Mediterranean diet adherence in individuals with prediabetes and unknown diabetes: the Di@bet.es Study.

BACKGROUND AND AIMS: Mediterranean diet (MedDiet) is causally related to diabetes and is a dietary pattern recommended to individuals with diabetes. We investigated MedDiet adherence in individuals with prediabetes and unknown (PREDM/UKDM) or known diabetes (KDM) compared to those with normal glucose metabolism (NORMAL). METHODS: This was a national, population-based, cross-sectional, cluster-sampling study. MedDiet adherence was scored (MedScore, mean ± SD 24 ± 5) using a qualitative food frequency questionnaire. Logistic regression was used to examine the association between MedScore and PREDM/UKDM or KDM versus control subjects. RESULTS: We evaluated 5,076 individuals. Mean age was 50 years, 57% were female, 826 (582/244) were PREDM/UKDM, 478 were KDM and 3,772 were NORMAL. Mean age increased across MedScore tertiles (46, 51 and 56 years, p < 0.0001). Higher age-adjusted adherence to MedDiet (5-unit increment in the MedScore) was associated with lower and nondifferent odds (OR, 95% CI) of prevalent PREDM/UKDM (0.88, 0.81-0.96, p = 0.001) and KDM (0.97, 0.87-1.07, p = 0.279), respectively, compared to individuals in the NORMAL group. CONCLUSIONS: In a representative sample of the whole Spanish population, MedDiet adherence is independently associated with PREDM/UKDM. Therapeutic intervention may be, in part, responsible for the lack of differences in adherence observed between the KDM and NORMAL groups. However, reverse causation bias cannot be ruled out in cross-sectional studies.

Determinants of dietary lignan intake in a representative sample of young Spaniards: association with lower obesity prevalence among boys but not girls.

BACKGROUND/OBJECTIVES: Lignan-rich diets have been associated with favorable health effects through improved metabolic profile. In this study, we hypothesized that dietary lignan intake could be also associated with childhood obesity. SUBJECTS/METHODS: We studied prevalent obesity in relation to lignan intake within the enKid study that involved 3438 children, adolescents and young adults (2-24 years old). Participant's dietary records were used to calculate lignan dietary intake using a lignan composition database adapted to the Spanish diet. RESULTS: The mean intake of the dietary lignans was calculated as ~1 mg/day, corresponding mainly (37%) to pinoresinol. No gender differences were found, but lignan intake was positively associated with age, physical activity level and dietary fiber intake, and negatively with the intake of polyunsaturated and saturated fatty acids. The main sources of dietary lignans were refined wheat, olive oil and whole-wheat bread. A strong association between dietary lignan intake and prevalent obesity was found only for boys, with odds ratio (highest versus lowest quartile of lignan intake) of 0.34 (95% confidence interval, 0.17-0.70) after adjusting for main confounders, including dietary fiber. CONCLUSIONS: Boys with the highest lignan-rich products including cereals, whole-grain products and olive oil, presented less cases of obesity in this representative sample of Spanish children and adolescents. It is unknown whether this association implies an active role of dietary lignans on obesity development, or is merely an indicator of a healthier lifestyle.

Weight status of European preschool children and associations with family demographics and energy balance-related behaviours: a pooled analysis of six European studies.

This study aimed to (i) gain insight in the prevalence of overweight indices in European preschoolers (4-7 years); (ii) identify energy balance-related behaviours associated with overweight/obesity; and (iii) identify children at risk for overweight/obesity. Secondary analyses of six European data sets were conducted according to standardized protocols. Based on objectively measured height and weight, prevalence of overweight and obesity across the countries ranged from 8% to 30% and 1% to 13%, respectively, with highest rates in Southern European countries (i.e. Spain and Greece). Positive associations between sedentary behaviours and overweight indices were found. Physical activity and dietary behaviours were not associated, possibly because of methodological limitations. Children of parents with high body mass index or low socioeconomic status were at increased risk of overweight/obesity. In conclusion, large differences in prevalence of overweight and obesity among preschoolers across Europe were observed. Future obesity prevention interventions in preschoolers should target screen time giving specific attention to children from overweight and/or low socioeconomic status parents. There is a need for high methodological quality studies, preferably with a long-term prospective design using sensitive, valid and reliable measures of behaviours, assessing whether and which physical activity and dietary behaviours are associated with overweight in preschoolers.

Harmonisation of food categorisation systems for dietary exposure assessments among European children.

Within the European project called EXPOCHI (Individual Food Consumption Data and Exposure Assessment Studies for Children), 14 different European individual food consumption databases of children were used to conduct harmonised dietary exposure assessments for lead, chromium, selenium and food colours. For this, two food categorisation systems were developed to classify the food consumption data in such a way that these could be linked to occurrence data of the considered compounds. One system served for the exposure calculations of lead, chromium and selenium. The second system was developed for the exposure assessment of food colours. The food categories defined for the lead, chromium and selenium exposure calculations were used as a basis for the food colour categorisation, with adaptations to optimise the linkage with the food colour occurrence data. With this work, an initial impetus was given to make user-friendly food categorisation systems for contaminants and food colours applicable on a pan-European level. However, a set of difficulties were encountered in creating a common food categorisation system for 14 individual food consumption databases that differ in the type and number of foods coded and in level of detail provided about the consumed foods. The work done and the problems encountered in this project can be of interest for future projects in which food consumption data will be collected on a pan-European level and used for common exposure assessments.

Mercury and methylmercury intake estimation due to seafood products for the Catalonian population (Spain).

This study estimates mercury and methylmercury levels in fish and fishery products commercialized in the city of Barcelona, Spain, from 2001 to 2007. Combining data of mercury levels in food with the consumption data of 2158 people (as the median of two 24-h recall), the total mercury intake of the Catalonian population was calculated. Mercury was detected in 32.8% of analysed samples. The general population average weekly intake of total mercury in the Catalonian population was 0.783 microg kg(-1) of body weight. This value is clearly lower than the Joint FAO/WHO Expert Committee on Food Additives (JECFA) provisional tolerable weekly intakes (PTWI) of 5 microg kg(-1) of body weight. The fish group was the main contributor to this value, mainly due to predatory species.

How many children and adolescents in Spain comply with the recommendations on physical activity?

AIM: Physical inactivity is likely one of the main causes of obesity and other chronic diseases. This study shows descriptive data on physical activity and compliance with the health enhancing physical activity recommendations for children and adolescents and the determining factors among the Spanish population. METHODS: The population of the study was enrolled for the enKid study, a cross-sectional study carried out on a representative sample of Spanish children, adolescents and youth to evaluate nutritional status and food intake. A subsample of the enKid study including individuals from 6 to 18 years was evaluated for compliance with the recommendation for health enhancing physical activity. RESULTS: The results showed that only 48% of individuals from 6 to 18 years did at least 60 minutes of physical activity daily. Forty nine percent of girls and 37% of boys did not practice any sports during their leisure time. The percentage of active people diminishes as they get older, especially with reference to girls. Social status and mother's educational level act positively on the level of physical activity of the population. CONCLUSION: Exercise is not a widespread leisure time activity in Spanish children and youth and few individuals did enough exercise for health promotion. Public health campaigns should take into account socio-economic variables and improve the access to sports facilities.

Evaluating associations between Mediterranean diet adherence indexes and biomarkers of diet and disease.

OBJECTIVE: We examined associations between two Mediterranean diet (MD) adherence indexes (the MD index, MDI, and the MD score, MDS) and several blood biomarkers of diet and disease. SUBJECTS: We studied 328 individuals from Catalonia (Northeastern Spain), ages 18-75, who provided fasting blood samples, a subset of the 2346 individuals as part of a larger representative and random sample from the 1992-1993 Catalan Nutritional Survey. DESIGN AND METHOD: Diet was measured using 24-h recalls. Biomarkers studied were plasma levels of beta-carotene, alpha-tocopherol, retinol, vitamins B12, C and folates as well as serum total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Multivariate linear regression was used to analyse associations of the nutrient biomarkers with the dietary pattern indexes, adjusting for potential confounders. RESULTS AND CONCLUSIONS: Subjects with higher MD adherence, as measured by the two dietary indexes, had significantly higher plasma concentrations of beta-carotene, folates, vitamin C, alpha-tocopherol and HDL cholesterol. The most highly significant relationship was that between folates and the adherence to the MD Pattern, as determined by both indexes. These research findings suggest the potential usefulness of biomarkers as complementary tools for assessing adherence to a dietary pattern. This type of data not only informs the development of robust dietary adherence indexes, but it also provides specific clues about the potential physiological mechanisms that explain the beneficial effects of the MD pattern on chronic disease risk.

Epidemiología y factores determinantes de la obesidad infantil y juvenil en España / No disponible

No disponible

[Food consumption and nutrient intake in relation to smoking]. / Relación del consumo de alimentos y nutrientes con el hábito tabáquico.

BACKGROUND: It is well known that smoking and some nutritional habits are two of the most important risk factors for the development of certain cancers and cardiovascular diseases. The purpose of this study is to assess the food and nutrient consumption in relation to smoking in the Catalan population, Spain. SUBJECTS AND METHOD: A representative sample of the Catalan population of 1774 people aged 18 to 64 years from both sexes. Nutritional status was evaluated using selected anthropometrical indexes, and food consumption with two 24-hour recall. Questionnaires about smoking consumption and a semiquantitative frequency questionnaire about alcohol consumption were also administered. RESULTS: Male non smokers consumed more dairy products than smokers, and more fruits and nuts than smokers and ex-smokers. Female non-smokers consumed more chicken, fruits and less sweets than smokers and ex-smokers. In both genders, smokers consumed more alcohol. With respect to nutrients, smokers consumed less fiber than non smokers and more energy from lipids and saturated and monounsaturated fatty acids. CONCLUSIONS: The diet of smokers is less healthy than that of non smokers and ex-smokers, which indicates a higher risk for the incidence of certain cancers and cardiovascular diseases.

[Food consumption and food sources of energy and nutrients in Canary Islands (1997-98)]. / Consumo de alimentos y fuentes alimentarias de energía y nutrientes en Canarias (1997-98).

OBJECTIVES: To evaluate food consumption and identify the main food sources of energy and nutrient intake in the Canary Island population (1997-98). DESIGN: Cross-sectional epidemiological study. METHODS: A dietary survey was realised in a representative sample of the Canary Island population (n = 1747; 821 men and 926 women) aged 6 to 75 years. The dietary survey technique utilised consisted of two 24-hour recalls over nonconsecutive days. Spanish Food Composition Tables were used as references. RESULTS: Food composition in the Canary Islands is characterised by typical Canary Island eating patterns, which have lost some of their Central American characteristics and have acquired clearly Mediterranean elements. As such, an acceptable intake of milk was noted (301 g/day) with highly elevated dairy product consumption (71 g/day), high intake of potatoes (143 g/day), moderate meat (red meat 46 g/day) and fish (46 g/day) consumption and low cereal (125 g/day) and legume (27 g/day) intakes. Nut consumption was observed to be fairly low (2 g/day), and average fruit intake (218 g/day) and low vegetable consumption (108 g/day) were also noted, the later being the lowest intake detected in Spain. It is also worth noting the elevated consumption of sweets (49 g/day). An inverse relationship was detected between social class and consumption of potatoes and pulses, and a direct one between vegetables, sausages and cheese. The main sources of energy were cereals and dairy products (21.2% and 18.4%, respectively), as well as the principal sources of saturated fats (5.8% and 28.1%), calcium (6.6% and 67.8%), sodium (27.5% and 18.8%) and riboflavin (6.6% and 41.2%).

[Anthropometric values and cardiovascular risk factors in Canary Islands (1997-98)]. / Valores antropométricos y factores de riesgo cardiovascular en las Islas Canarias (1997-98).

OBJECTIVE: To know the distribution of certain anthropometric parameters and cardiovascular risk factors: hypercholesterolemia, arterial hypertension, obesity, sedentary lifestyle, smoking and diabetes mellitus in the population of the Canary Islands. DESIGN: Epidemiological, cross-sectional study, with description of prevalence. SUBJECTS: 1365 individuals from de Canary Islands: 637 males (45.9%) and 738 females (54.1%) aged 18 to 75 years. RESULTS: In the Canary Islands obesity was found in 18.6% of the population, 14.3% males and 22.3% females. The prevalence of hypercholesterolemia was 30.4%, with an average serum cholesterol level of 213.1 mg/dl in males and 218.7 mg/dl in females. 63.1% of the population declared to have a sedentary lifestyle. In the population between 18 and 75 years old, the prevalence of hypercholesterolemia was 30.4%. CONCLUSIONS: The Canary Islands show a high prevalence of obesity compared to other Spanish data and low if we compare it with Latin American countries. The average and prevalent serum cholesterol levels are higher than those described in the rest of Spain and Latin America. The prevalence of a sedentary lifestyle during spare time is similar to the average of our country and lower than the one described in Latin America.

[Energy and nutrient intake and risk of inadequate intakes in Canary Islands (1997-98)]. / Ingesta de energía y nutrientes y riesgo de ingestas inadecuadas en Canarias (1997-98).

OBJECTIVES: To evaluate the consumption of energy and nutrients and to identify the risk of inadequate intakes in the Canary Island population (1997-98). DESIGN: Cross-sectional epidemiological study. METHODS: A dietary survey was conducted in a representative sample of the Canary Island population (n = 1747; 821 men and 926 women) aged 6 to 75 years. Two 24-hour recalls were utilised as the dietary survey instrument, carried out over non-consecutive days. Spanish Food Composition Tables were used and data was adjusted for intraindividual variability. RESULTS: The mean daily intakes were 1760 kcal for energy, 73 g for protein, 228 g for carbohydrates, 15 g for fibre and 62 g for fat (24 g SFA, 25 g MUFA and 8 g PUFA). Energy and nutrient consumption decreased with age excluding vitamins A. C and folate. Nutrient density increased with age, with the lowest intakes seen in children and adolescents. As for social class, decreased calorie intake was observed in the lowest category, with the highest income level showing the greatest intakes for vitamin A, B12, niacin and folate. Noteworthy findings include an overall low calorie intake, and elevated risks of inadequate intakes (percentages of the population with intakes below 2/3 of the RDI) for vitamins D (92.5%), E(87.4%), A(74%), folate(44.7%), iron(30.1%) magnesium (14.9%) and vitamin C (5.4%). Risk for inadequate protein intake was not observed.

[Distribution of blood lipids in a representative sample of the adult population of Catalonia. Research Group on Assessment of the Nutritional Status of the Catalonian Population: Biochemical Assessment]. / Distribución de la concentración de lípidos séricos en una muestra representativa de la población adulta de Cataluña. Grupo de Investigación sobre Evaluación del Estado Nutricional de la Población Catalana: Evaluación Bioquímica.

BACKGROUND: The leading cause of mortality in Spain are cardiovascular diseases. Their prevention largely depends on the control of hypercholesterolemia. The aim of this study is to describe the serum concentration of total cholesterol (TC), HDL-cholesterol (HDLc), LDL-cholesterol (LDLc) and triglycerides in the population of Catalonia (Spain). SUBJECTS AND METHODS: We obtained a representative sample of the catalan population 18-75 years-old in 1993. The concentrations of HDLc was analyzed after precipitation, the concentration of TC and triglycerides was obtained by enzimatic methods, and the concentration of LDLc was calculated using the Friedewald formula. RESULTS: We obtained a sample of 487 women and 393 men (participation rate: 38%). The mean concentrations of TC, LDLc, HDLc and triglycerides was, respectively, of 203.9 mg/dl (SD = 39.7 mg/dl) (5.24 mmol/l, SD = 1.02 mmol/l), 127.5 mg/dl (SD = 35.9 mg/dl) (3.28 mmol/l, SD = 0.92 mmol/l), 55.8 mg/dl (SD = 14.0 mg/dl) (1.45 mmol/l, SD = 0.36 mmol/l) and 103.9 mg/dl (SD = 75.4 mg/dl) (1.15 mmol/l, SD = 0.84 mmol/l). Nineteen percent of the sample had a concentration of TC > 240 mg/dl (6.42 mmol/l), 3.0% a concentration of HDLc < 35 mg/dl (0.91 mmol/l), 17.2% a concentration of LDL > 160 mg/dl (4.11 mmol/l) and 7.4% a concentration of triglycerides > 7.4 mg/dl (2.22 mmol/l). The concentrations of LDLc and triglycerides and the atherogenic index (TC/HDLc) were higher in men than in women and they increased with age. CONCLUSIONS: The cholesterol levels could be considered lower in Catalonia, Spain, than in other developed countries, and there is a tendency to decrease accordingly to the decrease in the cardiovascular mortality rates. However, the lipid profile in men older than 35 years and in women older than 50 years is still a cause of concern.

Changes in diet and mortality from selected cancers in southern Mediterranean countries, 1960-1989.

Mortality trends of breast, colorectal, ovarian and prostate cancer in Spain, Italy, Greece, Yugoslavia, and England and Wales are presented. Figures are discussed with regard to patterns of consumption of fat-containing foods in these countries. An increase of all cancer site mortality is shown in southern European countries, whereas in England and Wales a decrease in ovarian and colorectal cancer among women is observed. Consumption of milk, meat and animal fat products increased in all Mediterranean countries but decreased in England and Wales. Some differences regarding cancer mortality and food consumption patterns among southern European countries are pointed out. This markedly divergent fat consumption pattern between northern and southern Europe appears to antedate and be associated with their substantial differences in ovarian and colorectal cancer mortality trends, and to a lesser extent with breast cancer.