Patrones de desayuno en estudiantes universitarios de España, Túnez y Estados Unidos. Factores antropométricos, sociodemográficos y de estilo de vida / Breakfast patterns in university students of Spain, Tunisia, and The United States of America. Anthropometric, sociodemographic and lifestyle factors

La mayoría de los estudios apoyan la tesis de que el desayuno es la comida más importante del día. Un desayuno adecuado contribuye a lograr un patrón dietético global saludable y a mejorar la calidad de la dieta. El objetivo de este estudio fue determinar los principales patrones de desayuno en tres poblaciones universitarias de España, Túnez y Estados Unidos, analizar sus semejanzas y diferencias y estudiar la influencia de factores antropométricos, sociodemográficos y de estilo de vida en la adherencia a cada patrón. Se realizó un estudio transversal con datos de 730 estudiantes matriculados en las Universidades de Castilla-La Mancha, Cartago e Internacional de Florida en 2013. El consumo de alimentos se obtuvo mediante dos recordatorios de 24 horas, no consecutivos, uno de ellos en fin de semana. Los patrones se identificaron mediante análisis factorial exploratorio. La adherencia de los estudiantes a cada patrón se evaluó usando las puntuaciones factoriales. Se obtuvieron cuatro patrones para cada país. El principal patrón de los universitarios españoles incluyó pan, tomate, sal y aceite de oliva (varianza explicada: 20,85%); el principal de los tunecinos contenía pan, mermelada, nata y mantequilla (varianza explicada: 12,73%) y el principal de los americanos incluyó huevos, leche entera y azúcares (varianza explicada: 10,77%). Género, peso, IMC o comer fuera de casa fueron factores que influyeron en la adherencia a diferentes patrones. El estudio mostró la coexistencia de patrones tradicionales con otros occidentalizados y modelos transicionales intermedios. No se determinó un patrón generalizable asociado a mejores resultados del IMC(AU)

Most studies support the conclusion that breakfast is the most important meal of the day. An adequate breakfast contributes to achieving a healthy global dietary pattern and improving quality of diet. The objective of this study was to determine the main breakfast patterns of three university populations from Spain, Tunisia, and The United States of America, analyze their similarities and differences, and study the impact of anthropometric, sociodemographic and lifestyle factors on the adherence to each pattern. A cross-sectional study was developed with data from 730 students enrolled at the University of Castilla-La Mancha, University of Carthage, and Florida International University, during 2013. Food consumption data were obtained by means of two non-consecutive 24-hour recalls including one weekend day. Exploratory factor analysis was conducted to identify breakfast patterns. Factor scores were used to assess students' adherence to each pattern. Four breakfast patterns were obtained for each country. The main pattern of the Spanish students included bread, tomato, salt, and olive oil (explained variance: 20.85%); the main model of the Tunisians included bread, jam, cream and butter (explained variance: 12.73%); and the first pattern of the Americans was characterized by eggs, whole milk and sugars (explained variance: 10.77%). Gender, weight, BMI or eating out of home were factors that influenced the adherence to different patterns. Breakfast patterns obtained in this work showed the coexistence of traditional models with westernized and transitional ones. It was not determined a generalizable pattern associated with better BMI results(AU)

Food consumption in Tunisian university students and its association with sociodemographic characteristics and lifestyle behaviours.

OBJECTIVE: This study aimed to characterise food consumption among students at the University of Carthage (Tunisia), assessing quality of diet and main dietary patterns, and their association with potential conditioning factors. DESIGN: Cross-sectional study. Participants self-reported food consumption in two 24-h recalls and information about sociodemographic, anthropometric and lifestyle characteristics such as BMI, birthplace, physical activity, eating places or kitchen appliances. Mediterranean Diet Score (MDS) and the Nutrient Rich Foods (NRF) index (NRF9.3) were used to assess diet quality. Exploratory factor analysis was conducted to identify eating patterns. Linear regression models were used to test the association of dietary patterns with the diet quality markers. SETTING: Students at the University of Carthage, Tunisia. PARTICIPANTS: 132 students. RESULTS: Almost 96 % of participants need shifts towards healthier food. Four main food patterns were identified 'Traditional food', 'Transitional food', 'European breakfast' and 'Western food'. 'Traditional food' was the first dietary model, positively associated with MDS and NRF9.3. Women showed higher adherence to 'European breakfast' and higher quality of diet by NRF9.3. Students eating out of home showed higher adherence to 'Western food', those who never kept a regular schedule of meals consumed lower amount of vegetables and tubers, and sedentary or low active students had a higher intake of ready-to-eat products. CONCLUSIONS: Diet quality of the participating Tunisian students is inadequate, but traditional Mediterranean diet remains the main pattern in spite of the advanced transitional nutrition. Some lifestyle risk behaviours affecting quality of diet were identified in this work, which supports the youth's particular vulnerability.

Time trends in antibiotic consumption in the elderly: Ten-year follow-up of the Spanish National Health Survey and the European Health Interview Survey for Spain (2003-2014).

BACKGROUND: The purposes of this study were: firstly, to estimate time trends in the prevalence of prescription antibiotic consumption between 2003 and 2014; secondly, to identify the factors associated with the probability of consuming antibiotics during this period in elderly persons in Spain. METHODS: We analyzed data collected from the Spanish National Health Survey in 2003 (n = 21,650), 2006 (n = 29,478), and 2012 (n = 20,007) and from the European Health Interview Survey for Spain in 2009 (n = 22,188) and 2014 (n = 22,842). Antibiotic consumption was the dependent variable. We also analyzed sociodemographic features, self-perceived health status, lifestyle habits, comorbid diseases, and disabilities using logistic regression models. RESULTS: The prevalence of antibiotic consumption increased from 2003 to 2014 in both sexes. The variables that predicted antibiotic consumption (men; women) were secondary education (OR 1.38; OR 1.31), visits to a general practitioner (OR 2.05; OR 2.15), hospitalization (OR 1.91; OR 1.83), therapy with > 4 non-antibiotic drugs (OR 3.36; OR 5.84), instrumental activities of daily living (OR 1.50; OR 1.24), and activities of daily living (OR 1.39; OR 1.35). In contrast, age > 85 years was associated with low antibiotic consumption in both men (OR 0.81) and women (OR 0.88). CONCLUSIONS: The prevalence of antibiotic prescription has increased in Spain in the last decade. Our study identified several factors that appear to affect antibiotic consumption in elderly persons, with potential implications for healthcare providers.

Fiber Patterns in Young Adults Living in Different Environments (USA, Spain, and Tunisia). Anthropometric and Lifestyle Characteristics.

Benefits of dietary fiber go beyond its effect on chronic diseases associated with development. Consequently, the pattern of fiber intake has been considered an indicator for diet quality. Young adults are especially vulnerable to a food environment that drives an increase in chronic diseases linked to economic development. The aim of this work was to characterize patterns of fiber intake among university students. A cross-sectional study was conducted on a sample of 730 students enrolled at the University of Castilla-La Mancha (Spain), the University of Carthage (Tunisia), and Florida International University (USA). Mean age was 21.2. Food consumption was self-reported in two 24-h recalls. Mean dietary fiber intake was 17.8 g, not reaching the adequate intake. Contrary to expectations, American participants were the highest consumers (p < 0.001), and also exhibited the highest BMI. Cereals, legumes, vegetables and fruit were the main food sources of fiber. Fiber from appetizers, prepared and precooked meals, sauces, spices and condiments accounted for 16.7% in American participants, 7.4% in Spanish participants and 2.6% in Tunisian participants. Total fiber intake increased with energy intake but did not depend on smoking habits and physical activity in any country. It is essential to improve consumers' interpretation of guidelines on fiber intake.

Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis.

BACKGROUND: High prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents' functional disability. METHODS: A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data. RESULTS: The prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences. CONCLUSIONS: In line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.

Hábitos alimentarios y evaluación nutricional en una población universitaria tunecina / Food habits and nutritional assessment in a tunisian university population

Introducción: La nutrición y la salud tienen gran importancia a lo largo de la vida y, en particular, en la edad adulta, donde se encuadra la población productiva que sostiene la sociedad. Por ello es fundamental evaluar la calidad de su dieta y sus posibles factores condicionantes. Objetivos: Los objetivos del presente estudio fueron caracterizar los hábitos alimentarios y evaluar la calidad de la dieta de una población de estudiantes universitarios adultos de la Universidad Virtual de Túnez, país del Norte de África que se encuentra en transición nutricional. Métodos: Se desarrolló un estudio transversal con una muestra de 54 estudiantes de dicha Universidad. Los datos se recogieron mediante recordatorio de 24 horas autoadministrado y una encuesta sobre hábitos alimentarios considerando algunos factores socioeconómicos y demográficos que pueden condicionar la ingesta. El Índice de Alimentación Saludable y el Índice de Adherencia a la Dieta Mediterránea se usaron como indicadores de la calidad de la dieta.Resultados y discusión: Los resultados del estudio mostraron una dieta hipocalórica en dicha población. Un 18% de la energía total diaria la aportaron las proteínas y alrededor del 40% la aportaron los hidratos de carbono. Se encontró un alto consumo de azúcares simples, grasa saturada y colesterol. Aparte de los aceites y grasas, los alimentos cárnicos fueron la principal fuente de lípidos (19%), aportando el grupo del pescado sólo el 3%. Según el Índice de Alimentación Saludable más del 50% de los estudiantes tienen una dieta calificada como inadecuada y más del 40% tienen necesidad de cambios en su dieta. El estudio también mostró baja adherencia al patrón de dieta mediterráneo (AU)

Introduction: Nutrition and health are of great importance throughout life, in particular in adulthood due to active population is included among the adults. Therefore, it is essential to assess the quality of the diet and the possible conditioning factors. Objectives: The objectives of this study were to characterize food habits and assess the quality of the diet of university students from the Virtual University of Tunisia, a North African country in nutritional transition. Methods: This is a cross-sectional study performed with data collected from a sample of 54 students from this University. For each individual a questionnaire involving socio-economic and demographic data was self-reported. Food consumption was gathered by a 24 hours recall. The assessment of diet quality was conducted by Healthy Eating Index and Mediterranean Diet Score. Results and discussion: The study revealed that the diet of this population is hypocaloric. The percentage of total energy from proteins was 18% and the percentage of total energy from carbohydrates was about 40%. The diet was high in simple sugars, saturated fat and cholesterol. Apart from oils and fat, the main source of lipids had an animal origin from meat (19%), and the fish group only provided 3% of this macronutrient. According to Healthy Eating Index classification more than 50% of students scored "poor" and more than 40% "needs improvement" about the quality of their diet. The study also showed low adherence rates to the Mediterranean diet (AU)

[Food habits and nutritional assessment in a tunisian university population]. / Hábitos alimentarios y evaluación nutricional en una población universitaria tunecina.

INTRODUCTION: Nutrition and health are of great importance throughout life, in particular in adulthood due to active population is included among the adults. Therefore, it is essential to assess the quality of the diet and the possible conditioning factors. OBJECTIVES: The objectives of this study were to characterize food habits and assess the quality of the diet of university students from the Virtual University of Tunisia, a North African country in nutritional transition. METHODS: This is a cross-sectional study performed with data collected from a sample of 54 students from this University. For each individual a questionnaire involving socio-economic and demographic data was self-reported. Food consumption was gathered by a 24 hours recall. The assessment of diet quality was conducted by Healthy Eating Index and Mediterranean Diet Score. RESULTS AND DISCUSSION: The study revealed that the diet of this population is hypocaloric. The percentage of total energy from proteins was 18% and the percentage of total energy from carbohydrates was about 40%. The diet was high in simple sugars, saturated fat and cholesterol. Apart from oils and fat, the main source of lipids had an animal origin from meat (19%), and the fish group only provided 3% of this macronutrient. According to Healthy Eating Index classification more than 50% of students scored "poor" and more than 40% "needs improvement" about the quality of their diet. The study also showed low adherence rates to the Mediterranean diet.

Introducción: La nutrición y la salud tienen gran importancia a lo largo de la vida y, en particular, en la edad adulta, donde se encuadra la población productiva que sostiene la sociedad. Por ello es fundamental evaluar la calidad de su dieta y sus posibles factores condicionantes. Objetivos: Los objetivos del presente estudio fueron caracterizar los hábitos alimentarios y evaluar la calidad de la dieta de una población de estudiantes universitarios adultos de la Universidad Virtual de Túnez, país del Norte de África que se encuentra en transición nutricional. Métodos: Se desarrolló un estudio transversal con una muestra de 54 estudiantes de dicha Universidad. Los datos se recogieron mediante recordatorio de 24 horas autoadministrado y una encuesta sobre hábitos alimentarios considerando algunos factores socioeconómicos y demográficos que pueden condicionar la ingesta. El Índice de Alimentación Saludable y el Índice de Adherencia a la Dieta Mediterránea se usaron como indicadores de la calidad de la dieta. Resultados y discusión: Los resultados del estudio mostraron una dieta hipocalórica en dicha población. Un 18% de la energía total diaria la aportaron las proteínas y alrededor del 40% la aportaron los hidratos de carbono. Se encontró un alto consumo de azúcares simples, grasa saturada y colesterol. Aparte de los aceites y grasas, los alimentos cárnicos fueron la principal fuente de lípidos (19%), aportando el grupo del pescado sólo el 3%. Según el Índice de Alimentación Saludable más del 50% de los estudiantes tienen una dieta calificada como inadecuada y más del 40% tienen necesidad de cambios en su dieta. El estudio también mostró baja adherencia al patrón de dieta mediterráneo.

Relationships between nutritional screening and functional impairment in institutionalized Spanish older people.

OBJECTIVES: An association between functional status and nutritional status has previously been demonstrated and the value of the Mini Nutritional Assessment (MNA) as an indicator of functional status has been investigated. However, experience in nursing homes is still limited. The objectives of this survey were to study the relationships between functional impairment as measured by the Barthel Index (BI) and broad nutritional assessment categories as measured by the MNA. STUDY DESIGN: Cross-sectional study developed with data collected from 895 residents in 34 nursing homes all over the province of Albacete (Spain). MAIN OUTCOME MEASURES: Nutritional and functional statuses were assessed using the MNA and the BI, respectively. Correlations between MNA and BI were evaluated. Analyses of BI against the MNA were utilized to obtain cut-off points for three broad categories of the MNA, "well", "at risk" and "malnourished". Multiple logistic regression analyses were used to assess the association of the MNA items with the BI. RESULTS: MNA and BI were significantly correlated. The BI cut-off point that best determined malnourished versus well or at risk was 40.5. The BI cut-off point that best determined well versus malnourished or at risk was 85.5. The BI was positively associated with the following MNA items: mobility, mode of feeding, self view of health status and mid-arm circumference. CONCLUSIONS: Both tests, MNA and BI, are positively associated. The scores of BI can help determine who may be at risk of poor nutrition.

Adherence to Mediterranean diet in a Spanish university population.

The aim of this work was to characterize food habits of Spanish University students and to assess the quality of their diet and some possible determinant factors according to Mediterranean food pattern among other indices. Two hundred eighty-four enrolled students during the academic year 2012-2013 participated in this survey. For each individual a questionnaire involving anthropometric measurements, types of housing, smoking habits and levels of physical activity were self-reported. Food consumption was gathered by two nonconsecutive 24 hour recalls including one weekend day. BMI within the normal range was showed by 72.5% of students and 75% of the sample reflected a sedentary lifestyle or low physical activity. The percentage of total energy from each macronutrient was approximately 17% proteins, 40% carbohydrates and 40% lipids. The ratio of polyunsaturated to monounsaturated fat only reached 0.32. Cholesterol consumption in men exceeded the intake in women by 70 mg/day but nutritional objectives were exceeded in both genders. The main source of protein had an animal origin from meat (38.1%), followed by cereals (19.4%) and dairy products (15.6%). The assessment of diet quality conducted by Healthy Eating Index (HEI) and Mediterranean Diet Score (MDS) revealed a low-intermediate score in both (51.2 ± 12.8 and 4.0 ± 1.5, respectively). The main deviations from Mediterranean pattern were a low intake of vegetables and fruit and a high consumption of meat and dairy products. According to HEI classification, 96.1% of subjects scored "poor" or "needs improvement" about the quality of their diet and only 5.3% of students achieved a high adherence to Mediterranean diet. It is necessary to foster changes toward a healthier diet pattern according to cultural context in this population for preventing cardiovascular diseases, type 2 diabetes and insulin resistance.

[Food habits and nutritional assessment in a university population]. / Hábitos alimentarios y evaluación nutricional en una población universitaria.

INTRODUCTION: The university students are in critical period for the development of life styles which are very important for their future health. The eating behaviour of other students, the alcohol consumption, their economic situation and the ability of cooking make them change their dietary habits. In Spain there are a few studies on the quality of the diet in this population group. Most of them show Spanish students diet does not follow an adequate Mediterranean dietary pattern. OBJECTIVES: To describe the dietary habits of a population of university students and to assess the quality of their diet. METHODS: Cross sectional study conducted on a sample of 80 students from the Faculty of Nursing of Albacete (University of Castilla-La Mancha). Nine 24-hours follow-ups questionnaires were self-administered in three different seasons. The quality of the diet was assessed by the IAS and the MDS2. In all tests a level of significance p < 0.05 was considered. RESULTS AND DISCUSSION: Students diet is slightly low in calories. The contribution of the macronutrients to the total daily energy intake showed a diet high in protein (17%), lacking in carbohydrates (40%) and high in saturated fat and cholesterol. The consumption of simple sugars is almost the double of the recommended amount. Meat products are the main source of fat while fish accounts for only 3,1%. The intake of meat and dairy products is much higher than the one of other Mediterranean university students. More than 91% of the students need "diet changes" in order to acquire healthier dietary patterns. Adherence to the Mediterranean diet was only 53%.

Introducción: Los estudiantes universitarios se encuentran en un periodo crítico para el desarrollo de estilos de vida que tienen mucha importancia en su futura salud, ya que la influencia en el comportamiento alimentario de los compañeros, el consumo de alcohol, su situación económica y la habilidad para cocinar hacen que cambien sus hábitos de alimentación. Los pocos estudios en España sobre calidad de la dieta en este grupo de población reflejan mayoritariamente un inadecuado seguimiento del patrón mediterráneo. Objetivos: Caracterizar los hábitos alimentarios en una población de estudiantes universitarios y evaluar la calidad de su dieta. Métodos: Estudio transversal de una muestra de 80 estudiantes de la Facultad de Enfermería de Albacete (Universidad de Castilla-La Mancha). Los datos se recogieron mediante 9 recordatorios de 24 horas autoadministrados en tres periodos estacionales. El IAS y el MDS2 han sido usados como indicadores de la calidad de la dieta. En todas las pruebas el nivel de significación utilizado fue de 0,05. Resultados y discusión: La dieta de los estudiantes es ligeramente hipocalórica. La contribución de los macronutrientes a la energía total diaria la definen como hiperproteica (17%), pobre en hidratos de carbono, alrededor del 40%, casi duplica las recomendaciones de azúcares simples y es alta en grasa saturada y colesterol. La principal fuente de grasa son los alimentos cárnicos, mientras que el grupo del pescado sólo representa el 3,1%. La ingesta de cárnicos y lácteos supera ampliamente a la de poblaciones universitarias en otros países mediterráneos europeos. Más del 91% de los estudiantes se encuentra en una situación de «necesidad de cambios en la dieta¼ hacia patrones más saludables. La adherencia a la dieta mediterránea fue sólo del 53%.

Hábitos alimentarios y evaluación nutricional en una población universitaria / Food habits and nutritional assessment in a university population

Introducción: Los estudiantes universitarios se encuentran en un periodo crítico para el desarrollo de estilos de vida que tienen mucha importancia en su futura salud, ya que la influencia en el comportamiento alimentario de los compañeros, el consumo de alcohol, su situación económica y la habilidad para cocinar hacen que cambien sus hábitos de alimentación. Los pocos estudios en España sobre calidad de la dieta en este grupo de población reflejan mayoritariamente un inadecuado seguimiento del patrón mediterráneo. Objetivos: Caracterizar los hábitos alimentarios en una población de estudiantes universitarios y evaluar la calidad de su dieta. Métodos: Estudio transversal de una muestra de 80 estudiantes de la Facultad de Enfermería de Albacete (Universidad de Castilla-La Mancha). Los datos se recogieron mediante 9 recordatorios de 24 horas autoadministrados en tres periodos estacionales. El IAS y el MDS2 han sido usados como indicadores de la calidad de la dieta. En todas las pruebas el nivel de significación utilizado fue de 0,05. Resultados y discusión: La dieta de los estudiantes es ligeramente hipocalórica. La contribución de los macronutrientes a la energía total diaria la definen como hiperproteica (17%), pobre en hidratos de carbono, alrededor del 40%, casi duplica las recomendaciones de azúcares simples y es alta en grasa saturada y colesterol. La principal fuente de grasa son los alimentos cárnicos, mientras que el grupo del pescado sólo representa el 3,1%. La ingesta de cárnicos y lácteos supera ampliamente a la de poblaciones universitarias en otros países mediterráneos europeos. Más del 91% de los estudiantes se encuentra en una situación de "necesidad de cambios en la dieta" hacia patrones más saludables. La adherencia a la dieta mediterránea fue sólo del 53% (AU)

Introduction: The university students are in critical period for the development of life styles which are very important for their future health. The eating behaviour of other students, the alcohol consumption, their economic situation and the ability of cooking make them change their dietary habits. In Spain there are a few studies on the quality of the diet in this population group. Most of them show Spanish students' diet does not follow an adequate Mediterranean dietary pattern. Objectives: To describe the dietary habits of a population of university students and to assess the quality of their diet. Methods: Cross sectional study conducted on a sample of 80 students from the Faculty of Nursing of Albacete (University of Castilla-La Mancha). Nine 24-hours follow-ups questionnaires were self-administered in three different seasons. The quality of the diet was assessed by the IAS and the MDS2. In all tests a level of significance p < 0.05 was considered. Results and discussion: Students' diet is slightly low in calories. The contribution of the macronutrients to the total daily energy intake showed a diet high in protein (17%), lacking in carbohydrates (40%) and high in saturated fat and cholesterol. The consumption of simple sugars is almost the double of the recommended amount. Meat products are the main source of fat while fish accounts for only 3,1%. The intake of meat and dairy products is much higher than the one of other Mediterranean university students. More than 91% of the students need "diet changes" in order to acquire healthier dietary patterns. Adherence to the Mediterranean diet was only 53% (AU)