1,721,165 research outputs found
Challenges to the Mediterranean diet at a time of economic crisis.
No full textAims The traditional Mediterranean diet (MD) is reportedly associated with lower risk of major chronic diseases and long considered to contribute to the reduced rates of cardiovascular and cerebrovascular events and to the highest life expectancy in adults who lived near the Mediterranean Sea. But despite its widely documented health benefits, adherence to this dietary pattern has been rapidly declining over the last decades due to a clear socioeconomic influence. The present review provides an overview of the evidence on the current major determinants of adherence to the Mediterranean diet, with a particular emphasis on Mediterranean Countries at a time of economic crisis; second it explores emerging socioeconomic inequalities in other domains of healthy dietary behaviours such as dietary variety, access to organic foods and food purchasing behaviour. Data synthesis According to ecological evidence, the Mediterranean Countries that used to have the highest adherence to the Mediterranean pattern in the Sixties, more recently experienced the greatest decrease, while Countries in Northern Europe and some other Countries around the world are currently embracing a Mediterranean-like dietary pattern. A potential cause of this downward trend could be the increasing prices of some food items of the Mediterranean diet pyramid. Recent evidence has shown a possible involvement of the economic crisis, material resources becoming strong determinants of the adherence to the MD just after the recession started in 2007-2008. Beyond intake, the MD also encourages increasing dietary diversity, while international dietary recommendations suggest replacing regular foods with healthier ones. Conclusions Socioeconomic factors appear to be major determinants of the adherence to MD and disparities also hold for other indices of diet quality closely related to this dietary pattern
Should we recommend reductions in saturated fat intake or in red/processed meat consumption? The SUN prospective cohort study
Full text linkBackground & 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
Similar prediction of the decreased total mortality, diabetes incidence or cardiovascular events using a relative- and an absolute-component Mediterranean diet score: the sun COHORT .
No full textAbstract Background and Aim: Accumulated evidence supports the effectiveness of
Mediterranean-type diets (MeDiet) in reducing mortality and preventing several chronic
diseases. Widely used scores to assess adherence to MeDiet are based on specific sample characteristics;
alternatively, they might be built according to absolute/normative cut-off points
for the consumption of specific food groups (pre-defined servings/day or/week). The aim of
this study was to compare sample-specific MeDiet adherence scores (MDS) versus absolutenormative
scores (Mediterranean Diet Adherence Screener e MEDAS) on their association with
macronutrient intake, total mortality and incidence of chronic diseases. Design: SUN (Seguimiento
Universidad de Navarra) dynamic prospective cohort study (60.5% women; mean age
38.4 years).
Methods and Results: In cross-sectional analyses (nZ20,155) we evaluated macronutrient
distribution according to MDS (based on 136-item FFQ), MEDAS (based on 13 questions), and
variants of both. In prospective analyses (nZ9109; mean follow-up: 6.2 years), we evaluated
disease incidence or mortality. Adherence to MeDiet increased with age and, as expected, was
associated with higher fiber intake, lower total fat intake but higher monounsaturated/saturated
fat ratio, using all scores. Among subjects initially free of cancer, diabetes, and cardiovascular
disease (CVD), adherence to MeDiet appraised with an absolute-normative score
(MEDAS) similarly predicted macronutrient distribution and disease incidence or mortality (diabetes incidence, CVD or all-cause mortality), when compared to a sample-specific score
based on 136-item FFQ (MDS).
Conclusions: Adherence to MeDiet was associated with a decreased incidence of a composite
outcome including diabetes incidence, cardiovascular events incidence or all-cause mortality
Olive oil consumption is associated with a lower risk of cardiovascular disease and stroke
Full text linkFIS grants 17/1709, 20/144, PI20/00564 and PIE16/00022 (Instituto de Salud Carlos III, State Secretary of R+D+I, and FEDER/FSE), PNSD (2020/021), the CIBERESP, the CIBERCV and CIBEROBN (Instituto de Salud Carlos III).Donat-Vargas, C., Sandoval-Insausti, H., Peñalvo, J.L., Moreno Iribas, M.C., Amiano, P., Bes-Rastrollo, M., Molina-Montes, E., Moreno-Franco, B., Agudo, A., Mayo, C.L., Laclaustra, M., De La Fuente Arrillaga, C., Chirlaque Lopez, M.D., Sánchez, M.-J., Martínez-Gonzalez, M.A., Pilar, G.-C
FAST FOOD CONSUMPTION AND GESTATIONAL DIABETES INCIDENCE IN THE SUN PROJECT
Full text linkBackground: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is
continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast
food in a cohort of university graduates.
Methods: The prospective dynamic ‘‘Seguimiento Universidad de Navarra’’ (SUN) cohort included data of 3,048 women
initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and
March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency
questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food
were established: low (0–3 servings/month), intermediate (.3 servings/month and #2 servings/week) and high (.2
servings/week). Non-conditional logistic regression models were used to adjust for potential confounders.
Results: We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body
mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at
baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks
consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with
multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81–2.13) and 1.86 (95% CI: 1.13–3.06) for the intermediate
and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007).
Conclusion: Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for
gestational diabetes
PROSPECTIVE STUDY OF FAST-FOOD CONSUMPTION AND THE RISK OF GESTATIONAL DIABETES MELLITUS: THE SUN COHORT
No full textLittle is known about fast-food consumption as a risk factor for gestational diabetes mellitus (GDM). Therefore, our objective was to evaluate the association between fast-food consumption and GDM in a cohort of university graduates.
The prospective dynamic SUN cohort included data of 2903 women free of diabetes or previous gestational diabetes who reported at least one pregnancy between 1999 and 2010. Fast-food consumption was assessed through a validated semi-quantitative food frequency questionnaire. Fast-food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0-3 servings/month), intermediate (>3 servings/month-2 servings/week) and high (>2 servings/week). Non-conditional regression models were used to adjust for potential confounders.
We identified 169 incident cases of GDM during follow-up. After adjusting for age, baseline body mass index, smoking, physical activity, alcohol intake, fiber intake, Mediterranean dietary pattern, soft drinks consumption, family history of diabetes, cardiovascular disease and hypertension at baseline, and parity, regular fast-food consumption was significantly positively associated with incident GDM. Women in the intermediate category of consumption had an adjusted OR of 1.35 (95% CI 0.84-2.17) those in the highest category had an adjusted OR of 1.77 (95% CI: 1.08-2.91); p for linear trend: 0.018) using as a reference women with low consumption of fast-food .
Our results suggest that pre-pregnancy higher consumption of fast-food (defined as the consumption of hamburgers, sausages, and pizza) was a risk factor for GDM
Adherence to the Mediterranean diet is inversely associated with visceral abdominal tissue in Caucasian subjects
No full textBackground: & aim: Adherence to the Mediterranean dietary pattern (MDP) is inversely related with abdominal adiposity as detected by waist circumference but the specific association to subcutaneous and visceral abdominal tissue has not been investigated. To this purpose we evaluated the association between MDP, visceral (VAT) and subcutaneous (SAT) abdominal tissue in a large sample of Italian adults. Methods: A cross-sectional study was carried out on 4388 consecutive adults (73.2% women) followed as outpatients at Nutritional Research Centre in Milan, ICANS. VAT and SAT were measured by ultrasonography. MDP was evaluated using a Mediterranean dietary score (MEDscore) obtained from a validated 14-item questionnaire. Results: At multiple linear regression adjusted for sex, age, smoking and physical activity, a 1-unit increase in MEDscore was associated with a -0.118 kg/m2 decrease in BMI (p < 0.01), a -0.292 cm decrease in waist circumference (p < 0.01), a -0.002 cm:cm decrease in waist to height ratio (p < 0.001), a -1.125 mm decrease in the sum of 4 skinfolds (p < 0.001), and with a -0.045 cm decrease in VAT (p < 0.05). MEDscore was, however, not associated with SAT. Finally, the adherence to the MDP was a protective factor for obesity (OR = 0.717, 95%CI: 0.555-0.922) and VAT excess (OR = 0.717, 95%CI: 0.530 e0.971). Conclusion: Our study confirms the inverse association between MDP, BMI and waist circumference and adds that the association with abdominal obesity as detected by waist circumference is due to an association with VAT and not with SAT
Association of a dietary score with incident type 2 diabetes: The dietary-based diabetes-risk score (DDS)
Full text linkBackground: Strong evidence supports that dietary modifications may decrease incident type 2 diabetes mellitus (T2DM). Numerous diabetes risk models/scores have been developed, but most do not rely specifically on dietary variables or do not fully capture the overall dietary pattern. We prospectively assessed the association of a dietary-based diabetes-risk score (DDS), which integrates optimal food patterns, with the risk of developing T2DM in the SUN ("Seguimiento Universidad de Navarra") longitudinal study. Methods: We assessed 17,292 participants initially free of diabetes, followed-up for a mean of 9.2 years. A validated 136-item FFQ was administered at baseline. Taking into account previous literature, the DDS positively weighted vegetables, fruit, whole cereals, nuts, coffee, low-fat dairy, fiber, PUFA, and alcohol in moderate amounts; while it negatively weighted red meat, processed meats and sugar-sweetened beverages. Energy-adjusted quintiles of each item (with exception of moderate alcohol consumption that received either 0 or 5 points) were used to build the DDS (maximum: 60 points). Incident T2DM was confirmed through additional detailed questionnaires and review of medical records of participants. We used Cox proportional hazards models adjusted for socio-demographic and anthropometric parameters, health-related habits, and clinical variables to estimate hazard ratios (HR) of T2DM. Results: We observed 143 T2DM confirmed cases during follow-up. Better baseline conformity with the DDS was associated with lower incidence of T2DM (multivariable-adjusted HR for intermediate (25-39 points) vs. low (11-24) category 0.43 [95% confidence interval (CI) 0.21, 0.89]; and for high (40-60) vs. low category 0.32 [95% CI: 0.14, 0.69]; p for linear trend: 0.019). Conclusions: The DDS, a simple score exclusively based on dietary components, showed a strong inverse association with incident T2DM. This score may be applicable in clinical practice to improve dietary habits of subjects at high risk of T2DM and also as an educational tool for laypeople to help them in self-assessing their future risk for developing diabetes
Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies
No full textDiet plays a role in the onset and progression of metabolic disorders, including metabolic syndrome (MetS). We aimed to systematically review and conduct a quantitative meta-analysis of results from observational cross-sectional and prospective cohort studies on adherence to the Mediterranean dietary pattern and risk of MetS. Literature databases including PubMed, SCOPUS and EMBASE were searched from the beginning to May 2016. Eight cross-sectional and four prospective studies were included in this meta-analysis, accounting for a total of 33,847 individuals and 6342 cases of MetS. High adherence to the Mediterranean diet was associated with a risk of MetS (RR: 0.81, 95%CI: 0.71, 0.92). Regarding individual components of the MetS, the inverse associations were significant for waist circumference, blood pressure and low HDL-C levels. In conclusion, adoption of a Mediterranean dietary pattern was associated with lower risk of the MetS and it can be proposed for the primary prevention of the MetS.</p
Association of the Dietary-Based Diabetes-Risk Score (DDS) with the risk of gestational diabetes mellitus in the Seguimiento Universidad de Navarra (SUN) project
Get PDFIt is crucial to identify people at risk for type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM) to implement preventive interventions in order to address these pandemics. A simple score exclusively based on dietary components, the Dietary-Based Diabetes-Risk Score (DDS) showed a strong inverse association with incident T2DM. The objective was to assess the association between DDS and the risk of GDM in a cohort of Spanish university graduates. The 'Seguimiento Universidad de Navarra' project is a prospective and dynamic cohort which included data of 3455 women who notified pregnancies between 1999 and 2012. The diagnosis of GDM is self-reported and further confirmed by physicians. A validated 136-item semi-quantitative FFQ was used to assess pre-gestational dietary habits. The development of the DDS was aimed to quantify the association between the adherence to this a priori dietary score and T2DM incidence. The score exclusively included dietary components (nine food groups with reported inverse associations with T2DM incidence and three food groups which reported direct associations with T2DM). Three categories of adherence to the DDS were assessed: low (11-24), intermediate (25-39) and high (40-60). The upper category showed an independent inverse association with the risk of incident GDM compared with the lowest category (multivariate-adjusted OR 0·48; 95 % CI 0·24, 0·99; P for linear trend: 0·01). Several sensitivity analyses supported the robustness of these results. These results reinforce the importance of pre-gestational dietary habits for reducing GDM and provide a brief tool to practically assess the relevant dietary habits in clinical practice
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