Association Among Polyphenol Intake, Uric Acid, and Hyperuricemia: A Cross-Sectional Analysis in a Population at High Cardiovascular Risk.

Background Dietary polyphenol intake has been associated with a decreased risk of hyperuricemia, but most of this knowledge comes from preclinical studies. The aim of the present study was to assess the association of the intake of different classes of polyphenols with serum uric acid and hyperuricemia. Methods and Results This cross-sectional analysis involved baseline data of 6332 participants. Food polyphenol content was estimated by a validated semiquantitative food frequency questionnaire and from the Phenol-Explorer database. Multivariable-adjusted linear regression models with serum uric acid (milligrams per deciliter) as the outcome and polyphenol intake (quintiles) as the main independent variable were fitted. Cox regression models with constant follow-up time (t=1) were performed to estimate the prevalence ratios (PRs) of hyperuricemia (≥7 mg/dL in men and ≥6 mg/dL in women). An inverse association between the intake of the phenolic acid class (ß coefficient, -0.17 mg/dL for quintile 5 versus quintile 1 [95% CI, -0.27 to -0.06]) and hydroxycinnamic acids (ß coefficient, -0.19 [95% CI, -0.3 to -0.09]), alkylmethoxyphenols (ß coefficient, -0.2 [95% CI, -0.31 to -0.1]), and methoxyphenols (ß coefficient, -0.24 [95% CI, -0.34 to -0.13]) subclasses with serum uric acid levels and hyperuricemia (PR, 0.82 [95% CI, 0.71-0.95]; PR, 0.82 [95% CI, 0.71-0.95]; PR, 0.80 [95% CI, 0.70-0.92]; and PR, 0.79 [95% CI, 0.69-0.91]; respectively) was found. The intake of hydroxybenzoic acids was directly and significantly associated with mean serum uric acid levels (ß coefficient, 0.14 for quintile 5 versus quintile 1 [95% CI, 0.02-0.26]) but not with hyperuricemia. Conclusions In individuals with metabolic syndrome, a higher intake of some polyphenol subclasses (hydroxycinnamic acids, alkylmethoxyphenol, and methoxyphenol) was inversely associated with serum uric acid levels and hyperuricemia. Nevertheless, our findings warrant further research.

Association between the Prime Diet Quality Score and depressive symptoms in a Mediterranean population with metabolic syndrome. Cross-sectional and 2-year follow-up assessment from PREDIMED-PLUS study.

The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (ß (95 %) CI = -0·67 z-score (-1·17, -0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.

Association between coffee consumption and total dietary caffeine intake with cognitive functioning: cross-sectional assessment in an elderly Mediterranean population.

PURPOSE: Coffee is rich in compounds such as polyphenols, caffeine, diterpenes, melanoidins and trigonelline, which can stimulate brain activity. Therefore, the possible association of coffee consumption with cognition is of considerable research interest. In this paper, we assess the association of coffee consumption and total dietary caffeine intake with the risk of poor cognitive functioning in a population of elderly overweight/obese adults with metabolic syndrome (MetS). METHODS: PREDIMED-plus study participants who completed the Mini-Mental State Examination test (MMSE) (n = 6427; mean age = 65 ± 5 years) or a battery of neuropsychological tests were included in this cross-sectional analysis. Coffee consumption and total dietary caffeine intake were assessed at baseline using a food frequency questionnaire. Logistic regression models were fitted to evaluate the association between total, caffeinated and decaffeinated coffee consumption or total dietary caffeine intake and cognitive impairment. RESULTS: Total coffee consumers and caffeinated coffee consumers had better cognitive functioning than non-consumers when measured by the MMSE and after adjusting for potential confounders (OR 0.63; 95% CI 0.44-0.90 and OR 0.56; 95% CI 0.38-0.83, respectively). Results were similar when cognitive performance was measured using the Clock Drawing Test (CDT) and Trail Making Test B (TMT-B). These associations were not observed for decaffeinated coffee consumption. Participants in the highest tertile of total dietary caffeine intake had lower odds of poor cognitive functioning than those in the reference tertile when screened by the MMSE (OR 0.64; 95% CI 0.47-0.87) or other neurophysiological tests evaluating a variety of cognitive domains (i.e., CDT and TMT-A). CONCLUSIONS: Coffee consumption and total dietary caffeine intake were associated with better cognitive functioning as measured by various neuropsychological tests in a Mediterranean cohort of elderly individuals with MetS. TRIAL REGISTRATION: ISRCTN89898870. Registration date: July 24, 2014.

[Reasons for therapy non-compliance in older patients taking multiple medication]. / Motivos de incumplimiento terapéutico en pacientes mayores polimedicados, un estudio mediante grupos focales.

OBJECTIVE: To determine the prevalence of therapy non-compliance (TN) and the reasons for it in patients > or =65 taking multiple medication. DESIGN: Quantitative stage: TN prevalence by means of Morisky-Green test. Qualitative stage: 3 focus groups (FG). October 2005 to January 2006. SETTING: Primary care centre in Catalonia, Spain. PARTICIPANTS: Persons > or =65 years old taking 3 or more medicines. A total of 208 tests were administered at random and non-compliers were distributed by thumb into three FG. MEASUREMENTS AND MAIN RESULTS: Quantitative stage. Collection of variables: non-complier, gender, number of medicines, and age. SPSS analysis. Qualitative stage. Data collection through FG and analysis of content: text transcription and classification by theme and sub-theme lines. NC prevalence of 47.6%. In the consultation we found reasons relating to the doctor, the doctor-patient relationship and the context. At pharmacies, pharmacists acted as regulators of prescriptions. At home, patients' beliefs, life-style and the characteristics of the medicine affected compliance. Patients wanted to be sure that doctors understood their chronic medication and would guarantee there would be no interactions. They wanted pharmacists to back this guarantee up. They read the instructions leaflet and were frightened by the section on side-effects. CONCLUSIONS: Prescriptions can become trivial for doctors and extremely important for patients. We must understand reasons for NC and incorporate actions-recommendations to improve compliance, both in day-to-day practice and in the centre's organisation.

Motivos de incumplimiento terapéutico en pacientes mayores polimedicados, un estudio mediante grupos focales / Reasons for therapy non-compliance in older patients taking multiple medication

Objetivo. Determinar la prevalencia de incumplimiento terapéutico y sus motivos en pacientes de 65 años o mayores y polimedicados. Diseño. Fase cuantitativa: prevalencia de incumplimiento terapéutico mediante test de Morisky-Green. Fase cualitativa: 3 grupos focales. Desde octubre de 2005 a enero de 2006. Emplazamiento. Un centro de atención primaria de Cataluña. Participantes. Sujetos de 65 años o mayores que tomaban 3 o más fármacos. Se aplicaron aleatoriamente 208 tests y se distribuyó de forma facultativa a los incumplidores en 3 grupos focales. Mediciones y resultados principales. Fase cuantitativa, recogida de variables: incumplidor, sexo, número de fármacos y edad. Análisis con SPSS. Fase cualitativa, recogida de datos mediante grupos focales y análisis del contenido: transcripción textual y clasificación en líneas temáticas y subtemáticas. La prevalencia de incumplimiento terapéutico fue del 47,6%. En la consulta se detectan motivos relacionados con el médico, la relación médico-paciente y el entorno. En la farmacia el farmacéutico actúa como modulador de la prescripción. En la casa influyen creencias del paciente, hábitos de vida y características del fármaco. El paciente quiere estar seguro de que el médico conoce su medicación crónica y le asegure la inexistencia de interacciones, busca que el farmacéutico se la corrobore, lee el prospecto y se asusta con el apartado de efectos secundarios. Conclusiones. La prescripción puede llegar a ser trivial en el médico y trascendente para el paciente. Debemos conocer los motivos de incumplimiento terapéutico e incorporar acciones-recomendaciones para mejorarlo, tanto en la práctica diaria como en la organización del centro

Objective. To determine the prevalence of therapy non-compliance (TN) and the reasons for it in patients >=65 taking multiple medication. Design. Quantitative stage: TN prevalence by means of Morisky-Green test. Qualitative stage: 3 focus groups (FG). October 2005 to January 2006. Setting. Primary care centre in Catalonia, Spain. Participants. Persons >=65 years old taking 3 or more medicines. A total of 208 tests were administered at random and non-compliers were distributed by thumb into three FG. Measurements and main results. Quantitative stage. Collection of variables: non-complier, gender, number of medicines, and age. SPSS analysis. Qualitative stage. Data collection through FG and analysis of content: text transcription and classification by theme and sub-theme lines. NC prevalence of 47.6%. In the consultation we found reasons relating to the doctor, the doctor-patient relationship and the context. At pharmacies, pharmacists acted as regulators of prescriptions. At home, patients' beliefs, life-style and the characteristics of the medicine affected compliance. Patients wanted to be sure that doctors understood their chronic medication and would guarantee there would be no interactions. They wanted pharmacists to back this guarantee up. They read the instructions leaflet and were frightened by the section on side-effects. Conclusions. Prescriptions can become trivial for doctors and extremely important for patients. We must understand reasons for NC and incorporate actions-recommendations to improve compliance, both in day-to-day practice and in the centre's organisation