Mediterranean Diet Adherence and Health-Related Quality of Life during Pregnancy: Is the Mediterranean Diet Beneficial in Non-Mediterranean Countries?

This study aimed to examine the association of Mediterranean diet (MD) adherence and MD components with health-related quality of life (HRQoL) in pregnant women from Spain and Sweden. A total of 138 pregnant women from Spain (age: 32.9 ± 4.6 years old) and 302 pregnant women from Sweden (age: 31.3 ± 4.1 years old) were included. MD adherence was assessed with the Mediterranean food pattern (i.e., a MD index) at the 14-16th gestational weeks. HRQoL was assessed with the Spanish and Swedish versions of the 36-item Short-Form Health Survey (SF-36 and RAND-36, respectively) at the 14-16th and 34-37th gestational weeks. A greater MD adherence was associated with better physical functioning, bodily pain, vitality, emotional role, and mental health in cross-sectional associations (2nd trimester) in the Spanish sample (all p < 0.05). Furthermore, a greater MD adherence was associated with lower bodily pain in both Spanish and Swedish samples (both p < 0.05) in the 3rd trimester. The associations of MD adherence with pain seem to be explained by a greater intake of fiber, fish, fruits, nuts, and legumes (all p < 0.05). A greater MD adherence, driven by a higher intake of fiber, fish, fruits, nuts, and legumes, was associated with lower pain throughout pregnancy in both Mediterranean and non-Mediterranean populations.

Cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. The FLAMENCO Project / Análisis de coste-efectividad de un programa de ejercicio físico en mujeres perimenopáusicas. Proyecto FLAMENCO

OBJECTIVE: Adequate physical activity levels and a healthy lifestyle may prevent all kinds of non-communicable diseases, promote well-being and reduce health-care costs among perimenopausal women. This study assessed an exercise programme for perimenopausal women. METHOD: A total of 150 women (aged 45-64 years) not engaged in regular physical activity were randomly assigned to either a 16 week exercise intervention or to the control group. The study was conducted from the perspective of the National Health System. Health outcomes were quality-adjusted life years (QALYs), measured by the EuroQol-5D-5L questionnaire. The total direct costs of the programme were the costs of visits to primary care, specialty care, emergency, medicines, instructor cost and infrastructure cost. The results were expressed as the incremental cost-effectiveness ratio. Sensitivity analysis was undertaken to test the robustness of the analysis. RESULTS: Mean QALYs over 16 weeks were.228 in the control group and.230 in the intervention group (mean difference: .002; 95% confidence interval [95%CI]: -0.005 to 0.009). Improvements from baseline were greater in the intervention group in all dimensions of the EuroQol-5D-5L but not statistically significant. The total costs at the end of the intervention were 160.38 € in the control group and 167.80 € in the intervention group (mean difference: 7.42 €; 95%CI: -47 to 62). The exercise programme had an incremental cost-effectiveness ratio of 4,686 €/QALY. CONCLUSIONS: The programme could be considered cost-effective, although the overall difference in health benefits and costs was very modest. Longer term follow-up is needed

OBJETIVO: El ejercicio físico puede promover el bienestar y reducir los costes de atención médica en las mujeres perimenopáusicas. Este estudio evalúa un programa de ejercicio físico en mujeres perimenopáusicas. MÉTODO: Un total de 150 mujeres (de edades comprendidas entre 45 y 64 años) fueron asignadas aleatoriamente al grupo de intervención o al grupo de control. El estudio ha tenido una duración de 16 semanas. Los resultados en salud se han medido en años de vida ajustados por calidad (AVAC) mediante el cuestionario EuroQol-5D-5L. Se ha considerado el total de costes directos del programa, integrado por los costes de las visitas en atención primaria, atención especializada y urgencias, medicamentos, coste del monitor y coste de las instalaciones. Los resultados se han expresado como ratio coste-efectividad incremental. La robustez del modelo se ha contrastado con un análisis de sensibilidad. RESULTADOS: Al final de la intervención, los AVAC fueron 0,228 en el grupo de control y 0,230 en el grupo de intervención (diferencia media: 0,002; intervalo de confianza del 95% [IC95%]: -0,005 a 0,009). La mejoría fue mayor en el grupo de intervención en todas las dimensiones del EuroQol-5D-5L, pero sin significación estadística. Los costes totales al finalizar la intervención han sido de 160,38 € en el grupo de control y 167,80 € en el de intervención (diferencia media: 7,42 €; IC95%: -47 a 62). El programa de ejercicio físico ha tenido una ratio coste-efectividad incremental de 4686 €/AVAC. CONCLUSIÓN: El programa debe considerarse coste-efectivo, aunque la diferencia en resultados de salud y costes ha sido muy moderada. Se necesita un seguimiento a más largo plazo

Efecto del sexo y la actividad física doméstica en el fenotipo obeso metabólicamente sano y el obeso con alteraciones metabólicas. Estudio HERMEX / The role of sex and domestic physical activity on the metabolically healthy and unhealthy obesity. The HERMEX Study

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Ansiedad, depresión y su relación con el dolor y la gravedad de la fibromialgia / Anxiety, depression and fibromyalgia pain and severity

El presente estudio analiza la relación entre ansiedad y depresión con el dolor y la gravedad de la fibromialgia en 127 mujeres de 51,9±7 años. Los niveles de ansiedad y depresión fueron estimados mediante la “Escala hospitalaria de ansiedad y depresión” (HADS) y la gravedad de la enfermedad a través del “Cuestionario de impacto de la fibromialgia” (FIQ). El dolor se valoró mediante el número de puntos de dolor, el umbral de sensibilidad al dolor por algómetro y las dimensiones de dolor del FIQ y de la “Encuesta de salud, versión breve-36” (SF36). La dimensión SF36-dolor fue mayor para ansiedad grave comparada con ligera o moderada y para niveles de depresión grave frente a bajos. FIQ-dolor fue mayor para ansiedad grave en comparación con ligera. Valores de HADS-ansiedad o HADS-depresión superiores a 8 estuvieron asociados con un incremento del riesgo de padecer fibromialgia grave. Altos niveles de depresión y ansiedad incrementan la percepción del dolor en enfermas con fibromialgia y suponen un mayor riesgo de padecer fibromialgia grave, por lo que deberían detectarse y tratarse apropiadamente

We aimed to analyze the relationship of anxiety and depression with fibromyalgia pain and severity. The study comprised 127 women aged 51.9±7 years. Anxiety and depression was assessed by means of the Hospital Anxiety and Depression Scale (HADS) and fibromyalgia severity with the Fibromyalgia Impact Questionnaire (FIQ). Pain was assessed by four indicators: tenderness (tender points count [TPC] and algometer score) and the Short-Form-36 Health Survey (SF36)-pain and FIQ-pain subscales. Perceived pain, as measured by SF36-pain, was worse in the severe anxiety-group compared with the low and mild anxiety-groups and in the severe compared with the low depression-group. Perceived pain, as measured by FIQ, was higher for the severe compared to the low anxiety-group. Tenderness, as measured by algometer score and TPC, did not differ among anxiety and depression categories. HADS-anxiety scores ≥8 were associated with an increased odds ratio of severe fibromyalgia. HADS-depression ≥ 8 were associated with severe fibromyalgia. Overall, women with higher levels of anxiety and depression present increased pain perception and risk of severe fibromyalgia. Consequently, anxiety and depression should be detected and treated properly

Análisis de la composición corporal en mujeres con fibromialgia / Analysis of the body composition of Spanish women with fibromyalgia

Objetivos. Caracterizar el perfil antropométrico y de composición corporal de mujeres con fibromialgia (FM) del sur de España y compararlo con otros estudios nacionales e internacionales de similares características, así como con valores normativos de mujeres españolas. Materiales y métodos. Se ha analizado la composición corporal de 104 mujeres diagnosticadas de FM mediante un bioimpedianciómetro de 8 electrodos. La fiabilidad de la medida fue estudiada en una submuestra seleccionada aleatoriamente (n=28). El estudio de fiabilidad mostró un error sistemático test vs re-test cercano a cero en la mayoría de los parámetros estudiados. Resultados. Las mujeres con FM estudiadas tuvieron un peso promedio de 71,3±13,4kg, 158,1±6cm de altura, 28,6±5,1kg/m2 de índice de masa corporal, 38,6±7,6% de porcentaje graso, 31,6±3,8l de agua corporal total y 23,4±3,0kg de masa muscular. En general, no se observan diferencias importantes en peso e índice de masa corporal, tanto entre las mujeres con FM estudiadas y enfermas procedentes de otros estudios nacionales o europeos, como en comparación con los valores de referencia andaluces o nacionales. Sin embargo, la prevalencia de obesidad en el grupo de mujeres con FM fue del 33,7%, un valor superior a la prevalencia de obesidad nacional en mujeres de igual rango de edad (i.e. 26,4%). Conclusiones. Los resultados sugieren que la obesidad es una condición frecuente entre mujeres con FM, siendo su prevalencia sustancialmente superior a los valores normativos nacionales. Este estudio presenta información detallada sobre la composición corporal de mujeres con FM (AU)

Objectives. To describe the anthropometric profile and body composition of women from Southern Spain diagnosed with fibromyalgia (FM) and to compare the observed values with values from other studies conducted on FM patients and with national reference values. Materials and methods. The body composition of 104 women diagnosed with FM was assessed using an eight-electrode impedance meter. The reliability of the body composition measurement was tested in a randomly selected sub-sample (n=28). The reliability study showed a test-retest systematic error close to zero in most of the parameters studied. Results. The women with FM who were studied had a mean weight of 71.3±13.4 kg, height of 158±6 cm, body mass index of 28.6±5.1 kg/m2, body fat mass of 38.6±7.6%, total body water of 31.6±3.8 l and muscle mass of 23.4±3.0 kg. In general, there were no substantial differences in weight and body mass index between women with FM and those analyzed in other Spanish and European studies involving FM patients, nor when they were compared with regional or national reference values. However, the prevalence of obesity in the women with FM under study was 33.7%, a higher figure than that from the national reference data for obesity in similarly aged women (i.e. 26,4%). Conclusions. The results suggest that obesity is a common condition in women diagnosed with FM, its prevalence in this population being higher than the national reference values. This study provides detailed information about the body composition characteristics of women with FM (AU)