Association of beverage consumption with subclinical atherosclerosis in a Spanish working population.

Beverages play a substantial role meeting water, calorie, and nutrient requirements; however, they are presented as being major contributors to the current obesity epidemic. Although, the relationship between beverage consumption and metabolic risk factors for cardiovascular disease (CVD) in adults has been frequently studied, its association with subclinical atherosclerosis is of increased interest. We studied the association of beverage consumption with the presence of peripheral subclinical atherosclerosis among Spanish workers. We performed a cross-sectional study of 2089 middle-aged males, with a mean age of 50.9 (SD 3.9), and without CVD, carried out in the Aragon Workers' Health Study (AWHS). A food frequency questionnaire was used to measure beverage consumption of low-fat milk, coffee and tea (unsweetened), whole-fat milk, sugar-sweetened beverages, bottled fruit juice, artificially-sweetened beverages and 100% fruit juice. Atherosclerotic plaques were measured by ultrasound (in carotid arteries, and in femoral arteries). Atherosclerotic plaque was defined as a focal structure protruding ≥ 0.5 mm into the lumen, or reaching a thickness ≥ 50% of the surrounding intima-media thickness. As statistical analysis, we use logistic regression models, simultaneously adjusted for all beverage groups. As results, unsweetened coffee was the beverage most associated with peripheral subclinical atherosclerosis with an odds ratio (OR) of 1.25 (1.10-1.41), and 1.23 (1.09-1.40) 100g/day] for carotid, and femoral territories respectively. Moreover, subclinical atherosclerosis was positively associated with whole-fat milk [OR 1.10 (1.02-1.18) 100 g/day] in the femoral territory. The association was protective for low-fat milk in the carotid territory [OR 0.93 (0.88-0.99) 100g/day]. There was also a protective association with bottled fruit juices in the femoral territory [0.84 (0.74-0.94) 100g/day]. Our results suggest a detrimental association with the consumption of coffee, as well as with whole-fat milk and the presence of subclinical atherosclerosis. Therefore, an element of prudence excluding water and low-fat milk, must be applied when recommending beverage consumption.

Adherence to a Healthy Beverage Score Is Associated with Lower Frailty Risk in Older Adults.

Many beverages include bioactive components and energy but are frequently not considered in diet quality estimations. We examined the association of a healthy beverage score (HBS) with incident frailty in older adults from the Seniors-ENRICA-1 cohort. We used data from 1900 participants (mean ± SD age 68.7 ± 6.4 years, 51.7% women), recruited in 2008-2010 and followed-up until 2012 assessing food consumption at baseline with a validated diet history. The HBS was higher for increasing consumption of low fat milk, tea/coffee, lower consumption of whole milk, fruit juice, artificially sweetened beverages, sugar-sweetened beverages, and moderate intake of alcohol. Frailty was considered as having ≥3 criteria: exhaustion, low-physical activity, slow gait speed, weakness, and weight loss. We performed logistic regression analyses adjusted for potential confounders. During a 3.5 y mean follow-up, 136 new cases of frailty occurred. Compared to the lowest sex-specific HBS tertile, the fully adjusted odds ratio (95% confidence interval) of frailty was 0.59 (0.38, 0.92) in the intermediate tertile, and 0.52 (0.31, 0.88) in the highest tertile, p trend = 0.007. Results for slow gait speed were 0.79 (0.58, 1.07) and 0.71 (0.51-0.99), p trend = 0.033. Therefore, adherence to HBS was inversely associated with incident frailty and slow gait speed. HBS can help on the beverage quality evaluation, highlighting beverage importance as contributors to diet and to health.

Fried-Food Consumption Does Not Increase the Risk of Stroke in the Spanish Cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) Study.

BACKGROUND: The nutritional determinants of stroke and, more specifically, the association of frying with the risk of incident stroke have rarely been studied. OBJECTIVES: Our aim was to evaluate prospectively the association between the consumption of fried food and the risk of incident stroke in the European Prospective Investigation into Cancer and Nutrition study using the Spanish cohort. METHODS: Participants included 40,328 healthy adults (62% women) aged 29-69 y at study entry who were enrolled between 1992 and 1996. Participants were followed up until 31 December, 2017, at which time incident stroke (the main outcome) was measured. The main exposure measure was the percentage of energy obtained from fried-food consumption. Sex-specific quintiles were calculated. RESULTS: During a follow-up period of 23.5 y, 975 cases of stroke occurred (750 ischemic, 185 hemorrhagic, and 40 undetermined). Compared with those in the first (lowest) quintile of fried-food consumption, the multivariate HRs (95% CIs) of incident stroke in the consecutive quintiles were 1.05 (0.86, 1.30), 1.11 (0.90, 1.36), 1.05 (0.84, 1.31), and 0.91 (0.72, 1.15; P-trend = 0.45). There were no differences identified when subtypes of stroke were considered. CONCLUSIONS: In this Spanish cohort, whose participants mainly used olive oil or sunflower oil when frying, the consumption of fried food was not associated with an increased risk of incident stroke.

Ultra-Processed Food Consumption Is Associated with Abdominal Obesity: A Prospective Cohort Study in Older Adults.

INTRODUCTION AND OBJECTIVES: Ultra-processed food (UPF) consumption has been associated with increased incidence of cardiovascular disease and its risk factors. The aim of this study was to assess, for the first time in the literature, the prospective association between UPF consumption and the incidence of abdominal obesity (AO) in older adults. METHODS: The study sample consists of 652 participants in the Seniors Study on Nutrition and Cardiovascular Risk in Spain: Seniors-ENRICA-1 study, (mean age 67, 44% women). At baseline, standardized anthropometric measurements were collected (including abdominal circumference). After a median follow-up of six years, the abdominal circumference was measured again, and the incidence of abdominal obesity (AO) was calculated, defined as an abdominal perimeter ≥102 cm in men and ≥88 cm in women. At baseline, dietary information was collected using a computerized and validated dietary history. Information was obtained on the usual diet in the previous year. A total number of 880 foods were classified according to their degree of processing following the NOVA classification. Foods or drinks formulated mostly or entirely from substances derived from foods, with little or no presence of the unaltered original food were classified as UPF. For each participant, the percentage of energy from UPF was derived and sex-specific tertiles were calculated. Logistic regression models were built and adjusted for sociodemographic, lifestyle, morbidity, and drug treatment variables. RESULTS: Among those participants without AO at baseline, 177 developed AO during follow-up. The average consumption of UPF was 17% of total energy (7% in the first tertile; 29% in the third tertile). The odds ratio (95% confidence interval) for incident AO risk when compared to the lowest tertile was: 1.55 (0.99-2.44) for the second tertile of UPF consumption and 1.62 (1.04-2.54) for the third tertile; p for linear trend: 0.037. Results remained statistically significant after adjusting for potential dietary confounding factors such as fiber consumption, the intake of very long chain omega-3 fatty acids and adherence to the Mediterranean diet. CONCLUSIONS: A higher UPF consumption is positively associated with incident AO in older adults in Spain. These findings extend the current evidence of the detrimental effect of UPF consumption on cardiometabolic health.

Coffee consumption and risk of physical function impairment, frailty and disability in older adults.

PURPOSE: Habitual coffee consumption has been associated with lower risk of type 2 diabetes and cardiovascular disease. Since these diseases are main determinants of functional limitations, we have tested the hypothesis that coffee intake is associated with lower risk of physical function impairment, frailty and disability in older adults. We focused on women and those with obesity, hypertension or type 2 diabetes because they are at higher risk of functional limitations. METHODS: Prospective study with 3289 individuals ≥ 60 years from the Seniors-ENRICA cohort. In 2008-2010 coffee consumption was measured through a validated dietary history. Participants were followed up until 2015 to ascertain incident impaired physical function, frailty and disability, assessed by both self-report and objective measures. RESULTS: Compared with non-drinking coffee, consumption of ≥ 2 cups of coffee/day was associated with lower risk of impaired agility in women (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.51-0.97, P trend 0.04) and in those with obesity (HR 0.60; 95% CI 0.40-0.90, P trend 0.04). Intake of ≥ 2 cups of coffee/day was also linked to reduced risk of impaired mobility in women (HR 0.66; 95% CI 0.46-0.95, P trend 0.02) and among individuals with hypertension (HR 0.70, 95% CI 0.48-1.00, P trend 0.05). Moreover, among subjects with diabetes, those who consumed ≥ 2 cups/day had lower risk of disability in activities of daily living (HR 0.30, 95% CI 0.11-0.76, P trend 0.01). CONCLUSIONS: In older people, habitual coffee consumption was not associated with increased risk of functional impairment, and it might even be beneficial in women and those with hypertension, obesity or diabetes.

Habitual coffee consumption and 24-h blood pressure control in older adults with hypertension.

BACKGROUND & AIMS: In normotensive and hypertensive individuals, blood pressure (BP) rises acutely during a few hours following coffee or caffeine consumption. However, the effect of habitual coffee consumption on BP and BP control is uncertain. The aim of this study was to assess the association of habitual coffee consumption on 24-h BP and BP control among older adults with hypertension. METHODS: Data were taken from the Seniors-Study on Nutrition and Cardiovascular Risk in Spain (ENRICA), a cross-sectional study conducted in 2012 among 1164 individuals aged ≥63 years. Habitual coffee consumption was assessed with a validated diet history. BP was recorded by 24-h ambulatory monitoring. Ambulatory hypertension was defined as BP ≥ 130/80 mm Hg or being under antihypertensive treatment, and uncontrolled BP was deemed as BP ≥ 130/80 mm Hg among hypertensives. Analyses were performed with linear and logistic regressions adjusted for the main confounders, including diet, time since diagnosis of hypertension and the number of antihypertensive drugs. RESULTS: Among the 715 hypertensive participants, those consuming ≥3 cups of coffee/day showed higher 24-h systolic BP (beta: 3.25 mm Hg, p value = 0.04) and diastolic BP (beta: 2.24 mm Hg, p value = 0.02) than non-coffee drinkers. Compared to non-coffee drinkers, the odds ratios (95% confidence interval) for uncontrolled BP among those consuming 1, 2, and ≥3 cups of coffee/day were, respectively: 1.95 (1.15-3.30), 1.41 (0.75-2.68), and 2.55 (1.28-5.09); p for trend = 0.05. The association was similar among individuals who were smokers, had excess weight (body mass index ≥25 kg/m2), low adherence to the Mediterranean diet, or hypercholesterolemia. No association was found between coffee consumption and having a non-dipper BP pattern (<10% nocturnal decline in BP) among hypertensives. CONCLUSION: Habitual coffee consumption was associated with uncontrolled BP in a hypertensive older population.

Coffee consumption and health-related quality of life.

BACKGROUND AND AIMS: Understanding the effect of coffee on health-related quality of life (HRQL) would contribute to explain the mechanisms of the long-term effect of coffee on health. The aim of this study was to examine the association between coffee consumption and HRQL. METHODS: Cross-sectional study conducted in 2008-2010 among 11,423 individuals representative of the Spanish population aged ≥18 years. Habitual coffee and food consumption was assessed with a validated diet history. HRQL was measured using the Spanish version of the SF-12 questionnaire. The analyses were performed using linear regression and adjusted for the main confounders. RESULTS: Among men, no association was found between coffee consumption and the physical and mental composite summaries (PCS and MCS) of the SF-12. Among women, compared to those who did not consume coffee, habitual coffee drinkers showed similar scores on the PCS [beta coefficients (p value) for 1, 2, 3, and ≥4 cups/day: 0.49 (0.20), 0.62 (0.21), 0.50 (0.45), and 0.36 (0.59)]; but slightly better scores on the MCS [beta (p value): 1.58 (<0.001), 1.58 (0.004), 0.80 (0.31), and 1.22 (0.10)]. These results reflect mostly the consumption of non-filtered caffeinated coffee. Tea consumption and total caffeine intake did not show an association with HRQL. CONCLUSION: We found no evidence of an adverse effect of coffee on HRQL. These results are consistent with the null association between this beverage and several chronic diseases and all-cause mortality reported in many studies. The weak positive association of coffee with the MCS found among women needs further confirmation.

Adherence to the Mediterranean diet pattern has declined in Spanish adults.

This work examined the Spanish population's degree of accordance with the Mediterranean diet (MD). This was a cross-sectional study conducted in 2008-2010 among 11,742 individuals representative of the Spanish population aged ≥ 18 y. Habitual food consumption was assessed with a computerized diet history. Accordance of food consumption with the MD was assessed with the MD Adherence Screener (MEDAS) score using the cutoffs ≥ 9 to define strict accordance and ≥ 7 (mid-range value) for modest accordance. Accordance of nutrient intake with the MD was defined as ≥ 4.5 points (mid-range value) on the high-unsaturated fat OmniHeart diet score. The diet of 12% (95% CI: 11.3-12.7%) of the Spanish population reached MEDAS-based strict accordance with the MD and 46% (95% CI: 44.7-47.7) attained modest accordance. Moreover, 39.0% (95%: 37.8-40.1%) of the population achieved OnmiHeart-based MD accordance. Factor analysis identified 2 main dietary patterns. The first one was called "Westernized" and was rich in red and processed meat, French fries, refined cereals, and sweetened beverages and poor in fresh fruit; the second pattern was named "Mediterranean" and was rich in olive oil and plant-based foods. Regardless of how it was defined, MD accordance was less frequent and the Westernized pattern was more frequent among the younger, the less educated, current smokers, and those less physically active and more sedentary. In conclusion, the Spanish population is drifting away from the MD to adopt a less healthy diet, typical of Western countries. The departure from the MD mostly affects the socially disadvantaged and clusters with other unhealthy lifestyles, which may have synergistic undesirable effects on health.

Consumption of fried foods and risk of coronary heart disease: Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study.

OBJECTIVE: To assess the association between consumption of fried foods and risk of coronary heart disease. DESIGN: Prospective cohort study. SETTING: Spanish cohort of the European Prospective Investigation into Cancer and Nutrition. PARTICIPANTS: 40 757 adults aged 29-69 and free of coronary heart disease at baseline (1992-6), followed up until 2004. MAIN OUTCOME MEASURES: Coronary heart disease events and vital status identified by record linkage with hospital discharge registers, population based registers of myocardial infarction, and mortality registers. RESULTS: During a median follow-up of 11 years, 606 coronary heart disease events and 1135 deaths from all causes occurred. Compared with being in the first (lowest) quarter of fried food consumption, the multivariate hazard ratio of coronary heart disease in the second quarter was 1.15 (95% confidence interval 0.91 to 1.45), in the third quarter was 1.07 (0.83 to 1.38), and in the fourth quarter was 1.08 (0.82 to 1.43; P for trend 0.74). The results did not vary between those who used olive oil for frying and those who used sunflower oil. Likewise, no association was observed between fried food consumption and all cause mortality: multivariate hazard ratio for the highest versus the lowest quarter of fried food consumption was 0.93 (95% confidence interval 0.77 to 1.14; P for trend 0.98). CONCLUSION: In Spain, a Mediterranean country where olive or sunflower oil is used for frying, the consumption of fried foods was not associated with coronary heart disease or with all cause mortality.

Health-related quality of life and mental health in the medium-term aftermath of the Prestige oil spill in Galiza (Spain): a cross-sectional study.

BACKGROUND: In 2002 the oil-tanker Prestige sank off the Galician coast. This study analyzes the effect of this accident on health-related quality of life (HRQoL) and mental health in the affected population. METHODS: Using random sampling stratified by age and sex, 2700 residents were selected from 7 coastal and 7 inland Galician towns. Two exposure criteria were considered: a) residential exposure, i.e., coast versus interior; and b) individual exposure-unaffected, slightly affected, or seriously affected-according to degree of personal affectation. SF-36, GHQ-28, HADS and GADS questionnaires were used to assess HRQoL and mental health. Association of exposure with suboptimal scores was summarized using adjusted odds ratios (OR) obtained from logistic regression. RESULTS: For residential exposure, the SF-36 showed coastal residents as having a lower likelihood of registering suboptimal HRQoL values in physical functioning (OR:0.69; 95%CI:0.54-0.89) and bodily pain (OR:0.74; 95%CI:0.62-0.91), and a higher frequency of suboptimal scores in mental health (OR:1.28; 95%CI:1.02-1.58). None of the dimensions of the other questionnaires displayed statistically significant differences. For individual exposure, no substantial differences were observed, though the SF-36 physical functioning dimension rose (showed better scores) with level of exposure (91.51 unaffected, 93.86 slightly affected, 95.28 seriously affected, p < 0.001). CONCLUSION: Almost one and a half years after the accident, worse HRQoL and mental health levels were not in evidence among subjects exposed to the oil-spill. Nevertheless, some of the scales suggest the possibility of slight impact on the mental health of residents in the affected areas.