Impact of mediterranean diet promotion on environmental sustainability: a longitudinal analysis.

OBJECTIVE: This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). METHODS: Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models. RESULTS: After one year of intervention, the kcal/day consumed was significantly reduced (-125,1 kcal/day), adherence to a MD pattern was improved (+0,9) and the environmental impact due to the diet was significantly reduced (GHG: -361 g/CO2-eq; Acidification:-11,5 g SO2-eq; Eutrophication:-4,7 g PO4-eq; Energy use:-842,7 kJ; and Land use:-2,2 m2). Higher adherence to MD (high vs. low) was significantly associated with lower environmental impact both at baseline and one year follow-up. Meat products had the greatest environmental impact in all the factors analysed, both at baseline and at one-year follow-up, in spite of the reduction observed in their consumption. CONCLUSIONS: A program promoting a MD, after one year of intervention, significantly reduced the environmental impact in all the factors analysed. Meat products had the greatest environmental impact in all the dimensions analysed.

[Translated article] Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment.

INTRODUCTION: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations. MATERIAL AND METHOD: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow-up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint). RESULTS: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008). CONCLUSIONS: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

Fish intake in pregnant women and its impact on maternal-fetal health status.

OBJECTIVE: The objective was to evaluate the consumption of fish in pregnant women and its association with maternal and infant outcomes. MATERIAL AND METHODS: In this observational study carried out at the La Fe University and Polytechnic Hospital in Valencia, 300 pregnant women participated. The participants were divided into 2 groups according to their fish consumption during pregnancy for comparison. The χ2 test or ANOVA test were applied for comparisons for qualitative and quantitative variables respectively. RESULTS: It was observed that 49% of women consumed adequate amounts of fish during pregnancy (2 or 3 weekly servings). Significant differences were observed for iron supplementation (higher in women with inadequate fish consumption), threatened pregnancy loss (higher in women with inadequate fish consumption), infant size (better in women with adequate fish consumption), and arterial O2 pressure (better in women with adequate fish consumption). In regard to the other components of the dietary pattern, no differences were observed but the adequacy of intake for grains and white meat was very poor (less than 5.0%). CONCLUSIONS: Half of the women met the recommendations for fish intake during pregnancy and presented an overall healthier eating pattern but without statistical significance.

Type III acromioclavicular dislocation: Mid term results after operative and non-operative treatment. / Luxación acromioclavicular grado III. Resultados a medio plazo tras tratamiento conservador y quirúrgico.

INTRODUCTION: Controversy exists in the literature about the best treatment for type III acromioclavicular dislocations. The aim of this study is to compare functional results between surgical and conservative treatment in type III acromioclavicular joint dislocations. MATERIAL AND METHOD: We retrospectively evaluated the records of 30 patients from our area with acute type III acromioclavicular dislocations that were treated from January 1st, 2016 to December 31st, 2020. Fifteen patients were treated surgically and 15 conservatively. Follow up mean time was 37.93 months in operative group and 35.73 months in non-operative group. Results obtained on the Constant score was the main variable analysed and results obtained on the Oxford score and the Visual Analogue Scale for pain were the secondary variables. Epidemiological variables were analysed, as well as range of mobility in injured shoulder and subjective and radiological variables (distance between the superior border of the acromion and the superior border of the clavicle's distal end and presence of osteoarthritis in the acromioclavicular joint). RESULTS: Functional evaluation scores did not show differences between the two groups (Constant: operative 82/non-operative 86.38, p 0.412; Oxford: operative 42/non-operative 44.80, p 0.126) nor did Visual Analogue Scale (operative 1/non-operative 0.20, p 0.345). Subjective evaluation of the injured shoulder was excellent or good in 80% of the patients in both groups. Measurement of the distance between the superior border of the acromion and the superior border of the clavicle's distal end were significantly higher in non-operative group (operative 8.95/non-operative 14.21, p 0.008). CONCLUSIONS: Although radiographic results were better in the surgical treatment group, functional evaluation scores did not show significant differences between the two groups. These results do not support the routine use of surgical treatment for grade III acromioclavicular dislocations.

[Effect of intensive nutritional intervention in patients refractory to weight loss]. / Efecto de una intervención nutricional intensiva en pacientes refractarios a la pérdida de peso.

OBJECTIVE: To assess the effect of an intensive nutritional intervention on the body weight and waist circumference in adults refractory to weight loss, by applying a personalised low-calorie Mediterranean diet. MATERIAL AND METHODS: A prospective study was conducted for 6 months on 100 participants with an age range between 55 and 75 years, a BMI ≥ 27 and < 40 kg/my, and fulfilled 3 or more criteria of metabolic syndrome. The intervention consisted of prescribing a low-calorie Mediterranean diet, exercise recommendations, and motivational talks. Anthropometric variables were recorded 11a month during the entire intervention. An analysis was made of the results using the Chi-squared and Student-t tests. The Odds Ratio of the variables associated with weight loss and their 95% confidence intervals was calculated using a non-conditional logistic regression. RESULTS: After the "rescue" intervention, the patients lost an average of 2.9% of the body weight and 2.1% of waist circumference, the target of the loss ≥ 3% of the weight and 26% of the sample the target of reduction ≥ 3% of waist circumference being achieved 38% of the sample. No statistically significant differences were observed in weight and waist circumference loss in any of the variables analysed. CONCLUSIONS: Intensive intervention, based on a low-calorie Mediterranean diet, with recommendations of physical activity and motivational talks, achieved a moderate weight loss in patients refractory to treatments for obesity.

[Reproducibility, correlation and concordance of the Abbreviated Dietary Score questionnaire]. / Reproducibilidad, correlación y concordancia de un cuestionario abreviado del Dietary Score.

OBJECTIVE: The objective of this study was to evaluate the reproducibility, correlation and concordance of the abbreviated Dietary Score (aDS) used in the IBERICAN study. MATERIAL AND METHODS: A cross-sectional study was performed in order to assess the reproducibility of the aDS using a test-retest. Its internal consistency was evaluated using Cronbach's alpha, and reliability of the measurements using the intraclass correlation coefficient (ICC). From the food frequency questionnaire (FFQ) of the PREDIMED-Plus study, adherence to a Mediterranean diet pattern was evaluated using DS, and its correlation and agreement with aDS was assessed. In both cases the lineal regression, Bland-Altman, and kappa index techniques were used. RESULTS: A total of 142 subjects participated, mostly men (56.3%), with a mean age of 64.6±4.9 years. In terms of reproducibility, a Pearson correlation coefficient of 0.538 was obtained; a mean of the differences of 2.03 points, and a weighted kappa index of 0.400 (95% CI=0.295-0.577). The instrument had good internal consistency (Cronbach's alpha=0.699), as well as good reliability (CCI=0.931). The aDS had a correlation coefficient with the DS of 0.517, a mean difference of 1.19 points, and a weighted kappa index of 0.450 (95% CI=0.366-0.532). CONCLUSIONS: The aDS has moderate reproducibility and a good correlation and agreement with the DS, so it can be a useful tool in Primary Care to assess adherence to the Mediterranean diet.