Nuestros investigadores

Alfredo Gea Sánchez

Publicaciones científicas más recientes (desde 2010)

Autores: Martínez, Miguel Ángel, (Autor de correspondencia); Gea, Alfredo; Ruiz-Canela, Miguel;
Revista: CIRCULATION RESEARCH
ISSN 0009-7330  Vol. 124  Nº 5  2019  págs. 779 - 798
The Mediterranean diet (MedDiet), abundant in minimally processed plant-based foods, rich in monounsaturated fat from olive oil, but lower in saturated fat, meats, and dairy products, seems an ideal nutritional model for cardiovascular health. Methodological aspects of Mediterranean intervention trials, limitations in the quality of some meta-analyses, and other issues may have raised recent controversies. It remains unclear whether such limitations are important enough as to attenuate the postulated cardiovascular benefits of the MedDiet. We aimed to critically review current evidence on the role of the MedDiet in cardiovascular health. We systematically searched observational prospective cohorts and randomized controlled trials which explicitly reported to assess the effect of the MedDiet on hard cardiovascular end points. We critically assessed all the original cohorts and randomized controlled trials included in the 5 most comprehensive meta-analyses published between 2014 and 2018 and additional prospective studies not included in these meta-analyses, totaling 45 reports of prospective studies (including 4 randomized controlled trials and 32 independent observational cohorts). We addressed the existing controversies on methodology and other issues. Some departures from individual randomization in a subsample of the landmark Spanish trial (PREDIMED [Prevencion con Dieta Mediterranea]) did not represent any clinically meaningful attenuation in the strength of its findings and the results of PREDIMED were robust in a wide range of sensitivity analyses. The criteria for causality were met and potential sources of controversies did not represent any reason to compromise the main findings of the available observational studies and randomized controlled trials. The available evidence is large, strong, and consistent. Better conformity with the traditional MedDiet is associated with better cardiovascular health outcomes, including clinically meaningful reductions in rates of coronary heart disease, ischemic stroke, and total cardiovascular disease.
Autores: Garralda-Del-Villar, M. ; Carlos, Silvia; et al.
Revista: NUTRIENTS
ISSN 2072-6643  Vol. 11  Nº 1  2019  págs. E65
We assessed the relationship between a healthy lifestyle and the subsequent risk of developing metabolic syndrome. The "Seguimiento Universidad de Navarra" (SUN) Project is a prospective cohort study, focused on nutrition, lifestyle, and chronic diseases. Participants (n = 10,807, mean age 37 years, 67% women) initially free of metabolic syndrome were followed prospectively for a minimum of 6 years. To evaluate healthy lifestyle, nine habits were used to derive a Healthy Lifestyle Score (HLS): Never smoking, moderate to high physical activity (>20 MET-h/week), Mediterranean diet (>= 4/8 adherence points), moderate alcohol consumption (women, 0.1-5.0 g/day; men, 0.1-10.0 g/day), low television exposure (<2 h/day), no binge drinking (<= 5 alcoholic drinks at any time), taking a short afternoon nap (<30 min/day), meeting up with friends >1 h/day, and working at least 40 h/week. Metabolic syndrome was defined according to the harmonizing definition. The association between the baseline HLS and metabolic syndrome at follow-up was assessed with multivariable-adjusted logistic regressions. During follow-up, we observed 458 (4.24%) new cases of metabolic syndrome. Participants in the highest category of HLS adherence (7-9 points) enjoyed a significantly reduced risk of developing metabolic syndrome compared to those in the lowest category (0-3 points) (adjusted odds ratio (OR) = 0.66, 95% confidence interval (CI) = 0.47-0.93). Higher adherence to the Healthy Lifestyle Score was associated with a lower risk of developing metabolic syndrome. The HLS may be a simple metabolic health promotion tool.
Autores: Basterra, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; et al.
Revista: MEDICINA CLINICA
ISSN 0025-7753  Vol. 152  Nº 5  2019  págs. 181 - 184
Introduction and objective: Our aim was to examine the secular trends in obesity prevalence among Spanish adults with diabetes. Material and methods: Data were collected from 8 waves (from 1987 to 2012) of the National Health Surveys (NHS). NHS are cross-sectional studies conducted in representative samples of the Spanish adult population. Data of 7378 adults (>= 16 years) who reported having been diagnosed of diabetes were analyzed. Previously validated self-reported weight and height were used to estimate body mass index (BMI). Obesity was defined as a BMI of 30 kg/m(2) or greater. Age-adjusted obesity prevalence for each wave was calculated by the direct standardization method. Results: From 1987 to 2012 age-adjusted prevalence of obesity among persons with diabetes increased from 18.2% (95% confidence interval [CI]: 14.2-22.2%) to 39.8% (95% CI: 36.8-42.8%). Age-adjusted prevalence of obesity in males with diabetes increased from 13.2% (95% CI: 7.3-19.1%) to 38.0% (95% CI: 33.8-42.1%) and in females from 23.0% (95% CI: 17.6-28.4%) to 42.3% (95% CI: 38.0-46.6%). Conclusions: Between 1987 and 2012 the prevalence of obesity markedly increased in Spain among adults with diabetes. (C) 2018 Elsevier Espana, S.L.U. All rights reserved.
Autores: Cano-Ibáñez, N.; Gea, Alfredo; Martínez, Miguel Ángel; et al.
Revista: NUTRIENTS
ISSN 2072-6643  Vol. 11  Nº 5  2019  págs. E958
Dietary guidelines emphasize the importance of a varied diet to provide an adequate nutrient intake. However, an older age is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases, such as metabolic syndrome (MetS). To assess the association between dietary diversity (DD) and nutrient intake adequacy and to identify demographic variables associated with DD, we cross-sectionally analyzed baseline data from the PREDIMED-Plus trial: 6587 Spanish adults aged 55-75 years, with overweight/obesity who also had MetS. An energy-adjusted dietary diversity score (DDS) was calculated using a 143-item validated semi-quantitative food frequency questionnaire (FFQ). Nutrient inadequacy was defined as an intake below 2/3 of the dietary reference intake (DRI) forat least four of 17 nutrients proposed by the Institute of Medicine (IOM). Logistic regression models were used to evaluate the association between DDS and the risk of nutritionally inadequate intakes. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake: odds ratio (OR) = 28.56 (95% confidence interval (CI) 20.80-39.21). When we estimated food varietyfor each of the food groups, participants in the lowest quartile had a higher risk of inadequate nutrient intake for the groups of vegetables, OR = 14.03 (95% CI 10.55-18.65), fruits OR = 11.62 (95% CI 6.81-19.81), dairy products OR = 6.54 (95% CI 4.64-9.22) and protein foods OR = 6.60 (95% CI 1.96-22.24). As DDS decreased, the risk of inadequate nutrients intake rose. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow(er)s.
Autores: Bazal, R.; Gea, Alfredo; de la Fuente-Arrillaga, Carmen; et al.
Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ISSN 0939-4753  Vol. 29  Nº 5  2019  págs. 450 - 457
BACKGROUND AND AIMS: A Mediterranean-type diet enriched with extra virgin olive oil has been associated with a reduction in the incidence of atrial fibrillation (AF) in a population at high cardiovascular risk. However, no study has replicated these findings. In our study, we analyzed the association between olive oil consumption and AF in the SUN project, a cohort with young Spanish adults at low cardiovascular risk. METHODS AND RESULTS: We included all participants without prevalent AF at baseline (18,118 participants). Incident AF cases were confirmed by a cardiologist following a prespecified protocol. We used multivariable repeated-measurement Cox models adjusted for possible confounders (sex, age, BMI, and several classic cardiovascular risk factors). After a mean follow-up of 10.1 years, 94 AF incident cases were confirmed. Comparing to the lowest category of consumption (<7.9 g/d), the multivariable models showed hazard ratios (IC 95%) of 1.52 (0.93-2.48) for low-to-moderate, 1.44 (0.83-2.47) for moderate-to-high and 1.27 (0.56-2.86) for high olive oil intake. In a subgroup analysis stratified by overweight, an inverse although non-significant association was found only among overweight participants when we compared the highest vs the lowest category of consumption (p for interaction = 0.043). CONCLUSION: No association between olive oil and AF was found in this low-risk cohort, although the effect of extra-virgin olive oil on AF prevention especially among people with overweight deserves further investigation.
Autores: Bazal, R.; Gea, Alfredo; Martínez, Miguel Ángel; et al.
Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ISSN 0939-4753  Vol. 29  Nº 7  2019  págs. 676 - 683
Background and aims: There is ongoing controversy about the effect of a low to moderate alcohol consumption on atrial fibrillation (AF). Our aim is to assess the association between adherence to a Mediterranean alcohol drinking pattern and AF incidence. Methods and results: A total 6527 out of the 7447 participants in the PREDIMED trial met our inclusion criteria. A validated frequency food questionnaire was used to measure alcohol consumption. Participants were classified as non-drinkers, Mediterranean alcohol drinking pattern (MADP) (10-30 g/d in men and 5-15 g/day in women, preferably red wine consumption with low spirits consumption), low-moderate drinking (< 30 g/day men y and < 15 g/day women), and heavy drinking. We performed multivariable Cox regression models to estimate hazard ratios (HR) with 95% confidence intervals (95% CI) of incident AF according to alcohol drinking patterns. After a mean follow up of 4.4 years, 241 new incident AF cases were confirmed. Alcohol consumption was not associated to AF incidence among low-moderate drinkers (HR: 0.96; 95% CI: 0.67-1.37), adherents to MADP (HR: 1.15 95% CI: 0.75-1.75), or heavy drinkers (HR: 0.92; 95% CI: 0.53-1.58), compared with non-drinkers. Conclusions: In a high cardiovascular risk adult population, a Mediterranean alcohol consumption pattern (low to moderate red wine consumption) was not associated with an increased incidence of AF. (C) 2019 The Italian Society of Diabetology, 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. Published by Elsevier B.V. All rights reserved.
Autores: Navarro, A. M. ; Martínez, Miguel Ángel; Gea, Alfredo; et al.
Revista: CLINICAL NUTRITION
ISSN 0261-5614  Vol. 38  Nº 1  2019  págs. 389 - 397
BACKGROUND & AIMS: Evidence on coffee consumption and its association with the incidence of hypertension is still inconsistent. The aim of this study was to examine the association of regular or decaffeinated coffee consumption with the risk of developing hypertension in a middle-aged Mediterranean cohort. METHODS: The SUN Project is a prospective open cohort with more than 22,500 Spanish university graduates. For the present study, we analyzed data from 13,374 participants initially free of hypertension (mean follow-up 9.1 years). The consumption of regular and decaffeinated coffee was obtained at baseline using a previously validated semi-quantitative food frequency questionnaire. Validated, self-reported medical diagnoses of hypertension were collected biennially. We used Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for incident hypertension according to baseline coffee consumption. We assessed the interaction with sex and baseline adherence to the Mediterranean diet. RESULTS: Among 121,397 person-years of follow-up, a total of 1757 participants developed hypertension. Overall, coffee consumption -either caffeinated or decaffeinated- was not significantly associated with the risk of hypertension. Only among women, higher consumption of regular coffee was associated with a 26% lower risk of hypertension (>=2 cups/d vs. never/seldom, 95% CI 9%-39%; p for interaction: 0.0236). Women with a low baseline adherence to the Mediterranean diet showed the strongest risk reduction (HR ¿ 2 cups/d vs. never/seldom 0.58, 95% CI (0.41-0.82) p for interaction = 0.0452). CONCLUSION: In the SUN project we found an inverse association between regular coffee consumption and the risk of hypertension in women, which was strongest among women with a suboptimal food pattern (low adherence to the Mediterranean diet).
Autores: Mendonca, R. D.; Carvalho, N. C. ; Martin-Moreno, J. M.; et al.
Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ISSN 0939-4753  Vol. 29  Nº 1  2019  págs. 69 - 78
Background and aims: Polyphenol-rich diets have been associated with reduced risk of cardiovascular disease (CVD). However, few prospective epidemiological studies have examined the relationship between classes of ingested polyphenols and risk of CVD. Our aim was to evaluate the association between polyphenol intake and risk of major cardiovascular events in a prospective Spanish cohort. Methods and results: We included 17,065 university graduates (60.7% women, mean age: 37.2 years, age range: 20-89) followed-up for a mean of 10.1 years. Polyphenol intake was assessed at baseline using a validated semi-quantitative 136-item food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for incident cardiovascular events (myocardial infarction, stroke or cardiovascular death). Cherries, chocolate, coffee, apples, and olives were the major sources of variability in polyphenol intake. Participants with higher flavonoids intake (fifth quintile) had a 47% lower incidence of cardiovascular events compared to those in the lowest quintile (HR: 0.53, 95% CI: 0.29-0.98; P for trend = 0.09) after adjusting for potential confounders. The results were non-significant for other polyphenol types. Conclusion: The intake of flavonoids showed an inverse association with risk of cardiovascular events in a prospective cohort of Spanish middle-aged adult university graduates. (C) 2018 The Italian Society of Diabetology, 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. Published by Elsevier B.V. All rights reserved.
Autores: Martínez, Miguel Ángel; Martínez, JA; et al.
Revista: NUTRIENTS
ISSN 2072-6643  Vol. 11  Nº 7  2019 
Provegetarian diets (i.e., preference for plant-derived foods but not exclusion of animal foods) have been associated with a reduced risk of long-term weight gain and could be more easily embraced than strict vegetarian diets. However, not all plant-derived foods are equally healthy. In the "Seguimiento Universidad de Navarra" (SUN) cohort, we prospectively evaluated the association between different provegetarian food patterns and the incidence of overweight/obesity in 11,554 participants with initial body mass index <25 kg/m(2). A provegetarian food pattern (FP) was built by assigning positive scores to plant foods and reverse scores to animal foods. A healthful and an unhealthful provegetarian FP, which distinguished between healthy (fruits/vegetables/whole grains/nuts/legumes/olive oil/coffee) and less-healthy plant foods (fruit juices/potatoes/refined grains/pastries/sugary beverages), were also built. A total of 2320 new cases of overweight or obesity were identified after a median follow-up of 10.3 years. Higher baseline conformity with the overall provegetarian FP was inversely associated with overweight/obesity (HR comparing extreme quintiles: 0.85; 95% CI: 0.75 to 0.96; p-trend: 0.014). This association was stronger for the healthful FP (HR: 0.78; 95% CI: 0.67 to 0.90; p-trend: <0.001) and was not apparent for the unhealthful FP (HR: 1.07; 95% CI: 0.92 to 1.23; p-trend: 0.551). In a large prospective cohort of relatively young adults, better conformity with a healthy provegetarian diet was associated with a reduced long-term risk of overweight/obesity, whereas no consistent trend was found for a FP that emphasized less-healthy plant foods.
Autores: Dominguez, L. J., (Autor de correspondencia); Bes-Rastrollo, Maira; Basterra, Francisco Javier; et al.
Revista: CLINICAL NUTRITION
ISSN 0261-5614  Vol. 37  Nº 4  2018  págs. 1389 - 1398
Background & aims: While most studies have shown increased mortality associated with excessive red/processed meat consumption, the association of saturated fatty acids (SFA) intake with mortality is less homogeneous. We aimed to prospectively assess the association of both, meat consumption (red, processed, red + processed, and total) and SFA intake, with the risk of all-cause death. Methods: We assessed 18,540 participants of the SUN (Seguimiento Universidad de Navarra) cohort, followed-up for a mean of 9.5 years. A validated 136-item FFQ was administered at baseline. We used Cox models adjusted for potential confounders. Results: We observed 255 deaths during 176,916 person-years of follow-up. Age modified the association between meat consumption and all-cause mortality (p for interaction = 0.027, 0.075, and 0.013, for red, total, and processed meat, respectively). Among participants aged >45 years the fully-adjusted HRs (95% CIs) for one additional serving/d of red, total, and red + processed meat consumption were 1.47 (1.06, 2.04), 1.23 (1.05, 1.45), and 1.32 (1.05, 1.65), respectively, with significant linear trends (P for trend 0.022, 0.012, and 0.018, respectively). In these participants, SFA intake was non-significantly associated with mortality. However, isocaloric replacement of monounsaturated fat or carbohydrates by SFA resulted in significantly higher mortality risk. Likewise, replacing 100 g of vegetables, fruits & nuts or cereals by 100 g of red meat resulted in higher mortality risk. No association of meat consumption or SFA with all-cause mortality was observed in participants younger than 46 years. Conclusions: Among highly educated persons, aged >45 years, a high consumption of red, total, and red + processed meat was related to increased all-cause mortality, compared with those with low consumption, whereas no significant associations were found for SFA intake. Dietary guidelines should specifically limit meat consumption and not relying only in limiting SFA intake. (C) 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Autores: Estruch, R.; Ros, E.; Salas-Salvado, J. ; et al.
Revista: NEW ENGLAND JOURNAL OF MEDICINE
ISSN 0028-4793  Vol. 378  Nº 25  2018  págs. e34
BACKGROUND Observational cohort studies and a secondary prevention trial have shown inverse associations between adherence to the Mediterranean diet and cardiovascular risk. METHODS In a multicenter trial in Spain, we assigned 7447 participants (55 to 80 years of age, 57% women) who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was a major cardiovascular event (myocardial infarction, stroke, or death from cardiovascular causes). After a median follow-up of 4.8 years, the trial was stopped on the basis of a prespecified interim analysis. In 2013, we reported the results for the primary end point in the Journal. We subsequently identified protocol deviations, including enrollment of household members without randomization, assignment to a study group without randomization of some participants at 1 of 11 study sites, and apparent inconsistent use of randomization tables at another site. We have withdrawn our previously published report and now report revised effect estimates based on analyses that do not rely exclusively on the assumption that all the participants were randomly assigned. RESULTS A primary end-point event occurred in 288 participants; there were 96 events in the group assigned to a Mediterranean diet with extra-virgin olive oil (3.8%), 83 in the group assigned to a Mediterranean diet with nuts (3.4%), and 109 in the control group (4.4%). In the intention-to-treat analysis including all the participants and adjusting for baseline characteristics and propensity scores, the hazard ratio was 0.69 (95% confidence interval [CI], 0.53 to 0.91) for a Mediterranean diet with extra-virgin olive oil and 0.72 (95% CI, 0.54 to 0.95) for a Mediterranean diet with nuts, as compared with the control diet. Results were similar after the omission of 1588 participants whose study-group assignments were known or suspected to have departed from the protocol. CONCLUSIONS In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.
Autores: Navarro, A. M.; Martínez, Miguel Ángel; Gea, Alfredo; et al.
Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION
ISSN 0002-9165  Vol. 108  Nº 5  2018  págs. 1113 - 1120
Background: The relation of coffee consumption with total mortality is controversial, because the available evidence is still inconsistent. Objective: This study aimed to assess this association in a highly educated, middle-aged Mediterranean cohort. Design: We analyzed data from 201,055 person-years of follow-up arising from 19,888 participants. Coffee consumption was obtained at baseline with the use of a previously validated semi-quantitative food-frequency questionnaire. Information on mortality was ascertained by permanent contact with the "Seguimiento Universidad de Navarra" (SUN) participants and their families, postal authorities, and consultation of the National Death Index. We used Cox regression models to estimate HRs and 95% CIs for mortality according to baseline total coffee consumption adjusted for potential confounders. Sex, age, and baseline adherence to the Mediterranean diet were considered as potential effect modifiers. Results: Among the 19,888 participants, 337 died. Overall, in the multivariable adjusted analysis, we found a 22% lower risk of all-cause mortality for each 2 additional cups of total coffee per day (HR: 0.78; 95% CI: 0.66, 0.93). This association was stronger for participants aged >= 55 y (HR: 0.67; 95% CI: 0.52, 0.86) than for younger participants, who showed no significant association (P-interaction = 0.002). Conclusion: In a Mediterranean cohort, we found an inverse linear association between total coffee consumption and the risk of all-cause mortality that was strongest among participants older than 54 y.
Autores: Santiago, Susana; Zazpe I; Gea, Alfredo; et al.
Revista: JOURNAL OF NUTRITION HEALTH AND AGING
ISSN 1279-7707  Vol. 22  Nº 4  2018  págs. 526 - 533
To examine the association between a dietary fat quality index (FQI), and the risk of incident cardiovascular events or deaths in the Seguimiento Universidad de Navarra (SUN) cohort. Longitudinal analysis during 10.1 years of median follow-up. Cox models were used to estimate adjusted hazard ratios (HR) of incident cardiovascular diseases (CVD) according to tertiles of FQI and of different fat subtypes. University of Navarra, Spain. 19,341 middle-aged adults. Fat intake was measured with a validated food-frequency questionnaire. The FQI was calculated according to the ratio: (monounsaturated+polyunsaturated) / (saturated+trans fatty acids). We observed 140 incident cases of CVD. No association was found for FQI (HR=0.94, 95 %CI 0.61-1.47 for the highest vs the lowest tertile, p for trend=0.884). No significant associations were found for different dietary fat subtypes on CVD risk. The results suggest no clear association between a higher FQI and a higher amount of energy from fat and incidence of CVD (p for interaction: 0.259 and p for trend only among participants with a percentage of energy from fat ae<yen>35% of total energy: 0.272). In this Mediterranean cohort, the FQI was not associated with cardiovascular events. A "heart-healthy diet" should focus its attention on dietary fat sources and should use an overall dietary pattern approach, rather than limiting the focus on fat subtypes. More research is needed to validate dietary advice on specific fatty acids intake or saturated fatty acids replacements for reducing CVD risk.
Autores: Beulen, Y.; Martínez, Miguel Ángel; van de Rest, O.; et al.
Revista: NUTRIENTS
ISSN 2072-6643  Vol. 10  Nº 12  2018  págs. 2011
A moderately high-fat Mediterranean diet does not promote weight gain. This study aimed to investigate the association between dietary intake of specific types of fat and obesity and body weight. A prospective cohort study was performed using data of 6942 participants in the PREDIMED trial, with yearly repeated validated food-frequency questionnaires, and anthropometric outcomes (median follow-up: 4.8 years). The effects of replacing dietary fat subtypes for one another, proteins or carbohydrates were estimated using generalized estimating equations substitution models. Replacement of 5% energy from saturated fatty acids (SFA) with monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA) resulted in weight changes of -0.38 kg (95% Confidece Iinterval (CI): -0.69, -0.07), and -0.51 kg (95% CI: -0.81, -0.20), respectively. Replacing proteins with MUFA or PUFA decreased the odds of becoming obese. Estimates for the daily substitution of one portion of red meat with white meat, oily fish or white fish showed weight changes up to -0.87 kg. Increasing the intake of unsaturated fatty acids at the expense of SFA, proteins, and carbohydrates showed beneficial effects on body weight and obesity. It may therefore be desirable to encourage high-quality fat diets like the Mediterranean diet instead of restricting total fat intake.
Autores: Gea, Alfredo; et al.
Revista: EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
ISSN 0014-2972  Vol. 48  Nº Supl 1  2018  págs. 175 - 176
Autores: Fresán, Ujué; Gea, Alfredo; Bes-Rastrollo, Maira; et al.
Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ISSN 0939-4753  Vol. 27  Nº 10  2017  págs. 874 - 880
Background and aims The relationship between juice consumption and type 2 diabetes (T2D) has not been widely evidenced. Our aims were to prospectively evaluate the associations with T2D incidence of: 1) isovolumetric substitution of a water serving/day for one of fruit juice (different types), and of fresh fruit juice for its bottled version; 2) consumption of total, fresh or bottled juice; 3) energy intake from juices. Methods and results We followed 17,518 adults without T2D at baseline. Beverage consumption was assessed at baseline through a validated food-frequency questionnaire. The outcome was T2D incidence, according to American Diabetes Association's criteria. During a median follow-up of 10.2 years, 142 incident cases of T2D were identified. In substitution models, the substitution of water for bottled juice was associated with a lower T2D incidence, and also if the replacement was done by fresh juice, or especially fresh orange juice [HR 0.75 (95% CI 0.57¿0.99), 0.65 (95% CI 0.43¿0.98) and 0.56 (95% CI 0.34¿0.92); respectively]. Each additional serving/day of bottled juice was directly associated with T2D incidence [HR 1.33 (95% CI 1.01¿1.75)]. No significant association was observed for energy coming for bottled juice [HR 1.74 (95% CI 0.94¿3.20)]. Conclusion Our results suggest that isovolumetric substitution of water or fresh juice for bottled juice was inversely associated with T2D incidence in a long-term prospective study. Thus, these substitutions could be useful to tackle the diabetes epidemic.
Autores: Mendonca, R. D. ; Lopes, A. C. S.; Pimenta, A. M. ; et al.
Revista: AMERICAN JOURNAL OF HYPERTENSION
ISSN 0895-7061  Vol. 30  Nº 4  2017  págs. 358 - 366
BACKGROUND Some available evidence suggests that high consumption of ultra-processed foods (UPFs) is associated with a higher risk of obesity. Collectively, this association and the nutritional characteristics of UPFs suggest that UPFs might also be associated with hypertension. METHODS We prospectively evaluated the relationship between UPF consumption and the risk of hypertension in a prospective Spanish cohort, the Seguimiento Universidad de Navarra project. We included 14,790 Spanish adult university graduates who were initially free of hypertension at baseline who were followed for a mean of 9.1 years (SD, 3.9 years; total person-years: 134,784). UPF (industrial formulations of chemical compounds which, beyond substances of common culinary use such as salt, sugar, oils, and fats, include substances also derived from foods but not used in culinary preparations) consumption was assessed using a validated semi-quantitative 136-item food-frequency questionnaire. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for hypertension incidence. RESULTS During follow-up, 1,702 incident cases of hypertension were identified. Participants in the highest tertile of UPF consumption had a higher risk of developing hypertension (adjusted HR, 1.21; 95% CI, 1.06, 1.37; P for trend = 0.004) than those in the lowest tertile after adjusting for potential confounders. CONCLUSIONS In this large prospective cohort of Spanish middle-aged adult university graduates, a positive association between UPF consumption and hypertension risk was observed. Additional longitudinal studies are needed to confirm our results.
Autores: Basterra, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; et al.
Revista: MEDICINA CLINICA
ISSN 0025-7753  Vol. 148  Nº 6  2017  págs. 250 - 256
Background and objective: The prevalence of obesity and diabetes mellitus (DM) has increased worldwide. Our objective was to examine trends in the prevalence of overweight, obesity, morbid obesity and DM in Spain from 1987 to 2012. Participants and methods: Data were obtained from 8 waves of the national health surveys which are cross-sectional studies conducted in representative samples of the Spanish adult population. Self-reported data of 156,440 adults (>= 16 years) from 1987 to 2012 were used. Body mass index (BMI) was calculated from self-reported weight and height. Overweight was defined as a BMI of 25.0 to 29.9 kg/m(2), obesity as a BMI >= 30 kg/m(2) and morbid obesity as a BMI >= 40 kg/m(2). DM was considered present if the participant reported having been diagnosed. Age-adjusted prevalence was adjusted by the direct standardisation method to the 2003 survey population. Results: From 1987 to 2012 age-adjusted prevalence of overweight increased from 34.0% (95% confidence interval [95% CI] 33.2-34.8) to 35.8% (95% CI 35.0-36.6), prevalence of obesity from 8.0% (95% CI 7.5-8.5) to 16.5% (95% CI 15.7-17.1%) and DM prevalence from 4.2% (95% CI 3.9-4.5) to 7.1% (95% CI 6.7-7.4%). Morbid obesity increased from 0.20% (95% Cl 0.13-0.27) in 1993 to 0.88% (95% CI 0.70-1.05) in 2012. The growth rate was greater among males. Conclusions: An increasing trend of the prevalence of overweight, obesity, morbid obesity and DM was found in Spain from 1987 to 2012, particularly in males. (C) 2016 Elsevier Espana, S.L.U. All rights reserved.
Autores: Santiago, Susana; Zazpe I; Gea, Alfredo; et al.
Revista: INTERNATIONAL JOURNAL OF FOOD SCIENCES AND NUTRITION
ISSN 0963-7486  Vol. 68  Nº 5  2017  págs. 595 - 604
There is an emerging use of brief dietary questionnaires to investigate diet-health relation. We prospectively assess the association between eating attitudes (yes/no) and incident cardiovascular disease (CVD) in 19,138 participants of the Seguimiento Universidad de Navarra (SUN) Cohort. We calculated a baseline healthy-eating attitudes score (in quartiles), positively weighting answers on more fruit, vegetables, fish and fiber and less meat, sweets and pastries, fat, butter, fatty meats and added sugar in drinks. We observed 139 incident cases of CVD. A higher score was associated with a lower risk of CVD [3-5 points Hazard Ratio (HR): 0.38 (95% confidence interval: 0.18-0.81); 6-8 points: 0.57 (0.29-1.12); 9-10 points: 0.31 (0.15-0.67), compared to 0-2 points]. Key contributors were the attitude to increase fruit [HR: 0.59 (0.40-0.87)], vegetables [HR: 0.57 (0.29-1.12)] and fiber intake [HR: 0.69 (0.48-0.98)]. Brief questionnaire on attitudes towards healthy-eating may be a useful tool for the primary prevention of CVD.
Autores: Mendonca, R. D. ; Pimenta, A. M.; Gea, Alfredo; et al.
Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION
ISSN 0002-9165  Vol. 105  Nº 4  2017  págs. 1012 - 1013
Autores: Mendonca, R. D.; Pimenta, A. M.; Gea, Alfredo; et al.
Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION
ISSN 0002-9165  Vol. 105  Nº 4  2017  págs. 1011 - 1012
Autores: Molero, Patricio; Martínez, Miguel Ángel; Ruiz-Canela, Miguel; et al.
Revista: WORLD PSYCHIATRY
ISSN 1723-8617  Vol. 16  Nº 1  2017  págs. 110 - 111
Autores: Mendonca, R. D. ; Pimenta, A. M. ; Gea, Alfredo; et al.
Revista: AMERICAN JOURNAL OF CLINICAL NUTRITION
ISSN 0002-9165  Vol. 105  Nº 4  2017  págs. 1013 - 1014
Autores: Basterra, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; et al.
Revista: DIABETOLOGIA
ISSN 0012-186X  Vol. 60  Nº Supl. 1  2017  págs. S169 - S170
Autores: Pérez, Alejandra; Landecho, Manuel Fortún; et al.
Revista: INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
ISSN 1368-5031  Vol. 70  Nº 2  2016  págs. 147-155
The predictive rule was able to predict risk of death as a result of enterococcal bloodstream infection as well as to identify patients, who being below the threshold value, will have a low risk of death with a negative predictive value of 96%
Autores: de la Fuente-Arrillaga, Carmen; Zazpe I; Santiago, Susana; et al.
Revista: BMC PUBLIC HEALTH
ISSN 1471-2458  Vol. 16  Nº 209  2016  págs. 203
Nutritional adequacy implies sufficient intake of essential nutrients needed to [...] Background The assessment of changes in dietary habits provides interesting information on whether or not the observed trends are in line with accepted nutritional guidelines. The objective was to evaluate within-subject longitudinal changes in food consumption and nutrient intake and in a 10-year follow-up study. Methods The SUN ( ) project is a prospective Spanish cohort study. Diet was assessed using a 136-item food-frequency questionnaire (FFQ), previously validated in Spain. The participants were 3036 university graduates (55.8 % women) of Spain and the main outcome measures the changes in dietary quality and in food consumption and nutrient intake. Paired t-tests and conditional logistic regression models were used to evaluate within-subject longitudinal dietary changes and the risk of inadequacy respectively, after 10 years of follow-up. Results During follow-up, participants showed a relevant and significant increase (p 0.001) in the consumption of fruits (7.4 %), vegetables (8.6 %), low-fat dairy products (35.2 %), lean meat (12.4 %), fish (2.9 %), whole grains (53.2 %), nuts (52.4 %) and a significant decrease in legumes (-7.4 %), whole-fat dairy products (-44.2 %), red meat (-17.6 %), sugar-sweetened beverages (-58.7 %) and wine (-11.9 %). With respect to nutrients, we found a higher proportion of carbohydrates (3.6 %) and fiber (7.4 %) and a decrease in total energy intake (2.7 %), total fat (-4.5 %), SFA (-9.4 %), MUFA (-4.9 %), PUFA (-12.7 %), w-3 and w-6 fatty acids (-9.1 and -20.5 % respectively) and cholesterol (-9.6 %). Conclusions In this Mediterranean cohort study, mainly beneficial changes in the consumption of most foods and macronutrients were observed after 10 years of follow-up.
Autores: Ruiz-Canela, Miguel; Gea, Alfredo; et al.
Revista: CLINICAL PSYCHOLOGICAL SCIENCE
ISSN 2167-7026  Vol. 4  Nº 6  2016  págs. 1085 - 1093
This research assessed the association between the adherence to a Mediterranean lifestyle beyond the Mediterranean diet and the risk of depression in a prospective cohort of Spanish university graduates. Through a dynamic cohort study method, diet was assessed with a validated semiquantitative food-frequency questionnaire. The baseline assessment included a validated questionnaire on physical activity and average time spent with friends (socializing). Mediterranean lifestyle was defined as the joint exposure to Mediterranean diet, level of physical activity, and level of socializing. After a median follow-up of 8.5 years, 806 cases of depression among 11,800 participants were observed. Participants with the highest adherence to the Mediterranean lifestyle showed a 50% relative risk reduction in depression risk as compared to those participants with the lowest adherence (multivariable hazard ratio = 0.50; 95% confidence interval = [0.32, 0.81]). The Mediterranean lifestyle might reduce depression risk in the Seguimiento Universidad de Navarra cohort study beyond the known effects of the Mediterranean diet.
Autores: Bes-Rastrollo, Maira; et al.
Revista: JOURNAL OF NUTRITION
ISSN 0022-3166  Vol. 146  Nº 9  2016  págs. 1731 - 1739
Background: Yogurt and prebiotic consumption has been linked to better health. However, to our knowledge, no longitudinal study has assessed the association of yogurt and prebiotic consumption with depression risk. Objective: We longitudinally evaluated the association of yogurt and prebiotic consumption with depression risk in a Mediterranean cohort. Methods: The SUN (Seguimiento Universidad de Navarra) Project is a dynamic, prospective cohort of Spanish university graduates. A total of 14,539 men and women (mean age: 37 y) initially free of depression were assessed during a median follow-up period of 9.3 y. Validated food-frequency questionnaires at baseline and after a 10-y follow-up were used to assess prebiotic (fructans and galacto-oligosaccharide) intake and yogurt consumption (<0.5, ¿0.5 to <3, ¿3 to <7, and ¿7 servings/wk). Participants were classified as incident cases of depression when they reported a new clinical diagnosis of depression by a physician (previously validated). Multivariable Cox proportional hazards models were used to calculate HRs and 95% CIs. Results: We identified 727 incident cases of depression during follow-up. Whole-fat yogurt intake was associated with reduced depression risk: HR for the highest [¿7 servings/wk (1 serving = 125 g)] compared with the lowest (<0.5 servings/wk) consumption: 0.78 (95% CI: 0.63, 0.98; P-trend = 0.020). When stratified by sex, this association was significant only in women (HR: 0.66; 95% CI: 0.50, 0.87; P-trend = 0.004). Low-fat yogurt consumption was associated with a higher incidence of depression (HR: 1.32; 95% CI: 1.06, 1.65; P-trend = 0.001), although this association lost significance after the exclusion of early incident cases, suggesting possible reverse causation bias. Prebiotic consumption was not significantly associated with depression risk. Conclusions: Our study suggests that high consumption of whole-fat yogurt was related to a lower risk of depression in women of the SUN cohort. No association was observed for prebiotics. Further studies are needed to clarify why the yogurt-depression association may differ by fat content of the yogurt.
Autores: Bes-Rastrollo, Maira; et al.
Revista: PUBLIC HEALTH NUTRITION
ISSN 1368-9800  Vol. 20  Nº 13  2016  págs. 2383 - 2392
Objective: Our aim was to evaluate the relationship between adherence to different Dietary Approaches to Stop Hypertension (DASH) diet indices and the risk of depression. Design: In a prospective study we assessed 14051 participants of a dynamic (permanently ongoing recruitment) prospective cohort (the Seguimiento Universidad de Navarra (SUN) Project), initially free of depression. At baseline, a validated FFQ was used to assess adherence to four previously proposed DASH indices (Dixon, Mellen, Fung and Günther). To define the outcome we applied two definitions of depression: a less conservative definition including only self-reported physician-diagnosed depression (410 incident cases) and a more conservative definition that required both clinical diagnosis of depression and use of antidepressants (113 incident cases). Cox regression and restricted cubic splines analyses were performed. Results: After a median follow-up period of 8 years, the multiple-adjusted model showed an inverse association with the Fung DASH score (hazard ratio (HR)=0·76; 95 % CI 0·61, 0·94) when we used the less conservative definition of depression, and also under the more conservative definition (HR=0·63; 95 % CI 0·41, 0·95). We observed a weak inverse association with the Mellen DASH score, but no statistically significant association was found for the other definitions. The restricted cubic splines analyses suggested that these associations were non-linear (U-shaped). Conclusions: Moderate adherence to the DASH diet as operationalized by Fung and Mellen was related to lower depression risk. Since these associations were non-linear, additional prospective studies are required before the results can be generalized and clinical recommendations can be given.
Autores: Zazpe I; Santiago, Susana; Gea, Alfredo; et al.
Revista: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ISSN 0939-4753  Vol. 26  Nº 11  2016  págs. 1048 - 1058
BACKGROUND AND AIMS: Beyond the quantity of carbohydrate intake, further research is needed to know the relevance of carbohydrate quality following operational indices. No previous longitudinal study has assessed the association between an index for quality of dietary carbohydrate intake and the risk of cardiovascular disease (CVD). Here, we examined the association between a carbohydrate quality index (CQI) and the risk of CVD. METHODS AND RESULTS: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 17,424 middle-aged adults from Spain. The CQI was defined by four criteria: dietary fiber intake, glycemic index, whole-grain/total-grain carbohydrate ratio, and solid/total carbohydrate ratio. We observed 129 incident cases of CVD during 10.1 y of median follow-up. An inverse association for CQI was found (hazard ratio = 0.44, 95% confidence interval (CI): 0.25-0.78 for the highest versus the lowest tertile, p for trend = 0.008). Participants in the highest tertile of the whole-grain/total-grain carbohydrate ratio had 47% lower risk of CVD (95% CI: 0.33-0.85, p for trend = 0.008). Participants with higher baseline CQI and higher baseline energy from carbohydrates had the lowest risk of CVD. CONCLUSION: In this Mediterranean cohort, a better quality of dietary carbohydrates measured by the CQI, showed a significant inverse association with the incidence of CVD. Specially, a higher proportion of carbohydrates from whole grains was strongly inversely associated with CVD. "Heart-healthy" diets should be focused not only on carbohydrate quantity but also on a multidimensional assessment of the type and quality of carbohydrates.
Autores: Pérez, Alejandra; Gea, Alfredo; et al.
Revista: ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN 1137-6627  Vol. 38  Nº 1  2015  págs. 71-77
Analizar los predictores de mortalidad y mal pronóstico en el paciente oncológico diagnosticado de bacteriemia por E. faecium. Métodos. Se analizaron datos demográficos, clínicos y microbiológicos (Enero 1998-Junio 2011). Resultados. El análisis multivariable demostró que la presencia de una sonda urinaria se asoció a mal pronóstico a los 7 días y alta mortalidad del paciente al final del estudio. Un índice de Charlson elevado se asoció a un aumento en la mortalidad a los 7 días. Conclusión. En nuestro estudio, la presencia de sonda urinaria se asoció con mal pronóstico del paciente a los 7 días y aumento de la mortalida
Autores: Pimenta, A. M.; Bes-Rastrollo, Maira; Gea, Alfredo; et al.
Revista: PUBLIC HEALTH NUTRITION
ISSN 1368-9800  Vol. 19  Nº 4  2015  págs. 658 - 666
OBJECTIVE: To evaluate the association of snacking between main meals with the risk of developing metabolic syndrome. DESIGN: A dynamic prospective cohort study (the SUN Project; Seguimiento Universidad de Navarra). Snack consumption was evaluated using the question: 'Do you have the habit of snacking between main meals?' Metabolic syndrome was defined according to the updated harmonizing criteria. We estimated multivariable-adjusted relative risks (RR) of metabolic syndrome and their 95 % confidence intervals using Poisson regression models. An exploratory factor analysis was also used to identify patterns of snacking. SETTING: University of Navarra, Spain. SUBJECTS: The study included 6851 university graduates, initially free of metabolic syndrome, and followed-up them for a median of 8·3 years. RESULTS: Among our participants, 34·6 % reported usual snacking between main meals. The cumulative incidence of metabolic syndrome was 5·1 % (9·5 % among men and 2·8 % among women). Snacking between main meals was significantly associated with higher risk for developing metabolic syndrome after multivariable adjustment (RR=1·44; 95 %CI 1·18, 1·77). Higher adherence to an 'unhealthy snacking pattern' was also independently associated with increased incidence of metabolic syndrome (fourth quartile of adherence compared with non-snacking: RR=1·68; 95 % CI 1·23, 2·29; P for trend <0·001). CONCLUSIONS: Our findings suggest that avoidance of snacking between main meals can be included among the preventive approaches to reduce the risk of metabolic syndrome development, especially when snacks contain foods of poor nutritional quality.
Autores: Pérez, Alejandra; Gea, Alfredo; et al.
Revista: ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN 1137-6627  Vol. 38  Nº 1  2015  págs. 71-7
After multivariate analysis, presence of a urinary catheter was associated with a worse 7-day prognosis, and higher mortality at discharge. A high Charlson index was also associated with higher 7-day mortality. CONCLUSION: Presence of a urinary catheter was associated with poor 7-day prognosis and higher mortality at discharge in the present series.
Autores: Lopez-del Burgo, C; Gea, Alfredo; de Irala, J; et al.
Revista: NUTRIENTS
ISSN 2072-6643  Vol. 7  Nº 8  2015  págs. 6167 - 6178
The role of alcohol on fertility remains unclear. We aimed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant. We used a case-control study nested within the Seguimiento Universidad de Navarra (SUN) cohort, a prospective, dynamic and multipurpose cohort of 21,705 Spanish university graduates, followed biennially with mailed questionnaires. We identified 686 case-control pairs, matched for age and time in the cohort. Cases were women reporting difficulty getting pregnant. Controls did not consult due to difficulty conceiving and had at least one child during follow-up. After adjustment for potential confounders, we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week, (Odds Ratio [OR] > 5 drinks/week vs. none = 1.04, 95% Confidence Interval [CI] = 0.72-1.51). No association between types of alcoholic beverage and difficulty conceiving (OR > 5 drinks of wine/week vs. none = 1.16, 95% CI = 0.72-1.88; OR > 5 drinks of beer/week vs. none = 1.06, 95% CI = 0.82-1.37; OR > 5 drinks of spirits/week vs. none = 1.24, 95% CI = 0.84-1.64) was observed. In conclusion, we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving. More studies are needed to clearly elucidate the effects of alcohol intake on women's fertility. In the meantime, recommendations about alcohol intake to couples trying to conceive have to be given cautiously.
Autores: de Frutos, F. ; Gea, Alfredo; et al.
Revista: INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
ISSN 1569-9293  Vol. 20  Nº 2  2015  págs. 254 - 259
Coenzyme Q10 (CoQ10) is a lipid-soluble antioxidant that could have beneficial effects in patients undergoing cardiac surgery with cardiopulmonary bypass. There is no clear evidence about its clinical effects or a systematic review published yet. We aimed to conduct a systematic review and meta-analysis of the literature to elucidate the role of coenzyme Q10 in preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. We searched the PubMed Database using the following keywords: Coenzyme Q10, ubiquinone, ubiquinol, CoQ10, Heart Surgery, Cardiac surgery. Articles were systematically retrieved, selected, assessed and summarized for this review. We performed separate meta-analyses for different outcomes (inotropic drug requirements after surgery, incidence of ventricular arrhythmias and atrial fibrillation, cardiac index 24 h after surgery and hospital stay), estimating pooled odds ratios (ORs) or mean differences of the association of CoQ10 administration with the risk of these outcomes. Eight clinical trials met our inclusion criteria. Patients with CoQ10 treatment were significantly less likely to require inotropic drugs after surgery {OR [95% confidence interval (CI) 0.47 (0.27-0.81)]}, and to develop ventricular arrhythmias after surgery [OR (95% CI) 0.05 (0.01-0.31)]. However, CoQ10 treatment was not associated with Cardiac index 24 h after surgery [mean difference (95% CI) 0.06 (-0.30 to 0.43)], hospital stay (days) [mean difference (95% CI) -0.61 (-4.61 to 3.39)] and incidence of atrial fibrillation [OR (95% CI) 1.06 (0.19-6.04)]. Since none of the clinical trials included in this review report any adverse effects associated to CoQ10 administration, and coenzyme Q10 has been demonstrated to be safe even at much higher doses in other studies, we conclude that CoQ10 should be considered as a prophylactic treatment for preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. However, better quality randomized, controlled trials are needed to clarify the role of CoQ10 in patients undergoing cardiac surgery with cardiopulmonary bypass.
Autores: Martín, Nerea; Martínez, Miguel Ángel; Bes-Rastrollo, Maira; et al.
Revista: PUBLIC HEALTH NUTRITION
ISSN 1368-9800  Vol. 17  Nº 10  2014  págs. 2185 - 2193
Objective: To assess the association between the consumption of sugar-sweetened carbonated beverages (SSCB) and obesity in children and adolescents from Navarra (Spain). Design: We used a matched case-control study design. The exposure, SSCB consumption (1 serving: 200 ml), was measured with a previously validated FFQ. Anthropometrical measures were taken using standardized protocols. The outcome, obesity, was defined as BMI above the age- and sex-specific 97th percentile according to the Spanish reference charts. In the analysis we used conditional logistic regression. Potential confounders were controlled using a multivariable model. Setting: Subjects were recruited in the paediatric departments of the Universidad de Navarra Clinic and the Navarra Hospital Complex, and in three primary health centres of Navarra. Controls were recruited when attending for a routine medical examination or vaccination. Subjects: One hundred and seventy-four obese children and 174 individually sex- and age-matched controls, 52·87 % boys, with a mean age of 11·6 years. Exclusion criteria were dietary interventions, exposure to hormone treatment, development of secondary obesity due to endocrinopathy and serious intercurrent illness. Results: Independently of other factors, high consumption of SSCB (>4 servings/week) was significantly associated with obesity (OR = 3·46; 95 % CI 1·24, 9·62; P = 0·01). Besides, each additional daily serving of SSCB was associated with a 69 % relative increase in the risk of obesity (OR = 1·69; 95 % CI 1·04, 2·73; P = 0·03). Conclusions: We found a strong and significant association between SSCB consumption and obesity risk. Our results suggest a monotonic dose-response linear shape for this association in children and adolescents (P for trend = 0·02).
Autores: Gea, Alfredo; et al.
Revista: JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
ISSN 0143-005X  Vol. 68  Nº 9  2014  págs. 834 - 841
Background Polychlorinated biphenyls (PCB) are persistent organic pollutants (POP) that are consumed because of their bioaccumulation through the food chain. Recent studies have suggested the implication of POPs in the development of metabolic diseases such as type 2 diabetes and obesity. However, this relationship is not entirely consistent, and has not been investigated in longitudinal studies. The purpose of this study was to prospectively examine the association between dietary intake of PCBs and the incidence of obesity in the Seguimiento Universidad de Navarra (SUN) Project. Methods Our study included 12¿313 participants without obesity at baseline, who were followed-up for a median of 8.1¿years. Dietary intakes of PCBs, expressed as WHO toxic equivalents, were assessed at baseline through a 136-item semiquantitative food-frequency questionnaire. The published concentration levels of PCBs measured in samples of food consumed in Spain were used to estimate intakes. Multivariable Cox regression models were fitted to estimate HRs and 95% CI for incident obesity. Results During follow-up, we observed 621 incident cases of obesity. After adjustment for total energy intake and additional adjustment for potential confounders, participants in the fifth quintile of PCBs intake were at higher risk of becoming obese (adjusted HR: 1.58; (95% CI 1.21 to 2.06)) compared to those in the first quintile. The linear trend test was statistically significant (p<0.001). Conclusions Dietary intake of PCBs as estimated using a food frequency questionnaire was associated with a higher incidence of obesity. Nevertheless, further longitudinal studies are needed to confirm our results.
Autores: Bes-Rastrollo, Maira; Gea, Alfredo; et al.
Revista: BRITISH JOURNAL OF NUTRITION
ISSN 0007-1145  Vol. 112  Nº 6  2014  págs. 984 - 991
Reported associations between the consumption of fried foods and the incidence of obesity or weight gain make it likely that fried food consumption might also be associated with the development of hypertension. However, evidence from long-term prospective studies is scarce. Therefore, the aim of the present study was to longitudinally evaluate this association in a prospective cohort. The SUN (Seguimiento Universidad de Navarra) project is a Mediterranean cohort study of university graduates conducted in Spain, which started in December 1999 and is still ongoing. In the present study, we included 13,679 participants (5059 men and 8620 women), free of hypertension at baseline with a mean age of 36·5 (SD 10·8) years. Total fried food consumption was estimated at baseline. The outcome was the incidence of a medical diagnosis of self-reported hypertension during the follow-up period. To assess the association between the consumption of fried foods and the subsequent risk of developing incident hypertension during the follow-up period, Cox regression models were used. During a median follow-up period of 6·3 years, 1232 incident cases of hypertension were identified. After adjusting for potential confounders, the adjusted hazard ratios for developing hypertension were 1·18 (95% CI 1·03, 1·36) and 1·21 (95% CI 1·04, 1·41) for those consuming fried foods 2-4 and >4 times/week, respectively, compared with those consuming fried foods < 2 times/week (P for trend = 0·009). In conclusion, frequent consumption of fried foods at baseline was found to be associated with a higher risk of hypertension during the follow-up period in a Mediterranean cohort of university graduates.
Autores: Bes-Rastrollo, Maira; et al.
Revista: CLINICAL NUTRITION
ISSN 0261-5614  Vol. 32  Nº 5  2013  págs. 797-804
We observed 341 incident cases of MS. Consumers of ¿7 drinks/wk presented a significantly higher risk of developing MS (aOR: 1.80; 95% CI: 1.22-2.66; p < 0.001) compared with non-drinkers. In addition, alcohol drinkers (¿7 drinks/wk) had higher risk of hypertriglyceridemia (aOR: 2.07; 95% CI: 1.46-2.93) and impaired fasting glucose (aOR: 1.54; 95% CI: 1.16-2.04). Beer consumption was associated with higher risk for MS (p for trend = 0.027) and higher risk of hypertriglyceridemia (aOR: 1.81; 95% CI: 1.02-3.20), but with lower risk of low HDL-cholesterol criterion (aOR: 0.21; 95% CI: 0.05-0.89) for ¿7 drinks/wk versus no consumption. Non-significant association was observed between wine or liquor consumption and MS. CONCLUSIONS: Consumption of at least seven alcoholic drinks per week was associated with a higher risk of developing MS among subjects initially free of any MS criteria.
Autores: Gea, Alfredo; Toledo, Estefanía Ainhoa; et al.
Revista: BMC PUBLIC HEALTH
ISSN 1471-2458  Vol. 12  2012  págs. 954
Background: Longitudinal studies assessing the long-term association between alcohol intake and depression are scarce. The type of beverage may also be important. Therefore we aimed to prospectively evaluate the influence of alcohol intake on incident depression in a Mediterranean cohort. Methods: We assessed 13,619 university graduates (mean age: 38 years, 42% men) participating in a Spanish prospective epidemiological cohort (the SUN Project), initially free of depression. They were recruited between 1999-2008 and biennially followed-up during 2001-2010. At baseline, a 136-item validated food-frequency questionnaire was used to assess alcohol intake. Wine was the preferred beverage. Participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression and restricted cubic splines analyses were performed over 82,926 person-years. Results: Only among women, an U-shaped relationship between total alcohol intake and depression risk was found (P=0.01). Moderate alcohol intake (5-15 g/day) was associated with lower risk (Hazard Ratio: 0.62; 95% Confidence Interval: 0.43-0.89). No association was apparent for higher intakes of alcohol or for any specific type of alcoholic beverage. Conclusions: Moderate alcohol intake might protect against depression among women. Further confirmatory studies are needed.
Autores: Martínez, Miguel Ángel; Carlos, Silvia; Toledo, Estefanía Ainhoa; et al.
Libro:  Piédrola Gil. Medicina Preventiva y Salud Pública
2016  págs. 169 - 180
Autores: Carlos, Silvia; Reina, G; Gea, Alfredo;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para Ciencias de la Salud
2013  págs. 265 - 270