Less Favorable Nutri-Score Consumption Ratings Are Prospectively Associated with Abdominal Obesity in Older Adults.

Nutri-Score is a front-of-package (FOP) labeling designed to assist consumers in selecting healthier options at the point of purchase and ultimately enhance their health. This study aims to evaluate the association between the Nutri-Score system and incident abdominal obesity (AO) in community-dwelling older adults. A prospective cohort of 628 individuals aged ≥ 60 were recruited in Spain between 2008-2010 and were reexamined between 2015-2017. Dietary intake was evaluated utilizing a validated computerized dietary history. Food was categorized based on the Nutri-Score system into five levels from A (green, representing the best quality) to E (red, representing the poorest quality). A five-color Nutri-Score dietary index (5-CNS DI) in g/day/kg was calculated for each participant. AO was determined by a waist circumference (WC) of ≥102 cm for men and ≥88 cm for women. Logistic regression models were adjusted for the main potential confounders. During a mean six-year follow-up, 184 incident cases of AO occurred. The odds ratio (OR) and 95% confidence interval (CI) for AO, when comparing the highest and lowest quartiles of the 5-CNS DI, were 2.45 (1.17-5.14), with a p-value for trend of 0.035. In sensitivity analyses, the OR was 2.59 (1.22-5.52, p-trend: 0.032) after adjustment for WC at baseline, and 1.75 (0.74-4.18, p-trend: 0.316) after adjustment for ultra-processed food consumption. In conclusion, less favorable food-consumption ratings in the Nutri-Score are associated with incident AO in the elderly. These findings support the use of this FOP system to potentially improve metabolic health.

Dietary Micronutrient Adequacy and Risk of Multimorbidity in Community-dwelling Older Adults.

BACKGROUND: Multimorbidity refers to the coexistence of multiple chronic health conditions. The effect of nutritional adequacy on multimorbidity is mostly unknown. OBJECTIVE: The aim of this study was to assess the prospective association between dietary micronutrient adequacy and multimorbidity among community-dwelling older adults. METHODS: This cohort study included 1461 adults aged ≥65 y from the Seniors-ENRICA II cohort. Habitual diet was assessed at baseline (2015-2017) with a validated computerized diet history. The intakes of 10 micronutrients (calcium, magnesium, potassium, vitamins A, C, D, E, zinc, iodine, and folate) were expressed as percentages relative to the dietary reference intakes, with higher scores indicating greater adequacy. Dietary micronutrient adequacy was computed as the average of all the nutrient scores. Information on medical diagnosis was obtained from the electronic health records up to December 2021. Conditions were grouped into a comprehensive list of 60 categories and occurrence of multimorbidity was defined as having ≥6 chronic conditions. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders. RESULTS: The mean age was 71.0 y (SD: 4.2) and 57.8% of participants were males. During a median follow-up of 4.79 y, we documented 561 incident cases of multimorbidity. Participants in the highest (85.8%-97.7%) versus the lowest tertile (40.1%-78.7%) of dietary micronutrient adequacy had a low risk of multimorbidity [fully adjusted hazard ratio (95% confidence interval): 0.75 (0.59-0.95); P-trend: 0.02]. A 1-SD increment in minerals and vitamins adequacy was associated with a low risk of multimorbidity, although estimates were attenuated after additional adjustment for the opposite subindex [minerals subindex: 0.86 (0.74-1.00); vitamins subindex: 0.89 (0.76-1.04)]. No differences were observed by strata of sociodemographic and lifestyle factors. CONCLUSION: A high micronutrient index score was associated with low risk of multimorbidity. Improving the dietary micronutrient adequacy could prevent multimorbidity among older adults. CLINICAL TRIAL REGISTRY: clinicaltrials.govNCT03541135.

Distribution of daily protein intake across meals and all-cause mortality in community-dwelling older adults.

Recent findings suggest that the distribution of protein intake throughout the day has an impact on various health outcomes in older adults, independently of the amount consumed. We evaluated the association between the distribution of dietary protein intake across meals and all-cause mortality in community-dwelling older adults. Data from 3225 older adults aged ≥ 60 years from the Seniors-ENRICA-1 cohort were examined. Habitual dietary protein consumption was collected in 2008-2010 and in 2012 through a validated diet history. Protein distribution across meals was calculated for each participant as the coefficient of variation (CV) of protein intake per meal, in sex-specific tertiles. Vital status was obtained from the National Death Index up to 30 January 2020. Cox proportional hazards regression was performed to determine the hazard ratios (HR) and their 95 % CI for the association between the distribution of daily protein intake across meals and all-cause mortality. Over a median follow-up of 10·6 years, 591 deaths occurred. After adjustment for potential confounders, the CV of total protein intake was not associated with all-cause mortality (HR and 95 % CI in the second and third tertile v. the lowest tertile: 0·94 (0·77, 1·15) and 0·88 (0·72, 1·08); Ptrend = 0·22). Similarly, the HR of all-cause mortality when comparing extreme tertiles of CV for types of protein were 0·89 (0·73, 1·10) for animal-protein intake and 1·02 (0·82, 1·25) for plant-protein intake. Dietary protein distribution across meals was not associated with all-cause mortality, regardless of protein source and amount, among older adults. Further studies should investigate whether this picture holds for specific causes of death.

Cooking methods are associated with inflammatory factors, renal function, and other hormones and nutritional biomarkers in older adults.

Evidence of the role of cooking methods on inflammation and metabolic health is scarce due to the paucity of large-size studies. Our aim was to evaluate the association of cooking methods with inflammatory markers, renal function, and other hormones and nutritional biomarkers in a general population of older adults. In a cross sectional analysis with 2467 individuals aged ≥ 65, dietary and cooking information was collected using a validated face-to-face dietary history. Eight cooking methods were considered: raw, boiling, roasting, pan-frying, frying, toasting, sautéing, and stewing. Biomarkers were analyzed in a central laboratory following standard procedures. Marginal effects from generalized linear models were calculated and percentage differences (PD) of the multivariable-adjusted means of biomarkers between extreme sex-specific quintiles (Q) of cooking methods consumption were computed ([Q5 - Q1/Q1] × 100). Participants' mean age was 71.6 years (53% women). Significant PD for the highest vs lowest quintile of raw food consumption was - 54.7% for high sensitivity-C reactive protein (hs-CRP), - 11.9% for neutrophils, - 11.9% for Growth Differentiation Factor-15, - 25.0% for Interleukin-6 (IL-6), - 12.3% for urinary albumin, and - 10.3% for uric acid. PD for boiling were - 17.8% for hs-CRP, - 12.4% for urinary albumin, and - 11.3% for thyroid-stimulating hormone. Concerning pan-frying, the PD was - 23.2% for hs-CRP, - 11.5% for IL-6, - 16.3% for urinary albumin and 10.9% for serum vitamin D. For frying, the PD was a 25.7% for hs-CRP, and - 12.6% for vitamin D. For toasting, corresponding figures were - 21.4% for hs-CRP, - 11.1% for IL-6 and 10.6% for vitamin D. For stewing, the PD was 13.3% for hs-CRP. Raw, boiling, pan-frying, and toasting were associated with healthy profiles as for inflammatory markers, renal function, thyroid hormones, and serum vitamin D. On the contrary, frying and, to a less extent, stewing showed unhealthier profiles. Cooking methods not including added fats where healthier than those with added fats heated at high temperatures or during longer periods of time.

Association of Lifestyle Behaviors With Hearing Loss: The UK Biobank Cohort Study.

OBJECTIVE: To examine the combined association of five healthy lifestyle behaviors with hearing loss (HL) in the UK Biobank cohort, established between 2006 and 2010 in the United Kingdom. METHODS: This longitudinal analysis included 61,958 participants aged 40 to 70 years from April 2007 to December 2016. The healthy behaviors examined were: never smoking, high level of physical activity, high diet quality, moderate alcohol intake, and optimal sleep. Hearing loss was self-reported at baseline and in any physical exam during the follow-up. RESULTS: Over a median follow-up of 3.9±2.5 years, 3072 (5.0%) participants reported incident HL. After adjustment for potential confounders, including age, social factors, exposure to high-intensity noise, ototoxic medication, and comorbidity, the HRs of HL associated with having 1, 2, 3, and 4 to 5 vs 0 behaviors were: 0.85 (95% CI, 0.75 to 0.96), 0.85 (95% CI, 0.75 to 0.96), 0.82 (95% CI, 0.71 to 0.94), and 0.80 (95% CI, 0.67 to 0.97), respectively (P for trend, 0.02). We estimated that the population attributable risk percent for not adhering to any five low-risk lifestyle behaviors was 15.6%. CONCLUSION: In this large study, an increasing number of healthy behaviors was associated with decreased risk of HL.

The Mediterranean Diet Protects Renal Function in Older Adults: A Prospective Cohort Study.

BACKGROUND: Chronic kidney disease entails a high disease burden that is progressively increasing due to population aging. However, evidence on the effect of the Mediterranean diet on renal function is limited, in particular among older adults in Mediterranean countries. METHODS: Prospective cohort study with 975 community-dwelling adults aged ≥ 60 recruited during 2008-2010 in Spain and followed up to 2015. At baseline, food consumption was obtained using a validated dietary history. Two Mediterranean dietary patterns were used: (i) An a priori-defined pattern, the Mediterranean Diet Adherence Screener (MEDAS score: low adherence: 0-5 points; moderate: 6-8 points; high: 9-14 points); (ii) An a posteriori Mediterranean-like dietary pattern, based on 36 food groups, which was generated using factor analysis. Renal function decline was calculated as an estimated glomerular filtration rate (eGFR) decrease ≥1 mL/min/1.73 m2 per year of follow-up. RESULTS: A total of 104 cases of renal function decline occurred. Compared with participants with a low MEDAS adherence, the multivariable-adjusted odds ratios (95% confident interval) for renal function decline risk were 0.63 (0.38-1.03) for moderate adherence, and 0.52 (0.29-0.95) for high adherence (p-trend: 0.015). Multivariable-adjusted odds ratios (95% confidence interval) for renal function decline risk according to increasing quartiles of the adherence to the a posteriori Mediterranean-like dietary pattern were 1.00, 0.67 (0.38-1.20), 0.65 (0.35-1.19), and 0.47 (0.23-0.96) (p-trend: 0.042). CONCLUSION: A higher adherence to a Mediterranean diet was associated with a lower risk of renal function decline in older adults, suggesting benefits to health of this dietary pattern in Mediterranean countries.

A Higher Intake of Energy at Dinner Is Associated with Incident Metabolic Syndrome: A Prospective Cohort Study in Older Adults.

A higher energy intake (EI) at night has been associated with a higher risk of obesity, while a higher EI at lunch may protect against weight gain. This study examined the association between EI throughout the day and incident metabolic syndrome (MetS) among older adults. A cohort of 607 individuals aged ≥ 60 free from MetS at baseline was followed from 2008-2010 until 2015. At baseline, habitual EI was assessed on six eating occasions: breakfast, mid-morning snack, lunch, afternoon snack, dinner, and snacking. MetS was defined according to the harmonized definition. Statistical analyses were performed with logistic regression and adjusted for the main confounders, including total EI, diet quality, and physical activity/sedentary behavior. During follow-up, 101 new MetS cases occurred. Compared to the lowest sex-specific quartile of EI at dinner, the OR (95% confidence interval) for incident MetS were: 1.71 (0.85-3.46) in the second, 1.70 (0.81-3.54) in the third, and 2.57 (1.14-5.79) in the fourth quartile (p-trend: 0.034). Elevated waist circumference and triglycerides were the MetS components that most contributed to this association. A higher EI at dinner was associated with a higher risk of MetS in older adults. Reducing EI at dinner might be a simple strategy to prevent MetS.

High Consumption of Ultra-Processed Food is Associated with Incident Dyslipidemia: A Prospective Study of Older Adults.

BACKGROUND: Ultra-processed food (UPF) consumption has been associated with higher cardiovascular disease (CVD) and mortality risks. OBJECTIVES: The aim of this study was to assess the relationship between UPF consumption and incident dyslipidemia in older adults, where evidence is limited. METHODS: We studied a prospective cohort of 1082 community-dwelling adults in Spain, older than 60 (mean age, 68 ± 6 years old). Participants (52% were women) were recruited between 2008-10 and followed up to 2015. At baseline, food intake data were collected using a validated computerized face-to-face dietary history. UPFs were identified according to the nature and extent of their industrial processing (NOVA classification). Triglycerides, HDL cholesterol, and LDL cholesterol were measured in fasting plasma samples collected at baseline and at follow-up. Statistical analyses were performed with logistic regression adjusted for the main potential confounders. RESULTS: Among those free of corresponding dyslipidemia at baseline, and after a follow-up of between 5 to 7 years, 60 (out of 895) developed incident hypertriglyceridemia (≥150 mg/dL), 112 (out of 878) had low HDL cholesterol (<40 in men/<50 mg/dL in women), and 54 (out of 472) had high LDL cholesterol (>129 mg/dL). The mean percentage of UPF consumption was 19% ± 11% of total energy intake. Those in the highest versus the lowest tertile of energy intake from UPFs had more than twice the odds of incident hypertriglyceridemia (OR, 2.66; 95% CI: 1.20-5.90; P-trend, 0.011) or low HDL cholesterol (OR, 2.23; 95% CI: 1.22-4.05; P-trend, 0.012). UPF consumption was not associated with high LDL cholesterol plasma concentrations. CONCLUSIONS: Although UPF consumption in Spain was low among older adults, high consumption of UPFs was clearly associated with incident dyslipidemia. The increase in CVD risk recently found to be associated with UPF consumption might be mediated by these atherogenic lipid abnormalities.

Ultra-Processed Food Consumption is Associated with Renal Function Decline in Older Adults: A Prospective Cohort Study.

Ultra-processed food (UPF) consumption has been associated with increased risk of cardiovascular risk factors and mortality. However, little is known on the UPF effect on renal function. The aim of this study is to assess prospectively the association between consumption of UPF and renal function decline. This is a prospective cohort study of 1312 community-dwelling individuals aged 60 and older recruited during 2008-2010 and followed up to December 2015. At baseline, a validated dietary history was obtained. UPF was identified according to NOVA classification. At baseline and at follow-up, serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) levels were ascertained and changes were calculated. A combined end-point of renal decline was considered: SCr increase or eGFR decreased beyond that expected for age. Logistic regression with adjustment for potential confounders was performed. During follow-up, 183 cases of renal function decline occurred. The fully adjusted odds ratios (95% CI) of renal function decline across terciles of percentage of total energy intake from UPF were 1.56 (1.02-2.38) for the second tercile, and 1.74 (1.14-2.66) for the highest tercile; p-trend was 0.026. High UPF consumption is independently associated with an increase higher than 50% in the risk of renal function decline in Spanish older adults.

General and central obesity operate differently as predictors of falls requiring medical care in older women: a population-based cohort study in Spain.

OBJECTIVES: to examine the association of general and abdominal obesity with falls, falls requiring medical care and falls with fractures in older women. DESIGN: a population-based prospective cohort of 1,185 women aged ≥60 in Spain, followed up from 2008 to 2010 through 2012. MEASURES: weight, height and waist circumference were measured at baseline using standardised techniques. Participants were classified according to body mass index as normal weight (<25), overweight (25-29.9) and general obesity (≥30). Abdominal obesity was defined as waist circumference >88 cm. In 2012, participants reported the falls experienced in the previous year. Logistic regression models were mutually adjusted for general and abdominal obesity and for main confounders. RESULTS: in this cohort of older women, a total of 336 women experienced falls, 168 of them had falls requiring medical care and 64 falls with fractures. For falls, no association was found with general obesity nor abdominal obesity. However, compared with normal weight, overweight women had a decreased risk for falls requiring medical care [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.34-0.94] and for falls with fractures (OR 0.27; 95% CI 0.12-0.63). The corresponding values for general obesity were 0.44 (0.24-0.81) and 0.30 (0.11-0.82). Abdominal obesity was positively associated with falls requiring medical care (OR 1.82; 95% CI 1.12-2.94) and falls with fractures (OR 2.75; 95% CI 1.18-6.44). CONCLUSIONS: in older women, general obesity may protect from falls requiring medical care and falls with fractures. On the contrary, abdominal obesity increased the risk of suffering from types of falls.

[Cardiovascular preventive recommendations. PAPPS 2020 update]. / Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2020.

The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: Epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; Cardiovascular (CV) risk tables and recommendations for the calculation of CV risk; Main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; Indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation. The quality of testing and the strength of the recommendation are included in the main recommendations.

Twenty four-hour activity cycle in older adults using wrist-worn accelerometers: The seniors-ENRICA-2 study.

OBJECTIVES: This study aimed: (a) to provide a detailed description of sleep, sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) over the complete 24-hours period using raw acceleration data in older adults; and (b) to examine the differences in the 24-hours activity cycle by sex, age, education, and body mass index (BMI). METHODS: Population-based cohort comprising 3273 community-dwelling individuals (1739 women), aged 71.8 ± 4.5 years, participating in the Seniors-ENRICA-2 study. Participants wore a wrist-worn ActiGraph GT9X accelerometer for 7 consecutive days, and the raw signal was processed using the R-package GGIR. RESULTS: Participants reached 21.5 mg as mean acceleration over the whole day; 32.3% (7.7 h/d) of time was classified as sleep, 53.2% (12.7 h/d) as SED, 10.4% (148.6 min/d) as LPA, and 4.1% (59.0 min/d) as MVPA. No marked differences were found in sleep-related variables between socio-demographic and BMI groups. However, women showed higher LPA but lower SED and MVPA than men. Moreover, SED increased whereas LPA and MVPA decreased with age. Participants with obesity (BMI ≥ 30 kg/m2 ) accumulated more SED and less LPA and MVPA than those without obesity. As expected, adherence to physical activity recommendations varied widely (9.2%-76.6%) depending on the criterion of MVPA accumulation. CONCLUSION: Objective assessment of the 24-hour activity cycle provides extensive characterization of daily activities distribution in older adults and may inform health-promotion interventions in this population. Women, the oldest old, and those with obesity offer relevant targets of strategies to improve lifestyle patterns.

Combined Impact of Traditional and Nontraditional Healthy Behaviors on Frailty and Disability: A Prospective Cohort Study of Older Adults.

OBJECTIVES: To assess the short- and long-term association of 6 healthy behaviors (not smoking, vigorous to moderate physical activity, healthy diet, adequate sleeping duration, not being sedentary, and daily social interaction) with incident frailty and disability. DESIGN: Prospective population-based study. SETTINGS AND PARTICIPANTS: In 2001, 4008 community-dwelling individuals aged ≥60 years in Spain were recruited. Participants were followed up until 2003, when a short-term phone interview of the remaining 3235 individuals was performed. Then, the participants were followed up until 2009, when a long-term phone interview was conducted with 1309 participants. MEASURES: At baseline, a home interview and a physical examination were conducted to assess healthy behaviors. At baseline and at follow-ups, we ascertained frailty and 4 domains of disability: limitation in instrumental activities of daily living, restriction in daily activities, limitation in mobility, and self-care limitation. RESULTS: In the short-term analyses, vigorous to moderate physical activity and not being sedentary were associated with a reduction in frailty, multivariable odds ratios (OR) (95% confidence interval) 0.55 (0.35-0.85) and 0.43 (0.26-0.72). Vigorous to moderate physical activity and adequate sleeping duration decreased instrumental activities of daily living limitation OR 0.63 (0.44-0.91) and 0.69 (0.53-0.89) as well as self-care limitation OR 0.62 (0.41-0.92) and 0.65 (0.45-0.94). Adequate sleep duration and not being sedentary decreased restriction in daily activities OR 0.67 (0.49-0.90) and 0.57 (0.36-0.91). Vigorous to moderate physical activity and healthy diet decreased limitation in mobility OR 0.58 (0.35-0.96) and 0.73 (0.54-0.97). Considering these 5 healthy behaviors, participants who scored 5 (vs ≤ 2) in the combined score had a lower risk of frailty and disability. In the long-term analyses, results showed the same direction as in short-term analyses. CONCLUSIONS AND IMPLICATIONS: The combination of healthy behaviors is associated with a substantial reduction in the risk of frailty and of most disability outcomes in older adults.

Dietary n-3 polyunsaturated fatty acids, fish intake and healthy ageing.

BACKGROUND: Seafood consumption and dietary intake of n-3 polyunsaturated fatty acids (PUFA) protect from cardiovascular disease, muscle wasting and mortality; however, their role in delaying unhealthy ageing is uncertain. METHODS: A prospective cohort study with 1592 community-dwelling individuals aged ≥60 years recruited in 2008-2010, and followed through 2015. Intake of seafood and n-3 PUFA [eicosapentanoic acid (EPA) and docosahexanoic acid (DHA)] was estimated using a validated diet history and food composition tables. Unhealthy ageing was assessed across the domains of physical and cognitive function, mental health, morbidity, self-rated health and vitality. RESULTS: Higher blue fish consumption was negatively associated with unhealthy ageing in 2015 [multivariate ß (95% confidence interval) per interquartile range (IQR) increase of fish: -0.49 (-0.90; -0.08)] and, specifically, was associated with lower accumulation of functional impairments [-1.00 (-1.71; -0.28)] and morbidities [-0.30 (-0.73; 0.13)]. Individuals with high intakes of EPA (≥0.47 g/day) and DHA (≥0.89 g/day) presented the highest reductions in age-related deficits accumulation: -1.61 (-3.01; -0.22) and -1.34 (-2.76; 0.08), respectively. Intake of EPA and DHA were negatively associated with the accumulation of functional deficits [results per IQR increase: -0.79 (-1.64; -0.06) and -0.84 (-1.67; -0.01), respectively] and morbidities [-0.60 (-1.10; -1.11) and -0.60 (-1.09; -0.11)]. No associations were observed between n-3 PUFA and self-rated or mental health, or between white fish and unhealthy ageing. CONCLUSIONS: In this cohort of Spanish individuals with elevated intake of fish and a high adherence to the Mediterranean diet, consumption of blue fish and n-3 PUFA had a prospective protective association with deficits accumulation.

Diagnóstico en hipertensión arterial: cuando las técnicas no son accesibles en atención primaria y además se producen inequidades / Diagnosis in blood hypertension: When the techniques do not are accessible in primary care and are also produced inequities

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Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2018 / No disponible

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[Influence of habitual chocolate consumption over the Mini-Mental State Examination in Spanish older adults]. / Consumo habitual de chocolate y estado cognitivo en los adultos mayores españoles.

BACKGROUND: There are associations described between dementia, mild cognitive impairment (MCI) and foods with a high content of polyphenols. OBJECTIVE: To assess the infl uence of habitual chocolate consumption over the MMSE in Spanish older adults. METHODOLOGY: Cross-sectional study, using data of the follow-up of the Seniors-Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) cohort. Habitual chocolate consumption in the last year was assessed with a computerized dietary history; differences between dark chocolate and milk chocolate were recorded. Chocolate intake was classified into the following categories: no consumption, < 10 g/day, and ≥ 10 g/day. Validated MMSE scores for Spain were obtained during an interview and different cutoff points were used to define ≤ 25, ≤ 24 and ≤ 23. Linear and logistic regression models were used to calculate adjusted beta coefficients and odds ratios (OR). RESULTS: Compared to non-consumers, participants with a habitual chocolate consumption of ≥ 10 g/d had a better MMSE score (adjusted beta coefficient and 95% confidence interval: 0.26 (0.02-0.50; p trend = 0.05); for dark chocolate, the results were also statistically significant (0.48 [0.18-0.78]; p trend < 0.001). Total chocolate consumption was not associated with higher likelihood of having MCI. However, dark chocolate consumption was associated with less likelihood of MCI (OR and 95%CI for MMSE ≤ 25: 0.39 [0.20-0.77]; for MMSE ≤ 24: 0.26 [0.10-0.67]; and for MMSE ≤ 23: 0.25 [0.07-0.82]). CONCLUSION: Our results suggest that habitual dark chocolate consumption might improve cognitive function among the older population.

ANTECEDENTES: estudios previos han encontrado que el consumo de flavonoides se asocia a menor riesgo de deterioro cognitivo. Sin embargo, el efecto del consumo habitual de chocolate sobre el estado cognitivo no está bien esclarecido. OBJETIVO: examinar si el consumo habitual de chocolate se asocia con un mejor estado cognitivo en adultos mayores españoles. METODOLOGÍA: estudio transversal, utilizando datos del estudio ENRICA-Senior. El consumo habitual de chocolate fue evaluado con una historia dietética informatizada. Los participantes fueron divididos en las siguientes categorías, de acuerdo a su consumo de chocolate: sin consumo, < 10 g/d y ≥ 10 g/d. El estado cognitivo fue determinado mediante la versión del test Mini-Mental State Examination (MMSE) para España. Los puntos de corte para definir deterioro cognitivo leve (DCL) fueron: ≤ 25, ≤ 24 y ≤ 23. Se utilizaron modelos de regresión lineal y logística ajustados por los principales factores confusores para calcular coeficientes beta y odds ratios(OR) de asociación. RESULTADOS: en comparación con el grupo de personas que no reportaron consumir chocolate, aquellos con un consumo habitual de ≥ 10 g/d obtuvieron una mayor puntuación en el MMSE (coeficiente beta e intervalo de confianza al 95% [IC 95%] del modelo ajustado: 0,26 [0,02-0,50]; p de tendencia lineal = 0,05). Cuando examinamos la asociación solo con chocolate negro, los resultados también fueron significativos (coeficiente beta: 0,48 [IC 95%: 0,18-0,78]; p de tendencia lineal < 0,001). El consumo de chocolate total no se asoció con DCL en ninguna de las definiciones propuestas. Sin embargo, el consumo de chocolate negro se asoció con menor probabilidad de DCL (OR e IC 95% para MMSE ≤ 25: 0,39 [0,20-0,77]; para MMSE ≤ 24: 0,26 [0,10-0,67]; y para MMSE ≤ 23: 0,25 [0,07-0,82]). CONCLUSIÓN: estos resultados sugieren que puede existir una asociación entre consumo de chocolate y mejor función cognitiva en personas mayores.