of choline or betaine and 1-y changes in cardiometabolic and renal function traits within the frame of the PREDIMED (PREvención con DIeta MEDiterránea)-Plus trial. Methods: We used baseline and 1-y follow-up data from 5613 participants (48.2% female and 51.8% male; mean ± SD age: 65.01 ± 4.91 y) to assess cardiometabolic traits, and 3367 participants to assess renal function, of the Spanish PREDIMED-Plus trial. Participants met ¿3 criteria of metabolic syndrome and had overweight or obesity [BMI (in kg/m2) ¿27 and ¿40]. These criteria were similar to those of the PREDIMED parent study. Dietary intakes of choline and betaine were estimated from the FFQ. Results: The greatest 1-y increase in dietary choline or betaine intake (quartile 4) was associated with improved serum glucose concentrations (-3.39 and -2.72 mg/dL for choline and betaine, respectively) and HbA1c levels (-0.10% for quartile 4 of either choline or betaine intake increase). Other significant changes associated with the greatest increase in choline or betaine intake were reduced body weight (-2.93 and -2.78 kg, respectively), BMI (-1.05 and -0.99, respectively), waist circumference (-3.37 and -3.26 cm, respectively), total cholesterol (-4.74 and -4.52 mg/dL, respectively), and LDL cholesterol (-4.30 and -4.16 mg/dL, respectively). Urine creatinine was reduced in quartile 4 of 1-y increase in choline or betaine intake (-5.42 and -5.74 mg/dL, respectively). Conclusions: Increases in dietary choline or betaine intakes were longitudinally related to improvements in cardiometabolic parameters. Markers of renal function were also slightly improved, and they require further investigation.This trial was registered at https://www.isrctn.com/ as ISRCTN89898870.
Autores: Mico, V. (Autor de correspondencia); San-Cristóbal, R. (Autor de correspondencia); Martin, R.; et al.

Título: Morbid liver manifestations are intrinsically bound to metabolic syndrome and nutrient intake based on a machine-learning cluster analysis

Revista: FRONTIERS IN ENDOCRINOLOGY

ISSN: 1664-2392 Vol.13 2022 págs. 936956

Resumen

Metabolic syndrome (MetS) is one of the most important medical problems around the world. Identification of patient ' s singular characteristic could help to reduce the clinical impact and facilitate individualized management. This study aimed to categorize MetS patients using phenotypical and clinical variables habitually collected during health check-ups of individuals considered to have high cardiovascular risk. The selected markers to categorize MetS participants included anthropometric variables as well as clinical data, biochemical parameters and prescribed pharmacological treatment. An exploratory factor analysis was carried out with a subsequent hierarchical cluster analysis using the z-scores from factor analysis. The first step identified three different factors. The first was determined by hypercholesterolemia and associated treatments, the second factor exhibited glycemic disorders and accompanying treatments and the third factor was characterized by hepatic enzymes. Subsequently four clusters of patients were identified, where cluster 1 was characterized by glucose disorders and treatments, cluster 2 presented mild MetS, cluster 3 presented exacerbated levels of hepatic enzymes and cluster 4 highlighted cholesterol and its associated treatments Interestingly, the liver status related cluster was characterized by higher protein consumption and cluster 4 with low polyunsaturated fatty acid intake. This research emphasized the potential clinical relevance of hepatic impairments in addition to MetS traditional characterization for precision and personalized management of MetS patients.
Autores: Gutiérrez-Bedmar, M. (Autor de correspondencia); Gil, F.; Olmedo, P.; et al.

Título: Serum Selenium and Incident Cardiovascular Disease in the PREvencion con DIeta MEDiterranea (PREDIMED) Trial: Nested Case-Control Study

Revista: JOURNAL OF CLINICAL MEDICINE

ISSN: 2077-0383 Vol.11 N° 22 2022 págs. 6664

Resumen

Background: Selenium is an essential trace mineral with potential interest for cardiovascular disease (CVD) prevention owing to its antioxidant properties. Epidemiological data on selenium status and CVD remain inconsistent. The objective of this study was to ascertain whether low serum selenium (SSe) concentrations are related to an increased risk of a first CVD event in a population at high cardiovascular risk. Methods: We undertook a case-control study nested within the PREvencion con DIeta MEDiterranea (PREDIMED) trial. A total of 207 participants diagnosed with CVD (myocardial infarction, stroke, or cardiovascular death) during the follow-up period (2003-2010) were matched by sex, age, and intervention group to 436 controls by incidence density sampling. Median time between serum sample collection and subsequent CVD event occurrence was 0.94 years. SSe levels were determined using inductively coupled plasma mass spectrometry analysis. Covariates were assessed through validated questionnaires, in-person interviews, and medical record reviews. Conditional logistic regression was used to calculate multivariable-adjusted odds ratios (ORs). Results: Among women, the mean SSe concentration was lower in cases than in controls (98.5 mu g/L vs. 103.8 mu g/L; p = 0.016). In controls, SSe levels were directly associated with percentage of total energy intake from proteins and fish intake (p for linear trend < 0.001 and 0.049, respectively), whereas SSe concentrations were inversely associated with age, body mass index, and percentage of total energy intake from carbohydrates (p for linear trend < 0.001, 0.008 and 0.016 respectively). In the total group, we observed an inverse dose-response gradient between SSe levels and risk of CVD in the fully-adjusted model (highest vs. lowest quartile: OR = 0.47, 95% CI: 0.27-0.81; ptrend = 0.003). Conclusions: Among elderly individuals at high cardiovascular risk, high SSe concentrations within population reference values are associated with lower first CVD incidence.
Autores: Fernández Lázaro, Cesar Ignacio; Toledo Atucha, Estefanía; Buil Cosiales, Pilar; et al.

Título: Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 3 2022 págs. 1457 - 1475

Resumen

Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of >= 5 points for participants with baseline scores < 13 points or any increase if baseline score was >= 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25-1.83; OR12-month: 1.66, 95% CI 1.37-2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07-2.46; OR12-month: 1.62, 95% CI 1.07-2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53-0.79; OR12-month: 0.76, 95% CI 0.62-0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64-0.99; OR12-month: 0.71, 95% CI 0.57-0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions.
Autores: Razquin Burillo, Cristina; Menendez-Acebal, C. ; Cervantes Ibáñez, Sebastián; et al.

Título: Hypertension and changes in cognitive function in a Mediterranean population

Revista: NUTRITIONAL NEUROSCIENCE

ISSN: 1028-415X Vol.25 N° 3 2022 págs. 612 - 620

Resumen

Background:Severe cognitive decline is one of the major public health problems in developed countries. Finding modifiable risk factors could become essential to develop strategies to prevent or delay dementia progression and stop its rising incidence. Objective:Our aim was to investigate the association between hypertension and cognitive function and to assess whether better adherence to the Mediterranean diet may modify this association. Methods:A subsample of 764 participants from the 'Seguimiento Universidad de Navarra' (SUN) cohort older than 55 years was evaluated with the Spanish Telephone Interview for Cognitive Status (TICS-m) at two-time points, separated by 6 years. Multivariable-adjusted linear regression models were used to prospectively assess the association between hypertension -also according to adherence to the Mediterranean diet- and 6-y changes in cognitive function. Results:The adjusted between-group difference in the 6-year change of the TICS-m score between hypertensive participants and their non-hypertensive counterparts was -0.36 (95% CI -0.70, -0.02). This association was stronger among participants with a lower adherence to the Mediterranean diet [-0.62 (95% CI: -1.09, -0.15)] but the differences between hypertensive and non-hypertensive participants were no longer significant among participants with a higher baseline adherence to the Mediterranean diet. Conclusion:In this Mediterranean cohort, hypertension was inversely associated with cognitive function, but an attenuation of this detrimental association by a moderate/high adherence to the Mediterranean diet was suggested.
Autores: Pardavila Belio, Idoia; De la O Pascual, Víctor; Hershey de la Cruz, María Soledad; et al.

Título: Joint association of the Mediterranean diet and smoking with all-cause mortality in the Seguimiento Universidad de Navarra (SUN) cohort

Revista: NUTRITION

ISSN: 0899-9007 Vol.103 - 104 2022 págs. 111761

Resumen

Objectives: Although low-quality diets and smoking are independently associated with higher mortality risk, a joint analysis of both risk factors in relation to mortality has not been sufficiently studied. The aim of this study was to explore the effect modification between level of adherence to a Mediterranean dietary pattern (MedDiet) and smoking status on all-cause, cancer, and cardiovascular mortality.Methods: We conducted a prospective analysis to assess the association between diet and smoking status in the SUN (Seguimiento Universidad de Navarra) cohort study. Deaths were confirmed by review of the National Death Index. Participants were classified into six categories according to the MedDiet (adherence/non-adherence) and their exposure to smoking (never/former/current smoker). Multivariate-adjusted Cox regression models were fitted to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for mortality. During a mean follow-up of 11.5 y (SD 4.5), we observed 18 948 participants (mean age 38.4 y; SD 12.4) and 431 deaths (51.3% cancer deaths). Results: A higher risk for death was found among smokers with a low adherence to the MedDiet (HR, 2.20; 95% CI, 1.45-3.34) compared with never smokers with high adherence to the MedDiet. The P value for supra-multiplicative effect modification was not statistically significant, meaning that the effect of both factors is multiplicative. A higher risk for premature death from cancer was found in smokers and in those nonadherent with the MedDiet.Conclusion: Smoking and poor adherence to the MedDiet exerted a multiplicative effect in increasing allcause mortality and cancer-related mortality in a Spanish population of university graduates.(c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Autores: Valle-Hita, C.; Díaz-López, A.; Becerra-Tomás, N. (Autor de correspondencia); et al.

Título: Prospective associations between a priori dietary patterns adherence and kidney function in an elderly Mediterranean population at high cardiovascular risk

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.61 N° 6 2022 págs. 3095 - 3108

Resumen

Purpose To assess the association between three different a priori dietary patterns adherence (17-item energy reduced-Mediterranean Diet (MedDiet), Trichopoulou-MedDiet and Dietary Approach to Stop Hypertension (DASH)), as well as the Protein Diet Score and kidney function decline after one year of follow-up in elderly individuals with overweight/obesity and metabolic syndrome (MetS). Methods We prospectively analyzed 5675 participants (55-75 years) from the PREDIMED-Plus study. At baseline and at one year, we evaluated the creatinine-based estimated glomerular filtration rate (eGFR) and food-frequency questionnaires-derived dietary scores. Associations between four categories (decrease/maintenance and tertiles of increase) of each dietary pattern and changes in eGFR (ml/min/1.73m(2)) or >= 10% eGFR decline were assessed by fitting multivariable linear or logistic regression models, as appropriate. Results Participants in the highest tertile of increase in 17-item erMedDiet Score showed higher upward changes in eGFR (beta: 1.87 ml/min/1.73m(2); 95% CI: 1.00-2.73) and had lower odds of >= 10% eGFR decline (OR: 0.62; 95% CI: 0.47-0.82) compared to individuals in the decrease/maintenance category, while Trichopoulou-MedDiet and DASH Scores were not associated with any renal outcomes. Those in the highest tertile of increase in Protein Diet Score had greater downward changes in eGFR (beta: - 0.87 ml/min/1.73m(2); 95% CI: - 1.73 to - 0.01) and 32% higher odds of eGFR decline (OR: 1.32; 95% CI: 1.00-1.75). Conclusions Among elderly individuals with overweight/obesity and MetS, only higher upward change in the 17-item erMedDiet score adherence was associated with better kidney function after one year. However, increasing Protein Diet Score appeared to have an adverse impact on kidney health. Trial Registration Number: ISRCTN89898870 (Data of registration: 2014).
Autores: García-Gavilan, J.; Nishi, S. K.; Paz-Graniel, I.; et al.

Título: Plasma metabolite profiles associated with the amount and source of meat and fish consumption and the risk of Type 2 diabetes

Revista: MOLECULAR NUTRITION AND FOOD RESEARCH

ISSN: 1613-4125 Vol.66 N° 23 2022 págs. 2200145

Resumen

Scope Consumption of meat has been associated with a higher risk of type 2 diabetes (T2D), but if plasma metabolite profiles associated with these foods reflect this relationship is unknown. The objective is to identify a metabolite signature of consumption of total meat (TM), red meat (RM), processed red meat (PRM), and fish and examine if they are associated with T2D risk. Methods and results The discovery population includes 1833 participants from the PREDIMED trial. The internal validation sample includes 1522 participants with available 1-year follow-up metabolomic data. Associations between metabolites and TM, RM, PRM, and fish are evaluated with elastic net regression. Associations between the profiles and incident T2D are estimated using Cox regressions. The profiles included 72 metabolites for TM, 69 for RM, 74 for PRM, and 66 for fish. After adjusting for T2D risk factors, only profiles of TM (Hazard Ratio (HR): 1.25, 95% CI: 1.06-1.49), RM (HR: 1.27, 95% CI: 1.07-1.52), and PRM (HR: 1.27, 95% CI: 1.07-1.51) are associated with T2D. Conclusions The consumption of TM, its subtypes, and fish is associated with different metabolites, some of which have been previously associated with T2D. Scores based on the identified metabolites for TM, RM, and PRM show a significant association with T2D risk.
Autores: Domínguez-López, I.; Arancibia-Riveros, C.; Casas, R.; et al.

Título: Changes in plasma total saturated fatty acids and palmitic acid are related to pro-inflammatory molecule IL-6 concentrations after nutritional intervention for one year

Revista: BIOMEDICINE AND PHARMACOTHERAPY

ISSN: 0753-3322 Vol.150 2022 págs. 113028

Resumen

Systemic inflammation is associated with an increased risk of non-communicable diseases, such as cardiovascular diseases and diabetes. Circulating fatty acids (FA) are known to be related to these conditions, possibly through their role in inflammation, although different types of FAs can have opposite effects on inflammatory mediators. The aim of the present study was to analyze the association of plasma FAs with inflammatory biomarkers in a PREDIMED trial subsample after one year of intervention. In a one-year longitudinal study of 91 participants of the PREDIMED trial (Barcelona-Clinic center), plasma FAs and inflammatory biomarkers were analyzed using gas chromatography and ELISA, respectively. In baseline plasma, a multivariable-adjusted ordinary least squares regression model showed that n-3 polyunsaturated FAs concentrations were inversely associated with concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) and E-selectin, whereas the level of the most abundant saturated FA, palmitic acid, was directly associated with concentrations of interleukin-6 (IL-6) (beta = 0.48 pg/mL, 95% CI: 0.03, 0.93 per 1-SD increase, p-value = 0.037). After one year of nutritional intervention, changes of plasma diet-derived total saturated FAs and palmitic acid were directly associated with changes in IL6 (beta = 0.59 pg/mL [95% CI: 0.28, 0.89] per 1-SD, p-value = 0.001; beta = 0.64 pg/mL, 95% CI: 0.31, 0.98, p-value = 0.001), respectively, after correction for multiple testing. Our findings suggest that saturated FAs of dietary origin, especially palmitic acid, are directly involved in the increase of IL-6 in plasma.
Autores: Martínez-Urbistondo, D. (Autor de correspondencia); San Cristóbal, R.; Villares, P.; et al.

Título: Role of NAFLD on the health related QoL response to lifestyle in patients with metabolic syndrome: the PREDIMED plus cohort

Revista: FRONTIERS IN ENDOCRINOLOGY

ISSN: 1664-2392 Vol.13 2022 págs. 868795

Resumen

ObjectiveTo evaluate the effect of Non-alcoholic fatty liver disease (NAFLD) status in the impact of lifestyle over Health-related quality of life (HRQoL) in patients with metabolic syndrome (MetS). MethodsBaseline and 1 year follow up data from the PREDIMED-plus cohort (men and women, 55-75 years old with overweight/obesity and MetS) were studied. Adherence to an energy-restricted Mediterranean Diet (er-MeDiet) and Physical Activity (PA) were assessed with a validated screeners. Hepatic steatosis index (HSI) was implemented to evaluate NAFLD while the SF-36 questionnaire provided HRQoL evaluation. Statistical analyses were performed to evaluate the influence of baseline NAFLD on HRQoL as affected by lifestyle during 1 year of follow up. ResultsData from 5205 patients with mean age of 65 years and a 48% of female participants. Adjusted linear multivariate mixed regression models showed that patients with lower probability of NAFLD (HSI < 36 points) were more responsive to er-MeDiet (beta 0.64 vs beta 0.05 per er-MeDiet adherence point, p< 0.01) and PA (beta 0.05 vs beta 0.01 per MET-h/week, p = 0.001) than those with high probability for NAFLD in terms Physical SF-36 summary in the 1 year follow up. 10 points of er-MeDiet adherence and 50 MET-h/week were thresholds for a beneficial effect of lifestyle on HRQoL physical domain in patients with lower probability of NAFLD. ConclusionThe evaluation of NAFLD by the HSI index in patients with MetS might identify subjects with different prospective sensitivity to lifestyle changes in terms of physical HRQoL (http://www.isrctn.com/ISRCTN89898870).
Autores: Domínguez-López, I.; Arancibia-Riveros, C.; Tresserra-Rimbau, A.; et al.

Título: Relationship between estimated desaturase enzyme activity and metabolic syndrome in a longitudinal study

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 991277

Resumen

Desaturase enzyme activities (DEA) are associated with several metabolic diseases. The aim of the present study was to assess the relationship between estimated plasma DEA and the metabolic syndrome (MetS), as well as their relationship with individual components of the MetS. We conducted a longitudinal study of 148 participants recruited at random from the PREDIMED trial (Hospital Clinic site). At baseline and after 1 year of follow-up, DEA were estimated from product/precursor ratios of individual plasma fatty acids. Logistic regressions were used to assess the relationship of estimated DEA MetS, adjusted for potential cofounders. Estimated Delta 5 desaturase (D5D) activity was associated with lower risk of MetS, whereas stearoyl-CoA (SCD)-16 and SCD-18 were negatively associated with MetS status. SCD-16, SCD-18, and Delta 6 desaturase (D6D) were positively associated with triglycerides, SCD-18 was inversely associated with HDL-cholesterol. Estimated D6D activity was found to be associated with increases in diastolic blood pressure. In contrast, D5D was negatively associated with triglycerides, diastolic blood pressure and waist circumference. The present longitudinal study suggests that estimated SCD-16, SCD-18, and D6D have a negative impact in MetS and its components, whereas D5D may have beneficial effects for metabolic health.
Autores: Gonzalez Casanova, I. (Autor de correspondencia); Alonso-Gómez, A. M.; Romaguera, D.; et al.

Título: Association of Left Atrial Structure and Function With Cognitive Function in Adults With Metabolic Syndrome

Revista: AMERICAN JOURNAL OF CARDIOLOGY

ISSN: 0002-9149 Vol.183 2022 págs. 122 - 128

Resumen

Atrial fibrillation has been associated with cognitive impairment. Whether subclinical abnormalities in atrial function and substrate predisposing to atrial fibrillation impact cognitive function has received limited attention. We tested associations of echocardiographic markers of atrial structure and function with cognitive function and decrease in 510 participants with obesity and metabolic syndrome (mean age SD of 64.4 [5.2] years in men and 66.5 [3.9] years in women). Left atrial (LA) markers (volume index, emptying fraction, strain, function index, and stiffness index) were estimated based on transthoracic echocardiography. General cognitive functioning (Mini-mental state examination), verbal ability (verbal fluency test), memory and attention (Digit Span Tests), and processing speed and executive function (Trail-Making Tests A and B) were assessed at baseline and at 2-year follow-up. Multiple linear regression was used to test associations of atrial markers (modeled in SD units) with baseline and 2-year changes in cognitive scores adjusted for demographic and health covariates. LA structure and function were not associated with cognitive function at baseline. Larger LA volume index (standardized beta [95% confidence interval] -0.13 [-0.22 to -0.03]), lower peak longitudinal strain (-0.11 [-0.20 to -0.01]), and higher stiffness index (-0.18 [-0.28 to -0.08]) were associated with 2-year worsening in Trail-Making Test A. Strain measurements were also associated with a 2-year change in the Controlled Oral Word Association Test. In conclusion, overall, adverse markers of LA structure and function were associated with 2-year detrimental executive function-related cognitive changes in a sample of participants at high risk for cardiovascular disease, highlighting LA substrate as a potential risk factor for cognitive decrease and dementia. (c) 2022 Elsevier Inc. All rights reserved.
Autores: Goñi Mateos, Leticia; Gil Conesa, Mario; De la O Pascual, Víctor; et al.

Título: Development and validation of a new home cooking frequency questionnaire: a pilot study

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.14 N° 6 2022 págs. 1136

Resumen

Home cooking and the type of cooking techniques can have an effect on our health. However, as far as we know, there is no questionnaire that measures in depth the frequency and type of cooking techniques used at home. Our aim was to design a new Home Cooking Frequency Questionnaire (HCFQ) and to preliminarily assess its psychometric properties. For this purpose we used a five-phase approach, as follows: Phase 1: item generation based on expert opinion, relevant literature and previous surveys; Phase 2: content validity assessed by experts for relevance and clarity (epidemiologists, dietitians, chefs); Phase 3: face validity and inter-item reliability; Phase 4: criterion validity using a 7-day food and culinary record; and Phase 5: test stability and inter-item reliability. The content validity index for scale and item level values provided evidence of the content validity for relevance and clarity. Criterion validity analysis showed intraclass correlation coefficients ranged from 0.31-0.69. Test-retest reliability coefficients ranged from 0.49-0.92, with ¿ values > 0.44. Overall Cronbach's alpha was 0.90. In conclusion, the HCFQ is a promising tool with sound content and face validity, substantial criterion validity, and adequate reliability. This 174-item HCFQ is the first questionnaire to assess how often people cook and which cooking methods they use at home.
Autores: De Deus Mendonca, R.; Aparecida Mingoti, S.; Gazzinelli Bethony, M. F.; et al.

Título: Intervention for promoting intake of fruits and vegetables in Brazilians: a randomised controlled trial

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.25 N° 3 2022 págs. 781 - 793

Resumen

Objective: To evaluate the effectiveness of a nutritional intervention to promote fruit and vegetable (FV) intake. Design: A randomised controlled community trial was conducted to evaluate the effectiveness of a 7-month nutritional intervention and to promote FV intake, separately and together. All participants attended physical exercise sessions. The intervention was based on the transtheoretical model and Paulo Freire's pedagogy. The interventions included group educational sessions, motivational cards and informational materials. The primary outcome was a change in FV intake (g/d), and secondary outcomes included stages of change, self-efficacy, decisional balance and knowledge on FV. All data were collected face-to-face; and FV intake was assessed using a validated brief questionnaire. Setting: Health promotion services of Brazilian Primary Health Care. Participants: 3414 users of Brazilian Primary Health Care (1931 in the control group and 1483 in the intervention group (IG)). Results: At baseline, the average daily FV intake was 370 center dot 4 g/d (95 % CI 364 center dot 2, 376 center dot 6). The increase in FV intake (23 center dot 4 g/d; 95 % CI 6 center dot 7, 40 center dot 0) and fruit intake (+17 center dot 3 g/d; 95 % CI 5 center dot 1, 29 center dot 4; P = 0 center dot 01) was greater in the IG among participants in the lowest baseline intake. Participants in the IG also showed progression in the stages of change (P < 0 center dot 001), increased self-efficacy (P < 0 center dot 001) and improved knowledge of FV crops (P < 0 center dot 001). Conclusions: The nutritional intervention was effective in increasing FV intake and fruits intake among individuals with a lower intake at baseline and in maintaining FV intake among those who reported consuming FV as recommended (400 g/d).
Autores: Fernández Lázaro, Cesar Ignacio (Autor de correspondencia); Sayon Orea, María del Carmen; Toledo Atucha, Estefanía; et al.

Título: Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort

Revista: BMC MEDICINE

ISSN: 1741-7015 Vol.20 N° 1 2022 págs. 232

Resumen

Background The American Heart Association recommends Life's Simple 7 as ideal cardiovascular health (ICVH) to reduce cardiovascular risk. Rate advancement period (RAP), a useful tool to quantify and communicate exposure impact on risks, may enhance communication about the benefits of achieving ICVH. We aimed to examine whether greater adherence to ICVH metrics was associated with reduced incidence of cardiovascular risk in a population-based cohort and estimate its impact on the timing of occurrence using RAP. Methods Prospective analyses of 3826 participants, initially free from cardiovascular disease at baseline, enrolled in the Vascular Risk in Navarra Study (RIVANA), a Mediterranean population-based cohort of Spanish adults. ICVH metrics were defined using participants' baseline information as follows: never-smoker or quitting > 12 months ago, body mass index < 25 kg/m(2), >= 150 min/week of moderate physical activity or equivalent, healthy dietary pattern (>= 9 points on a validated 14-item Mediterranean diet adherence screener), untreated cholesterol < 200 mg/dL, untreated blood pressure < 120/80 mmHg, and untreated fasting blood glucose < 100 mg/dL. Participants were assigned 1 point for each achieved metric and were grouped according to their number of accumulated metrics in <= 2, 3, 4, and >= 5. The primary endpoint was major cardiovascular events (composite of myocardial infarction, stroke, or death from cardiovascular causes). Cox proportional hazard ratios (HRs) and RAPs with their corresponding 95% confidence intervals (95% CI) adjusted for potential confounders were calculated. Results During a median follow-up of 12.8 years (interquartile range 12.3-13.1), a total of 194 primary endpoints were identified. Compared to participants with <= 2 ideal metrics, HR (95% CI) for major cardiovascular events among participants meeting >= 5 metrics was 0.32 (0.17-0.60) with RAP (95% CI) of - 14.4 years (- 22.9, - 5.9). Conclusions Greater adherence to ICVH metrics was associated with lower cardiovascular risk among Spanish adults of the RIVANA cohort. Adherence to ideal metrics may substantially delay cardiovascular risk.
Autores: García-Blanco, L.; Berasaluce, A.; Romanos Nanclares, Andrea; et al.

Título: Parental perception of child's weight, their attitudes towards child's dietary habits and the risk of obesity

Revista: WORLD JOURNAL OF PEDIATRICS

ISSN: 1708-8569 Vol.18 N° 7 2022 págs. 482 - 489

Resumen

Background The association between parental perception of child's weight and their attitudes towards his/her dietary habits has not been reported yet. This study aimed to assess the association between parental underestimation of child's weight and parental attitudes towards child's dietary habits. Methods We conducted a cross-sectional analysis of SENDO cohort participants recruited between January 2015 and June 2020. All information was collected through online questionnaires completed by parents. We calculated crude and multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) for unhealthy attitudes towards child's dietary habits associated with parental underestimation of child's weight. Results Sixteen percent of children in the SENDO project had parents who underestimated their weight. Parents who underestimated their child's weight status were more likely to have unhealthy attitudes toward his/her dietary habits [OR 3.35; 95% CI (1.71-6.53)]. Conclusions Parental underestimation of child's weight was associated with unhealthy attitudes towards child's dietary habits. Pediatricians and public health practitioners should pay attention to the parental perception of child's weight to identify parents who underestimate it as an at-risk group in which to inquire about lifestyle and dietary habits.
Autores: Álvarez-Mon, M. A. (Autor de correspondencia); Fernández Lázaro, Cesar Ignacio; Ortega, M. A.; et al.

Título: Analyzing psychotherapy on Twitter: an 11-year analysis of tweets from major U.S. media outlets

Revista: FRONTIERS IN PSYCHIATRY

ISSN: 1664-0640 Vol.13 2022 págs. 871113

Resumen

BackgroundThe Internet has become the main source of information on health issues, and information now determines the therapeutic preferences of patients. For this reason, it is relevant to analyze online information discussing psychotherapy. ObjectiveTo investigate tweets posted by 25 major US media outlets between 2009 and 2019 concerning psychotherapy. MethodsWe investigated tweets posted by 25 major US media outlets about psychotherapy between January 2009 and December 2019 as well as the likes generated. In addition, we measured the sentiment analysis of these tweets. ResultsMost of the tweets analyzed focused on Mindfulness (5,498), while a low number were related to Psychoanalysis (376) and even less to Cognitive-Behavioral Therapy (61). Surprisingly, Computer-supported therapy, Psychodynamic therapy, Systemic therapy, Acceptance and commitment therapy, and Dialectical behavior therapy did not generate any tweet. In terms of content, efficacy was the main focus of the posted tweets, receiving Cognitive-Behavioral Therapy and Mindfulness a positive appraisal. ConclusionsUS media outlets focused their interest on Mindfulness which may have contributed to the growing popularity in the past years of this therapeutic modality.
Autores: Sánchez Bayona, Rodrigo; Bes Rastrollo, Maira; Fernández Lázaro, Cesar Ignacio; et al.

Título: Vitamin D and risk of obesity-related cancers: results from the SUN ('Seguimiento Universidad de Navarra') Project

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.14 N° 13 2022 págs. 2561

Resumen

Obesity is associated with a higher risk of several types of cancer, grouped as obesity-related cancers (ORC). Vitamin D deficiency is more prevalent in obese subjects, and it has been suggested to play a role in the association between obesity and cancer risk. The aim of the study was to analyze the association between vitamin D intake and the subsequent risk of ORC in a prospective Spanish cohort of university graduates. The SUN Project, initiated in 1999, is a prospective dynamic multipurpose cohort. Participants answered a 556-item lifestyle baseline questionnaire that included a validated food-frequency questionnaire. We performed Cox regression models to estimate the hazard ratios (HRs) of ORC according to quartiles of energy-adjusted vitamin D intake (diet and supplements). We included 18,017 participants (mean age = 38 years, SD = 12 years), with a median follow-up of 12 years. Among 206,783 person-years of follow-up, we identified 225 cases of ORC. We found no significant associations between vitamin D intake and ORC risk after adjusting for potential confounders: HRQ2vsQ1 = 1.19 (95% CI 0.81-1.75), HRQ3vsQ1 = 1.20 (95% CI 0.81-1.78), and HRQ4vsQ1 = 1.02 (95% CI 0.69-1.51). Dietary and supplemented vitamin D do not seem to be associated with ORC prevention in the middle-aged Spanish population.
Autores: Arredondo-Montero, J. (Autor de correspondencia); Antona, G.; Rivero-Marcotegui, A.; et al.

Título: Congenital cytomegalovirus infection with brainstem hemorrhage and polymicrogyria: necropsic and histopathological findings

Revista: CONGENITAL ANOMALIES

ISSN: 0914-3505 Vol.62 N° 6 2022 págs. 248 - 253

Resumen

Congenital cytomegalovirus (CMV) infection can cause severe neurological sequelae or even fetal death. We present a 17-year-old pregnant woman with fetal CMV infection, leading to voluntary termination of pregnancy. Fetopsy demonstrated a brainstem hemorrhage and focal polymicrogyria. CMV inclusions were observed in the lung, liver, thyroid, pancreas, kidneys, adrenal, placenta, and central nervous system. Intracranial hemorrhage is a rare finding in the context of congenital CMV infection, with isolated brainstem hemorrhage being an exceptional form of presentation. Polymicrogyria appears to be a more frequent finding, although its actual incidence is unknown. Future studies are needed to determine the causal association.
Autores: Marhuenda-Muñoz, M.; Domínguez-López, I.; Langohr, K.; et al.

Título: Circulating carotenoids are associated with favorable lipid and fatty acid profiles in an older population at high cardiovascular risk

Revista: FRONTIERS IN NUTRITION

ISSN: 2296-861X Vol.9 2022 págs. 967967

Resumen

Carotenoid intake has been reported to be associated with improved cardiovascular health, but there is little information on actual plasma concentrations of these compounds as biomarkers of cardiometabolic risk. The objective was to investigate the association between circulating plasma carotenoids and different cardiometabolic risk factors and the plasma fatty acid profile. This is a cross-sectional evaluation of baseline data conducted in a subcohort (106 women and 124 men) of an ongoing multi-factorial lifestyle trial for primary cardiovascular prevention. Plasma concentrations of carotenoids were quantified by liquid chromatography coupled to mass spectrometry. The associations between carotenoid concentrations and cardiometabolic risk factors were assessed using regression models adapted for interval-censored variables. Carotenoid concentrations were cross-sectionally inversely associated with serum triglyceride concentrations [-2.79 mg/dl (95% CI: -4.25, -1.34) and -5.15 mg/dl (95% CI: -7.38, -2.93), p-values = 0.0002 and <0.00001 in women and men, respectively], lower levels of plasma saturated fatty acids [-0.09% (95% CI: -0.14, -0.03) and -0.15 % (95% CI: -0.23, -0.08), p-values = 0.001 and 0.0001 in women and men, respectively], and higher levels of plasma polyunsaturated fatty acids [(0.12 % (95% CI: -0.01, 0.25) and 0.39 % (95% CI: 0.19, 0.59), p-values = 0.065 and 0.0001 in women and men, respectively] in the whole population. Plasma carotenoid concentrations were also associated with higher plasma HDL-cholesterol in women [0.47 mg/dl (95% CI: 0.23, 0.72), p-value: 0.0002], and lower fasting plasma glucose in men [-1.35 mg/dl (95% CI: -2.12, -0.59), p-value: 0.001].
Autores: Alonso Gómez, A. M. (Autor de correspondencia); Tojal Sierra, L.; Mora Mora, N.; et al.

Título: Left atrial strain improves echocardiographic classification of diastolic function in patients with metabolic syndrome and overweight-obesity

Revista: INTERNATIONAL JOURNAL OF CARDIOLOGY

ISSN: 0167-5273 Vol.348 2022 págs. 169 - 174

Resumen

Background: Current recommendations for echocardiographic assessment of diastolic function (2016 guidelines of the American Society of Echocardiography (ASE)/Eumpean Association of Cardiovascular Imaging (EACVI) in patients with metabolic syndrome and overweight/obesity result in a significant number of patients with indeterminate diastolic dysfunction (LVDD). The aim of this article is to study whether the use of the left atrial strain criterion (LALS) reduces the number of indeterminate patients. Methods: 229 patients were studied with a complete echocardiographic study that included left ventricular longitudinal strain (LVLS) analysis, LALS and a maximal ergospirometry test with assessment of oxygen uptake (VO2max). Results: The mean age was 65 +/- 5 years, 153 (67%) males, with a mean EF of 60 +/- 5%. The mean LVLS was -19.4 +/- 2% and the LALS Reservoir was 23.8 +/- 7%. There were 140 patients who did not meet LVDD criteria and 82 who did meet the indeterminate LVDD criterion. When the left atrial volume index (LAVI) >34 ml/m(2) criterion was replaced in the 2016 ASE/EACVI algorithm by LALS Reservoir <= 20%, the number of indeterminate patients was reduced from 36% to 23% (p < 0.001) at the expense of increasing normal studies (61% and 74%). Adding the LALS Reservoir criterion <= 23% in the 82 patients of the indeterminate group resulted in two groups with a different VO2max (11.6 +/- 3 and 18 +/- 5 ml/kg/min, p:0.081). Conclusions: This study confirms the low prevalence of diastolic dysfunction in overweight/obese patients with metabolic syndrome. Adding left atrial strain criterion to the current recommendations significantly reduces the number of indeterminate patients by reclassifying them as normal.
Autores: Díez Goñi, María de las Nieves (Autor de correspondencia); García del Barrio, Loreto; Rodríguez Díez, María Cristina; et al.

Título: Validation of the Jefferson Scale of Patient Perception of Physician Empathy Spanish (Spain) version in primary care

Revista: FAMILY MEDICINE

ISSN: 0742-3225 Vol.54 N° 8 2022 págs. 621 - 628

Resumen

BACKGROUND AND OBJECTIVES: Empathy is considered a prerequisite for a successful physician-patient relationship. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) is a regularly-used, patient-rated measure of physician empathy. The aim of this study is to translate and analyze the reliability and validity of the JSPPPE Spanish (Spain) version (Sp-JSPPPE) in primary care in order to use it with medical trainees. METHODS: After translation and back translation of the JSPPPE, 369 patients from 21 primary care physicians in Pamplona (Navarre, Spain) completed the Sp-JSPPPE, a sociodemographic questionnaire, the Spanish (Spain) Consultation and Relational Empathy Measure (Sp-CARE), and a question about overall satisfaction. We studied internal reliability (Cronbach's alpha and ordinal alpha), homogeneity (corrected item-total correlations), construct validity (confirmatory factor analysis [CFA]) and concurrent validity (Spearman's correlation) of Sp-JSPPPE. RESULTS: Cronbach's alpha and ordinal alpha were 0.870 and 0.919, respectively, for the Sp-JSPPPE, and all corrected item-total correlations exceeded the accepted cutoff of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The total score for the Sp-JSPPPE was significantly correlated with sp-CARE (Spearman's rho 0.651, P <.001) and with overall patient satisfaction (Spearman's rho 0.504, P <.001). CONCLUSIONS: The results support the reliability and validity of the Sp-JSPPPE in primary care. Sp-JSPPPE could be useful in empathy assessment of medical trainees, both graduate and postgraduate, in the Spanish context.
Autores: Arredondo Montero, J. (Autor de correspondencia); Antona, G.; Rivero Marcotegui, A.; et al.

Título: Discriminatory capacity of serum interleukin-6 between complicated and uncomplicated acute appendicitis in children: a prospective validation study

Revista: WORLD JOURNAL OF PEDIATRICS

ISSN: 1708-8569 Vol.18 N° 12 2022 págs. 810 - 817

Resumen

Background Serum interleukin-6 (IL-6) has a moderate diagnostic performance in pediatric acute appendicitis (PAA). The evidence regarding its capacity to discern between complicated and uncomplicated PAA is scarce. Methods We designed a prospective observational study to validate serum IL-6 as a marker for diagnostic classification between complicated and uncomplicated PAA. This study included 205 patients divided into three groups: (1) patients who underwent major outpatient surgery (n = 57); (2) patients with non-surgical abdominal pain (NSAP) in whom the diagnosis of PAA was excluded (n = 53), and (3) patients with a confirmed diagnosis of PAA (n = 95). The PAA patients were further classified as uncomplicated or complicated PAA. IL-6 concentration was determined in all patients at diagnosis. Comparative statistical analysis was performed using the Mann-Whitney U test, the Fisher exact test and the Kruskall Wallis test. The area under the receiver operating characteristic curves (AUC) were calculated. Results Median (interquartile range, IQR) serum IL-6 values were 2 pg/mL (2.0-3.4) in group 1, 3.9 pg/mL (2.4-11.9) in group 2, and 23.9 pg/mL (11.1-61.0) in group 3 (P < 0.001). Among the participants in group 3, those with uncomplicated PAA had median (IQR) serum IL-6 values of 17.2 pg/mL (8.5-36.8), and those with complicated PAA had 60.25 pg/mL (27.1-169) serum IL-6 (P < 0.001). At the cut-off point of 19.55 pg/mL, the AUC for the discrimination between patients in group 2 vs. 3 was 0.83 [95% confidence interval (CI) 0.76-0.90], with a sensitivity of 61.3% and a specificity of 86.8. The AUC for the discrimination between patients with uncomplicated and complicated PAA was 0.77 (95% CI 0.68-0.86) and the cut-off point was 25.90 pg/mL, with a sensitivity and specificity of 84.6% and 65.6%, respectively. Conclusions Serum IL-6 has a good performance in discerning between complicated and uncomplicated PAA. A score including clinical and radiological variables may increase the diagnostic performance of this molecule.
Autores: Fernández-Lázaro, D.; González-Gross, M.; Seco-Calvo, J.; et al.

Título: Does the mediterranean diet improve humoral responses to the SARS-COV-2 BNT162B2 vaccine in elderly institutionalized patients?

Revista: ANNALS OF NUTRITION AND METABOLISM

ISSN: 0250-6807 Vol.78 N° SUPPL 3 2022 págs. 55 - 56
Autores: Gabaldón-Figueira, J. C.; Galvosas, M.; Orrillo, V.; et al.

Título: Continuous cough monitoring with AI. Cases: treatment response, smoking cessation and COVID-19

Revista: EUROPEAN RESPIRATORY JOURNAL

ISSN: 0903-1936 Vol.60 N° Supl. 66 2022
Autores: Fernández-Lázaro, D.; Fernández Lázaro, Cesar Ignacio; Mielgo Ayuso, J. J.; et al.

Título: Glycophosphopeptical AM3 food immunesupplement: A potential adjuvant in the treatment of early-stage SARS-COV-2 infection. A randomized, controlled pilot study

Revista: ANNALS OF NUTRITION AND METABOLISM

ISSN: 0250-6807 Vol.78 N° Supl. 3 2022 págs. 54 - 55
Autores: Diaz-Gutiérrez, J.; Baron-Esquivias, G.; Martínez González, Miguel Ángel; et al.

Título: Body adiposity estimated with CUN-BAE predicts atrial fibrillation: the SUN cohort

Revista: EUROPEAN HEART JOURNAL

ISSN: 0195-668X Vol.43 2022 págs. 2235 - 2235
Autores: Morales, G. (Autor de correspondencia); Ruiz, F.; Bes Rastrollo, Maira; et al.

Título: Dietas basadas en plantas y factores de riesgo cardio-metabólicos: ¿Qué dice la evidencia?

Revista: REVISTA CHILENA DE NUTRICION

ISSN: 0717-7518 Vol.48 N° 3 2021 págs. 425 - 436

Resumen

Plant-based diets (PBD) are characterized by a high intake of foods of plant origin and the partial or total avoidance of animal products. The objective of the current study was to compile the evidence on types of PBD and its effect on the main modifiable cardio-metabolic risk factors (CMRF). Healthy and unhealthy PBD were found to exist. Some healthy PBDs were: vegetarian, mediterranean and DASH (Dietary Approaches to Stop Hypertension). These promote the intake of healthy plant-based foods (fruits, vegetables, legumes, seeds, nuts, whole grains, avocado, olive oil and / or canola) and a gradual reduction of all foods of animal origin, especially red and processed meats; avoiding less healthy plant-based foods (refined, fried cereals, pastry products, foods with added sugar). Unhealthy PBDs were characterized by a high intake of these less healthy foods, and are associated with greater cardiovascular risk, due to the low contribution of antioxidants, micronutrients, dietary fiber and unsaturated fats. Healthy PBDs can lower the risk of type 2 diabetes, high blood pressure, being overweight, and obesity. They have shown greater cardiovascular benefits compared to traditional diets, significantly reducing: HbA1c and fasting glycemia in diabetics; systolic and diastolic blood pressure in hypertensive and prehypertensive patients; body mass index in overweight / obese subjects and improves lipid profile in subjects with dyslipidemia. Healthy PBD patterns, such as vegetarian, Mediterranean, and DASH are recommended to prevent and treat CMRF.
Autores: Jani, R. (Autor de correspondencia); Mhaskar, K.; Tsiampalis, T.; et al.

Título: Circulating 25-hydroxy-vitamin D and the risk of cardiovascular diseases. Systematic review and meta-analysis of prospective cohort studies

Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES

ISSN: 0939-4753 Vol.31 N° 12 2021 págs. 3282 - 3304

Resumen

Aims: Circulating vitamin D is linked with the risk of cardiovascular disease (CVD). A meta-analysis has yet to explicitly explore correlation between vitamin D and the risk of CVD incidence and recurrent CVD. This meta-analysis examines the association between 25hydroxy-vitamin D (25(OH)D) and the risk of CVD incidence (fatal, non-fatal, fatal and nonfatal combined events) and the risk of recurrent CVD (fatal, recurrent, and fatal and recurrent combined events). PROSPERO registration-CRD42021251483. Data synthesis: A total of 79 studies (46 713 CVD cases in 1 397 831 participants) were included in the meta-analysis, of which 61 studies examined the risk of CVD incidence events, and 18 studies examined risk of recurrent CVD events. The risk of CVD incidence events (RR = 1.34, 95% CI: 1.26 1.43, p < 0.001) and recurrent CVD events (RR = 1.86, 95% CI: 1.46-2.36, p < 0.001) was higher in the lowest than the highest category of circulating 25(OH)D. Dose-response analysis reported a linear association for every 10 ng/ml increment of 25(OH)D and non-fatal CVD incidence events (RR = 0.94; 95% CI = 0.89-0.98, p = 0.005), lower fatal recurrent CVD events (RR = 0.45; 95% CI = 0.32-0.62, p < 0.001) and lower combined recurrent CVD events (RR = 0.80; 95% CI = 0.65 0.97, p = 0.023). A non-linear association was observed between higher 25(OH)D and lower fatal CVD incidence events (P-nonlinear<0.001), lower combined CVD incidence events (P nonlinear = 0.001), and lower non-fatal recurrent CVD events (P-nonlinear = 0.044). Conclusions: The lowest category of circulating 25(OH)D was associated with a higher risk of CVD incidence events and recurrent CVD events.
Autores: Fernández Lázaro, Cesar Ignacio; Ruiz-Canela, Miguel (Autor de correspondencia); Martínez González, Miguel Ángel

Título: Deep dive to the secrets of the PREDIMED trial

Revista: CURRENT OPINION IN LIPIDOLOGY

ISSN: 0957-9672 Vol.32 N° 1 2021 págs. 62 - 69

Resumen

Purpose of review The aim of this study was to briefly summarize the contribution of the PREDIMED (PREvencion con DIeta MEDiterranea) trial on cardiovascular evidence and examine in depth its groundbreaking trajectory. PREDIMED was conducted during 2003-2010 and represented the largest primary prevention trial ever testing the effects of changes in a complete food pattern (namely, the Mediterranean diet) on cardiovascular disease (CVD). Major contributions relied on the relevant changes in the food pattern attained by the behavioural intervention and their robust effect in reducing hard clinical end-points. Given some potential concerns, which were appropriately addressed with supporting analyses, this review is timely and relevant. Recent findings PREDIMED has continued contributing to the existing literature with extensive, robust and abundant new evidence on the benefits of the Mediterranean diet, particularly on cardiovascular health, including recent studies using high-throughput metabolomic techniques. After robustly addressing some controversies, the conclusions of the original trial remained unaltered. The Mediterranean diet represents an effective and robust nutritional strategy against CVD in high cardiovascular risk populations. Recent findings from the PREDIMED have identified a metabolic signature of the Mediterranean diet that can objectively determine dietary adherence and predict CVD risk. This metabolomic signature opens up a new era for nutritional epidemiology and personalized nutrition.
Autores: Fernández-Lázaro, D. (Autor de correspondencia); Fernández Lázaro, Cesar Ignacio (Autor de correspondencia); Mielgo-Ayuso, J.; et al.

Título: Glycophosphopeptical AM3 food supplement: A potential ddjuvant in the treatment and vaccination of SARS-CoV-2

Revista: FRONTIERS IN IMMUNOLOGY

ISSN: 1664-3224 Vol.12 2021 págs. 698672

Resumen

The world is currently experiencing the coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-2 (SARS-CoV-2). Its global spread has resulted in millions of confirmed infections and deaths. While the global pandemic continues to grow, the availability of drugs to treat COVID-19 infections remains limited to supportive treatments. Moreover, the current speed of vaccination campaigns in many countries has been slow. Natural substrates with biological immunomodulatory activity, such as glucans, may represent an adjuvant therapeutic agent to treat SARS-CoV-2. AM3, a natural glycophosphopeptical, has previously been shown to effectively slow, with no side effects, the progression of infectious respiratory diseases by regulating effects on innate and adaptive immunity in experimental models. No clinical studies, however, exist on the use of AM3 in SARS-CoV-2 infected patients. This review aims to summarize the beneficial effects of AM3 on respiratory diseases, the inflammatory response, modulation of immune response, and attenuation of muscle. It will also discuss its potential effects as an immune system adjuvant for the treatment of COVID-19 infections and adjuvant for SARS-CoV-2 vaccination.
Autores: Pano Espínola, Octavio; Martínez-Lapiscina, E. H.; Sayon Orea, María del Carmen; et al.

Título: Healthy diet, depression and quality of life: a narrative review of biological mechanisms and primary prevention opportunities

Revista: WORLD JOURNAL OF PSYCHIATRY

ISSN: 2220-3206 Vol.11 N° 11 2021 págs. 997 - 1016

Resumen

Unipolar depressive disorder (UDD) affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030. It is imperative for leading economies to implement preventive strategies targeted towards UDD, given consistent policies are currently lacking. Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field. It is believed that dietary practices could potentially reduce the incidence of depression; similar to their effects on metabolism. Thus, the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD. Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees. Interestingly, a common factor of UDD is the production and overall effects of inflammatory cytokines, such as interleukin-6, tumor necrosis factor-alpha, and C-reactive protein. These compounds have been associated with depressive symptoms, disturbances in neuroendocrine function, leaky gut, monoamine activity and brain function, while also being key factors in the development of cardiometabolic diseases. The Mediterranean diet (MD) in particular, is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations. In one of the few clinical trials investigating these associations, the PREDIMED trial, individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41% relative risk reduction for developing depression. Lastly, there is a need to include health related quality of life as an indicator of physical and mental well-being, considering its putative associations with depression and suicide risk. Going forward, focusing on clinical trials, using precise nutritional assessments, and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.
Autores: Martín Calvo, Nerea (Autor de correspondencia); Martínez González, Miguel Ángel

Título: Respuesta a la carta al editor de Retuerto Griessner M. et al.

Revista: ATENCION PRIMARIA

ISSN: 0212-6567 Vol.53 N° 9 2021 págs. 102148
Autores: Gomez Donoso, Clara; Martínez González, Miguel Ángel; Bes Rastrollo, Maira (Autor de correspondencia)

Título: Nutri-score, alimentos ultraprocesados y salud

Revista: ANALES DEL SISTEMA SANITARIO DE NAVARRA

ISSN: 1137-6627 Vol.44 N° 1 2021 págs. 5 - 8
Autores: Navarrete-Muñoz, E. M.; Vioque, J. (Autor de correspondencia); Toledo Atucha, Estefanía; et al.

Título: Correction to: dietary folate intake and metabolic syndrome in participants of PREDIMED-Plus study: a cross-sectional study

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.60 N° 2 2021 págs. 1137 - 1139
Autores: Martín Calvo, Nerea (Autor de correspondencia); Bes Rastrollo, Maira; Gomez Donoso, Clara; et al.

Título: Reducción de carnes rojas y procesadas en la población española: ¿cuál es su impacto sobre la mortalidad cardiovascular?

Revista: ATENCION PRIMARIA

ISSN: 0212-6567 Vol.53 N° 2 2021 págs. 101950

Resumen

Objective: Quantify the impact of reducing the consumption of red/processed meats on cardiovascular mortality and all-cause mortality of the Spanish adult population based in 5 revisions published. Participants and main measurements: We defined exposure as consumption of >= 3 servings/week of red or processed meats and considered four possible scenarios of exposed population (30%-60%). Based on data from the Spanish National Statistics Institute, we calculated the weighted mortality between 40 and 80 years. Using the relative risks (RR) and 95% confidence intervals (CI) published by the referred revisions (RR= 0.88; IC 95%: 0.84-0.93 for all-cause mortality and RR =0.92; IC 95%: 0.90-0.93 for cardiovascular mortality), we calculated the expected mortality rate in both exposed and unexposed categories. By multiplying these rates by the number of exposed individuals, we estimated the attributable number of yearly deaths. Results: If 60% of the population was exposed, with a 95% CI, the number of cardiovascular deaths that could be averted each year if population consumed < 3 servings/week of red or processed meats was between 2.112 and 3.055. If was exposed that 30%, the difference in the yearly number of potentially averted deaths was between 1.079 and 1.577. Conclusions: Even under the most conservative assumption, the benefit, at the population level, of reducing red or processed meats consumption < 3 servings/week on cardiovascular mortality is important. The conclusions of the recently published reviews contradicted their own results and contributed to a state of confusion that can create substantial harm for public health.
Autores: Lan, F. Y.; Filler, R.; Mathew, S.; et al.

Título: Sociodemographic risk factors for coronavirus disease 2019 (COVID-19) infection among Massachusetts healthcare workers: a retrospective cohort study

Revista: INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY

ISSN: 0899-823X Vol.42 N° 12 2021 págs. 1473 - 1478

Resumen

Objective: To better understand coronavirus disease 2019 (COVID-19) transmission among healthcare workers (HCWs), we investigated occupational and nonoccupational risk factors associated with cumulative COVID-19 incidence among a Massachusetts HCW cohort. Design, setting, and participants: The retrospective cohort study included adult HCWs in a single healthcare system from March 9 to June 3, 2020. Methods: The SARS-CoV-2 nasopharyngeal RT-PCR results and demographics of the study participants were deidentified and extracted from an established occupational health, COVID-19 database at the healthcare system. HCWs from each particular job grouping had been categorized into frontline or nonfrontline workers. Incidence rate ratios (IRRs) and odds ratios (ORs) were used to compare subgroups after excluding HCWs involved in early infection clusters before universal masking began. A sensitivity analysis was performed comparing jobs with the greatest potential occupational risks with others. Results: Of 5,177 HCWs, 152 (2.94%) were diagnosed with COVID-19. Affected HCWs resided in areas with higher community attack rates (median, 1,755.2 vs 1,412.4 cases per 100,000; P < .001; multivariate-adjusted IRR, 1.89; 95% CI, 1.03-3.44 comparing fifth to first quintile of community rates). After multivariate adjustment, African-American and Hispanic HCWs had higher incidence of COVID-19 than non-Hispanic white HCWs (IRR, 2.78; 95% CI, 1.78-4.33; and IRR, 2.41, 95% CI, 1.42-4.07, respectively). After adjusting for race and residential rates, frontline HCWs had a higher IRR (1.73, 95% CI, 1.16-2.54) than nonfrontline HCWs overall, but not within specific job categories nor when comparing the highest risk jobs to others. Conclusions: After universal masking was instituted, the strongest risk factors associated with HCW COVID-19 infection were residential community infection rate and race.
Autores: Etxeberria, U. (Autor de correspondencia); Gayoso, L.; Goñi Mateos, Leticia; et al.

Título: Papel de la gastronomía en la transformación de la salud de la población

Revista: REVISTA ESPAÑOLA DE NUTRICION HUMANA Y DIETETICA

ISSN: 2173-1292 Vol.25 2021 págs. 73 - 74
Autores: Ribo-Coll, M.; Lassale, C.; Sacanella, E.; et al.

Título: Mediterranean diet and antihypertensive drug use: a randomized controlled trial

Revista: JOURNAL OF HYPERTENSION

ISSN: 0263-6352 Vol.39 N° 6 2021 págs. 1230 - 1237

Resumen

Objective: To examine in older individuals at high cardiovascular risk whether following a Mediterranean diet decreased the necessity of antihypertensive drugs and modulated their associated cardiovascular risk. Methods: In the PREvencion con DIeta MEDiterranea study, we assessed whether volunteers randomly allocated to an intervention with a Mediterranean diet enriched with extra-virgin olive oil or nuts (relative to a low-fat control diet) disclosed differences in the risk of: initiating antihypertensive medication in nonusers at baseline (n = 2188); and escalating therapy in participants using one, two, or three drugs at baseline (n = 2361, n = 1579, and n = 554, respectively). We also assessed whether allocation to Mediterranean diet modified the association between antihypertensive drug use and incident cardiovascular events. Results: Participants allocated to Mediterranean diet interventions were associated with lower risk of initiating antihypertensive therapy [5-year incidence rates: 47.1% in the control diet, 43.0% in MedDiets; hazard ratio = 0.84, 95% CI (0.74--0.97), in a model adjusted for age, sex, and recruitment site]. Volunteers using two drugs at baseline in the Mediterranean diet intervention enriched with extra-virgin olive oil decreased their risk of therapy escalation [5-year incidence rates: 22.9% in the control diet, 20.1% in the MedDiet; hazard ratio = 0.77, 95% CI (0.60--0.99)]. Allocation to Mediterranean diet interventions attenuated the association between antihypertensive therapy at baseline and incidence of major adverse cardiovascular events (P interaction = 0.003). Conclusion: In an older population at high cardiovascular risk, following a Mediterranean diet reduced the risk of initiating or escalating antihypertensive medication and attenuated cardiovascular risk in antihypertensive drug users.
Autores: Nishi, S. K. (Autor de correspondencia); Babio, N. (Autor de correspondencia); Gómez-Martínez, C.; et al.

Título: Mediterranean, DASH, and MIND dietary patterns and cognitive function: the 2-year longitudinal changes in an older Spanish cohort

Revista: FRONTIERS IN AGING NEUROSCIENCE

ISSN: 1663-4365 Vol.13 2021 págs. 782067

Resumen

Background and Aims: Plant-forward dietary patterns have been associated with cardiometabolic health benefits, which, in turn, have been related to cognitive performance with inconsistent findings. The objective of this study was to examine the relationship between baseline adherence to three a priori dietary patterns (Mediterranean, DASH, and MIND diets) with 2-year changes in cognitive performance in older adults with overweight or obesity and high cardiovascular disease risk.Methods: A prospective cohort analysis was conducted within the PREDIMED-Plus trial, involving 6,647 men and women aged 55-75 years with overweight or obesity and metabolic syndrome. Using a validated, semiquantitative 143-item food frequency questionnaire completed at baseline, the dietary pattern adherence scores were calculated. An extensive neuropsychological test battery was administered at baseline and 2-year follow-up. Multivariable-adjusted linear regression models were used to assess associations between 2-year changes in cognitive function z-scores across tertiles of baseline adherence to the a priori dietary patterns.Results: Adherence to the Mediterranean diet at baseline was associated with 2-year changes in the general cognitive screening Mini-Mental State Examination (MMSE, beta: 0.070; 95% CI: 0.014, 0.175, P-trend = 0.011), and two executive function-related assessments: the Trail Making Tests Part A (TMT-A, beta: -0.054; 95% CI: -0.110, - 0.002, P-trend = 0.047) and Part B (TMT-B, beta: -0.079; 95% CI: -0.134, -0.024, P-trend = 0.004). Adherence to the MIND diet was associated with the backward recall Digit Span Test assessment of working memory (DST-B, beta: 0.058; 95% CI: 0.002, 0.114, P-trend = 0.045). However, higher adherence to the DASH dietary pattern was not associated with better cognitive function over a period of 2 years.Conclusion: In older Spanish individuals with overweight or obesity and at high cardiovascular disease risk, higher baseline adherence to the Mediterranean dietary pattern may be associated with better cognitive performance than lower adherence over a period of 2 years.
Autores: Bullo, M.; Papandreou, C.; Ruiz-Canela, Miguel; et al.

Título: Plasma metabolomic profiles of glycemic index, glycemic load, and carbohydrate quality index in the PREDIMED study

Revista: JOURNAL OF NUTRITION

ISSN: 0022-3166 Vol.151 N° 1 2021 págs. 50 - 58

Resumen

Background: The quality of carbohydrate consumed, assessed by the glycemic index (GI), glycemic load (GL), or carbohydrate quality index (CQI), affects the postprandial glycemic and insulinemic responses, which have been implicated in the etiology of several chronic diseases. However, it is unclear whether plasma metabolites involved in different biological pathways could provide functional insights into the role of carbohydrate quality indices in health. Objectives: We aimed to identify plasma metabolomic profiles associated with dietary GI, GL, and CQI. Methods: The present study is a cross-sectional analysis of 1833 participants with overweight/obesity (mean age = 67 y) from 2 case-cohort studies nested within the PREDIMED (Prevencion con Dieta Mediterranea) trial. Data extracted from validated FFQs were used to estimate the GI, GL, and CQI. Plasma concentrations of 385 metabolites were profiled with LC coupled to MS and associations of these metabolites with those indices were assessed with elastic net regression analyses. Results: A total of 58, 18, and 57 metabolites were selected for GI, GL, and CQI, respectively. Choline, cotinine, gamma -butyrobetaine, and 36:3 phosphatidylserine plasmalogen were positively associated with GI and GL, whereas they were negatively associated with CQI. Fructose-glucose-galactose was negatively and positively associated with GI/GL and CQI, respectively. Consistent associations of 21 metabolites with both GI and CQI were found but in opposite directions. Negative associations of kynurenic acid, 22:1 sphingomyelin, and 38:6 phosphatidylethanolamine, as well as positive associations of 32:1 phosphatidylcholine with GI and GL were also observed. Pearson correlation coefficients between GI, GL, and CQI and the metabolomic profiles were 0.30, 0.22, and 0.27, respectively. Conclusions: The GI, GL, and CQI were associated with specific metabolomic profiles in a Mediterranean population at high cardiovascular disease risk. Our findings may help in understanding the role of dietary carbohydrate indices in the development of cardiometabolic disorders. This trial was registered at isrctn.com as ISRCTN35739639. J Nutr 2021;151:50-58. ABSTRACT Background: The quality of carbohydrate consumed, assessed by the glycemic index (GI), glycemic load (GL), or carbohydrate quality index (CQI), affects the postprandial glycemic and insulinemic responses, which have been implicated in the etiology of several chronic diseases. However, it is unclear whether plasma metabolites involved in different biological pathways could provide functional insights into the role of carbohydrate quality indices in health. Objectives: We aimed to identify plasma metabolomic profiles associated with dietary GI, GL, and CQI. Methods: The present study is a cross-sectional analysis of 1833 participants with overweight/obesity (mean age = 67 y) from 2 case-cohort studies nested within the PREDIMED (Prevencion con Dieta Mediterranea) trial. Data extracted from validated FFQs were used to estimate the GI, GL, and CQI. Plasma concentrations of 385 metabolites were profiled with LC coupled to MS and associations of these metabolites with those indices were assessed with elastic net regression analyses. Results: A total of 58, 18, and 57 metabolites were selected for GI, GL, and CQI, respectively. Choline, cotinine, gamma -butyrobetaine, and 36:3 phosphatidylserine plasmalogen were positively associated with GI and GL, whereas they were negatively associated with CQI. Fructose-glucose-galactose was negatively and positively associated with GI/GL and CQI, respectively. Consistent associations of 21 metabolites with both GI and CQI were found but in opposite directions. Negative associations of kynurenic acid, 22:1 sphingomyelin, and 38:6 phosphatidylethanolamine, as well as positive associations of 32:1 phosphatidylcholine with GI and GL were also observed. Pearson correlation coefficients between GI, GL, and CQI and the metabolomic profiles were 0.30, 0.22, and 0.27, respectively. Conclusions: The GI, GL, and CQI were associated with specific metabolomic profiles in a Mediterranean population at high cardiovascular disease risk. Our findings may help in understanding the role of dietary carbohydrate indices in the development of cardiometabolic disorders. This trial was registered at isrctn.com as ISRCTN35739639. J Nutr 2021;151:50-58.
Autores: Gutierrez-Bedmar, M. (Autor de correspondencia); Olmedo, P.; Gil, F.; et al.

Título: Low serum iron levels and risk of cardiovascular disease in high risk elderly population: Nested case-control study in the PREvencion con DIeta MEDiterranea (PREDIMED) trial

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.40 N° 2 2021 págs. 496 - 504

Resumen

Background & aims: Epidemiological data on iron status and cardiovascular disease (CVD) are still controversial. The aim of this study was to determine whether low serum iron (SI) levels are associated with an increased odds of first CVD event in a population at high cardiovascular risk. Methods: Case-control study design nested within the "PREvención con DIeta MEDiterránea" (PREDIMED) trial. A total of 207 participants diagnosed with CVD (myocardial infarction, stroke or cardiovascular death) during follow-up period (2003-2010) were matched by sex, age and intervention group to 436 controls by incidence density sampling. Median time between serum sample collection and subsequent CVD event occurrence was 0.94 years. Inductively coupled plasma mass spectrometry analysis was used to determine SI levels. In-person interviews, medical record reviews, and validated questionnaires were used to assess covariates. Multivariable-adjusted odds ratios (ORs) of CVD were calculated with conditional logistic regression. Results: Mean SI levels were higher in men than in women (1224.0 ¿g/L vs. 1093.8 ¿g/L; p < 0.001). Among women, but not in men, the mean SI concentration was lower in cases than in controls (1008.5 ¿g/L vs. 1132.9 ¿g/L; p = 0.030). There was a gradual decrease in the multivariable-adjusted ORs of CVD with increasing SI levels (highest vs. lowest quartile: OR = 0.55, 95% CI: 0.32-0.93; ptrend = 0.020). This inverse relationship was more pronounced among women (highest vs. lowest quartile: OR = 0.15, 95% CI: 0.03-0.69; ptrend = 0.011). Conclusions: The present findings are consistent with previously reported inverse associations between SI and CVD. SI levels as an independent marker of short-term cardiovascular risk may be useful for risk assessment in older populations. Trial registration: www.controlled-trials.com; International Standard Randomized Controlled Trial Number (ISRCTN): 35,739,639. Registered 5 October 2005. Retrospectively registered.
Autores: Sánchez Bayona, Rodrigo; Gardeazábal González, Itziar; Romanos Nanclares, Andrea; et al.

Título: Leisure-time physical activity, sedentary behavior, and risk of breast cancer: Results from the SUN ('Seguimiento Universidad De Navarra') project

Revista: PREVENTIVE MEDICINE

ISSN: 0091-7435 Vol.148 2021 págs. 106535

Resumen

Evidence is still limited on the influence of sedentary lifestyles on breast cancer (BC) risk. Also, prospective information on the combined effects of both sedentariness and leisure-time physical activity (LTPA) is scarce. We aimed to assess the association of higher sedentary behavior and LTPA (separately and in combination) with the risk of BC in a middle-aged cohort of university graduates. The SUN Project is a follow-up study initiated in 1999 with recruitment permanently open. Baseline assessments included a validated questionnaire on LTPA and sedentary habits. Subsequently, participants completed biennial follow-up questionnaires. Multivariable adjusted Cox models were used to estimate the hazard ratios (HR) for incident BC according to LTPA, TV-watching, the joint classification of both, and a combined 8-item multidimensional active lifestyle score. We included 10,812 women, with 11.8 years of median follow-up of. Among 115,802 women-years of follow-up, we confirmed 101 incident cases of BC. Women in the highest category of LTPA ( 2 points) group. There was no significant supra-multiplicative interaction between TV-watching and LTPA. Both low LTPA and TV-watching 2 h/d may substantially increase BC risk, independently of each other.
Autores: Chaccour Diaz, Carlos Javier; Casellas, A.; Blanco Di Matteo, Andrés Enrique; et al.

Título: The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: a pilot, double-blind, placebo-controlled, randomized clinical trial

Revista: ECLINICALMEDICINE

ISSN: 2589-5370 Vol.32 2021 págs. 100720

Resumen

Background: Ivermectin inhibits the replication of SARS-CoV-2 in vitro at concentrations not readily achievable with currently approved doses. There is limited evidence to support its clinical use in COVID-19 patients. We conducted a Pilot, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of a single dose of ivermectin reduce the transmission of SARS-CoV-2 when administered early after disease onset. Methods: Consecutive patients with non-severe COVID-19 and no risk factors for complicated disease attending the emergency room of the Clínica Universidad de Navarra between July 31, 2020 and September 11, 2020 were enrolled. All enrollments occurred within 72 h of onset of fever or cough. Patients were randomized 1:1 to receive ivermectin, 400 mcg/kg, single dose (n = 12) or placebo (n = 12). The primary outcome measure was the proportion of patients with detectable SARS-CoV-2 RNA by PCR from nasopharyngeal swab at day 7 post-treatment. The primary outcome was supported by determination of the viral load and infectivity of each sample. The differences between ivermectin and placebo were calculated using Fisher's exact test and presented as a relative risk ratio. This study is registered at ClinicalTrials.gov: NCT04390022. Findings: All patients recruited completed the trial (median age, 26 [IQR 19-36 in the ivermectin and 21-44 in the controls] years; 12 [50%] women; 100% had symptoms at recruitment, 70% reported headache, 62% reported fever, 50% reported general malaise and 25% reported cough). At day 7, there was no difference in the proportion of PCR positive patients (RR 0·92, 95% CI: 0·77-1·09, p = 1·0). The ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24). Patients in the ivermectin group recovered earlier from hyposmia/anosmia (76 vs 158 patient-days; p < 0.001). Interpretation: Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials. Funding: ISGlobal, Barcelona Institute for Global Health and Clínica Universidad de Navarra.
Autores: Cárdenas-Fuentes, G.; Lassale, C.; Martínez González, Miguel Ángel; et al.

Título: Anthropometric variables as mediators of the association of changes in diet and physical activity with inflammatory profile

Revista: JOURNALS OF GERONTOLOGY SERIES A -BIOLOGICAL SCIENCES AND MEDICAL SCIENCES

ISSN: 1079-5006 Vol.76 N° 11 2021 págs. 2021 - 2029

Resumen

Background: Mechanisms underlying the associations of high levels of physical activity (PA) and adherence to the Mediterranean diet (MedDiet) with a better inflammatory profile remain unclear. Our objective was to assess the mediating role of changes in body mass index (BMI) and waist circumference (WC), as markers of body fat in the association of changes in PA and adherence to the MedDiet, with changes in the inflammatory profile. Method: This study included 489 adults, aged 55-75 years, from the PREDIMED-Plus multicenter lifestyle intervention trial. An inflammatory score was calculated, based on 8 blood biomarkers: high-sensitivity C-reactive protein, interleukin 6, interleukin 8, interleukin 18, monocyte chemo-attractant protein-1, C-peptide, leptin, and regulated on activation, normal T-cell-expressed and secreted chemokine. Biomarkers, levels of PA, score of MedDiet adherence, BMI, and WC were measured at baseline and at 1-year follow-up. Linear regression models were fitted according to the Baron and Kenny framework for mediation analysis. Results: Changes in BMI and WC mediated the association of both changes in PA and changes in the MedDiet adherence with the inflammatory score. Body mass index mediated 26% of the association of changes in total PA with the inflammatory profile, and 27% of the association of changes in the MedDiet, while WC mediated 13% and 12% of these associations, respectively. Conclusion: In older adults at high cardiovascular risk, increasing PA levels and adherence to a MedDiet during 1 year were associated with a lower inflammatory score, which was partly mediated by a reduction in body fat.
Autores: Urpi-Sarda, M.; Casas, R.; Sacanella, E.; et al.

Título: The 3-year effect of the Mediterranean diet intervention on inflammatory biomarkers related to cardiovascular disease

Revista: BIOMEDICINES

ISSN: 2227-9059 Vol.9 N° 8 2021 págs. 862

Resumen

The intervention with the Mediterranean diet (MD) pattern has evidenced short-term anti-inflammatory effects, but little is known about its long-term anti-inflammatory properties at molecular level. This study aims to investigate the 3-year effect of MD interventions compared to low-fat diet (LFD) on changes on inflammatory biomarkers related to atherosclerosis in a free-living population with a high-risk of cardiovascular disease (CD). Participants (n = 285) in the PREDIMED trial were randomly assigned into three intervention groups: MD with extra-virgin olive oil (EVOO) or MD-Nuts, and a LFD. Fourteen plasma inflammatory biomarkers were determined by Luminex assays. An additional pilot study of gene expression (GE) was determined by RT-PCR in 35 participants. After 3 years, both MDs showed a significant reduction in the plasma levels of IL-1 beta, IL-6, IL-8, TNF-alpha, IFN-gamma, hs-CRP, MCP-1, MIP-1 beta, RANTES, and ENA78 (p < 0.05; all). The decreased levels of IL-1 beta, IL-6, IL-8, and TNF-alpha after MD significantly differed from those in the LFD (p < 0.05). No significant changes were observed at the gene level after MD interventions, however, the GE of CXCR2 and CXCR3 tended to increase in the control LFD group (p = 0.09). This study supports the implementation of MD as a healthy long-term dietary pattern in the prevention of CD in populations at high cardiovascular risk.
Autores: Schroder, H. (Autor de correspondencia); Zomeno, M. D.; Martínez González, Miguel Ángel; et al.

Título: Validity of the energy-restricted Mediterranean Diet Adherence Screener

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.40 N° 8 2021 págs. 4971 - 4979

Resumen

Background: Short dietary assessment tools can be useful to estimate food intake and diet quality in large-scale epidemiological studies with time constraints. Objective: To determine the concurrent validity of the 17-item energy-restricted Mediterranean Adherence Screener (er-MEDAS) used in the PREDIMED (PREvencion con DIeta MEDiterranea)-Plus trial and to analyse its capacity to detect 1-year changes in diet and cardiometabolic risk factors. Methods: Validation study nested in the PREDIMED-Plus (n = 6760, 55-75 years). Dietary data were collected by the 17-item er-MEDAS and a 143-item validated semiquantitative food frequency questionnaire (FFQ) at baseline and after 1-year intervention. Cardiometabolic risk markers were measured at both time points. A Mediterranean diet (MedDiet) score was derived from both instruments. Concurrent validity was evaluated by Pearson and intra-class correlation coefficients (ICC) and Bland and Altman limits of agreement. Construct validity was evaluated by assessing 1-year changes in FFQ-reported dietary intake and cardiometabolic profile changes in relation to changes in er-MEDAS. Results: A moderate to good correlation between the MedDiet score calculated by both measurement instruments was found: r = 0.61 and ICC = 0.60 (both p < 0.001). Agreement of each of the er-MEDAS items ranged from 55.4% to 85.0% with a moderate mean concordance (kappa = 0.41). Between baseline and 1-year follow-up, energy intake measured by the FFQ decreased by 242 kcal, while Mediterranean food consumption increased in participants with the highest increase in the er-MEDAS MedDiet score. An increase in the er-MEDAS MedDiet score ratings was associated with a decrease in BMI, waist circumference, triglycerides, fasting glucose, diastolic blood pressure, and triglycerides/HDL-cholesterol ratio (p < 0.001 for all), and with an increase in HDL-cholesterol (p = 0.006). Conclusion: The er-MEDAS shows a modest to good concurrent validity compared with FFQ data. It shows acceptable construct validity, as a greater er-MEDAS score was associated with more favourable dietary and cardiometabolic profiles over time.
Autores: Gabaldón-Figueira, J. C. (Autor de correspondencia); Brew, J.; Dore, D. H.; et al.

Título: Digital acoustic surveillance for early detection of respiratory disease outbreaks in Spain: a protocol for an observational study

Revista: BMJ OPEN

ISSN: 2044-6055 Vol.11 N° 7 2021 págs. e051278

Resumen

Introduction Cough is a common symptom of COVID-19 and other respiratory illnesses. However, objectively measuring its frequency and evolution is hindered by the lack of reliable and scalable monitoring systems. This can be overcome by newly developed artificial intelligence models that exploit the portability of smartphones. In the context of the ongoing COVID-19 pandemic, cough detection for respiratory disease syndromic surveillance represents a simple means for early outbreak detection and disease surveillance. In this protocol, we evaluate the ability of population-based digital cough surveillance to predict the incidence of respiratory diseases at population level in Navarra, Spain, while assessing individual determinants of uptake of these platforms. Methods and analysis Participants in the Cendea de Cizur, Zizur Mayor or attending the local University of Navarra (Pamplona) will be invited to monitor their night-time cough using the smartphone app Hyfe Cough Tracker. Detected coughs will be aggregated in time and space. Incidence of COVID-19 and other diagnosed respiratory diseases within the participants cohort, and the study area and population will be collected from local health facilities and used to carry out an autoregressive moving average analysis on those independent time series. In a mixed-methods design, we will explore barriers and facilitators of continuous digital cough monitoring by evaluating participation patterns and sociodemographic characteristics. Participants will fill an acceptability questionnaire and a subgroup will participate in focus group discussions. Ethics and dissemination Ethics approval was obtained from the ethics committee of the Centre Hospitalier de l'Universite de Montreal, Canada and the Medical Research Ethics Committee of Navarre, Spain. Preliminary findings will be shared with civil and health authorities and reported to individual participants. Results will be submitted for publication in peer-reviewed scientific journals and international conferences.
Autores: Monedero Rodríguez, Pablo (Autor de correspondencia); Gea Sánchez, Alfredo; Castro, P.; et al.

Título: Early corticosteroids are associated with lower mortality in critically ill patients with COVID-19: a cohort study

Revista: CRITICAL CARE (PRINT)

ISSN: 1364-8535 Vol.25 N° 1 2021 págs. 2

Resumen

BackgroundCritically ill patients with coronavirus disease 19 (COVID-19) have a high fatality rate likely due to a dysregulated immune response. Corticosteroids could attenuate this inappropriate response, although there are still some concerns regarding its use, timing, and dose.MethodsThis is a nationwide, prospective, multicenter, observational, cohort study in critically ill adult patients with COVID-19 admitted into Intensive Care Units (ICU) in Spain from 12th March to 29th June 2020. Using a multivariable Cox model with inverse probability weighting, we compared relevant outcomes between patients treated with early corticosteroids (before or within the first 48 h of ICU admission) with those who did not receive early corticosteroids (delayed group) or any corticosteroids at all (never group). Primary endpoint was ICU mortality. Secondary endpoints included 7-day mortality, ventilator-free days, and complications.ResultsA total of 691 patients out of 882 (78.3%) received corticosteroid during their hospital stay. Patients treated with early-corticosteroids (n=485) had lower ICU mortality (30.3% vs. never 36.6% and delayed 44.2%) and lower 7-day mortality (7.2% vs. never 15.2%) compared to non-early treated patients. They also had higher number of ventilator-free days, less length of ICU stay, and less secondary infections than delayed treated patients. There were no differences in medical complications between groups. Of note, early use of moderate-to-high doses was associated with better outcomes than low dose regimens.ConclusionEarly use of corticosteroids in critically ill patients with COVID-19 is associated with lower mortality than no or delayed use, and fewer complications than delayed use.
Autores: Miguel, V.; Tituana, J.; Herrero, J. I.; et al.

Título: Renal tubule Cpt1a overexpression protects from kidney fibrosis by restoring mitochondrial homeostasis

Revista: JOURNAL OF CLINICAL INVESTIGATION

ISSN: 0021-9738 Vol.131 N° 5 2021 págs. e140695

Resumen

Chronic kidney disease (CKD) remains a major epidemiological, clinical, and biomedical challenge. During CKD, renal tubular epithelial cells (TECs) present a persistent inflammatory and profibrotic response. Fatty acid oxidation (FAO), the main source of energy for TECs, is reduced in kidney fibrosis and contributes to its pathogenesis. To determine whether gain of function in FAO (FAO-GOF) could protect from fibrosis, we generated a conditional transgenic mouse model with overexpression of the fatty acid shuttling enzyme carnitine palmitoyl-transferase 1A (CPT1A) in TECs. Cpt1a-knockin (CPT1A-KI) mice subjected to 3 models of renal fibrosis (unilateral ureteral obstruction, folic acid nephropathy [FAN], and adenine-induced nephrotoxicity) exhibited decreased expression of fibrotic markers, a blunted proinflammatory response, and reduced epithelial cell damage and macrophage influx. Protection from fibrosis was also observed when Cpt1a overexpression was induced after FAN. FAO-GOF restored oxidative metabolism and mitochondrial number and enhanced bioenergetics, increasing palmitate oxidation and ATP levels, changes that were also recapitulated in TECs exposed to profibrotic stimuli. Studies in patients showed decreased CPT1 levels and increased accumulation of shortand middle chain acylcarnitines, reflecting impaired FAO in human CKD. We propose that strategies based on FAO-GOF may constitute powerful alternatives to combat fibrosis inherent to CKD.
Autores: Pastorino, S. (Autor de correspondencia); Bishop, T.; Sharp, S. J.; et al.

Título: Heterogeneity of associations between total and types of fish intake and the incidence of type 2 diabetes: federated meta-analysis of 28 prospective studies including 956,122 participants

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.13 N° 4 2021 págs. 1223

Resumen

The association between fish consumption and new-onset type 2 diabetes is inconsistent and differs according to geographical location. We examined the association between the total and types of fish consumption and type 2 diabetes using individual participant data from 28 prospective cohort studies from the Americas (6), Europe (15), the Western Pacific (6), and the Eastern Mediterranean (1) comprising 956,122 participants and 48,084 cases of incident type 2 diabetes. Incidence rate ratios (IRRs) for associations of total fish, shellfish, fatty, lean, fried, freshwater, and saltwater fish intake and type 2 diabetes were derived for each study, adjusting for a consistent set of confounders and combined across studies using random-effects meta-analysis. We stratified all analyses by sex due to observed interaction (p = 0.002) on the association between fish and type 2 diabetes. In women, for each 100 g/week higher intake the IRRs (95% CIs) of type 2 diabetes were 1.02 (1.01-1.03, I-2 = 61%) for total fish, 1.04 (1.01-1.07, I-2 = 46%) for fatty fish, and 1.02 (1.00-1.04, I-2 = 33%) for lean fish. In men, all associations were null. In women, we observed variation by geographical location: IRRs for total fish were 1.03 (1.02-1.04, I-2 = 0%) in the Americas and null in other regions. In conclusion, we found evidence of a neutral association between total fish intake and type 2 diabetes in men, but there was a modest positive association among women with heterogeneity across studies, which was partly explained by geographical location and types of fish intake. Future research should investigate the role of cooking methods, accompanying foods and environmental pollutants, but meanwhile, existing dietary regional, national, or international guidelines should continue to guide fish consumption within overall healthy dietary patterns.
Autores: Hershey de la Cruz, María Soledad; Sotos-Prieto, M.; Ruiz-Canela, Miguel; et al.

Título: The Mediterranean lifestyle (MEDLIFE) index and metabolic syndrome in a non-Mediterranean working population

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.40 N° 5 2021 págs. 2494 - 2503

Resumen

Background & aims: The Mediterranean lifestyle (MEDLIFE), as an overall lifestyle pattern, may be associated with a lower prevalence of metabolic syndrome. We assessed the association of a validated MEDLIFE index with metabolic syndrome and its components in a non-Mediterranean working population. Methods: A cross-sectional analysis was conducted at baseline among 249 US career firefighters in Feeding America's Bravest 2016-2018. The MEDLIFE index consisted of 26 items on food consumption, dietary habits, physical activity, rest, and social interactions that scored 0 or 1 point. Thus, total scores could range from 0 to 26 points. Multivariable logistic regression models were used to determine the associations across tertiles of MEDLIFE adherence with metabolic syndrome and each of its individual components. Multivariable linear models further assessed each component as a continuous outcome. Results: The prevalence of metabolic syndrome was 17.7%. Participants with higher MEDLIFE adherence (T3: 11-17 points) had 71% lower odds of having metabolic syndrome compared to those with lower MEDLIFE adherence (T1: 2-7 points) (OR = 0.29; 95%CI: 0.10 to 0.90, p for trend = 0.04). Furthermore, significant inverse associations were found for T3 versus T1 on abdominal obesity (OR = 0.42; 95%CI: 0.18 to 0.99, p for trend = 0.07) and hypertriglyceridemia (OR = 0.24; 95%CI: 0.09 to 0.63, p for trend = 0.002). Significant inverse associations for continuous outcomes included total-cholesterol (total-c), low-density lipoprotein (LDL) cholesterol, and total-c:high-density lipoprotein (HDL) cholesterol (p for trend <0.05). Conclusion: Higher adherence to traditional Mediterranean lifestyle habits, as measured by a comprehensive MEDLIFE index, was associated with a lower prevalence of metabolic syndrome and a more favorable cardiometabolic profile in a non-Mediterranean working population. Future studies employing the MEDLIFE index in other populations are warranted to support this hypothesis.
Autores: Fernández-Lázaro, D. (Autor de correspondencia); Mielgo-Ayuso, J.; Fernández-Zoppino, D.; et al.

Título: Athletic, muscular and hormonal evaluation in CrossFit® athletes using the ''Elevation Training Mask''

Revista: ARCHIVOS DE MEDICINA DEL DEPORTE

ISSN: 0212-8799 Vol.38 N° 3 2021 págs. 274 - 281

Resumen

Introduction: The possibility of performing intense workouts without falling into states of chronic fatigue stimulates the use of devices that improve muscular and hormonal functionality in athletes. The Elevation Training Mask (Training Mask LLC) (ETM) allows the application of hypoxia during exercise. The ETM is integrated into training routines increasing the physical stimulus to improve performance. Objective: We evaluated the impact of ETM on Workouts of the Day (WODs), muscular and hormonal behavior in Crossfit® athletes. Material and method: Prospective cohort study. During 12 weeks 20 Crossfit® athletes trained 60 minutes 3 days a week were randomly divided into 2 groups, control group (CG) (n=10) and ETM group (EG) (n=10) applying an additional progressive simulated altitude between 914 and 2743 meters. WODs (press, squat, deadlift, total CF and grace), macular markers: lactate dehydrogenase (LDH); creatine kinase (CK); myoglobin (Mb) and hormones: testosterone (T); cortisol (C), were evaluated at 2 time points of the study: day 1 (T1) and day 84 (T2). Results: All WODs and parameters LDH, CK, Mb, T and C showed no significant difference (p>0.05) in the time group interaction. In EG, a substantially lower percentage change (¿) between T1 and T2 was observed in Mb (-16.01±25.82%), CK (6.16±26.05%) and C (-0.18±4.01%) than in CG (Mb: -094±4.39%; CK: 17.98±27.19%; C: 4.56±3.44%). The ¿ T1-T2 in the WODs were similar. Conclusion: After 12 weeks of training under simulated hypoxia conditions with ETM there are no improvements in athletic performance assessed by WODs. However, the greater tendency to decrease Mb, CK and C, after using ETM, could stimulate recovery and indicate a lower muscle catabolism of the Crossfit® athlete in the long term.
Autores: Romanos-Nanclares, A.; Gea Sánchez, Alfredo (Autor de correspondencia); Martínez González, Miguel Ángel; et al.

Título: Carbohydrate quality index and breast cancer risk in a Mediterranean cohort: the SUN project

Revista: CLINICAL NUTRITION

ISSN: 0261-5614 Vol.40 N° 1 2021 págs. 137 - 145

Resumen

Background & aims: Beyond the quantity of carbohydrate intake, further research is needed on the relevance of carbohydrate quality. Thus, we evaluated the association between an a priori defined carbohydrate quality index (CQI) and the incidence of breast cancer (BC) in a Mediterranean cohort study. Methods: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 10,812 middle-aged women. We evaluated at baseline the CQI following 4 criteria: dietary fiber intake, glycemic index, whole-grain:total-grain carbohydrates ratio and the solid carbohydrate:total carbohydrate ratio. Subjects were classified into quartiles according to the final CQI score. Results: During a median follow-up of 11.8 years, we confirmed 101 incident cases of BC. Our study suggests that a higher quality of carbohydrate intake, as measured by the baseline CQI, was associated with a lower risk of BC [HR Q4 vs. Q1 0.39 (95% CI 0.17, 0.87)]. Particularly, a higher whole-grain:total-grain carbohydrates ratio was associated with lower risk of BC [HR T3 vs. T1 0.56 (0.34, 0.90)]. When we stratified by menopausal status, we found an inverse association between CQI and BC in the comparison of extreme quartiles among premenopausal women. Conclusions: In this Mediterranean cohort, a better quality of dietary carbohydrate intake showed a significant inverse association with the incidence of BC, which suggests that strategies for cancer prevention should highlight the quality of this macronutrient.
Autores: Diaz-Lopez, A.; Becerra-Tomas, N.; Ruiz, V.; et al.

Título: Effect of an intensive weight-loss lifestyle intervention on kidney function: a randomized controlled trial

Revista: AMERICAN JOURNAL OF NEPHROLOGY

ISSN: 0250-8095 Vol.52 N° 1 2021 págs. 45 - 58

Resumen

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 "PREvencion con DIeta MEDiterranea-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 m(2)) and micro- to macroalbuminuria (UACR >= 30 mg/g), and reversion of moderately (45 to <60 mL/min/1.73 m(2)) to mildly impaired GFR (60 to <90 mL/min/1.73 m(2)) or micro- to macroalbuminuria. Results: After 1 year, eGFR declined by 0.66 and 1.25 mL/min/1.73 m(2) in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m(2); 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.
Autores: Moreno Galarraga, Laura; Romanos Nanclares, Andrea; García Blanco, Lorena; et al.

Título: Caesarean delivery is associated with an absolute increase in the prevalence of overweight in the offspring: The SENDO project

Revista: JOURNAL OF PAEDIATRICS AND CHILD HEALTH

ISSN: 1034-4810 Vol.57 N° 6 2021 págs. 819-825

Resumen

Aim: The association between caesarean delivery and the risk of overweight/obesity in the offspring has been previously reported using conventional measures of association (relative risks or odds ratios). We aimed at refining the existing evidence by calculating the marginal effect of the exposure and estimating the unmeasured residual confounding. Methods: In the 'SEguimiento del Nino para un Desarrollo Optimo' Project, a dynamic multipurpose paediatric cohort study, we collected information from parents through self-administered online questionnaires. We estimated the offspring's risk of overweight/obesity at age 4-6 years, associated with the type of delivery through marginal effect of the exposure. Unmeasured residual confounding was assessed using the E-value. Results: Among 407 participants (mean-age: 5.0 years (standard deviation: 0.9)), 86 (21.1%) were born by caesarean delivery. Children born by caesarean delivery had higher odds of overweight/obesity than those born vaginally. Subgroup analyses showed similar results. The multivariable adjusted marginal effect showed that caesarean delivery was associated with an 8.0% (95% confidence interval: 0.2-15.7) absolute increase in the prevalence of overweight/obesity. The estimated residual confounding showed an E-value of 4.03, higher than the OR obtained for all the confounding factors we accounted for. Conclusions: Caesarean delivery was associated with an 8% absolute increase in the risk of overweight/obesity that is very unlikely explained by residual confounding.
Autores: Moreno Galarraga, Laura; Martin-Álvarez, I.; Fernández Montero, Alejandro; et al.

Título: Consumption of ultra-processed products and wheezing respiratory diseases in children: The SENDO project

Revista: ANALES DE PEDIATRIA

ISSN: 1695-4033 Vol.95 N° 1 2021 págs. 18 - 25

Resumen

Introduction: The consumption of ultra-processed products (UP) is associated with many diseases in the adult, such as arterial hypertension, diabetes, or asthma. Objective: To determine whether the consumption of UP in children is associated with wheezing respiratory diseases (asthma or bronchitis/recurrent wheezing). Material and methods: A cross-sectional study was conducted within the Follow-up of the Child for Optimal Development ?SENDO? project (an open, multidisciplinary and multiple outcome study of Spanish children). The consumption of UP was calculated using semi-quantitative questionnaires on the frequency of food consumption. The foods were grouped according the NOVA classification, and the daily consumption was estimated along with the percentage of kilocalories from the UP. The exposure was grouped into "high" and "low" from the median consumption. Odds ratios and 95% confidence intervals were calculated for wheezing respiratory diseases associated with the high consumption UP, using low consumption as a reference. Crude and multi-adjusted estimators were calculated, and mixed regression models were used to take into account the correlation between siblings. Results: In the 513 children studied (51.8% males, mean age 5.2 years), the mean consumption of UP was 446.76 g/day, representing 39.9% of the total calories ingested. A high consumption of UP was associated with an increase of 87% in the prevalence of wheezing respiratory diseases (OR 1.87; 95% CI 1.01-3.45). It was found that a higher consumption of UP multiplied by 2.12 (95% CI 1.10-4.05) the prevalence of bronchitis/recurrent wheezing. Conclusions: The results of this study show a direct relationship between UP consumption and the prevalence of wheezing diseases in children. (c) 2021 Asociaci & oacute;n Espa & ntilde;ola de Pediatr & iacute;a. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
Autores: Pearce, M. (Autor de correspondencia); Fanidi, A.; Bishop, T. R. P.; et al.

Título: Associations of total legume, pulse, and soy consumption with incident type 2 diabetes: Federated meta-analysis of 27 studies from diverse world regions

Revista: JOURNAL OF NUTRITION

ISSN: 0022-3166 Vol.151 N° 5 2021 págs. 1231 - 1240

Resumen

Background: The consumption of legumes is promoted as part of a healthy diet in many countries but associations of total and types of legume consumption with type 2 diabetes (T2D) are not well established. Analyses across diverse populations are lacking despite the availability of unpublished legume consumption data in prospective cohort studies. Objective: To examine the prospective associations of total and types of legume intake with the risk of incident T2D. Methods: Meta-analyses of associations between total legume, pulse, and soy consumption and T2D were conducted using a federated approach without physical data-pooling. Prospective cohorts were included if legume exposure and T2D outcome data were available and the cohort investigators agreed to participate. We estimated incidence rate ratios (IRRs) and C Is of associations using individual participant data including <42,473 incident cases among 807,785 adults without diabetes in 27 cohorts across the Americas, Eastern Mediterranean, Europe, and Western Pacific. Random-effects meta-analysis was used to combine effect estimates and estimate heterogeneity. Results: Median total legume intake ranged from 0-140 g/d across cohorts. We observed a weak positive association between total legume consumption and T2D (IRR = 1.02, 95% CI: 1.01 to 1.04) per 20 g/d higher intake, with moderately high heterogeneity (I-2 = 74%). Analysis by region showed no evidence of associations in the Americas, Eastern Mediterranean, and Western Pacific. The positive association in Europe (IRR = 1.05, 95% CI: 1.01 to 1.10, I-2 = 82%) was mainly driven by studies from Germany, UK, and Sweden. No evidence of associations was observed for the consumption of pulses or soy. Conclusions: These findings suggest no evidence of an association of legume intakes with T2D in several world regions. The positive association observed in some European studies warrants further investigation relating to overall dietary contexts in which legumes are consumed, including accompanying foods which may be positively associated with T2D.
Autores: Papandreou, C. (Autor de correspondencia); Bullo, M.; Hernández-Alonso, P.; et al.

Título: Choline metabolism and risk of atrial fibrillation and heart failure in the PREDIMED study

Revista: CLINICAL CHEMISTRY

ISSN: 0009-9147 Vol.67 N° 1 2021 págs. 288 - 297

Resumen

BACKGROUND: Few studies have examined the associations of trimethylamine-N-oxide (TMAO) and its precursors (choline, betaine, dimethylglycine, and L-carnitine) with the risk of atrial fibrillation (AF) and heart failure (HF). This study sought to investigate these associations. METHODS: Prospective associations of these metabolites with incident AF and HF were examined among participants at high cardiovascular risk in the PREDIMED study (PREvencion con DIeta MEDiterranea) after follow-up for about 10 years. Two nested case-control studies were conducted, including 509 AF incident cases matched to 618 controls and 326 HF incident cases matched to 426 controls. Plasma levels of TMAO and its precursors were semi-quantitatively profiled with liquid chromatography tandem mass spectrometry. Odds ratios were estimated with multivariable conditional logistic regression models. RESULTS: After adjustment for classical risk factors and accounting for multiple testing, participants in the highest quartile vs. the lowest quartile of baseline choline and betaine levels had a higher risk of AF [OR (95% CI): 1.85 (1.30-2.63) and 1.57 (1.09-2.24), respectively]. The corresponding OR for AF for extreme quartiles of dimethylglycine was 1.39 (0.99-1.96). One SD increase in log-transformed dimethylglycine was positively associated with AF risk (OR, 1.17; 1.03-1.33). The corresponding ORs for HF for extreme quartiles of choline, betaine, and dimethylglycine were 2.51 (1.57-4.03), 1.65 (1.00-2.71) and 1.65 (1.04-2.61), respectively. TMAO and L-carnitine levels were not associated with AF or HF. CONCLUSIONS: Our findings support the role of the choline metabolic pathway in the pathogenesis of AF and HF.
Autores: Fernández de la Puente, M.; Hernández-Alonso, P.; Canudas, S. (Autor de correspondencia); et al.

Título: Modulation of telomere length by mediterranean diet, caloric restriction, and exercise: results from PREDIMED-plus study

Revista: ANTIOXIDANTS

ISSN: 2076-3921 Vol.10 N° 10 2021 págs. 1596

Resumen

Telomere length (TL) has been associated with aging and is determined by lifestyle. However, the mechanisms by which a dietary pattern such as the Mediterranean diet (MedDiet) affects TL homeostasis are still unknown. Our aim was to analyse the effect of an energy-restricted MedDiet with physical activity promotion (intervention group) versus an unrestricted-caloric MedDiet with no weight-loss advice (control group) on TL and 8-hydroxydeoxyguanosine (8-OHdG) plasma levels. In total, 80 non-diabetic participants with metabolic syndrome were randomly selected from the PREDIMED (PREvencion con DIeta MEDiterranea)-Plus-Reus study. TL was measured by a hybridisation method and 8-OHdG levels by ELISA at baseline and after one year of intervention. Linear mixed models (LMM)-raw and after adjusting for potential confounders-were used to examine the associations between TL or 8-OHdG plasma levels by intervention group and/or time. A total of 69 subjects with available DNA samples were included in the analyses. A significant beta-coefficient was found for time towards increasing values through the year of follow-up for TL (unadjusted beta of 0.740 (95% CI: 0.529 to 0.951), and multivariable model beta of 0.700 (95% CI: 0.477 to 0.922)). No significant beta s were found, neither for the intervention group nor for the interaction between the intervention group and time. Regarding 8-OHdG plasma levels, no significant beta s were found for the intervention group, time, and its interaction. Our results suggest that MedDiet could have an important role in preventing telomere shortening, but calorie restriction and exercise promotion did not provide an additional advantage concerning telomere length after one year of MedDiet intervention.
Autores: Santiago Neri, Susana; Zazpe García, Itzíar; Fernández Lázaro, Cesar Ignacio; et al.

Título: Macronutrient quality and all-cause mortality in the SUN cohort

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.13 N° 3 2021 págs. 972

Resumen

No previous study has assessed the relationship between overall macronutrient quality and all-cause mortality. We aimed to prospectively examine the association between a multidimensional macronutrient quality index (MQI) and all-cause mortality in the SUN (Seguimiento Universidad de Navarra) (University of Navarra Follow-Up) study, a Mediterranean cohort of middle-aged adults. Dietary intake information was obtained from a validated 136-item semi-quantitative food-frequency questionnaire. We calculated the MQI (categorized in quartiles) based on three quality indexes: the carbohydrate quality index (CQI), the fat quality index (FQI), and the healthy plate protein source quality index (HPPQI). Among 19,083 participants (mean age 38.4, 59.9% female), 440 deaths from all causes were observed during a median follow-up of 12.2 years (IQR, 8.3-14.9). No significant association was found between the MQI and mortality risk with multivariable-adjusted hazard ratio (HR) for the highest vs. the lowest quartile of 0.79 (95% CI, 0.59-1.06; P-trend = 0.199). The CQI was the only component of the MQI associated with mortality showing a significant inverse relationship, with HR between extreme quartiles of 0.64 (95% CI, 0.45-0.90; P-trend = 0.021). In this Mediterranean cohort, a new and multidimensional MQI defined a priori was not associated with all-cause mortality. Among its three sub-indexes, only the CQI showed a significant inverse relationship with the risk of all-cause mortality.
Autores: Martín Calvo, Nerea; Santiago Neri, Susana; Segura, G.; et al.

Título: Pregestational BMI and higher offspring's risk of overweight/obesity in smoker and non-smoker mothers

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.24 N° 13 2021 págs. 4204 - 4211

Resumen

Objective: To assess the association between pregestational BMI and offspring's risk of overweight/obesity after accounting for the most important confounders, especially maternal smoking habit. Design: Prospective cohort study. Setting: The Seguimiento Universidad de Navarra (SUN) study is a prospective cohort of Spanish graduates with more than 22 000 participants nationwide. Recruitment started in 1999, and it is permanently open. Data on diet, lifestyle and clinical diagnoses are collected at baseline and every 2 years. Participants: Women from the SUN cohort who reported at least one pregnancy during follow-up (n 3496) were invited to this study. Among them, 1527 agreed to participate and completed an additional more detailed online questionnaire on their pregnancy history and their offspring's nutritional status. Results: After excluding 165 children, we analysed data of 2791 participants born to 1485 mothers and observed that each 5 kg/m(2) increase in pregestational BMI was associated with a 0 center dot 22 (95 % CI 0 center dot 15, 0 center dot 29) higher z-score in offspring's BMI and higher risk of overweight/obesity (multivariable-adjusted relative risk (RR) 1 center dot 57 (95 % CI 1 center dot 39, 1 center dot 77)) in childhood or adolescence. Furthermore, we observed stronger association in children born to smoker mothers (RR 1 center dot 91; 95 % CI 1 center dot 48, 2 center dot 46) than from non-smoker mothers (RR 1 center dot 51; 95 % CI 1 center dot 31, 1 center dot 73) (P-for interaction = 0 center dot 02). Conclusions: We found a synergistic interaction between pregestational BMI and maternal smoking habit on offspring's z-score of the BMI and in their risk of overweight/obesity. Although further research is needed to analyse dose-response relationships, these findings reinforce the importance of promoting healthy lifestyles in pregnant women in order to prevent childhood obesity.
Autores: Santiago Neri, Susana; Benítez-Borja, A.; Martín Calvo, Nerea (Autor de correspondencia); et al.

Título: Association between parental attitudes towards their offspring's diet and children's actual dietary habits - The SENDO project

Revista: NUTRICION HOSPITALARIA

ISSN: 0212-1611 Vol.38 N° 5 2021 págs. 961 - 970

Resumen

Introduction: the preschool stage is a critical period for teaching and modeling healthy habits to positively influence children's health and wellbeing throughout their lifetime. Objectives: to evaluate the association between parental attitudes towards their offspring's dietary habits in Spanish children aged 4 to 7 years participating in the Follow-up of Children for Optimal Development (SENDO) project. Methods: we defined an index to measure information on parental attitudes towards their offspring's diet (0 to 8 points), and another one to measure children's actual dietary habits (0 to 19 points). A higher score meant healthier attitudes and healthier habits, respectively. Information was collected through an online questionnaire completed by parents. We calculated crude and multivariable-adjusted odds ratios (OR) and 95 % confidence intervals (CI) for children's healthy dietary habits associated with parental scores in the parental attitudes index. Generalized estimation equations (GEE) were used to account for intra-cluster correlation between siblings. Results: a total of 423 preschoolers (52.3 % boys, mean age 5.3 years) were included in the analyses. Half of the children (51 %) reported unhealthy dietary habits, whereas 56 % of parents reported high adherence to the healthy eating index. Compared to those in the lowest category, the children whose parents were in the highest category in the parental attitudes index showed significantly higher odds of having healthy dietary habits (OR: 2.91; 95 % CI: 1.30-6.53, p for trend = 0.004). Conclusions: our results support a direct association between parental attitudes and their offspring's dietary habits, suggesting that public health interventions aimed at improving children's dietary habits should shift from the individual- to a family-based approach.
Autores: Navarro-Font, X.; Kales, S. N.; Vicente-Herrero, M. T.; et al.

Título: Association between the "COVID-19 Occupational Vulnerability Index" and COVID-19 severity and sequelae among hospital employees

Revista: JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE

ISSN: 1076-2752 Vol.63 N° 10 2021 págs. 895 - 900

Resumen

Objectives: In addition to personal and health related factors, healthcare workers have an increased risk due to their work. We assessed the association of the score of the Occupational Vulnerability Index with the risk of suffering a severe COVID-19 and sequelae. Methods: Retrospective observational study carried out in healthcare workers. Among 119 employees infected, the COVID-19 Occupational Vulnerability Index (composed of 29 items regarding personal health, working conditions, and ability to comply with preventive measures) was calculated and correlated with COVID-19 severity/sequelae. Results: Workers with higher scores (six to seven points) had a significantly increased risk of developing severe disease (OR = 9.73; 95% CI, 1.53 to 35.56) and clinical sequelae (OR = 5.22; 95% CI, 1.80 to 15.16) than those with lower scores (0 to 3). Conclusion: The "COVID-19 Occupational Vulnerability Index" may predict the risk of severe COVID-19 disease and clinical sequelae among healthcare workers.
Autores: Hernaez, A. (Autor de correspondencia); Lassale, C.; Castro-Barquero, S.; et al.

Título: Mediterranean diet maintained platelet count within a healthy range and decreased thrombocytopenia-related mortality risk: a randomized controlled trial

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.13 N° 2 2021 págs. 559

Resumen

There is little information on the dietary modulation of thrombosis-related risk factors such as platelet count. We aimed to assess the effects of Mediterranean diet (MedDiet) on platelet count and related outcomes in an older population at high cardiovascular risk. In participants of the PREDIMED (PREvencion con DIeta MEDiterranea) study, we assessed whether an intervention with a MedDiet enriched with extra-virgin olive oil or nuts, relative to a low-fat control diet, modulated platelet count (n = 4189), the risk of developing thrombocytosis and thrombocytopenia (n = 3086), and the association between these alterations and all-cause mortality (median follow-up time: 3.0 years). Although platelet count increased over time (+0.98 center dot 10(9) units/L center dot year [95% confidence interval: 0.12; 1.84]), MedDiet interventions moderated this increase, particularly in individuals with near-high baseline count (both MedDiets combined: -3.20 center dot 10(9) units/L center dot year [-5.81; -0.59]). Thrombocytopenia incidence was lower in the MedDiet interventions (incidence rates: 2.23% in control diet, 0.91% in MedDiets combined; hazard ratio: 0.44 [0.23; 0.83]). Finally, thrombocytopenia was associated with a higher risk of all-cause mortality (hazard ratio: 4.71 [2.69; 8.24]), but this relationship was attenuated in those allocated to MedDiet (p-interaction = 0.018). In brief, MedDiet maintained platelet counts within a healthy range and attenuated platelet-related mortality in older adults at high cardiovascular risk.
Autores: Pimenta, A. M. (Autor de correspondencia); Lahortiga Ramos, Francisca; Sayon Orea, María del Carmen; et al.

Título: Depression and metabolic syndrome in participants of the " Seguimiento Universidad de Navarra " (SUN) cohort study

Revista: JOURNAL OF AFFECTIVE DISORDERS

ISSN: 0165-0327 Vol.284 2021 págs. 183 - 189

Resumen

Background: Depression is a major public health concern worldwide and its association with metabolic syndrome (MetS) remains unclear. Thus, we prospectively examined the association between depression and the risk of MetS, according to different diagnosis criteria. Methods: This study included 9,237 participants of a Spanish dynamic prospective cohort of adult university graduates [mean (SD) age: 36.7 year (10.7)], initially free of any specific criterion of MetS, who were followed up for a median of 8.3 years. The exposure variables were medical diagnosis of depression at baseline or in the first 2-year follow-up questionnaire. The outcome variable was the incidence of MetS, assessed according to each of three different criteria proposed by: International Diabetes Federation (IDF); National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III); IDF/NCEP-ATP III (updated harmonizing definition). Multivariable-adjusted Relative Risks (RR) of new-onset MetS and their 95% Confidence Intervals (95% CI) were estimated, using Poisson regression models. Results: The cumulative incidences of MetS were 475 cases (IDF definition), 288 cases (NCEP-ATP III definition) and 492 cases (update harmonized definition). No association was observed between baseline depression and incidence of MetS, but the presence of depression after 2-years of follow-up was significantly associated with a higher risk of new-onset MetS, according to NCEP-ATP III definition (multivariable-adjusted RR, 2.46; 95% CI, 1.06-5.67). Limitations: Diagnosis of depression and MetS were self-reported. Conclusions: In this large prospective cohort of Spanish middle-aged adult university graduates, a direct association between depression and the risk of MetS according to NCEP-ATP III definition was found.
Autores: Fernández Lázaro, Cesar Ignacio; Martínez González, Miguel Ángel; Aguilera-Buenosvinos, I.; et al.

Título: Dietary antioxidant vitamins and minerals and breast cancer risk: prospective results from the SUN cohort

Revista: ANTIOXIDANTS

ISSN: 2076-3921 Vol.10 N° 3 2021 págs. 340

Resumen

There is growing interest in natural antioxidants and their potential effects on breast cancer (BC). Epidemiological evidence, however, is inconsistent. We prospectively evaluated the association between dietary intake of vitamins A, C, and E, selenium, and zinc and BC among 9983 female participants from the SUN Project, a Mediterranean cohort of university graduates. Participants completed a food frequency questionnaire at baseline, and biennial follow-up information about incident BC diagnosis was collected. Cases were ascertained through revision of medical charts and consultation of the National Death Index. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CI). During an average follow-up of 11.3 years, 107 incident BC cases were confirmed. The multivariable HRs (95% CI) for BC comparing extreme tertiles of energy-adjusted dietary intakes were 1.07 (0.64-1.77; P-trend = 0.673) for vitamin A, 1.00 (0.58-1.71; P-trend = 0.846) for vitamin C, 0.92 (0.55-1.54; P-trend = 0.728) for vitamin E, 1.37 (0.85-2.20; P-trend = 0.135) for selenium, and 1.01 (0.61-1.69; P-trend = 0.939) for zinc. Stratified analyses showed an inverse association between vitamin E intake and postmenopausal BC (HRT3 vs. T1 = 0.35; 95% CI, 0.14-0.86; P-trend = 0.027). Our results did not suggest significant protective associations between dietary vitamins A, C, and E, selenium, or zinc and BC risk.
Autores: Morales, G. ; Martínez González, Miguel Ángel; Barbería Latasa, María; et al.

Título: Mediterranean diet, alcohol-drinking pattern and their combined effect on all-cause mortality: the Seguimiento Universidad de Navarra (SUN) cohort

Revista: EUROPEAN JOURNAL OF NUTRITION

ISSN: 1436-6207 Vol.60 N° 3 2021 págs. 1489 - 1498

Resumen

Purpose The health benefits of the Mediterranean diet (MedDiet) have been widely studied. However, controversy remains for one of its components: alcohol intake. We aimed to assess the joint effect of adherence to the MedDiet and alcohol-drinking pattern on all-cause mortality. Methods We used data from 20,506 subjects from a prospective cohort of Spanish university graduates, the Seguimiento Universidad de Navarra (SUN) cohort. Adherence to the MedDiet was operationalized using four different dietary indexes and then categorized in low or high adherence, according to the median score. Alcohol-drinking pattern was evaluated with the previously defined the Mediterranean alcohol-drinking pattern (MADP), grouped into three categories of adherence (low, moderate and high adherence) and a fourth category for abstainers. The outcome was all-cause mortality. Results During a median follow-up of 12.1 years, we observed 460 deaths. No statistically significant supra-multiplicative interaction between the two exposures was found. Low adherence to both the MedDiet and MADP was associated with higher all-cause mortality compared to high adherence to both exposures [multivariable-adjusted hazard ratio (HR) = 2.02, 95% confidence interval (CI): 1.33-3.07]. Similar results were found for cancer mortality and cardiovascular mortality. Conclusions Although the combined effect of the MedDiet and MADP was not significantly higher than the product of their individual effects, a low adherence to both the MedDiet and MADP was associated with higher rates of all-cause mortality. This report also shows the usefulness of the dietary pattern approach applied to alcohol intake and of including the drinking pattern as another component of the MedDiet.
Autores: Henriquez, L. A. (Autor de correspondencia); Ortiz, A. ; Alvarez, J. ; et al.

Título: Human biomonitoring of persistent organic pollutants in elderly people from the Canary Islands (Spain): A temporal trend analysis from the PREDIMED and PREDIMED-Plus cohorts

Revista: SCIENCE OF THE TOTAL ENVIRONMENT

ISSN: 0048-9697 Vol.758 2021 págs. 143637

Resumen

The population of the Canary Islands has been exposed to high levels of persistent organic pollutants (POPs). Bio-monitoring studies are essential to know the temporal trend in residue levels, particularly of substances banned decades ago. The purpose of this study was to analyze the distribution of plasma concentrations of 59 POPs in 175 participants from the PREDIMED-Plus trial (2014-2016), and to compare them with the distribution of these POPs in 343 participants in the PREDIMED trial (2006-2009). All participants had metabolic syndrome. No difference in the distribution of age, gender or BMI was observed between trials. POPs were determined by gas chromatography-mass spectrometry. Density plots-POP Geoffrey Rose curves-were used to represent the full population distribution of each compound. Three out of 59 POPs were detected and quantified in >= 95% of the samples (p,p'-DDE, median = 694.7 ng/g lipid; HCB, median = 57.0 ng/g lipid; and beta-HCH, median = 75.7 ng/g lipid). PCB congeners 138, 153 and 180 were detected in 64.6, 40.0 and 88.0% of the samples. Females showed highest concentrations of organochlorine pesticides and those subjects who lost (>)5kg showed significant higher plasma concentrations of POPs. In a range of 6-14 years, plasma concentrations of POPs decreased 3.3-21.6 fold, being notable the decrease of 28.7-fold observed for HCB among women. Despite this sharp decline, levels of POPs are still higher than those reported in other regions, since one third of the subjects included in the present report had high concentration of more than three pollutants. Continuous biomonitoring studies are required to know the evolution of the levels of residues and to evaluate the effectiveness of environmental policies. (C) 2020 Elsevier B.V. All rights reserved.
Autores: Sánchez Bayona, Rodrigo; Sayon Orea, María del Carmen; Gardeazábal González, Itziar; et al.

Título: Body shape trajectories and risk of breast cancer: results from the SUN ('Seguimiento Universidad De Navarra') Project

Revista: PUBLIC HEALTH NUTRITION

ISSN: 1368-9800 Vol.24 N° 3 2021 págs. 467 - 475

Resumen

Objective: The aim of this study was to assess body shape trajectories in childhood and midlife in relation to subsequent risk of breast cancer (BC) in a Mediterranean cohort. Design: The 'Seguimiento Universidad de Navarra' (SUN) Project is a dynamic prospective cohort study of university graduates initiated in 1999. With a group-based modelling approach, we assessed body shape trajectories from age 5 to 40 years. Multivariable Cox regression models were used to estimate the hazard ratio (HR) for BC after the age of 40 years according to the body shape trajectory. Setting: City of Pamplona, in the North of Spain. Participants: 6498 women with a mean age of 40 years (sd 9). Results: We identified four distinct body shape trajectories ('childhood lean-midlife increase' (19 center dot 9 %), 'childhood medium-midlife stable' (53 %), 'childhood heavy-midlife stable' (21 %) and 'childhood heavy-midlife increase' (6 center dot 1 %)). Among 54 978 women-years of follow-up, we confirmed eighty-two incident cases of BC. Women in the 'childhood lean-midlife increase' group showed a higher risk of BC (HR = 1 center dot 84, 95 % CI 1 center dot 11, 3 center dot 04) compared with women in the 'childhood medium-midlife stable' category. This association was stronger for postmenopausal BC (HR = 2 center dot 42, 95 % CI 1 center dot 07, 5 center dot 48). Conclusions: Our results suggest a role for lifetime adiposity in breast carcinogenesis.
Autores: Guasch-Ferre, M. (Autor de correspondencia); Hernández-Alonso, P. (Autor de correspondencia); Drouin-Chartier, J. P.; et al.

Título: Walnut consumption, plasma metabolomics, and risk of type 2 diabetes and cardiovascular disease

Revista: JOURNAL OF NUTRITION

ISSN: 0022-3166 Vol.151 N° 2 2021 págs. 303 - 311

Resumen

Background Walnut consumption is associated with lower risk of type 2 diabetes (T2D) and cardiovascular disease (CVD). However, it is unknown whether plasma metabolites related to walnut consumption are also associated with lower risk of cardiometabolic diseases. Objectives The study aimed to identify plasma metabolites associated with walnut consumption and evaluate the prospective associations between the identified profile and risk of T2D and CVD. Methods The discovery population included 1833 participants at high cardiovascular risk from the PREvencion con DIeta MEDiterranea (PREDIMED) study with available metabolomics data at baseline. The study population included 57% women (baseline mean BMI (in kg/m(2)): 29.9; mean age: 67 y). A total of 1522 participants also had available metabolomics data at year 1 and were used as the internal validation population. Plasma metabolomics analyses were performed using LC-MS. Cross-sectional associations between 385 known metabolites and walnut consumption were assessed using elastic net continuous regression analysis. A 10-cross-validation (CV) procedure was used, and Pearson correlation coefficients were assessed between metabolite weighted models and self-reported walnut consumption in each pair of training-validation data sets within the discovery population. We further estimated the prospective associations between the identified metabolite profile and incident T2D and CVD using multivariable Cox regression models. Results A total of 19 metabolites were significantly associated with walnut consumption, including lipids, purines, acylcarnitines, and amino acids. Ten-CV Pearson correlation coefficients between self-reported walnut consumption and the plasma metabolite profile were 0.16 (95% CI: 0.11, 0.20) in the discovery population and 0.15 (95% CI: 0.10, 0.20) in the validation population. The metabolite profile was inversely associated with T2D incidence (HR per 1 SD: 0.83; 95% CI: 0.71, 0.97; P = 0.02). For CVD incidence, the HR per 1-SD was 0.71 (95% CI: 0.60, 0.85; P < 0.001). Conclusions A metabolite profile including 19 metabolites was associated with walnut consumption and with a lower risk of incident T2D and CVD in a Mediterranean population at high cardiovascular risk.
Autores: Fernández, A. I.; Bermejo, J. (Autor de correspondencia); Yotti, R.; et al.

Título: The impact of Mediterranean diet on coronary plaque vulnerability, microvascular function, inflammation and microbiome after an acute coronary syndrome: study protocol for the MEDIMACS randomized, controlled, mechanistic clinical trial

Revista: TRIALS

ISSN: 1745-6215 Vol.22 N° 1 2021

Resumen

Background: Primary prevention trials have demonstrated that the traditional Mediterranean diet is associated with a reduction in cardiovascular mortality and morbidity. However, this benefit has not been proven for secondary prevention after an acute coronary syndrome (ACS). We hypothesized that a high-intensity Mediterranean diet intervention after an ACS decreases the vulnerability of atherosclerotic plaques by complex interactions between anti-inflammatory effects, microbiota changes and modulation of gene expression. Methods: The MEDIMACS project is an academically funded, prospective, randomized, controlled and mechanistic clinical trial designed to address the effects of an active randomized intervention with the Mediterranean diet on atherosclerotic plaque vulnerability, coronary endothelial dysfunction and other mechanistic endpoints. One hundred patients with ACS are randomized 1:1 to a monitored high-intensity Mediterranean diet intervention or to a standard-of-care arm. Adherence to diet is assessed in both arms using food frequency questionnaires and biomarkers of compliance. The primary endpoint is the change (from baseline to 12 months) in the thickness of the fibrous cap of a non-significant atherosclerotic plaque in a non-culprit vessel, as assessed by repeated optical coherence tomography intracoronary imaging. Indices of coronary vascular physiology and changes in gastrointestinal microbiota, immunological status and protein and metabolite profiles will be evaluated as secondary endpoints. Discussion: The results of this trial will address the key effects of dietary habits on atherosclerotic risk and will provide initial data on the complex interplay of immunological, microbiome-, proteome- and metabolome-related mechanisms by which non-pharmacological factors may impact the progression of coronary atherosclerosis after an ACS.
Autores: Romanos Nanclares, Andrea (Autor de correspondencia); Collins, L. C.; Hu, F. B.; et al.

Título: Sugar-sweetened beverages, artificially sweetened beverages, and breast cancer risk: results from 2 prospective US cohorts

Revista: JOURNAL OF NUTRITION

ISSN: 0022-3166 Vol.151 N° 9 2021 págs. 2768 - 2779

Resumen

Background: Whether consumption of sugar-sweetened beverages (SSBs) or artificially sweetened beverages (ASBs) is associated with the risk of breast cancer is of public health interest. Objectives: We sought to evaluate associations between consumption of SSBs and ASBs and risks of total and subtype-specific breast cancer. Methods: We followed 82,713 women from the Nurses' Health Study (1980 to 2016) and 93,085 women from the Nurses' Health Study II (1991 to 2017). Cumulatively averaged intakes of SSBs and ASBs from FFQs were tested for associations with incident breast cancer cases and subtypes using Cox regression models. We also evaluated the associations stratified by menopausal status, physical activity, BMI, and alcohol intake. Results: We documented 11,379 breast cancer cases during 4,655,153 person-years of follow-up. Consumption of SSBs or ASBs was not associated with total breast cancer risk: pooled HRs comparing extreme categories (>= 1/day compared with <1/month) were 1.03 (95% CI, 0.95-1.12) and 0.96 (95% CI, 0.91-1.02), respectively. We observed a suggestive interaction by BMI using pooled data (P-interaction = 0.08), where a modestly higher risk of breast cancer with each serving per day increment of SSBs was found in lean women (HR, 1.06; 95% CI, 1.01-1.11) but not among overweight or obese women (HR, 1.00; 95% CI, 0.95-1.06). Moreover, in the pooled, fully adjusted analysis, compared to infrequent consumers (<1/month), those who consumed >= 1 serving of ASBs per day had a lower risk of luminal A breast tumors (HR, 0.90; 95% CI, 0.80-1.01; P-trend = 0.02). Conclusions: Although no significant associations were observed overall, consumption of SSBs was associated with a slightly higher risk of breast cancer among lean women. This finding could have occurred by chance and needs confirmation. Our findings also suggest no substantial increase in the risk of breast cancer with consumption of ASBs.
Autores: Domínguez-López, I.; Parilli-Moser, I.; Arancibia-Riveros, C.; et al.

Título: Urinary tartaric acid, a biomarker of wine intake, correlates with lower total and LDL cholesterol

Revista: NUTRIENTS

ISSN: 2072-6643 Vol.13 N° 8 2021 págs. 2883

Resumen

Postmenopausal women are at higher risk of developing cardiovascular diseases due to changes in lipid profile and body fat, among others. The aim of this study was to evaluate the association of urinary tartaric acid, a biomarker of wine consumption, with anthropometric (weight, waist circumference, body mass index (BMI), and waist-to-height ratio), blood pressure, and biochemical variables (blood glucose and lipid profile) that may be affected during the menopausal transition. This sub-study of the PREDIMED (Prevencion con Dieta Mediterranea) trial included a sample of 230 women aged 60-80 years with high cardiovascular risk at baseline. Urine samples were diluted and filtered, and tartaric acid was analyzed by liquid chromatography coupled to electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). Correlations between tartaric acid and the study variables were adjusted for age, education level, smoking status, physical activity, BMI, cholesterol-lowering, antihypertensive, and insulin treatment, total energy intake, and consumption of fruits, vegetables, and raisins. A strong association was observed between wine consumption and urinary tartaric acid (0.01 mu g/mg (95% confidence interval (CI): 0.01, 0.01), p-value < 0.001). Total and low-density lipoprotein (LDL) cholesterol were inversely correlated with urinary tartaric acid (-3.13 mu g/mg (-5.54, -0.71), p-value = 0.016 and -3.03 mu g/mg (-5.62, -0.42), p-value = 0.027, respectively), whereas other biochemical and anthropometric variables were unrelated. The results suggest that wine consumption may have a positive effect on cardiovascular health in postmenopausal women, underpinning its nutraceutical properties.
Autores: Zazpe García, Itzíar; Santiago Neri, Susana; Toledo Atucha, Estefanía; et al.

Título: Diet quality indices in the SUN cohort: Observed changes and predictors of changes in scores over a 10-year period

Revista: JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS

ISSN: 2212-2672 Vol.121 N° 10 2021 págs. 1948 - 1960.e7

Resumen

Background: Dietary quality indices (DQI) are widely used in nutritional epidemiology. However, how they might change over time in a Mediterranean population is not well understood. Objective: To evaluate within-participant longitudinal changes in scores for nine a priori¿defined DQIs: Fat Quality Index (FQI), Carbohydrate Quality Index (CQI), Pro-vegetarian Dietary Pattern (PVG), Mediterranean Diet Adherence Screener (MEDAS), Mediterranean Diet Score (MDS), Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegen

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Publicaciones Científicas desde 2018