Circulating carotenoids are associated with favorable lipid and fatty acid profiles in an older population at high cardiovascular risk.

Carotenoid intake has been reported to be associated with improved cardiovascular health, but there is little information on actual plasma concentrations of these compounds as biomarkers of cardiometabolic risk. The objective was to investigate the association between circulating plasma carotenoids and different cardiometabolic risk factors and the plasma fatty acid profile. This is a cross-sectional evaluation of baseline data conducted in a subcohort (106 women and 124 men) of an ongoing multi-factorial lifestyle trial for primary cardiovascular prevention. Plasma concentrations of carotenoids were quantified by liquid chromatography coupled to mass spectrometry. The associations between carotenoid concentrations and cardiometabolic risk factors were assessed using regression models adapted for interval-censored variables. Carotenoid concentrations were cross-sectionally inversely associated with serum triglyceride concentrations [-2.79 mg/dl (95% CI: -4.25, -1.34) and -5.15 mg/dl (95% CI: -7.38, -2.93), p-values = 0.0002 and <0.00001 in women and men, respectively], lower levels of plasma saturated fatty acids [-0.09% (95% CI: -0.14, -0.03) and -0.15 % (95% CI: -0.23, -0.08), p-values = 0.001 and 0.0001 in women and men, respectively], and higher levels of plasma polyunsaturated fatty acids [(0.12 % (95% CI: -0.01, 0.25) and 0.39 % (95% CI: 0.19, 0.59), p-values = 0.065 and 0.0001 in women and men, respectively] in the whole population. Plasma carotenoid concentrations were also associated with higher plasma HDL-cholesterol in women [0.47 mg/dl (95% CI: 0.23, 0.72), p-value: 0.0002], and lower fasting plasma glucose in men [-1.35 mg/dl (95% CI: -2.12, -0.59), p-value: 0.001].

Longitudinal changes in Mediterranean diet and transition between different obesity phenotypes.

BACKGROUND & AIMS: Little is known about the impact of specific dietary patterns on the development of obesity phenotypes. We aimed to determine the association of longitudinal changes in adherence to the traditional Mediterranean diet (MedDiet) with the transition between different obesity phenotypes. METHODS: Data of 5801 older men and women at high cardiovascular risk from PREDIMED trial were used. Adherence to MedDiet was measured with the validated 14p-Mediterranean Diet Adherence Screener (MEDAS). Using the simultaneous combination of metabolic health- and body size-related parameters participants were categorized into one of four phenotypes: metabolically healthy and abnormal obese (MHO and MAO), metabolically healthy and abnormal non-obese (MHNO and MANO). Cox regression models with yearly repeated measures during 5-year of follow-up were built with use of Markov chain assumption. RESULTS: Each 2-point increase in MEDAS was associated with the following transitions: in MAO participants, with a 16% (95% CI 3-31%) greater likelihood of becoming MHO; in MHO participants with a 14% (3-23%) lower risk of becoming MAO; in MHNO participants with a 18% (5-30%) lower risk of becoming MHO. In MANO women, but not in men, MEDAS was associated with 20% (5-38%) greater likely of becoming MHNO (p for interaction by gender 0.014). No other significant associations were observed. CONCLUSIONS: Better adherence to the traditional MedDiet is associated with transitions to healthier phenotypes, promoting metabolic health improvement in MAO, MANO (only in women), and MHO, as well as protecting against obesity incidence in MHNO subjects.

Yogurt consumption and abdominal obesity reversion in the PREDIMED study.

BACKGROUND AND AIMS: Evidence on the association yogurt consumption and obesity is not conclusive. The aim of this study was to prospectively evaluate the association between yogurt consumption, reversion of abdominal obesity status and waist circumference change in elderly. METHODS AND RESULTS: 4545 individuals at high cardiovascular risk were prospectively followed. Total, whole-fat and low-fat yogurt consumption were assessed using food frequency questionnaires. Generalized estimating equations were used to analyze the association between yogurt consumption and waist circumference change (measured at baseline and yearly during the follow-up). Logistic regression models were used to evaluate the odds ratios (ORs) and 95% CIs of the reversion rate of abdominal obesity for each quintile of yogurt consumption compared with the lowest quintile. After multivariable adjustment, the average yearly waist circumference change in the quintiles of whole-fat yogurt consumption was: Q1: 0.00, Q2: 0.00 (-0.23 to 0.23), Q3: -0.15 (-0.42 to 0.13), Q4: 0.10 (-0.21 to 0.42), and Q5: -0.23 (-0.46 to -0.00) cm; p for trend = 0.05. The ORs for the reversion of abdominal obesity for whole-fat yogurt consumption were Q1: 1.00, Q2: 1.40 (1.04-1.90), Q3: 1.33 (0.94-1.89), Q4: 1.21 (0.83-1.77), and Q5: 1.43 (1.06-1.93); p for trend = 0.26. CONCLUSION: Total yogurt consumption was not significantly associated with reversion of abdominal obesity status and a lower waist circumference. However, consumption of whole-fat yogurt was associated with changes in waist circumference and higher probability for reversion of abdominal obesity. Therefore, it seems that whole-fat yogurt has more beneficial effects in management of abdominal obesity in elderly population at high cardiovascular risk.

Documento de Consenso sobre el posible empleo de Ácido Conjugado Linoleico (CLA), como complemento alimenticio, en la infancia y la adolescencia / Consensus Document of possible use of Conjugated Linoleic Acid (CLA), as dietary supplement in childhood and adolescence

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Compliance with the European and national nutritional objectives in a Mediterranean population.

OBJECTIVE: To analyze compliance with the current European and Spanish nutritional objectives in a representative sample from Catalonia, a Spanish Mediterranean region; and to examine relationships between diet and plasma fatty acid composition. DESIGN: Cross-sectional nutritional survey. SETTING: Population based random sample derived from the Catalan Nutrition Survey. SUBJECTS: A total of 516 healthy adult men (n=203) and women (n=313). METHODS: Dietary habits were assessed by means of a quantitative food frequency questionnaire. A physical exam included height, weight, waist and hip circumferences, and a fasting blood draw. RESULTS: Gender differences were observed in nutrient and energy intakes. Women showed a better compliance with the nutritional recommendations for monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) than did men. Men showed a better compliance for saturated fatty acid (SFA) and carbohydrate than did women. However, the SFA:MUFA:PUFA ratio was similar in both gender (1.6:2.3:1.0 for men; 1.7:2.5:1.0 for women). The highest compliance was observed for nutritional goals of sodium, calcium and fruit and vegetable intakes for both genders. In addition, the present study showed that levels of certain fatty acids in plasma are clearly associated with dietary intake of foods rich in these components. The highest correlations were found for n-3 long chain polyunsaturated fatty acids with blue fish intake in both men and women (r (men)=0.36 and r (women)=0.42; P<0.001). CONCLUSIONS: The diet followed in Catalonia seems to ensure compliance with most of the intermediate nutritional objectives for the Spanish population. However, a reduction in the SFA intake and an increase in the carbohydrate intake could be recommended in order to reduce the current prevalence of overweight and obesity in this Mediterranean region. SPONSORSHIP: This study was supported by the Catalan Department of Health, the Nutrition Catalan Centre of the Institute of Catalan Studies, and Mercadona SA.

Increasing serum levels of non-DDT-derivative organochlorine pesticides in the younger population of the Canary Islands (Spain).

Organochlorine pesticides are a lipophilic class of chemicals that persist in the environment and tend to accumulate in human tissues for years. They came into widespread use in the late 1940s. Because of their capacity to bioaccumulate and biomagnify in food chains and their toxic effects, most of them were banned in industrialized countries, among them Spain, in the late 1970s and 1980s. In 1998 organochlorine pesticides were determined in a representative sample of a Spanish population (around 690 serum samples from people 6 to 75years old from the Canary Islands). Serum levels of lindane aldrin, dieldrin and endrin, were determined. Our results showed that a high percentage of samples presented detectable levels of some of the organochlorines measured, endrin being the most frequently detected (72%) and at highest concentration (mean 136.7ng/g fat). Mean concentrations of the main cyclodiene evaluated, dieldrin, was lower to those found in other Western populations. However, serum levels of lindane were higher than those described in North European populations. Influence of geographical and sociodemographic factors was evaluated. Urban populations showed the highest levels of dieldrin, while non-urban population showed the highest serum values of lindane, aldrin and endrin. Unexpectedly, serum values of lindane, aldrin and dieldrin were higher in younger than in older people. Subjects under 18years showed almost twice as high serum levels of lindane, aldrin and dieldrin than subjects of 65-75years. These results may well suggest that people living in the Canary Islands have been and are currently exposed to non-DDT-organochlorine pesticides. The type and source of exposure could vary between islands and type of habitat. Contaminated food and/or the environment could be related with this situation.

Nutrición comunitaria / Community nutrition

Cada vez es más sólida la evidencia científica y epidemiológica sobre la relación entre distintos aspectos de la dieta como factores de riesgo o bien con potencial protector para la salud. Este hecho ha suscitado un creciente interés por los aspectos cualitativos que pudieran repercutir en mayor medida en la génesis de las enfermedades crónicas, la calidad de vida, las potencialidades físicas e intelectuales y la longevidad y que han dado lugar al desarrollo de la Nutrición Comunitaria. Las principales funciones prácticas que se desarrollan en una Unidad de Nutrición Comunitaria consisten en identificar y evaluar problemas nutricionales de la comunidad y diseñar, organizar, implementar y evaluar programas de intervención nutricional mediante distintas estrategias orientados hacia el medio ocupacional, medio escolar, colectivos de riesgo o para la población general. Las intervenciones en la comunidad pretenden conseguir gradualmente una adecuación del modelo nutricional hacia un perfil más saludable. Los programas de Nutrición Comunitaria requieren el abordaje de estrategias de distinta naturaleza de manera simultánea en un equipo multidisciplinar. Son numerosos los aspectos que influyen en el estado nutricional de un individuo o de una población y que es necesario conocer y vigilar para conseguir un trabajo efectivo (AU)

A growing body of scientific and epidemiological evidence indicates that diet and health are related: diet may be a risk factor or have potential protective effects. As a consequence, the focus of nutrition research has experienced a shift towards qualitative aspects of diet which could influence chronic disease, longevity, quality of life and physical and cognitive performance, leading to the development of Community Nutrition. The main undertakings in a Community Nutrition Unit are related to the identification, assessment and monitoring of nutrition problems at the community level and to planning, design, implementation and evaluation of nutrition intervention programs. Such programs combine a number of suitable strategies in a whole population approach, a high risk approach or an approach targeted at specific population groups, and are implemented in different settings, such as the work place, schools or community organizations. Community nutrition interventions aim to gradually achieve change in eating patterns towards a healthier profile. Community Nutrition programs require the use of a combination of strategies and a working group of people from different backgrounds. Many factors influence the nutritional status of an individual or a population. In order to gain effective work output, sound understanding of these patterns and a practical surveillance system are required (AU)

Olive oil and the Mediterranean diet: beyond the rhetoric.

OBJECTIVE: The purpose of this study was to analyze the association of food, nutrient and energy intakes with olive oil consumption in Spain. DESIGN: Cross-sectional study by face-to-face interview. SETTING: Population-based random sample derived from the Catalan Nutrition Survey. SUBJECTS: In total, 1600 individuals between 18 and 60 y of age. INTERVENTION: Two 24-h recalls were administered to measure food and nutrient intakes. Food consumption and nutrient intakes were analyzed comparing the highest and lowest quartiles of olive oil consumption. RESULTS: Those with the highest consumption of olive oil (greater than 13.5% of total calories, fourth quartile) consumed less cereal, baked goods, whole milk, sausages, candy, fruit juice and soft drinks, but more fish, eggs, vegetables and added fats, as compared to those with the lowest olive oil consumption (less than 6.8% of total calories, first quartile). The group with the greatest olive oil consumption also demonstrated high total fat intake, although saturated fats showed a lower percentage of total energy intake. Vitamin intake was more adequate in those with the highest consumption of olive oil. CONCLUSION: Olive oil is a key contributor to the healthy aspects attributed to the Mediterranean diet, and as such, nutritional objectives in Mediterranean countries should address reducing saturated fats, without modifying quantities of olive oil.

Nutrient adequacy and Mediterranean Diet in Spanish school children and adolescents.

OBJECTIVE: To evaluate dietary habits and nutritional status of Spanish school children and adolescents, and their relationship with the Mediterranean Diet. DESIGN: Cross-sectional study by face-to-face interview. SETTING: Free living children and adolescents of all Spanish regions. SUBJECTS: A random sample of 3166 people aged 6-24 y. METHODS: Home interviews conducted by a team of 43 dietitians included 24-h recalls (a second 24-h recall in 25% of the sample) and a short frequency questionnaire to determine the quality of the Mediterranean Diet (KIDMED). RESULTS: The participation rate was 68%. In general, the adequacy of the Mediterranean Diet rose with increased mean intakes of the majority of vitamins and minerals and decreased percentages of inadequate intakes (&<2/3 of the RNI) for calcium, magnesium, vitamin B(6) and C in both sexes, and iron and vitamin A only in females. CONCLUSIONS: This study demonstrates that the Mediterranean Diet contributes to nutritional quality, and also shows concomitant risks as the Mediterranean Diet deteriorates.

Sociodemographic and lifestyle determinants of food patterns in Spanish children and adolescents: the enKid study.

OBJECTIVE: To analyse prevailing food patterns among Spanish children and young people and their relationship to sociodemographic and lifestyle factors. DESIGN: Cross-sectional population survey. SETTING: Population study. Data were collected at participants' home addresses. SUBJECTS: Random sample of the Spanish population aged 2-24 y (n=3534; 1629 boys and 1905 girls). INTERVENTIONS: Food consumption was assessed by means of a 24-h recall and a food frequency questionnaire. Sociodemographic and lifestyle related data were collected by specially designed questionnaires, previously pretested and validated. All the information was collected during a personal interview by trained dietitians. DATA COLLECTION: May 1998-April 2000. RESULTS: Average consumption of fruit and vegetables was low. The youngest age group (2-5 y) showed the lowest proportions of inadequacy for the dairy group (P<0,001; chi(2)=39.11 boys; chi(2)=49.60 girls). Factor analysis identified five main components of dietary patterns. The 'Snacky' pattern was characterised by more frequent and higher consumption of bakery products (buns, cakes and biscuits), sweets, salted snacks and soft drinks. Higher intakes of fruit, vegetables and fish were associated to the 'Healthy' pattern. Children whose mother had a low level of education and those who spent more than 2 h daily watching TV were more likely to follow the 'Snacky' pattern. Girls were more likely to follow the 'Healthy' pattern, while children and young people whose mother had a lower level of education were less likely. CONCLUSION: Results from this study highlight the importance of enhancing school-based and community-based actions to promote healthy eating and physical activity addressed to children and young people.

Food preferences of Spanish children and young people: the enKid study.

OBJECTIVE: To describe the profile of food preferences, likes and dislikes of Spanish children and young people and analyse its connection with prevailing food patterns. DESIGN: Cross-sectional population survey. SETTING: Population study. Data were collected at participants' home address. SUBJECTS: Random sample of the Spanish population aged 2-24 y (n=3534; 1629 boys and 1905 girls). INTERVENTIONS: Food preferences, food consumption and practices as well as nutrition-related information were assessed by means of a multiple choice questionnaire. A food preference score was computed considering food items ranked as first, second or third choice within each food group. Data collection was carried out during May 1998-April 2000. RESULTS: Bananas and apples were the fruit items preferred by Spanish children and young people across all age and gender groups. Within the vegetable group tomato sauce and salads, particularly lettuce and tomato salad scored highest, followed by carrots in all age and gender groups. However, 47% (95% confidence interval 46-48%) of the sample reported dislike for vegetables and an additional 5.7% (95% confidence interval 4.9-6.5%) a dislike for fruit. The proportion of individuals with low consumption of vegetables or fruit was significantly higher among those reporting a dislike either for vegetables (chi(2)=127.69; P<0.001); fruit (chi(2)=24.62; P<0.001) or for both groups (chi(2)=81.53; P<0.001). CONCLUSION: There is a significant relationship between the likes/dislikes for fruits and vegetables and usual consumption of this food group among children and young people. Strategies addressed to improve acceptance for this food group should be considered when designing interventions aimed at promoting adequate consumption of fruits and vegetables among children and young people.

Nutritional risks in the Spanish population: results of the eVe study.

OBJECTIVE: To determine the vitamin status of different groups within the Spanish population. DESIGN: Pooled analysis of cross-sectional population nutritional regional studies and meta-analysis of smaller studies in population subgroups performed in Spain between 1990 and 1999. SUBJECTS: In total, 10 208 participants in eight random population studies aged 25-60 y and participants in 76 studies included in the meta-analysis. INTERVENTIONS: The data from different nutritional studies performed on sample populations representative of eight regions of Spain were integrated into a single database. A meta-analysis was also performed on the results of nutritional studies on the Spanish population involving subjects of other ages and status (all published between 1990 and 1999). RESULTS: The mean intakes observed after the integration of the eight regional studies, and in the meta-analysis study, were similar to those recommended, although a considerable percentage of people had insufficient intakes. CONCLUSIONS: Further studies are required, but the vitamin status of the Spanish population clearly shows room for improvement, especially with respect to vitamins B(2), B(6), A, E, D and folates. Bearing in mind that adequate vitamin intakes are associated with protection from a range of diseases, steps should be taken to correct the imbalances recorded.

Nontraditional nutrition education interventions: the radio ECCA method.

OBJECTIVE: To evaluate a nutrition education intervention using a radio programme in the Canary Islands. DESIGN: Pre-post quasiexperimental epidemiological study. SETTING: Free living population in the Canary Islands, Spain. SUBJECTS: A sample of 1753 individuals out of 6846 volunteers participating in the educational programme. INTERVENTIONS: A 6-week radio programme consisting of 12 didactic units with supplementary print support material and four optional attendance-based healthy cooking seminars. RESULTS: At 2 months postintervention, an increased consumption of pulses, salads, fruits and juices, cereals and fish, and a decreased consumption of meat, sausages, pastries, French fries, bread and eggs were observed.

[Concentrations of Na, K, Ca, and P in serum from a representative sample of the Canary Islands population]. / Concentraciones de Na, K, Ca y P en sueros de una muestra representativa de la población canaria.

As part of the nutritional survey of the Canary Islands (ENCA-1998), the concentrations in serum of Na, K, Ca and P were determined in 395 individuals representing the population of the Canary Islands. The concentrations were found to be within the reference intervals described for the healthy population. Differences were observed in the mean concentrations depending on the island of residence. Thus, individuals on the island of Tenerife showed higher levels of natremia and calcaemia (p < 0.05) than those on the other islands. The islanders of La Palma have the highest (p < 0.05) and lowest (p < 0.05) concentrations of K and Ca, respectively, whereas those living on the easternmost islands have the highest levels of phosphataemia. No differences were detected in the mineral levels by sex. Phosphataemia levels fall (p < 0.05) in line with socio-economic levels. Females under the age of 18 present lower levels of natremia (p < 0.05) than others while males over the age of 35 present higher levels of kalaemia (p < 0.05). No important age-related differences were found in calcaemia and individuals under the age of 18 had lower levels of phosphataemia (p < 0.05) than the remainder. Highly significant relationships were found between Na and K and between Ca and P, thus confirming existing physiological relationships. Smoking had no effect on the serum levels of the elements under study. Those individuals reporting an intake of more than seven beers and seven shots of spirit per week presented lower levels of calcaemia and natremia than the rest (p < 0.05). With wine consumption, an increase in kalaemia and a significant reduction (p < 0.05) in the Na/K ratio were detected. Individuals drinking only tap water had higher levels (p < 0.05) of natraemia and kalaemia, with lower levels (p < 0.05) of calcaemia and the Na/K ratio than those drinking bottled water. The Ca/P ratio was significantly reduced (p < 0.05) with physical exercise.

Concentraciones de Na, K Ca y P en sueros de una muestra representativa de la población canaria / Concentrations of Na, K, Ca and P in sera from a population sample representing the canary islands

Como parte de la encuesta nutricional de Canarias (ENCA-1998) se determinaron las concentraciones séricas de Na, K, Ca y P en 395 individuos representativos de la población canaria. Las concentraciones se encuentran dentro de los intervalos de referencia descritos para población sana. Se observan diferencias entre las concentraciones medias en función de la isla de residencia. Así los individuos de Tenerife presentan natremias y calcemias superiores (p<0,05) al resto de las islas. Los individuos de La Palma tienen las mayores (p<0,05) y menores (p<0,05) concentraciones de K y Ca respectivamente, mientras que los de las islas orientales muestran las mayores (p<0,05) fosfatemias. No se detectan diferencias entre los minerales en función del sexo. La fosfatemia disminuye (p<0,05) a medida que el nivel socioeconómico es menor. Las féminas menores de 18 años presentan natremias inferiores (p<0,05) al resto y los varones de más de 35 años mayores (p<0,05) potasemias. No se encuentran diferencias importantes de caicemia en función de la edad, y los individuos menores de 18 años muestran fosfatemias (p<0,05) inferiores al resto. Se observan correlaciones altamente significativas entre Na y K y entre Ca y P lo que confirma relaciones fisiológicas existentes. El hábito de fumar no influye sobre los niveles séricos de los elementos estudiados. Los individuos que manifiestan un consumo superior a siete cervezas y a siete bebidas espirituosas por semana presentan calcemias y natremias inferiores (p<0,05) respectivamente al resto. Se detecta un aumento de la potasemia y disminución significativamente (p<0,05) de la relación Na/K con el consumo de vino. Los individuos que consumen agua del grifo presentan mayor (p<0,05) natremia y potasemia, y menor (p<0,05) calcemia y relación Na/K, que los individuos que consumen agua embotellada. La relación Ca/P disminuye de forma significativa (p<0,05) con el ejercicio físico (AU)

As part of the nutritional survey of the Canary Islands (ENCA-1998), the concentrations in serum of Na, K, Ca and P were determined in 395 individuals representing the population of the Canary Islands. The concentrations were found to be within the reference intervals described for the healthy population. Differences were observed in the mean concentrations depending on the island of residence. Thus, individuals on the island of Tenerife showed higher levels of natremia and calcaemia (p < 0.05) than those on the other islands. The islanders of La Palma have the highest (p < 0.05) and lowest (p < 0.05) concentrations of K and Ca, respectively, whereas those living on the easternmost islands have the highest levels of phosphataemia. No differences were detected in the mineral levels by sex. Phosphataemia levels fall (p < 0.05) in line with socio-economic levels. Females under the age of 18 present lower levels of natremia (p < 0.05) than others while males over the age of 35 present higher levels of kalaemia (p < 0,05). No important age-related differences were found in calcaemia and individuals under the age of 18 had lower levels of phosphataemia (p < 0.05) than the remainder. Highly significant relationships were found between Na and K and between Ca and P, thus confirming existing physiological relationships. Smoking had no effect on the serum levels of the elements under study. Those individuals reporting an intake of more than seven beers and seven shots of spirit per week presented lower levels of calcaemia and natremia than the rest (p < 0.05). With wine consumption, an increase in kalaemia and a significant reduction (p < 0.05) in the Na/K ratio were detected. Individuals drinking only tap water had higher levels (p < 0.05) of natraemia and kalaemia, with lower levels (p < 0.05) of calcaemia and the Na/K ratio than those drinking bottled water. The Ca/P ratio was significantly reduced (p < 0.05) with physical exercise (AU)