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.

Capacity and organisation of Madrid's community hospitals during first wave of COVID-19 pandemic.

INTRODUCTION AND OBJECTIVES: The first wave of the SARS-CoV-2 pandemic exerted enormous stress on the healthcare system. Community of Madrid hospitals responded by restructuring and scaling their capacity to adapt to the high demand for care. METHODS: This was a retrospective observational study conducted between 18 March and 21 June 2020 with data from public and private hospitals in CoM, Spain. Absolute and relative frequencies were calculated for inpatients with and without COVID-19, available and occupied beds in intensive care unit (ICU) and non-ICU wards, daily new admissions (NA), individuals awaiting hospitalisation in the emergency department (ED), and discharges. RESULTS: Compared to pre-pandemic years, during the maximum care pressure period (18 March-17 April 2020), the average number of total available and occupied beds increased by 27% and 36%, respectively. Also, the average number of available and occupied ICU beds increased by 174% and 257% respectively, and average occupancy was 81%. The average daily NAs were 1,503 (90% from the ED) and 949 (63% due to COVID-19), and of these, 61 (6.4%) were admitted to the ICU. On average, at 6:00p.m., 1112 patients were waiting in the ED to be admitted and 299 (26.8%) patients waited for more than 24h. Discharges due to death for COVID-19 inpatients in the non-ICU and ICU wards were 16% and 36%, respectively. CONCLUSIONS: This study confirmed the critical role of the ICU and ED, especially in the care of patients before being hospitalizated, in pandemic or health crisis scenarios.

Comorbidities of Primary Care patients with COVID-19 during the first wave of the SARS-CoV-2 pandemic in the Community of Madrid.

OBJECTIVE: Recent publications on inpatients with COVID-19 describing their comorbidities and demographic profile exists, but data from large populations requiring only primary care (PC) are scarce. This paper aims to fill this gap and report the prevalence of eight comorbidities (high blood pressure, diabetes mellitus, cancer, cardiovascular disease, asthma, chronic kidney disease, chronic obstructive pulmonary disease, and chronic heart failure) among patients attending PC during the onset of the SARS-CoV-2 pandemic in the Community of Madrid (CoM), Spain. METHODS: This is an observational retrospective study that collects data registered in the CoM between February 25th and May 31st, 2020. Data are divided in two groups: Group-1 (N=339,890) consist of all patients with suspected or proven SARS-CoV-2 infection; and Group-2 is the subgroup (N=48,556, 14.3% of Group-1) of individuals with COVID-19 confirmed by positive RT-PCR test. RESULTS: Comparing Group-1 with Group-2, 339,890/48,556 patients, respectively, the main results were as follows: average age (60.9/69.9 years), presence of at least one comorbidity (33.51%/47.69%), high blood pressure (19.74%/32.74%), diabetes mellitus (7.13%/13.75%), cancer (6.56%/10.6%), cardiovascular disease (4.52%/9.26%), asthma (7.98%/6.56%), chronic kidney disease (1.84%/4.41%), chronic obstructive pulmonary disease (2%/4.03%), and chronic heart failure (1.14%/2.77%). High blood pressure and diabetes mellitus were seen to be the most frequent (6.56%/8.38%) association. CONCLUSIONS: Patients requiring PC attention during the first wave of the COVID-19 pandemic in the CoM presented with a very high rate of comorbidities, with marked differences among those with or without a confirmed SARS-CoV-2 infection.