Meat Consumption and Risk of Developing Type 2 Diabetes in the SUN Project: A Highly Educated Middle-Class Population.

BACKGROUND: Meat consumption has been consistently associated with the risk of diabetes in different populations. The aim of our study was to investigate the incidence of type 2 diabetes according to baseline total meat consumption in a longitudinal assessment of a middle-aged Mediterranean population. METHODS: We followed 18,527 participants (mean age: 38 years, 61% women) in the SUN Project, an open-enrolment cohort of a highly educated population of middle-class Spanish graduate students. All participants were initially free of diabetes. Diet was assessed at baseline using a semi-quantitative food frequency questionnaire of 136-items previously validated. Incident diabetes was defined according to the American Diabetes Association's criteria. RESULTS: We identified 146 incident cases of diabetes after a maximum of 14 years of follow-up period (mean: 8.7 years). In the fully adjusted model, the consumption of ≥3 servings/day of all types of meat was significantly associated with a higher risk of diabetes (HR: 1.85; 95% CI: 1.03-3.31; p for trend = 0.031) in comparison with the reference category (<2 servings/day). When we separated processed from non-processed meat, we observed a non-significant higher risk associated with greater consumption of processed meat and a non-significant lower risk associated with non-processed meat consumption (p for trend = 0.123 and 0.487, respectively). No significant difference was found between the two types of meat (p = 0.594). CONCLUSIONS: Our results suggest that meat consumption, especially processed meat, was associated with a higher risk of developing diabetes in our young Mediterranean cohort.

Propuesta de perfil de ácidos grasos omega 3 en nutrición enteral / Proposed profile of omega 3 fatty acids in enteral nutrition

Revisamos las recomendaciones internacionales de ingesta oral de ácidos grasos n-3.y su contenido en las fórmulas de nutrición enteral. Sus acciones metabólicas dependen de su metabolización a EPA y DHA. La actividad de las 5D y 6D desaturasas, que catalizan este proceso, aumenta con el ejercicio, insulina, estrógenos de mujer fértil y proliferadores peroxisómicos, mientras que disminuye con el ayuno, déficit de proteínas y oligoelementos, edad > 30 años, sedentarismo, tabaco, alcohol, colesterol, ácidos grasos trans y saturados, insulinopenia y hormonas de estrés (adrenalina y glucocorticoides). La mayoría de las guías recomiendan 20-35% de la energía total en forma de grasas, repartidas en saturadas 7-10%, poliinsaturadas 6-10% y monoinsutaradas en España 20%. El de AG n-3 es de 0,5-2 g/día o bien 0,5-2% de la ingesta calórica total, con un límite superior de 3 g/día. El de AG n-6 es del 2,5-10% del aporte calórico total y el cociente recomendado n-6/n-3 no está bien definido pero la mayoría recomienan 5/1. El contenido en EPA y DHA, debe ser de al menos los 500 mg diarios. Por último, la ratio EPA/DHA en la mayoría es de 2/1. Las fórmulas de nutrición estándar presentan un contenido en grasas adecuado, pero la mayoría de los productos que contienen EPA y DHA exceden el límite de los 3 g/día. De los productos hiperproteicos y/o concentrados por vía oral sólo un producto de este grupo contiene EPA y DHA. Las del anciano frágil no todas aportan EPA y DHA y las que los contienen, su concentración puede ser incluso excesiva y en una relación poco parecida a la del aceite de pescado (AU)

We review the international recommendations on oral intake of n-3 fatty acids and their content in the enteral nutrition formulas. Their metabolic actions depend on their metabolization to EPA and DHA. The activity of desaturases catalyzing this process increases with exercise, insulin, estrogens in the fertile women, and peroxisomal proliferators, whereas it decreases with fasting, protein and oligoelements deficiencies, age < 30 years, sedentary lifestyle, cigarette smoking, alcohol, cholesterol, trans and saturated fatty acids, insulin deficiency, and stress hormones (adrenalin and glucocorticoids). Most of the guidelines recommend that 20-35% of the total energy comes from fat, being 7-10% saturated fats, 6-10% polyunsaturated, and 20% monounsaturated, in Spain. The recommendation for n-3 FA is 0.5-2 g/day or 0.5-2% of total caloric intake, with an upper limit of 3 g/day. For n-6 FA, 2.5-10% of total caloric intake, the n-6/n-3 ratio not being well established although most of the guidelines recommend 5:1. The EPA and DHA content should be at least 500 mg per day. Finally, the EPA/DHA ratio is 2:1 in most of them. Standard nutrition formulas present an appropriate fat content, although most of the products containing EPA and DHA exceed the limit of 3 g/day. Among the products with hyperprotein and/or concentrated, only of them contains EPA y DHA. Not all the formulas used for the frail elderly contain EPA or DHA, and in those containing them their concentration may be excessive and with a proportion very dissimilar to that of fish oil (AU)

[Proposed profile of omega 3 fatty acids in enteral nutrition]. / Propuesta de perfil de ácidos grasos omega 3 en nutrición enteral.

We review the international recommendations on oral intake of n-3 fatty acids and their content in the enteral nutrition formulas. Their metabolic actions depend on their metabolization to EPA and DHA. The activity of desaturases catalyzing this process increases with exercise, insulin, estrogens in the fertile women, and peroxisomal proliferators, whereas it decreases with fasting, protein and oligoelements deficiencies, age < 30 years, sedentary lifestyle, cigarette smoking, alcohol, cholesterol, trans and saturated fatty acids, insulin deficiency, and stress hormones (adrenalin and glucocorticoids). Most of the guidelines recommend that 20-35% of the total energy comes from fat, being 7-10% saturated fats, 6-10% polyunsaturated, and 20% monounsaturated, in Spain. The recommendation for n-3 FA is 0.5-2 g/day or 0.5-2% of total caloric intake, with an upper limit of 3 g/day. For n-6 FA, 2.5-10% of total caloric intake, the n-6/n-3 ratio not being well established although most of the guidelines recommend 5:1. The EPA and DHA content should be at least 500 mg per day. Finally, the EPA/DHA ratio is 2:1 in most of them. Standard nutrition formulas present an appropriate fat content, although most of the products containing EPA and DHA exceed the limit of 3 g/day. Among the products with hyperprotein and/or concentrated, only of them contains EPA y DHA. Not all the formulas used for the frail elderly contain EPA or DHA, and in those containing them their concentration may be excessive and with a proportion very dissimilar to that of fish oil.

[Olive oil consumption and incidence of diabetes mellitus, in the Spanish sun cohort]. / Consumo de aceite de oliva e incidencia de diabetes mellitus en la cohorte española seguimiento Universidad de Navarra (SUN).

INTRODUCTION: The beneficial effects of the overall Mediterranean dietary pattern on cardiovascular risk factors and on carbohydrate metabolism are well known; however, it is unclear whether the consumption of olive oil in particular is able to reduce the incidence of type 2 diabetes. OBJECTIVE: To evaluate the specific effect of olive oil consumption on the risk of developing type 2 diabetes mellitus in a large Spanish cohort (the SUN Project). METHODS: We followed up 10,491 participants for a median of 5.7 years. Habitual diet was assessed at baseline with a semi-quantitative 136-item food-frequency questionnaire previously validated in Spain. The outcome of interest was incident type 2 diabetes diagnosed by a physician and confirmed by review of a medical report. The multivariate-adjusted odds ratios for incident type 2 diabetes for each of the 4 upper quintiles of olive oil consumption using the lowest quintile as the reference were assessed using logistic regression models. RESULTS: At baseline mean age was 38.9 + 11.38 year with a BMI of 23.8 + 3.41 kg/m². Forty two new cases of diabetes mellitus were diagnosed during follow-up. The adjusted odds ratio for the highest vs. the lowest quintile of consumption of olive oil was 1.11 (95% CI: 0.45-2.78; p for trend = 0.32). CONCLUSIONS: We found no association between olive oil consumption and the incidence of type 2 diabetes. The lack of association could be attributed to the small number of observed incident cases of diabetes. Further studies in Mediterranean countries with a longer follow-up and a higher baseline risk are needed to evaluate this association.

Consumo de aceite de oliva e incidencia de diabetes mellitus en la cohorte española seguimiento Universidad de Navarra (SUN) / Olive oil consumption and incidence of diabetes mellitus, in the spanish SUN cohort

Introducción: Se conoce el beneficio de la dieta mediterránea sobre los factores de riesgo cardiovascular y sobre el metabolismo hidrocarbonado. No está claro sin embargo, el papel particular del aceite de oliva sobre la incidencia de diabetes mellitus tipo 2. Objetivo: Evaluar el efecto específico del consumo de aceite de oliva sobre el riesgo de desarrollar diabetes mellitus tipo 2 en la cohorte española Seguimiento Universidad de Navarra. Métodos: Un total de 10.491 participantes seguidos durante una media de 5,7 años fueron incluidos en el análisis. La valoración dietética inicial se realizó mediante un cuestionario previamente validado y con un total de 136 ítems. El evento de interés fueron los nuevos casos de diabetes incidente diagnosticados a los participantes durante el seguimiento mediante evaluaciones repetidas cada dos años. Se estimaron los riesgos relativos (odds ratios) de diabetes asociados a cada nivel de consumo de aceite de oliva (quintiles) mediante modelos de regresión logística para ajustar por posibles factores de confusión.Resultados: La edad media fue de 38,9 + 11,4 años, con uníndice de masa corporal de 23,8 + 3,4 kg/m2. Se detectaron durante el seguimiento 42 nuevos casos de diabetes mellitustipo 2. No hubo relación estadísticamente significativa entre el consumo de aceite de oliva y el riesgo de diabetes. La odd sratio ajustada para el quintil superior (vs. el inferior) fue de1,11 (IC 95% 0,45-2,78) (p de tendencia = 0,32).Conclusiones: No hemos encontrado asociación entre el consumo de aceite de oliva y la incidencia de diabetes tipo 2 en esta cohorte. La ausencia de asociación encontrada se podría atribuir a los pocos casos incidentes en una población sana y con pocos factores de riesgo. Probablemente sea necesario un seguimiento más prolongado de una cohorte Mediterránea con mayor riesgo basal para poder evaluar esta asociación (AU)

Introduction: The beneficial effects of the overall Mediterranean dietary pattern on cardiovascular risk factors and on carbohydrate metabolism are well known;however, it is unclear whether the consumption of olive oil in particular is able to reduce the incidence of type 2 diabetes.O bjective: To evaluate the specific effect of olive oil consumption on the risk of developing type 2 diabetes mellitus in a large Spanish cohort (the SUN Project).Methods: We followed up 10,491 participants for amedian of 5,7 years. Habitual diet was assessed at baseline with a semi-quantitative 136-item food-frequency questionnaire previously validated in Spain. The outcome of interest was incident type 2 diabetes diagnosed by a physician and confirmed by review of a medical report.The multivariate-adjusted odds ratios for incident type 2 diabetes for each of the 4 upper quintiles of olive oil consumptionusing the lowest quintile as the reference were assessed using logistic regression models. Results: At baseline mean age was 38,9 + 11,38 yearwith a BMI of 23,8 + 3,41 kg/m2. Forty two new cases of diabetes mellitus were diagnosed during follow-up. The adjusted odds ratio for the highest vs. the lowest quintile of consumption of olive oil was 1.11 (95% CI: 0.45-2.78; pfor trend = 0.32).Conclusions: We found no association between olive oil consumption and the incidence of type 2 diabetes. The lack of association could be attributed to the small number of observed incident cases of diabetes. Further studies in Mediterranean countries with a longer follow-up and a higher baseline risk are needed to evaluate this association (AU)