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Influencia de la ingesta de polifenoles en el desarrollo de diferentes tipos de cáncer: estudio multicaso-control MCC Spain = Influence of polyphenol intake in the development of different types of cancer: a multicase-control study MCC Spain
No full text281 p.El objetivo principal de esta tesis doctoral es evaluar la influencia del consumo de PF en el desarrollo de cáncer de mama y cáncer gástrico, en el marco del proyecto MCC-Spain.
La presente tesis se enmarca en dos proyectos, el estudio nacional Multicaso-control - MCC-Spain y el consorcio internacional Stomach cancer Pooling Project (Stop-Project) cuyos datos han sido utilizados para realizar distintos estudios sobre el efecto de los PF en el desarrollo de distintos tipos de cáncer y en el cual también está presente el proyecto MCC-Spain
Flavonoids and the Risk of Gastric Cancer: An Exploratory Case-Control Study in the MCC-Spain Study
Get PDFSeveral epidemiological studies have investigated the association between the dietary
flavonoid intake and gastric cancer (GC) risk; however, the results remain inconclusive. Investigating
the relationship between the different classes of flavonoids and the histological types and origin of
GC can be of interest to the research community. We used data from a population-based multi-case
control study (MCC-Spain) obtained from 12 different regions of Spain. 2700 controls and 329 GC
cases were included in this study. Odds ratios (ORs) were calculated using the mixed e ects logistic
regression considering quartiles of flavonoid intakes and log2. Flavonoid intake was associated
with a lower GC risk (ORlog2 = 0.76; 95% CI = 0.65–0.89; ORq4vsq1 = 0.60; 95%CI = 0.40–0.89;
ptrend = 0.007). Inverse and statistically significant associations were observed with anthocyanidins,
chalcones, dihydroflavonols and flavan-3-ols. The isoflavanoid intake was positively associated with
higher cancer risk, but without reaching a statistical significance. In general, no differences were
observed in the GC risk according to the location and histological type. The flavonoid intake seems
to be a protective factor against GC within the MCC-study. This effect may vary depending on the
flavonoid class but not by the histological type and location of the tumor. Broader studies with larger
sample size and greater geographical variability are necessary.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish
Ministry Council on 11 October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533,
PI08/1359, PS09/00773-Cantabria, PS09/01286-León, PS09/01903-Valencia, PS09/02078-Huelva, PS09/01662-Granada,
PI11/01403, PI11/01889-FEDER, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715,
PI12/00150, PI14/01219, PI14/0613, PI15/00069, PI15/00914, PI15/01032, PI17CIII/00034), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL (The ICGC CLL-Genome
Project is funded by Spanish Ministerio de Economía y Competitividad (MINECO) through the Instituto de
Salud Carlos III (ISCIII) and Red Temática de Investigación del Cáncer (RTICC) del ISCIII (RD12/0036/0036)), by
the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571-2009,
PI-0306-2011, salud201200057018tra), by the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10),
by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country, by the Consejería de
Sanidad de la Región de Murcia, by the European Commission grants FOOD-CT-2006-036224-HIWATE, by the
Spanish Association Against Cancer (AECC) Scientific Foundation – grant GCTRA18022MORE, by the Catalan
Government- Agency for Management of University and Research Grants (AGAUR) grants 2017SGR723 and
2014SGR850, by the Fundación Caja de Ahorros de Asturias and by the University of Oviedo. ISGlobal is a
member of the CERCA Programme, Generalitat de Catalunya
Effect of polyphenol intake on biomarkers and cardiovascular risk
Get PDF174 p.[ES] Introducción La enfermedad cardiovascular es la principal causa de muerte en todo el mundo y, a pesar de las estrategias preventivas llevadas a cabo, continúa siendo un problema de salud pública. La dieta mediterránea ha demostrado numerosos beneficios cardiosaludables dada su riqueza en moléculas antioxidantes y antiinflamatorias y, muy especialmente, en polifenoles. Estos compuestos bioactivos han mostrado beneficios a nivel cardiovascular debido a sus propiedades antitrombóticas, antiinflamatorias y antiagregantes. Sin embargo, el estudio de su potencial en humanos es limitado. Dado el gran número de compuestos que existen, y, por ende, sus variadas biodisponibilidades y mecanismos de acción, aún hay muchos puntos que necesitan ser esclarecidos. Por este motivo, el objetivo principal de la presente tesis doctoral es evaluar la asociación entre el consumo de polifenoles, y el riesgo y biomarcadores de riesgo cardiovascular (RCV).
Metodología Se utilizó la información disponible de 6.633 participantes del estudio PREDIMED-Plus, un ensayo clínico aleatorizado multicéntrico, que recopiló información sobre hábitos alimentarios y estilos de vida, así como muestras sanguíneas para análisis bioquímicos. El consumo de polifenoles se estimó utilizando los datos de consumo de alimentos del cuestionario semicuantitativo de frecuencia alimentaria de 143 ítems y el contenido de polifenoles de cada alimento contenido en la base de datos Phenol-Explorer. Los consumos estimados se ajustaron por la ingesta total de energía de acuerdo al método de residuales.
Mediante modelos de regresión lineal multivariante, se evaluó la asociación entre la ingesta de polifenoles y el RCV (estimado mediante ecuaciones de riesgo). Además, se evaluó la asociación entre la ingesta de polifenoles y, el ácido úrico (mediante regresión lineal multivariante) y, mediante modelos de regresión de Cox con un tiempo de seguimiento constante (t=1) se estimó los Prevalence Ratio de la hiperuricemia.
Por otro lado, se establecieron patrones de consumo de polifenoles mediante análisis factorial y análisis clúster, comparando ambos métodos y relacionando la adherencia a cada patrón con el RCV estimado.
Todos los análisis se realizaron para hombres y mujeres por separado, además de en la población total.
Resultados La ingesta total de polifenoles (βQ5vs.Q1= 0,10, IC 95%: 0,04 a 0,17) y flavonoides (βQ5vs.Q1= 0,17, IC 95%: 0,10 a 0,24) se asoció directa y significativamente con una mejor salud cardiovascular óptima (Life’s Simple 7). Se encontraron asociaciones inversas entre el consumo de la clase otros polifenoles y, el RCV estimado mediante Framingham (βQ5vs.Q1= -1,22%, IC 95%: -2,37 a -0,07) y SCORE (βQ5vs.Q1=-0,32, IC 95%: -2,37 a -0,07). En las mujeres, las asociaciones entre el consumo de polifenoles y todas las ecuaciones de riesgo, tienden a ser protectoras.
La ingesta de ácidos fenólicos (βQ5vs.Q1= -0,17, IC 95%: -0,27 a -0,06), ácidos hidroxicinámicos (βQ5vs.Q1= -0,19, IC 95%: -0,3 a -0,09), alquilmetoxifenoles (βQ5vs.Q1= 0,2, IC 95%: -0,31 a -0. 1) y metoxifenoles (βQ5vs.Q1= -0,24, IC 95%: -0,34 a -0,13) -0,24, IC 95%: -0,34 a -0,13) mostró una asociación inversa con los niveles de ácido úrico en suero y, la hiperuricemia (PRQ5vs.Q1=0,82, IC 95%:0,71-0,95; PRQ5vs.Q1=0,82, IC 95%:0,71-0,95; PRQ5vs.Q1=0,80, IC 95%:0,70-0,92 y PR=0,79, IC 95%:0,69-0,91, respectivamente).
Los patrones de polifenoles revelaron diferencias entre hombres y mujeres, así como en su asociación con el RCV. Respecto a aquellos derivados del análisis factorial: para el total de la muestra, y los hombres, el patrón 3 (aceitunas y aceite de oliva) se asoció positivamente con el RCV, también presentaron, mayor prevalencia de diabetes y mayores consumos de sodio. El patrón 4 formado por el café en todos los grupos, también se asoció con mayor RCV. En cuanto al análisis clúster, el clúster 2 en el total y en hombres, caracterizados por consumo de polifenoles del café y las aceitunas y aceite de oliva, también mostraron mayor RCV.
Conclusiones La clase otros polifenoles mostró asociaciones inversas con el riesgo cardiovascular estimado, encontrándose resultados similares con las ecuaciones de Framingham, Framingham-REGICOR y Life’s Simple 7 (después de eliminar el componente de dieta) y diferentes con la SCORE, pero los predictores que se incluyen en esta herramienta son escasos.
Una mayor ingesta subclases de polifenoles presentes en el café: ácidos hidroxicinámicos, alquilmetoxifenoles y metoxifenoles se asoció de forma inversa a los niveles de ácido úrico y la hiperuricemia.
Encontramos diferencias en los patrones de ingesta de polifenoles entre hombres y mujeres, y en sus asociaciones con la RCV. Estas diferencias de sexo pueden explicarse por el hecho de que llevan estilos de vida diferentes, ya que un patrón no se refiere sólo a los hábitos dietéticos.
Además, los sujetos que presentaban un mayor riesgo al inicio del estudio podrían sentirse más motivados para mejorar su hábito dietético (causalidad inversa).
Nuestros hallazgos añaden nuevos conocimientos en el estudio de los compuestos fenólicos, destacando la importancia de analizarlos por sexo y de estudiar los determinantes de las elecciones alimentarias y los patrones dietéticos en relación con la percepción de riesgo y los estilos de vida específicos.[EN] Introduction Cardiovascular disease is the leading cause of death worldwide and, despite preventive strategies, continues to be a public health problem. The Mediterranean diet has demonstrated numerous benefits in this regard given its richness in antioxidant and anti-inflammatory molecules, and most especially, in polyphenols. These bioactive compounds have shown cardiovascular benefits due to their antithrombotic, anti-inflammatory and antiplatelet properties. However, the study of their potential in humans is limited. Given the large number of compounds that exist and, therefore, their varied bioavailability and mechanisms of action, there are still many points that need to be clarified. For this reason, the main objective of this doctoral thesis is to evaluate the association between polyphenol intake and cardiovascular risk (CVR) and biomarkers.
Methods The information available from 6,633 participants in the PREDIMED-Plus study was used, it is a multicenter randomized clinical trial, which collected information on dietary habits and lifestyles, as well as blood samples for biochemical analysis. Polyphenol intakes were estimated using food consumption data from the 143-item semi-quantitative food frequency questionnaire and the polyphenol content of each food contained in the Phenol-Explorer database. Estimated intakes were adjusted for total energy intake according to the residuals method.
The association between polyphenol intake and CVR (estimated using risk equations) was evaluated using multivariate linear regression models. In addition, the association between polyphenol intake and uric acid was evaluated (using multivariate linear regression) and, using Cox regression models with a constant follow-up time (t=1), the prevalence ratio of hyperuricemia was estimated.
On the other hand, polyphenol consumption patterns were established by factor analysis and cluster analysis, comparing both methods and relating adherence to each pattern with the estimated CVR.
All analyses were performed for men and women separately, as well as in the total population.
Results Total polyphenol (βQ5vs.Q1= 0.10, 95% CI: 0.04 to 0.17) and flavonoid (βQ5vs.Q1= 0.17, 95% CI: 0.10 to 0.24) intakes were directly and significantly associated with improved optimal cardiovascular health (Life's Simple 7). Inverse associations were found between other polyphenols class intake and, CVR estimated by Framingham (βQ5vs.Q1= -1.22%, 95% CI: -2.37 to -0.07) and SCORE (βQ5vs.Q1=-0.32, 95% CI: -2.37 to -0.07). In women, the associations between polyphenol intake and all risk equations tended to be protective.
The intake of phenolic acids (βQ5vs.Q1= -0.17, 95% CI: -0.27 to -0.06), hydroxycinnamic acids (βQ5vs.Q1= -0.19, 95% CI: -0.3 to -0.09), alkylmethoxyphenols (βQ5vs.Q1= 0.2, 95% CI: -0.31 to -0. 1) and methoxyphenols (βQ5vs.Q1= -0.24, 95% CI -0.34 to -0.13) showed an inverse association with serum uric acid levels and, hyperuricemia (PRQ5vs.Q1=0.82, 95% CI:0.71-0.95; PRQ5vs.Q1=0.82, 95% CI:0.71-0.95; PRQ5vs.Q1=0.80, 95% CI:0.70-0.92 and PRQ5vs.Q1=0.79, 95% CI:0.69-0.91, respectively).
The polyphenol patterns revealed differences between men and women, as well as, in their association with CVR. Regarding those derived from the factorial analysis: for the total sample and the men, pattern 3 (olives and olive oil poyphenols) was positively associated with CVR, they also had a higher prevalence of diabetes and higher sodium intake. Pattern 4, formed by coffee polyphenols in all groups, was also associated with higher CVR. As for the cluster analysis, cluster 2 in the total and in men, characterized by consumption of coffee polyphenols and olives and olive oil, also showed higher CVR.
Conclusions The other polyphenols class showed inverse associations with estimated cardiovascular risk, finding similar results with the Framingham, Framingham-REGICOR and Life's Simple 7 equations (after eliminating the diet component), and different with the SCORE, but predictors included in this scale are scarce.
Higher intakes of polyphenols present in coffee: hydroxycinnamic acids, alkylmethoxyphenols, and methoxyphenols, were inversely associated with serum uric acid levels and hyperuricemia.
We found differences in polyphenol intake patterns between men and women, and in their associations with CVR. These sex differences may be explained by the fact that they lead different lifestyles, since a pattern does not refer only to dietary habits. Moreover, subjects who were at higher risk at baseline might be more motivated to improve their dietary habit (reverse causality).
Our findings add new insights in the study of phenolic compounds, highlighting the importance of analyzing them by sex and studying the determinants of food choices and dietary patterns in relation to risk perception and specific lifestyles
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Family history and gastric cancer risk: A pooled investigation in the stomach cancer pooling (STOP) project consortium
No full textAlthough there is a clear relationship between family history (FH) and the risk of gastric cancer (GC), quantification is still needed in relation to different histological types and anatomical sites, and in strata of covariates. The objective was to analyze the risk of GC according to first-degree FH in a uniquely large epidemiological consortium of GC. This investigation includes 5946 cases and 12,776 controls from 17 studies of the Stomach Cancer Pooling (StoP) Project consortium. Summary odds ratios (OR) and the corresponding 95% confidence intervals (CIs) were calculated by pooling study-specific ORs using fixed-effect model meta-analysis techniques. Stratified analyses were carried out by sex, age, tumor location and histological type, smoking habit, socioeconomic status, alcohol intake and fruit consumption. The pooled OR for GC was 1.84 (95% CI: 1.64-2.04; I2 = 6.1%, P heterogeneity = 0.383) in subjects with vs. those without first-degree relatives with GC. No significant differences were observed among subgroups of sex, age, geographic area or study period. Associations tended to be stronger for non-cardia (OR = 1.82; 95% CI: 1.59-2.05 for subjects with FH) than for cardia GC (OR = 1.38; 95% CI: 0.98-1.77), and for the intestinal (OR = 1.92; 95% CI: 1.62-2.23) than for the diffuse histotype (OR = 1.62; 95% CI: 1.28-1.96). This analysis confirms the effect of FH on the risk of GC, reporting an approximately doubled risk, and provides further quantification of the risk of GC according to the subsite and histotype. Considering these findings, accounting for the presence of FH to carry out correct prevention and diagnosis measures is of the utmost importance
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Effect of an intensive intervention based on the consumption of a low-calorie mediterranean diet on environmental sustainability
Get PDF200 p.[ES] Introducción
El cambio climático es uno de los grandes problemas del siglo XXI y cada vez son más las estrategias encaminadas a reducir el impacto del ser humano sobre el planeta. En este sentido, la dieta desempeña un papel clave, ya que los sistemas alimentarios se consideran responsables de un tercio de las emisiones de gases de efecto invernadero (GEI), del uso del 60% del agua dulce y de la utilización de cerca de la mitad de la superficie libre de hielo del planeta. Dado que no todos los alimentos tienen el mismo impacto ambiental, la elección de los diferentes patrones dietéticos se vuelve fundamental para promover un sistema alimentario más sostenible, ya que el tipo de dieta influye sobre la calidad y cantidad de las ingestas, condicionando la huella ambiental individual que se genera.
Los estudios actuales coinciden en que los patrones alimentarios con menos alimentos de origen animal y más de origen vegetal, además de ser más saludables, tienen un menor impacto ambiental. Uno de los patrones dietéticos que reúne estas características es la Dieta Mediterránea (MedDiet), caracterizada por un elevado consumo de productos vegetales y un consumo bajo-moderado de carne, aves y productos lácteos. Este patrón dietético está reconocido por sus importantes beneficios para la salud cardiovascular y la prevención de enfermedades crónicas. Además, dado que reduce la ingesta de productos animales y fomenta la biodiversidad, se espera que este modelo dietético beneficie a la sostenibilidad medioambiental. Por ello, el objetivo principal de la presente tesis doctoral es valorar el efecto sobre la sostenibilidad ambiental de una intervención intensiva basada en la promoción de una Dieta Mediterránea hipocalórica.
Metodología
Se utilizó la información de 5800 participantes del estudio PREDIMED-Plus y de 1554 participantes de la cohorte EPITeen sobre hábitos alimentarios y estilos de vida. La ingesta de alimentos se estimó mediante cuestionarios semicuantitativos de frecuencia de consumo de alimentos validados en población española y portuguesa, y la adherencia a la MedDiet mediante el índice Dietary Score que se clasificó por terciles.
A partir de las tablas de la Comisión EAT-Lancet se evaluó la influencia de la ingesta alimentaria en el impacto medioambiental medido a través de cinco indicadores: GEI, acidificación y eutrofización potencial, uso del suelo y energía utilizada.
La asociación entre la adherencia a la MedDiet y su impacto ambiental, así como la asociación entre la intervención y los cambios en cada uno de los factores ambientales se calculó mediante modelos de regresión lineal multivariante ajustados. Además, se realizaron análisis de mediación para estimar en qué medida los cambios en cada uno de los 2 componentes de la intervención, la adherencia a la MedDiet o la reducción calórica, eran responsables de las reducciones observadas en el impacto ambiental.
Resultados
En el marco del estudio PREDIMED-Plus, una mayor adherencia a la MedDiet (alta vs. baja) se asoció significativamente con un menor impacto ambiental en los cinco términos estudiados tanto al inicio del estudio (GEI (4895,8 vs. 5133,2 g/CO2-eq), uso del suelo (8,9 vs. 10,6 m2), uso de energía (8763,3 vs. 9682,3 kJ), acidificación potencial (59,0 vs. 69,8 g SO2-eq) y eutrofización (22,6 vs. 26,1 g PO4-eq)) como un año después de permanecer en el estudio ((GEI (4513,7 vs. 4776,0 g/CO2-eq), uso del suelo (6,8 vs. 8,4 m2), uso de energía (8004,9 vs. 8817,5 kJ), acidificación potencial (47,9 vs. 58,1 g SO2-eq) y eutrofización (18,1 vs. 21,5 g PO4-eq)).
Los productos cárnicos tuvieron el mayor impacto ambiental en todos los factores analizados, aunque su consumo se redujo tras un año de intervención, provocando una reducción de un 6,5% en la emisión de GEI, 4,9% en el uso de energía, 3% en la acidificación, 3,6% en la eutrofización y 3,1% en el uso del suelo.
Además, en el grupo de intervención (GI) y tras un año de permanencia en el estudio, observamos una reducción significativa de los niveles de acidificación (-13,3 vs. a -9,9 g SO2-eq), eutrofización (-5,4 vs. -4,0 g PO4-eq) y uso del suelo (-2,7 vs. -1,8 m2). En cuanto a las emisiones de GEI y el uso de energía, aunque se observó una mayor reducción en el GI, no se alcanzó significación estadística (-377,7 vs. -345,1 g CO2-eq; y -899,7 vs. -787,9 kJ respectivamente).
La adherencia a la MedDiet medió parcialmente la asociación entre la intervención y la reducción de la acidificación en un 15%, la eutrofización en un 10% y el uso del suelo en un 10%. La reducción calórica medió parcialmente la asociación con los mismos factores en un 55%, 51% y 38% respectivamente. Además, la adherencia a la MedDiet medió totalmente en la asociación entre la intervención y la reducción de las emisiones de GEI en un 56% y del uso de energía en un 53%.
En el marco del estudio EPITeen, la mayor adherencia (alta vs. baja) a la MedDiet se asoció a un menor impacto ambiental en términos de uso del suelo (7,8 vs. 8,5 m2, p =0,002), acidificación potencial (57,8 vs. 62,4 g SO2-eq, p =0,001) y eutrofización (21,7 frente a 23,5 g PO4-eq, p <0,001). El uso de energía disminuyó solo en el modelo ajustado por la ingesta de calorías (9689,5 vs. 10265,9 kcal, p <0,001), y las emisiones de GEI únicamente se redujeron en un modelo complementario en el que se eliminó el consumo del pescado (3035,3 vs. 3281,2 g CO2-eq, p <0.001).
En este estudio, también los productos cárnicos fueron los alimentos con mayor impacto ambiental para los cinco factores ambientales analizados, contribuyendo a un 35,7% del total de emisiones de GEI, 60,9% en uso de energía, 72,8% en uso del suelo, 70% en acidificación y 61,8% en eutrofización.
Conclusiones
En población adulta española, los participantes con una mayor adherencia a la MedDiet, al año de permanencia en el programa, redujeron su impacto medioambiental de forma significativa en términos de emisiones de GEI, acidificación y eutrofización potencial, uso del suelo y energía utilizada.
Tras un año de intervención nutricional intensiva con promoción de una MedDiet reducida en energía, los participantes del GI redujeron en mayor medida los cinco indicadores analizados, haciéndolo de forma significativa en acidificación, eutrofización y uso del suelo. Esta mejora en el impacto ambiental estuvo mediada parcialmente por el aumento de la adherencia a MedDiet y la reducción calórica en la dieta de los participantes.
En población joven portuguesa, una mayor adherencia a la MedDiet se asoció con un menor impacto ambiental en términos de acidificación, eutrofización y uso del suelo, e incluso menores emisiones de GEI y menor uso de energía dependiendo del modelo de ajuste utilizado.
En ambos casos, los productos cárnicos fueron los que tuvieron más peso en términos de impacto ambiental en los cinco factores analizados, por lo que se espera que las dietas bajas en estos productos sean más sostenibles ambientalmente.[EN] Introduction
Climate change is one of the major issues of the 21st century and there are a growing number of strategies aimed at reducing human impact on the planet. Diet plays a key role in this regard, as food systems are considered to be responsible for one third of greenhouse gas (GHG) emissions, 60% of freshwater use and the use of about half of the planet's ice-free surface. Given that not all foods have the same environmental impact, the choice of different dietary patterns becomes fundamental in making the food system more sustainable, as the type of diet followed directly influences the quality and quantity of what is eaten and this conditions the individual environmental footprint generated.
Current studies agree that dietary patterns with less animal-based foods and more plant-based foods, in addition to being healthier, have a lower environmental impact. One of the dietary patterns that meets these characteristics is the Mediterranean Diet (MedDiet), characterized by a high consumption of vegetable products and a low-moderate consumption of meat, poultry, and dairy products. This dietary pattern is recognized for its important benefits for cardiovascular health and the prevention of chronic diseases. In addition, since it reduces the intake of animal products and promotes biodiversity, this dietary pattern is expected to benefit environmental sustainability. Therefore, the main objective of this doctoral thesis is to assess the effect on environmental sustainability of an intensive intervention based on the promotion of a low-calorie MedDiet.
Methods
Information on dietary habits and lifestyles of 5800 participants from the PREDIMED-Plus study and 1554 participants from the EPITeen cohort was used. Food intake was estimated using semi-quantitative food frequency questionnaires validated in the Spanish and Portuguese population, and adherence to the MedDiet using the Dietary Score index.
Based on the EAT-Lancet Commission tables, the influence of dietary intake on environmental impact (through five indicators: GHG, acidification and eutrophication potential, land, and energy use) was assessed.
The association between adherence to the MedDiet and its environmental impact, as well as the association between the intervention and changes in each of the environmental factors was estimated using multivariate adjusted linear regression models. In addition, mediation analyses were performed to estimate the extent to which changes in each of the 2 intervention components, namely adherence to the MedDiet and calorie reduction, were responsible for the observed reductions in environmental impact.
Results
In the framework of the PREDIMED-Plus study, higher MedDiet adherence (high vs. low) was significantly associated with lower environmental impact both at baseline ((GHG (4895.8 vs. 5133.2 g/CO2-eq), land use (8.9 vs. 10.6 m2), energy use (8763.3 vs. 9682.3 kJ), potential acidification (59.0 vs. 69.8 g SO2-eq) and eutrophication (22.6 vs. 26.1 g PO4-eq)) and one year after remaining in the study ((GHG (4513.7 vs. 4776.0 g/CO2-eq), land use (6.8 vs. 8.4 m2), energy use (8004.9 vs. 8817.5 kJ), potential acidification (47.9 vs. 58.1 g SO2-eq) and eutrophication (18.1 vs. 21.5 g PO4-eq)).
Meat products had the highest environmental impact on all factors analysed, although their consumption was reduced after one year of intervention, leading to a 6.5% reduction in GHG emission, 4.9% in energy use, 3% in acidification, 3.6% in eutrophication and 3.1% in land use.
Furthermore, in the intervention group (IG) and after one year in the study, we observed a significant reduction in acidification levels (-13.3 vs. -9.9 g SO2-eq), eutrophication (-5.4 vs. -4.0 g PO4-eq) and land use (-2.7 vs. -1.8 m2). For GHG emissions and energy use, although a greater reduction was observed for IG, statistical significance was not reached (-377.7 vs. -345.1 g CO2-eq; and -899.7 vs. -787.9 kJ respectively).
Adherence to MedDiet partially mediated the association between intervention and reduction of acidification by 15%, eutrophication by 10% and land use by 10%. Caloric reduction partially mediated the association with the same factors by 55%, 51% and 38% respectively. In addition, adherence to MedDiet fully mediated the association between intervention and reduction in GHG emissions by 56% and energy use by 53%.
In the framework of the EPITeen study, higher adherence (high vs. low) to the MedDiet was associated with lower environmental impact in terms of land use (7.8 vs. 8.5 m2, p =0.002), potential acidification (57.8 vs. 62.4 g SO2-eq, p =0.001) and eutrophication (21.7 vs. 23.5 g PO4-eq, p <0.001). Energy use decreased only in the model adjusted for calorie intake (9689.5 vs. 10265.9 kcal, p <0.001), and GHG emissions were only reduced in a complementary model in which fish consumption was removed (3035.3 vs. 3281.2 g CO2-eq, p <0.001).
In this study, meat products were also the food with the highest environmental impact for the five environmental factors analysed, contributing to 35.7% of total GHG emissions, 60.9% in energy use, 72.8% in land use, 70% in acidification and 61.8% in eutrophication.
Conclusions
In the Spanish adult population, participants with higher adherence to the MedDiet significantly reduced their environmental impact in terms of GHG emissions, acidification and potential eutrophication, land, and energy used after one year in the programme.
After one year of intensive nutritional intervention with promotion of an energy reduced MedDiet, the IG participants reduced the most on all five indicators analysed, doing so significantly in terms of acidification, eutrophication, and land use. This improvement in environmental impact was partially mediated by increased adherence to the MedDiet and calorie reduction in participants' diets.
In young Portuguese population, higher adherence to the MedDiet was associated with lower environmental impact in terms of acidification, eutrophication, and land use, and even lower GHG emissions and energy use depending on the adjustment model used.
In both cases, meat products had the highest weight in terms of environmental impact in the five factors analysed, so diets low in these products are expected to be more environmentally sustainable.The work was carried out in the Area of Preventive Medicine and Public Health of the University of León, with a four-month international stay at the Instituto da Saúde Pública da Universidade do Porto (ISPUP) (Porto, Portugal). The data collected in the PREDIMED-Plus project, financed by the Spanish government’s official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (three coordinated FIS projects led by Jordi Salas-Salvadó and Josep Vidal, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/0147, PI14/00636, PI14/00972, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01,332)The Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to Jordi Salas-Salvadó, the European Research Council (Advanced Research Grant 2013–2018, 340918) to Miguel Ángel Martínez-Gonzalez, the Recercaixa Grant to Jordi Salas-Salvadó (2013ACUP00194), CICYT [AGL2016- 75329-R], a grant from the Generalitat Valenciana (APOSTD/2019/136 to RB) and Generalitat de Catalunya (SGR-2019 to RE), grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), grants from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN Grant, EU-COST Action CA16112, a grant of support to research groups no. 35/2011 from the Balearic Islands Government, Grants from Balearic Islands Health Research Institute (IDISBA), funds from the European Regional Development Fund (CIBEROBN CB06/03 and CB12/03) and from the European Commission (EAT2BENI-CE_H2020_SFS2016). The Spanish Ministry of Science Innovation and Universities for the Formación de Profesorado Universitario (FPU17/00785) contract. The data collected in the EPITeen was funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology e FCT (Portuguese Ministry of Science, Technology and Higher Education) (POCI-01-0145-FEDER-016829), under the project “A longitudinal approach to metabolically to healthy obesity: from inflammation to cardiovascular risk profile” PTDC/DTP-EPI/6506/2014, and the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013)
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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