Dietary exposure to parabens and body mass index in an adolescent Spanish population.

Parabens are alkyl esters of p-hydroxybenzoic acid which are extensively used in cosmetics, pharmaceuticals and foodstuffs due to their antimicrobial properties. The most commonly used parabens are methyl-(MeP), ethyl-(EtP), propyl-(PrP) and butyl-(BuP) paraben. Most human exposure to parabens is achieved through the consumption of food or pharmaceutical products and the use of personal care products. However, studies on dietary parabens exposure and the associated factors are very scarce. The main aim of the present study was to explore factors associated with dietary exposure to parabens in Spanish adolescents according to gender. Dietary data and anthropometric measures were collected from 585 adolescents (53.4% boys) aged 12-16 years. Parabens exposure through diet was assessed using a food frequency questionnaire with food products providing more than 95% of energy and macronutrient intake being included in analysis. Stepwise regression was used to identify the foods that most contributed to parabens intake. Logistic regression was used to evaluate factors predicting higher dietary exposure to parabens. The main contributors to dietary MeP, EtP, PrP and BuP exposure in adolescent boys were eggs (41.9%), canned tuna (46.4%), bakery and baked goods products (57.3%) and pineapple (61.1%). In adolescent girls, the main contributors were apples and pears (35.3%), canned tuna (42.1%), bakery and baked goods products (55.1%) and olives (62.1%). Overweight/obese girls were more likely to belong to the highest tertile of overall parabens intake (odds ratio [OR]: 3.32; 95% confidence interval [95% CI]: 1.21-9.15) and MeP (OR: 3.05; 95% CI: 1.14-8.12) than those with a body mass index lower than 25 kg/m2. These findings suggest a positive association between dietary exposure to parabens and overweight/obesity in adolescent girls.

Beverage consumption patterns and energy contribution from beverages per meal type: results from a national dietary survey in Sweden.

OBJECTIVE: Many studies of food intake have been performed and published in Sweden, but to our knowledge no studies have extensively explored the beverage consumption of the Swedish adult population. The present study aimed to describe the beverage consumption and the contribution of beverage energy (including alcohol energy) to total energy intake according to gender, region of living, meal type and day for a Swedish adult population. DESIGN: National dietary survey Riksmaten (2010-2011), collected by the Swedish National Food Agency. SETTING: Sweden. SUBJECTS: A total of 1682 participants (57 % women) reported dietary intake data during four consecutive days, specified by portion size, meal, time point, day of the week and venue. Meals were categorized as breakfast, lunch, dinner and 'other'.ResultThe beverage reported to be consumed the most was water (ml/d), followed by coffee. Men had a higher consumption of juice, soft drinks, beer, spirits and low-alcohol beer, while the consumption of tea and water was higher for women. For both genders, milk contributed the most to beverage energy intake. Energy percentage from beverages was higher at lunch and dinner during weekends for both genders. Participants from the biggest cities in Sweden had a higher consumption of wine for both genders and tea for men than participants from other regions. CONCLUSIONS: A considerable part of total energy intake was contributed by beverages, especially for men. Beverages can contribute to a more enjoyable diet, but at the same time provide energy, sugar and alcohol in amounts that do not promote optimal health.

Reported habitual intake of breakfast and selected foods in relation to overweight status among seven- to nine-year-old Swedish children.

AIM: The aim of this study was to examine the reported frequency of breakfast intake and selected food and beverages in the investigated group of Swedish children in comparison with recommended intakes. Furthermore, the study analyses these food habits and some demographic and lifestyle factors in relation to overweight and obesity. METHODS: This cross-sectional study builds on data collected in 2008 and 2010. Measured anthropometric data and parent questionnaire data were collected. A total of 2620 Swedish children (52.1% boys) aged seven to nine years were included. RESULTS: The majority of parents reported that their children (95.4%) had breakfast every day. The majority of children had fresh fruit (84.7%) and vegetables (83.9%) most days a week. Only 1.6% of the children were reported to have fast food and 6.0% to have sugar containing soft drinks, four days a week or more. The prevalence of overweight including obesity (OW/OB) was 17.8% for boys, 18.6% for girls. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.20-2.96), drinking diet soft drink (OR 2.6, 95% CI 1.52-4.42) and skimmed/semi-skimmed milk (OR 1.8, 95% CI 1.37-2.36) four days a week or more. Parents being overweight and having low education levels were also related to a higher risk of their children being overweight. CONCLUSIONS: The parental reports of children's food habits pointed at favourable eating patterns for most investigated children. Breakfast skipping, diet soft drinks and low-fat milk consumption were more frequent among OW/OB children. Longitudinal studies are needed to determine the causal relationships.

Comparison of Mediterranean diet compliance between European and non-European populations in the Mediterranean basin.

Fruit, vegetables, cereals, and olive oil are common elements of the Mediterranean diet (MD), but each country in the Mediterranean basin has its own gastronomic customs influenced by socio-cultural, religious, and economic factors. This study compared the dietary habits of three Mediterranean populations with different cultures and lifestyles, a total of 600 adults (61.9% females) between 25 and 70 yrs from Spain, Morocco, and Palestine. All participants completed a self administered questionnaire, including sociodemographic and anthropometric items, a validated semi-quantitative food frequency questionnaire adapted to the foods consumed in each country, and three 24-h recalls. MD adherence was estimated with the MD Serving Score (MDSS). All populations showed a moderate adherence to the Mediterranean dietary pattern. In comparison to the Palestine population, MDSS-assessed adherence to the MD was 6.36-fold higher in the Spanish population and 3.88-fold higher in the Moroccan population. Besides the country of origin, age was another predictive factor of MD adherence, which was greater (higher MDSS) in participants aged over 50 yrs than in those aged 30 yrs or younger. This preliminary study contributes initial data on dietary differences between European and non-European countries in the Mediterranean basin. The Spanish diet was shown to be closer to MD recommendations than the diet of Morocco or Palestine. Given the impact of good dietary habits on the prevention of chronic non-transmittable diseases, health policies should focus on adherence to a healthy diet, supporting traditional dietary patterns in an era of intense commercial pressures for change.

Development and validation of a nutritional questionnaire for the Palestine population.

OBJECTIVE: Dietary habits vary widely among regions and cultural groups, and FFQ need to be designed for specific populations. The objectives of the present study were to develop and test the repeatability and relative validity of a medium-length semi-quantitative FFQ for measuring the energy and macronutrient intakes of a specific population and to contribute a methodological framework for this procedure. SETTING: Palestinian families in the Hebron area. DESIGN: After a preliminary survey of a subgroup of homemakers using 3 d diet recall, stepwise multiple regression analysis was used for selected nutrients to choose foods for inclusion in the FFQ. SUBJECTS: The FFQ was administered to a study population of 169 women representing the same number of families. RESULTS: The Wilcoxon test and Bland-Altman plots were used to compare the FFQ results with the mean 3 d diet recall results. A high level of concordance was found, validating the FFQ. In this population, the mean consumption of SFA was above recommendations and the intakes of vitamin D, folic acid, Ca, Fe and K were deficient. CONCLUSIONS: The availability of diet assessment instruments designed for specific populations and cultures is of immense value to researchers and policy makers. The study describes a simple and effective method to develop and validate an FFQ for a given population of interest.

Proposal for a Breakfast Quality Index (BQI) for children and adolescents.

OBJECTIVE: To propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area. DESIGN: Randomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Student's t test and ANOVA. SETTING: Schools in Granada and Balearic Islands (Spain). SUBJECTS: All schoolchildren (n 4332) aged 8-17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex. RESULTS: Breakfast was not consumed by 6·5 % of participants. BQI score was highest for children aged 7-9 years and decreased with age (P = 0·001). Females scored higher in all age groups. The lowest score was in males aged 14-17 years and the highest in females aged 7-9 years (P = 0·006). CONCLUSIONS: The proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.

Mediterranean diet and bone mineral density in two age groups of women.

We hypothesized that adherence to the Mediterranean diet measured as a Mediterranean diet score (MDS) has a beneficial effect on bone mineral density (BMD). For the purposes of this study, a sample of healthy women from Southern Spain was chosen. Subjects were grouped into two major groups: a first group consisted of women of reproductive age (premenopausal, pre-M) and a second group consisted of postmenopausal women (pos-M). The consumption of vegetables and fruit was found to be significantly related to BMD in both groups of subjects studied. In the pre-M group, the lipid ratio was positively associated with BMD and in pos-M women nuts intake was also associated with BMD. After implementing the analysis of covariance analysis, significant linear trends between the MDS and BMD were observed in all subjects studied. Our results indicate that a varied diet based on Mediterranean diet patterns may be beneficial in the prevention of osteoporosis.

Levels of Bisphenol A and its analogs in nails, saliva, and urine of children: a case control study.

Introduction: A growing number of studies link the increase in overweight/obesity worldwide to exposure to certain environmental chemical pollutants that display obesogenic activity (obesogens). Since exposure to obesogens during the first stages of life has been shown to have a more intense and pronounced effect at lower doses, it is imperative to study their possible effects in childhood. The objective here was to study the association of Bisphenol A (BPA) and 11 BPA analogs in children, using three biological matrices (nails, saliva and urine), and overweight and obesity (n = 160). Methods: In this case-control study, 59 overweight/obese children and 101 controls were included. The measuring of Bisphenols in the matrices was carried out by ultra-high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UHPLC-MS/MS). Logistic regression was used to study the association between overweight/obesity and Bisphenol exposure. Results: The results suggested that BPF in nails is associated with overweight/ obesity in children (OR:4.87; p = 0.020). In saliva, however, the highest detected concentrations of BPAF presented an inverse association (OR: 0.06; p = 0.010) with overweight/obesity. No associations of statistical significance were detected between exposure to BPA or its other analogs and overweight/obesity in any of the biological matrices.

Presence of Parabens in Different Children Biological Matrices and Its Relationship with Body Mass Index.

Parabens have been accepted almost worldwide as preservatives by the cosmetic, food, and pharmaceutical industries. Since epidemiological evidence of the obesogenic activity of parabens is weak, the aim of this study was to investigate the association between parabens exposure and childhood obesity. Four parabens (methylparaben/MetPB, ethylparaben/EthPB, propylparaben/PropPB, and butylparaben/ButPB) were measured in 160 children's bodies between 6 and 12 years of age. Parabens measurements were performed with ultrahigh-performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). Logistic regression was used to evaluate risk factors for elevated body weight associated with paraben exposure. No significant relation was detected between children's body weight and the presence of parabens in the samples. This study confirmed the omnipresence of parabens in children's bodies. Our results could be a basis for future research about the effect of parabens on childhood body weight using nails as a biomarker due to the ease of its collection and its non-invasive character.

Assessing nutritional status of acute intermittent porphyria patients.

BACKGROUND: Acute intermittent porphyria (AIP) is a metabolic disease of haem synthesis, whose haem precursors may accumulate in the body. A well-balanced diet may prevent the symptoms, so that porphyric patients should be monitored closely during therapy for possible complications concerning any progression of acute porphyria. The aim was to evaluate the nutritional status of patients with AIP and to assess their compliance with nutritional recommendations, comparing the findings with a control group and assessing any possible nutritional deficiency. MATERIAL AND METHODS: Sixteen patients with AIP and a control group were evaluated by means of a lifestyle questionnaire, the Nutrition Screening Initiative checklist and a dietary questionnaire. The following diet quality indicators were calculated: animal and vegetal proteins, protein quality index, PUFA/SFA and MUFA + PUFA/SFA ratios, insoluble dietary fibre (DF)/total DF, soluble DF/total DF and insoluble DF/soluble DF ratios, thiamine, riboflavin and niacin density and the vitamin B6/protein ratio. STATISTICAL METHODS: Differences in continuous variables were compared using the unpaired Student's t-test and the chi-square test for nonparametric variables. The odds ratio (OR) of malnutrition was also used. RESULTS: Our patients showed a low intake of carbohydrates, a high lipid intake and very high protein intake, and accompanied by an inadequate intake of zinc, folic acid and tocopherol, increasing the risk of malnutrition for energy, Ca, Fe, Mg, K, folic acid and tocopherols. CONCLUSIONS: The patients with AIP studied individually show an increased risk of malnutrition and, given the potential increase of oxidative stress in patients with porphyria, it is recommended that they should increase their intake of carbohydrates, minerals and antioxidant nutrients.

Effects of genetic polymorphisms in body mass index according to dietary exposure to bisphenols and parabens.

A growing body of evidence supports that more than 900 single nucleotide polymorphisms (SNPs) and exposure to endocrine disrupting chemicals, such as bisphenols and parabens, are important contributors to the development of obesity. The aim of this study was to evaluate the way in which fat mass and obesity-associated gene (FTO) rs9939609 and leptin receptor (LEPR) rs9436303 variants contribute to variability in body mass index (BMI) according to estimated dietary exposure of bisphenols and parabens. This cross-sectional study included 101 Spanish participants (16-24 years). SNP genotyping assays were performed through quantitative PCRs (qPCRs) using Taqman® probes. Dietary exposure to bisphenols and parabens was calculated from food frequency questionnaire and chemical determination in food samples by ultra-high performance liquid chromatography-tandem mass spectrometry system. Linear regression models were conducted to address the association of genetic variants and BMI according to levels of bisphenols/parabens exposure. Risk G allele of LEPR rs9436303 was significantly positively associated with BMI (exp (ß) = 1.20, 95% CI: 1.04-1.38, p = 0.011). In participants highly exposed to bisphenols, the LEPR rs9436303 G allele was related to a significant increased BMI (exp (ß) = 1.27, 95% CI: 1.03-1.57, p = 0.024). A more relevant trend was observed with high exposure to parabens (exp (ß) = 1.33, 95% CI: 1.08-1.63, p = 0.009). We provide the first evidence that interaction between LEPR polymorphism and dietary intake of bisphenols and parabens may be responsible for an increased BMI, suggesting a potential effect in obesity. Moreover, we proposed LEPR rs9436303 as a genetic marker of susceptibility to excess weight induced by exposure.

Factors Associated with Exposure to Dietary Bisphenols in Adolescents.

Obesogenic endocrine-disrupting chemicals, such as bisphenol A (BPA) and its analogue bisphenol S (BPS), seem to play an important role in the development of obesity, although contradictory results have been reported. The aim of the present study was to conduct a gender analysis of the factors associated with exposure to dietary bisphenols in 585 Spanish adolescents. Dietary BPA and BPS exposure was assessed using a food frequency questionnaire. Foods and macronutrients accounting for more than 95% of energy intake were selected for analysis. Stepwise regression was used to estimate the foods that most contributed to dietary bisphenol exposure in the sample. Gender-related factors associated with greater dietary bisphenol exposure were evaluated using multivariate logistic regression models. Canned tuna was the main dietary source of BPA and BPS in both adolescent boys and girls. Overweight/obese girls showed a higher risk of high dietary exposure to BPA (odds ratio (OR): 3.38, 95% confidence interval (CI): 1.25-9.07) and total bisphenols (OR: 2.81, 95% CI: 1.03-7.67) in comparison with girls with a BMI lower than 25 kg/m2. Present results indicate a positive association of dietary exposure to both total bisphenols and BPA with being overweight/obese in adolescent girls.

Endocrine Disruptors in Food: Impact on Gut Microbiota and Metabolic Diseases.

Endocrine disruptors (EDCs) have been associated with the increased incidence of metabolic disorders. In this work, we conducted a systematic review of the literature in order to identify the current knowledge of the interactions between EDCs in food, the gut microbiota, and metabolic disorders in order to shed light on this complex triad. Exposure to EDCs induces a series of changes including microbial dysbiosis and the induction of xenobiotic pathways and associated genes, enzymes, and metabolites involved in EDC metabolism. The products and by-products released following the microbial metabolism of EDCs can be taken up by the host; therefore, changes in the composition of the microbiota and in the production of microbial metabolites could have a major impact on host metabolism and the development of diseases. The remediation of EDC-induced changes in the gut microbiota might represent an alternative course for the treatment and prevention of metabolic diseases.

Proposal of a Mediterranean diet index for pregnant women.

Numerous studies have addressed the nutritional needs of pregnant women. The nutritional status of the woman before and during gestation affects the growth of the fetus and the course of the pregnancy and influences the risk of obesity for mother and infant. The aim of this study was to propose a diet quality index for pregnancy based on a Mediterranean-type diet (MDS-P), evaluating the diet of a group of pregnant women by applying the Mediterranean Diet Score (MDS) and evaluating their intake of micronutrients required in optimal amounts during pregnancy, such as Fe, folic acid and Ca. The data used to construct this index (MDS-P) were gathered by means of a FFQ specifically designed for pregnant women. The mean MDS of this group, was 4.31 (sd 1.32), considered to represent satisfactory compliance with the Mediterranean diet (range 0-8). The mean MDS-P (range 0-11), which also takes account of dietary intake or supplements of folic acid, Fe and Ca was 7.53 (sd 1.44), indicating a compliance of around 70 %. The present study findings suggest that the MDS-P, which evaluates the adequacy of folic acid, Fe and Ca as well as compliance with the Mediterranean diet, may represent a valid tool for the specific assessment of the diet of pregnant women living in countries in the Mediterranean area. Further studies are required to complete the validation process.

Bisphenol A Analogues in Food and Their Hormonal and Obesogenic Effects: A Review.

Bisphenol A (BPA) is the most well-known compound from the bisphenol family. As BPA has recently come under pressure, it is being replaced by compounds very similar in structure, but data on the occurrence of these BPA analogues in food and human matrices are limited. The main objective of this work was to investigate human exposure to BPA and analogues and the associated health effects. We performed a literature review of the available research made in humans, in in vivo and in vitro tests. The findings support the idea that exposure to BPA analogues may have an impact on human health, especially in terms of obesity and other adverse health effects in children.

Folate intake in a Swedish adult population: Food sources and predictive factors.

Introduction: Folate plays an important role in cell metabolism, but international studies show that intake is currently below recommendations, especially among women. The study objective was to identify folate food sources by food group, gender, and age group, and to identify factors influencing folate intake, based on food consumption data for Swedish adults in the 2010-11 Riksmaten study. Methods: The sample included a representative Swedish population aged 18-80 years (n = 1657; 56.3% female). Food and nutrient intakes were estimated from self-reported food records during 4 consecutive days. Food consumption was categorized into 26 food groups. Stepwise regression was used to analyze food groups as folate sources for participants. Factors predicting the highest folate intake (third tertile) were determined by logistic regression analysis. Results: Vegetables and pulses represented the most important folate source for all age groups and both genders, especially in women aged 45-64 years (49.7% of total folate intake). The next folate source in importance was dairy products for the youngest group (18-30 years), bread for men, and fruit and berries for women. The likelihood of being in the highest tertile of folate intake (odds ratio = 1.69, 95% confidence interval 1.354-2.104) was higher for men. Influencing factors for folate intake in the highest tertile were low body mass index and high educational level in the men, and high educational level, vegetarian diet, organic product consumption, non-smoking, and alcohol consumption within recommendations in the women. Conclusion: This study describes the folate intake per food group of Swedish adults according to the 2010-11 Riksmaten survey, identifying vegetables and pulses as the most important source. Data obtained on factors related to folate consumption may be useful for the development of specific nutrition education programs to increase the intake of this vitamin in high-risk groups.

Association of bisphenol A exposure with dietary quality indices in Spanish schoolchildren.

Young children, whose growth and development are highly dependent on the endocrine system, are particularly vulnerable to endocrine disruptor exposure. The main objectives of this study were to measure BPA migration levels from cans, fruit juice bottles/packs, and microwave containers used for food/drinks consumed by a sample of 6- to 8-year old schoolchildren in Spain and to estimate the relationship between their resulting BPA exposure and diet quality index scores (Mediterranean Diet Score and Breakfast Quality Index). The mean BPA concentration was 11.8 ng/mL for vegetable cans, 22.1 ng/mL for pulse cans, 3.6 ng/mL for juice bottles/packs, and 1.2 ng/mL for microwave containers. Results revealed a significant association between the Mediterranean Diet Score and low BPA exposure of the children. BPA exposure below the median level was significantly associated with a higher score in both the first-grade (P = 0.030) and second-grade (p = 0.0001) groups. However, no association was found between BPA exposure and the Breakfast Quality Index. In conclusion, children with a stronger adherence to a Mediterranean-like diet appear to be less exposed to BPA migrating from food packaging and microwave containers. Further research is warranted on the inadvertent exposure of children to endocrinedisrupting chemicals from these sources.

SCHOOL DIETARY HABITS AND INCIDENCE OF DENTAL CARIES.

INTRODUCTION: healthy dietary habits are considered to improve oral health and tooth quality. Caries treatment comprises tooth restoration with dental composites and sealants, almost all (> 90%) of which contain bisphenol A (BPA). Study hypotheses were: a) breakfast and oral hygiene habits are important factors in dental caries development; and b) dental caries treatment with epoxy-resins entails a risk of oral exposure to monomers migrating from the polymeric material. We evaluated caries in the teeth of a Spanish school population and determined the percentage treated with dental composites. OBJECTIVE: to relate consumption of breakfast components and oral hygiene habits to dental caries and determine the presence of sealants/composites as potential sources of BPA exposure. METHODS: subjects: 582 schoolchildren from Granada city (Southern Spain) aged 7 yrs; mean (SD) of 7.55 (0.64) yrs. RESULTS: caries was detected in 21.7% of their teeth. Mean breakfast quality index (BQI) score, based on nutritional questionnaires, was 5.18 (1.29). Breakfast with foods rich in simple sugars representing > 5% of total daily energy was consumed by 24% of the population and was significantly associated with caries frequency in binary logistic regression analysis. Biscuit consumption was reported by 35.8% and significantly associated with caries frequency. Breakfast intake of bakery products/ cereals and of dairy products showed a significant inverse association with caries frequency. No significant relationship was observed between caries and BQI score or oral hygiene factors. CONCLUSION: further research is required to elucidate the role of diet in caries and the associated risk of exposure to estrogenic xenobiotics such as BPA.

Introducción: los hábitos alimentarios saludables influyen sobre la salud oral. El tratamiento de la caries comprende la restauración dental con selladores y composites dentales, la mayoría con bisfenol A (BPA). Hipótesis: a) el desayuno y hábitos de higiene oral son factores importantes en el desarrollo de caries; b) el tratamiento de la caries con epoxirresinas conlleva riesgo de exposición oral a monómeros plásticos. Objetivo: relacionar la ingesta del desayuno y los hábitos de higiene oral con la caries dental y determinar la presencia de selladores/composites como fuentes potenciales de exposición al BPA. Métodos: se analizaron 582 niños/as en edad escolar de Granada (sur de España) de 7 años de edad (7,55 [0,64] años). Se empleó un cuestionario de frecuencia de consumo de alimentos, 3 recordatorios de 24 h y variables de estilo de vida, incluyendo la higiene bucodental. La calidad del desayuno fue estimada con el Breakfast Quality Index (BQI). Resultados: se detectó un 21,7% de caries. El valor medio del BQI fue 5,18 (1,29). El 24% de la población realizó un desayuno con alimentos ricos en azúcares simples (> 5% de la energía total), asociado significativamente con la frecuencia de caries en el análisis de regresión logística. El 35,8% de los participantes tomaron galletas; asociado significativamente con la frecuencia de caries. La ingesta de productos de panadería, cereales y lácteos mostró una asociación inversamente significativa con la frecuencia de caries. Conclusión: se necesitan más investigaciones para aclarar el papel de la dieta en la caries y el riesgo de exposición a xenobióticos estrogénicos, como el BPA.

Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople.

BACKGROUND: Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. MATERIAL AND METHODS: A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. RESULTS: A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. CONCLUSIONS: These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk.