[Nutrition and gastronomy in Aragón]. / Nutrición y gastronomía en Aragón.

INTRODUCTION: Objectives: review the knowledge on the nutritional situation of the Aragonese population and on Aragón's own gastronomy as necessary elements for the welfare and health of its population. Methods: literature review in relation to the subject. Results: a gastronomy characteristic of Aragón is identified. The main finding identified on the literature review is to do with the historical evolution of the population in the Aragonese territory. At present, the population tends to concentrate in provincial urban centers, mainly in Zaragoza, where the food tradition tends to be diluted by external influences. The health authorities qualify quality foods by PGI (Protected Geographical Indication) certifications in wines and oils, as well as vegetables and meats. Aragón is the fifth county in food consumption per inhabitant in Spain with the highest consumption of potatoes and fresh vegetables from Spain. Meat consumption is high and are those who have a greater energy intake from lipids of all the autonomous communities. These data are related to the fact that most men are overweight or obese. Conclusions: there is a lack of updated studies that assess the nutritional status of the population in Aragón. The last study was promoted by the National Pharmacists Vocalic of Nutrition of the CGCOF (General Council of Pharmaceutical Associations of Spain) throughout Spain for adults who perform some kind of physical activity. The nutritional education of the population must be improved so that they are able to choose rations and foods that promote their health and well-being and integrate traditional gastronomy into their daily diet as part of their cultural heritage.

INTRODUCCIÓN: Objetivos: revisar los conocimientos sobre la situación nutricional de la población aragonesa y sobre la gastronomía propia de Aragón como elementos necesarios para el bienestar y la salud de la población. Métodos: búsqueda bibliográfica en relación con el tema. Resultados: se identifica una gastronomía propia de Aragón relacionada con la evolución histórica de la población en el territorio. Actualmente, la población tiende a concentrarse en centros urbanos y capitales de provincia, especialmente en Zaragoza, donde la tradición alimentaria tiende a diluirse por influencias externas. Por parte de las autoridades se impulsan los alimentos de calidad con las certificaciones IGP tanto en vinos y aceites como en hortalizas y carnes. Los aragoneses se encuentran en el quinto lugar en consumo de alimentos por habitante de España, con el mayor consumo de patatas y hortalizas frescas. También tienen un elevado consumo de carnes y son quienes poseen un mayor aporte energético proveniente de lípidos de todas las comunidades autónomas. Estos datos estarían relacionados con que la mayoría de los varones adultos tienen sobrepeso u obesidad. Conclusiones: se echan en falta estudios más actualizados que valoren la situación nutricional de la población en Aragón. El último ha sido promovido por la Vocalía Nacional del Consejo General de Colegios Farmacéuticos (CGCOF) a nivel nacional para adultos que realizan actividad física. Debe mejorarse la educación nutricional de la población a fin de que sean capaces de elegir raciones y alimentos que promocionen su salud y bienestar e integren la gastronomía tradicional en su alimentación cotidiana como parte de su patrimonio cultural.

Nutrición y gastronomía en Aragón / Nutrition and gastronomy in Aragón

Objetivos: revisar los conocimientos sobre la situación nutricional de la población aragonesa y sobre la gastronomía propia de Aragón como elementos necesarios para el bienestar y la salud de la población. Métodos: búsqueda bibliográfica en relación con el tema. Resultados: se identifica una gastronomía propia de Aragón relacionada con la evolución histórica de la población en el territorio. Actualmente, la población tiende a concentrarse en centros urbanos y capitales de provincia, especialmente en Zaragoza, donde la tradición alimentaria tiende a diluirse por influencias externas. Por parte de las autoridades se impulsan los alimentos de calidad con las certificaciones IGP tanto en vinos y aceites como en hortalizas y carnes. Los aragoneses se encuentran en el quinto lugar en consumo de alimentos por habitante de España, con el mayor consumo de patatas y hortalizas frescas. También tienen un elevado consumo de carnes y son quienes poseen un mayor aporte energético proveniente de lípidos de todas las comunidades autónomas. Estos datos estarían relacionados con que la mayoría de los varones adultos tienen sobrepeso u obesidad. Conclusiones: se echan en falta estudios más actualizados que valoren la situación nutricional de la población en Aragón. El último ha sido promovido por la Vocalía Nacional del Consejo General de Colegios Farmacéuticos (CGCOF) a nivel nacional para adultos que realizan actividad física. Debe mejorarse la educación nutricional de la población a fin de que sean capaces de elegir raciones y alimentos que promocionen su salud y bienestar e integren la gastronomía tradicional en su alimentación cotidiana como parte de su patrimonio cultural

Objectives: review the knowledge on the nutritional situation of the Aragonese population and on Aragón’s own gastronomy as necessary elements for the welfare and health of its population. Methods: literature review in relation to the subject. Results: a gastronomy characteristic of Aragón is identified. The main finding identified on the literature review is to do with the historical evolution of the population in the Aragonese territory. At present, the population tends to concentrate in provincial urban centers, mainly in Zaragoza, where the food tradition tends to be diluted by external influences. The health authorities qualify quality foods by PGI (Protected Geographical Indication) certifications in wines and oils, as well as vegetables and meats. Aragón is the fifth county in food consumption per inhabitant in Spain with the highest consumption of potatoes and fresh vegetables from Spain. Meat consumption is high and are those who have a greater energy intake from lipids of all the autonomous communities. These data are related to the fact that most men are overweight or obese. Conclusions: there is a lack of updated studies that assess the nutritional status of the population in Aragón. The last study was promoted by the National Pharmacists Vocalic of Nutrition of the CGCOF (General Council of Pharmaceutical Associations of Spain) throughout Spain for adults who perform some kind of physical activity. The nutritional education of the population must be improved so that they are able to choose rations and foods that promote their health and well-being and integrate traditional gastronomy into their daily diet as part of their cultural heritage

Aflatoxins in sunflower seeds and unrefined sunflower oils from Singida, Tanzania.

A total of 61 samples comprising sunflower seeds (40) and unrefined sunflower oils (21) samples collected randomly from Singida, Tanzania were analysed by Reverse Phase-high performance liquid chromatography (RP-HPLC). 15% (6/40) of the seed samples were contaminated with aflatoxin B1 ranging from limit of detection (LOD) to 218 ng g-1 with three of them exceeding the European Commission/European Union (EC/EU) and Tanzania Bureau of Standards (TBS)/Tanzania Food and Drug Authority (TFDA) maximum limits of 2 ng g-1 for AFB1 in oilseeds. The levels of total aflatoxins (AFT) in seeds ranged from LOD to 243 ng g-1. Other aflatoxins, except AFG2, were also detected. For the unrefined sunflower oils, the levels of AFB1 ranged from LOD to 2.56 ng mL-1. About 80.9% (17/21) of the analysed oil samples contained AFB1 of which 17.65% (3/17) exceeded the EC/EU and TBS/TFDA maximum limits of 2 ng mL-1. Other aflatoxins were also detected in the oils. The measured levels indicate there is a need for food quality education among food processors.

Liver Protective Effects of Extra Virgin Olive Oil: Interaction between Its Chemical Composition and the Cell-signaling Pathways Involved in Protection.

BACKGROUND AND OBJECTIVE: The liver is an organ susceptible to a multitude of injuries that causes liver damage, like steatosis, non-alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, and ischemia-reperfusion injury. Extra virgin olive oil (EVOO), presents several protective effects on the liver, reducing hepatic steatosis, hepatocyte ballooning, fibrogenesis, preventing lipid peroxidation, among other effects. Due to its high levels of monounsaturated fatty acids, mainly oleic acid and phenolic compounds, such as hydroxytyrosol and oleuropein, EVOO is able to participate in the activation of different signaling pathways in the hepatocytes involved in the prevention of inflammation, oxidative stress, endoplasmic reticulum stress, mitochondrial dysfunction, and insulin resistance, allowing the prevention or resolution of liver damage. The aim of this work is to offer an update of the molecular effects of EVOO in the liver and its protective properties to prevent the establishment of liver damage through the regulation of different cell-signaling pathways. METHODS: Searches that considered the effects of EVOO in in vivo and in vitro models, whith emphasis in the molecular mechanism of liver tissue damage and prevention and/or treatment of steatosis, steatohepatitis, cirrhosis, hepatocellular carcinoma, and ischemia-reperfusion injury. CONCLUSION: The most relevant molecular effects of EVOO involved in the prevention or resolution of liver damage are: (i) Activation of the nuclear transcription factor erythroid-derived 2-like 2 (Nfr2), inducing the cellular antioxidant response; (ii) Inactivation of the nuclear transcription factor-κB (NF- κB), preventing the cellular inflammatory response; and (iii) Inhibition of the PERK pathway, preventing endoplasmic reticulum stress, autophagy, and lipogenic response.

[Dietary Recommendations in Metabolic Vascular Syndrome]. / Ernährungsempfehlungen beim metabolisch-vaskulären Syndrom.

Cardiovascular disease is the number one cause of death globally. Poor diet constitutes a key factor in the initiation and progression of cardiovascular disease and has become the leading risk factor for disability and death worldwide. Therefore, addressing suboptimal nutrition is of key prognostic relevance in primary and secondary prevention of metabolic vascular syndrome.Metabolic vascular syndrome is a multidimensional network of acquired cardiometabolic risk factors closely related to insulin resistance (IR) and concomitant hyperinsulinemia. IR, being the underlying cause of metabolic vascular syndrome and certain types of cancer, should attract the attention of every clinician. As changes in lipoprotein metabolism are one of the earliest indicators of metabolic dysfunction, a relevant biomarker for identifying individuals with IR is the TAG/HDL-C ratio.IR - and concomitant metabolic vascular risk - can be effectively treated by lifestyle intervention. If IR is present, dietary carbohydrate restriction has consistently been shown to be superior to dietary fat restriction in reversing metabolic dysfunction. The beneficial effects of carbohydrate restricted diets on metabolic vascular risk are independent of BMI - diet quality therefore confers patient benefit beyond weight reduction.The effect of single nutrients on isolated lipid surrogate markers such as LDL-C does not capture their global effect on metabolic vascular risk.Targeting IR with a low glycemic load, real food diet will reduce overall energy density and will improve all risk factors of metabolic vascular syndrome. In particular, replacing refined carbohydrates with healthy fats in the context of a Mediterranean style-, low carbohydrate and calorie-unrestricted dietary pattern has been shown to significantly reduce burden of metabolic vascular disease.

Virgin olive oil: a key food for cardiovascular risk protection.

Olive oil is considered to be one of the most healthy dietary fats. However, several types of olive oils are present in the market. A key question for the consumer is: What of the olive oils is the best when concerning nutritional purposes? With the data available at present, the answer is: the Virgin Olive Oil (VOO), rich in phenolic compounds. On November 2011, the European Food Safety Authority released a claim concerning the benefits of daily ingestion of olive oil rich in phenolic compounds, such as VOO. In this review, we summarised the key work that has provided the evidence of the benefits of VOO consumption on other types of edible oils, even olive oils. We focused on data from randomised, controlled human studies, which are capable of providing the evidence of Level I that is required for performing nutritional recommendations at population level.

Does cooking with vegetable oils increase the risk of chronic diseases?: a systematic review.

Overweight/obesity, CVD and type 2 diabetes are strongly associated with nutritional habits. High consumption of fried foods might increase the risk of these disorders. However, it is not clear whether the use of vegetables oils for cooking increases the risk of chronic diseases. We systematically searched for published studies that assessed the association between vegetable oil consumption including fried food consumption and the risk of overweight/obesity or weight gain, T2DM or the metabolic syndrome, and CVD or hypertension in the following databases: PubMed; Web of Science; Google Scholar. Keywords such as 'fried food' or 'vegetable oil' or 'frying' or 'frying oils' or 'dietary fats' and 'weight gain' or 'overweight' or 'obesity' or 'CHD' or 'CVD' or 'type 2 diabetes' or 'metabolic syndrome' were used in the primary search. Additional published reports were obtained through other sources. A total of twenty-three publications were included based on specific selection criteria. Based on the results of the studies included in the present systematic review, we conclude that (1) the myth that frying foods is generally associated with a higher risk of CVD is not supported by the available evidence; (2) virgin olive oil significantly reduces the risk of CVD clinical events, based on the results of a large randomised trial that included as part of the intervention the recommendation to use high amounts of virgin olive oil, also for frying foods; and (3) high consumption of fried foods is probably related to a higher risk of weight gain, though the type of oil may perhaps modify this association.

Quantitative analysis and health risk assessment of polycyclic aromatic hydrocarbons in edible vegetable oils marketed in Shandong of China.

This work studies on the quantitative analysis and health risk assessment of polycyclic aromatic hydrocarbons (PAHs) in edible vegetable oils in Shandong, China. The concentrations of 15 PAHs in 242 samples were determined by high performance liquid chromatography coupled with fluorescence detection. The results indicated that the mean concentration of 15 PAHs in oil samples was 54.37 µg kg(-1). Low molecular weight PAH compounds were the predominant contamination. Especially, the carcinogenic benzo(a)pyrene (BaP) was detected at a mean concentration of 1.28 µg kg(-1), which was lower than the limit of European Union and China. A preliminary evaluation of human health risk assessment for PAHs was accomplished using BaP toxic equivalency factors and the incremental lifetime cancer risk (ILCR). The ILCR values for children, adolescents, adults, and seniors were all larger than 1 × 10(-6), indicating a high potential carcinogenic risk on the dietary exposed populations.

Fumonisins B1, B2 and B3 in corn products, wheat flour and corn oil marketed in Shandong province of China.

In this study a total of 522 samples were collected from Shandong province of China in 2014 and analysed for the occurrence of fumonisin B1 (FB1), FB2 and FB3 by isotope dilution ultrahigh performance liquid chromatography-tandem mass spectrometry. Fumonisins were detected in 98.1% of the corn products, with the average total level of 369.2 µg kg(-1). The individual average values of FB1, FB2 and FB3 in corn products were 268.3, 53.7 and 47.2 µg kg(-1), respectively. The simultaneous occurrence of FB1, FB2 and FB3 was observed in 76.7% of the corn products. Especially, the results demonstrated that the difference in the contamination levels for fumonisins in these three types of corn products was apparent. In addition, 6.2% of the wheat flour samples were contaminated with FB1, with concentrations ranging from 0.3 to 34.6 µg kg(-1). No FB2 or FB3 was detected in wheat flour. In corn oil samples no fumonisins were detected.

Virgin olive oil, palm olein and coconut oil diets do not raise cell adhesion molecules and thrombogenicity indices in healthy Malaysian adults.

BACKGROUND/OBJECTIVES: Effects of high-protein diets that are rich in saturated fats on cell adhesion molecules, thrombogenicity and other nonlipid markers of atherosclerosis in humans have not been firmly established. We aim to investigate the effects of high-protein Malaysian diets prepared separately with virgin olive oil (OO), palm olein (PO) and coconut oil (CO) on cell adhesion molecules, lipid inflammatory mediators and thromobogenicity indices in healthy adults. METHODS: A randomized cross-over intervention with three dietary sequences, using virgin OO, PO and CO as test fats, was carried out for 5 weeks on each group consisting of 45 men and women. These test fats were incorporated separately at two-thirds of 30% fat calories into high-protein Malaysian diets. RESULTS: For fasting and nonfasting blood samples, no significant differences were observed on the effects of the three test-fat diets on thrombaxane B2 (TXB2), TXB2/PGF1α ratios and soluble intracellular and vascular cell adhesion molecules. The OO diet induced significantly lower (P<0.05) plasma leukotriene B4 (LTB4) compared with the other two test diets, whereas PGF1α concentrations were significantly higher (P<0.05) at the end of the PO diet compared with the OO diet. CONCLUSION: Diets rich in saturated fatty acids from either PO or CO and high in monounsaturated oleic acid from virgin OO do not alter the thrombogenicity indices-cellular adhesion molecules, thromboxane B2 (TXB2) and TXB2/prostacyclin (PGF1α) ratios. However, the OO diet lowered plasma proinflammatory LTB4, whereas the PO diet raised the antiaggregatory plasma PGF1α in healthy Malaysian adults. This trial was registered at clinicaltrials.gov as NCT 00941837.

Extravirgin olive oil up-regulates CB1 tumor suppressor gene in human colon cancer cells and in rat colon via epigenetic mechanisms.

Extravirgin olive oil (EVOO) represents the typical lipid source of the Mediterranean diet, an eating habit pattern that has been associated with a significant reduction of cancer risk. Diet is the more studied environmental factor in epigenetics, and many evidences suggest dysregulation of epigenetic pathways in cancer. The aim of our study was to investigate the effects of EVOO and its phenolic compounds on endocannabinoid system (ECS) gene expression via epigenetic regulation in both human colon cancer cells (Caco-2) and rats exposed to short- and long-term dietary EVOO. We observed a selective and transient up-regulation of CNR1 gene - encoding for type 1 cannabinoid receptor (CB1) - that was evoked by exposure of Caco-2 cells to EVOO (100 ppm), its phenolic extracts (OPE, 50 µM) or authentic hydroxytyrosol (HT, 50 µM) for 24 h. None of the other major elements of the ECS (i.e., CB2; GPR55 and TRPV1 receptors; and NAPE-PLD, DAGL, FAAH and MAGL enzymes) was affected at any time point. The stimulatory effect of OPE and HT on CB1 expression was inversely correlated to DNA methylation at CNR1 promoter and was associated with reduced proliferation of Caco-2 cells. Interestingly, CNR1 gene was less expressed in Caco-2 cells when compared to normal colon mucosa cells, and again this effect was associated with higher level of DNA methylation at CNR1. Moreover, in agreement with the in vitro studies, we also observed a remarkable (~4-fold) and selective increase in CB1 expression in the colon of rats receiving dietary EVOO supplementation for 10 days. Consistently, CpG methylation of rat Cnr1 promoter, miR23a and miR-301a, previously shown to be involved in the pathogenesis of colorectal cancer and predicted to target CB1 mRNA, was reduced after EVOO administration down to ~50% of controls. Taken together, our findings demonstrating CB1 gene expression modulation by EVOO or its phenolic compounds via epigenetic mechanism, both in vitro and in vivo, may provide a new therapeutic avenue for treatment and/or prevention of colon cancer.

Quality parameters for cold pressed edible argan oils.

Argan oil belongs to the high-price vegetable oils on the market. Therefore, consumers have the right to purchase a high-quality product. The quality of edible vegetable oils is defined in food standards in which sensory quality is the most important feature. Additional parameters are defined to assess the identity of oils or to evaluate their oxidative state. The sensory quality of cold pressed argan oil is altered if the production has not been performed with reasonable care regarding raw material and extraction. Only oil from roasted seeds extracted by a screw-press had a sufficient sensory quality over a period of 20 weeks without unacceptable sensory attributes. Under accelerated storage conditions oil from roasted seeds extracted by a screw-press remained below the limits given by the Codex Alimentarius or the German guideline for Edible Fats and Oils for peroxide and totox value. Oil from unroasted seeds or oil from goat-digested roasted seeds and extracted by a screw-press, as well as oil from roasted seeds traditionally extracted, exceeded these limits. Initial oxidative stability of oil from unroasted seeds was significantly lower than that of the other oils. After 35 days under accelerated storage, oil from roasted seeds obtained using a screw-press showed the highest oxidative stability. Moreover, tocopherol and phytosterol compositions are useful features of argan oil.

[Oxidative and hydrolytic deterioration of palm oil and fat products based on it under various conditions of storage and transportation].

Studies have been conducted on the effect of storage conditions for refined deodorized palm oil on the quality and safety: in containers made of ferrous metals (mild steel) at unregulated temperature, in sealed plastic bags at the temperature -20 degrees C in stainless steel under stratification of nitrogen at the temperature of 40+/-1 degrees C. The choice of the objects of study determined by the normative documents of the Russian Federation governing the transportation and storage of vegetable oils and fat products based on them. All samples of palm oil with peroxide value of 1,0 to 1,5 meq O2/kg indicated the presence of a weak foreign taste, is not peculiar impersonalfat, the samples with peroxide value above 1,5 meq O2/kg were observed pronounced off-flavors and odors characteristic of stale oil. Rancidity was observed in samples having peroxide value of 2,0 meq O2/kg or more. Free acid value and anizidin value for the studied period changed to a lesser extent, from 0,06 to 0,1 mg KOH/g and from 1,2 to 1,4 respectively. It is proved that, transportation/storage of palm oil at the temperature above 50 degrees C without stratification of nitrogen greatly accelerates the process of oxidative damage. Based on these data we can recommend transportation/storage and management process with the least possible time of contact of melted palm oil with oxygen to produce high-quality final product (within 2-3 hours from the time of melting).

Review of the use of phytosterols as a detection tool for adulteration of olive oil with hazelnut oil.

Adulteration of virgin olive oil with less expensive oils such as hazelnut oil is a serious problem for quality control of olive oil. Detection of the presence of hazelnut oil in olive oil at low percentages (<20%) is limited with current official standard methods. In this review, various classes of phytosterols in these two oils are assessed as possible markers to detect adulterated olive oil. The composition of 4-desmethyl- and 4-monomethylsterols is similar in both oils, but the 4,4'-dimethylsterols differ. Lupeol and an unknown (lupane skeleton) compound from 4,4'-dimethylsterols are exclusively present in hazelnut oil and can be used as markers via GC-MS monitoring to detect adulteration at levels as low as 2%. The phytosterol classes need to be separated and enriched by a preparative method prior to analysis by GC or GC/MS; these SPE and TLC methods are also described in this review.

Chemistry of deep-fat frying oils.

Deep-fat frying produces desirable or undesirable flavor compounds and changes the flavor stability and quality of the oil by hydrolysis, oxidation, and polymerization. Tocopherols, essential amino acids, and fatty acids in foods are degraded during deep-fat frying. The reactions in deep-fat frying depend on factors such as replenishment of fresh oil, frying conditions, original quality of frying oil, food materials, type of fryer, antioxidants, and oxygen concentration. High frying temperature, the number of fryings, the contents of free fatty acids, polyvalent metals, and unsaturated fatty acids of oil decrease the oxidative stability and flavor quality of oil. Antioxidant decreases the frying oil oxidation, but the effectiveness of antioxidant decreases with high frying temperature. Lignan compounds in sesame oil are effective antioxidants in deep-fat frying.

Determination of peroxide value of edible oils by FTIR spectroscopy with the use of the spectral reconstitution technique.

Spectral reconstitution (SR), a technique that has been developed to facilitate mid-FTIR transmission analysis of inherently viscous samples, was applied to simplify and automate a previously reported FTIR method for the determination of peroxide value (PV) of edible oils. The basis of the PV determination is the rapid reaction of triphenylphosphine (TPP) with the hydroperoxides present in an oil to produce triphenylphosphine oxide (TPPO), which exhibits a readily measurable absorption band at 542 cm(-1). In the SR procedure, the viscosity of oil samples is reduced by mixing them with a diluent, which allows them to be readily loaded into a flow-through transmission cell. The spectra of the neat oil samples are then reconstituted from those of the diluted samples by using the absorption of a spectral marker present in the diluent to determine the dilution ratio. For the SR-based PV method, the TPP reagent was added to the diluent, which consisted of odorless mineral spirits (OMS) containing methylcyclopentadienyl manganese tricarbonyl (MMT) as the spectral marker. Sample preparation for PV analysis involved mixing approximately 10 ml of oil with approximately 25 ml of the TPP-containing diluent; accurate weighing or delivery of precise volumes was not required because the dilution ratio was determined spectroscopically from the intensity of the nu(CO) absorption of MMT at 1942 cm(-1) in the spectrum of the diluted sample relative to that in the spectrum of the diluent. Calibration standards, prepared by gravimetric addition of TPPO to a peroxide-free oil, were handled in the same manner, and a linear calibration equation relating the concentration of TPPO (expressed as the equivalent PV) to the absorbance of TPPO at 542 cm(-1) relative to a baseline at 530 cm(-1) in the reconstituted spectra was obtained, with a regression S.D. of +/-0.15 meq/kg oil. PV determinations on two sets of validation samples, spanning PV ranges of 0-20 and 0-2 meq/kg oil, were carried out in parallel by the AOCS titrimetric and SR-based FTIR procedures, and comparison of the results of duplicate analyses by the two methods indicated that the latter was more reproducible and slightly more sensitive. The SR-based PV method, when implemented on an autosampler-equipped FTIR system, allowed for the automated analysis of approximately 90 samples per hour.

Diabetes Nutrition and Complications Trial: adherence to the ADA nutritional recommendations, targets of metabolic control, and onset of diabetes complications. A 7-year, prospective, population-based, observational multicenter study.

OBJECTIVE: To know the adherence to the ADA nutritional recommendations and its relation to targets of metabolic control and onset of diabetic complications in a sample of diabetic people in Spain. RESEARCH DESIGN AND METHODS: The Diabetes Nutrition and Complications Trial (DNCT) is a prospective, population-based, observational multicenter study designed to know the nutritional pattern, based on the 7-day food diaries, of a population with long-standing diabetes mellitus (93/99 type 1/type 2 diabetic patients, 20/18 years of duration of diabetes, and 6.9%/6.4% HbA(1c) values) and its relation with the onset of microvascular and macrovascular diabetes complications between 1993 and 2000. RESULTS: After a median follow-up period of 6.5 years, more than 55% of diabetic people complied with the recommendation of protein intake between 15% and 20%, but only 27% consumed less than 10% of saturated fatty acids (SFAs), the 13% achieved up 10% of polyunsaturated fatty acids (PUFAs) intake, the 39% consumed more than 60% from carbohydrate and monounsaturated fatty acids (MUFAs), and the 30% consumed <300 mg/day of cholesterol. In spite of these, more than 90% had an optimal HDL cholesterol and non-HDL cholesterol level, and triglycerides level, while less than 41% of diabetic people had an HbA(1c) value >7.5%. Moreover, more than 69% consumed a MUFAs-to-SFAs ratio >1.5 and the 46% a PUFAs-to-SFAs ratio >0.4. Nonadherence to nutritional recommendation, but MUFAs/SFAs ratio >1.5 and PUFAs/SFAs ratio >0.4, was associated with a reduction between 3.4- and 8.2-fold in the risk of onset of diabetic complications. CONCLUSIONS: The adherence to ADA nutritional recommendations for people with diabetes in Spain is rather poor except for the protein consumption. Only PUFAs/SFAs >0.4 and MUFAs/SFAs>1.5 were associated to near-optimal targets of metabolic control and a reduction in the risk of the onset of diabetic complications. These data suggest that other nutritional recommendations should be taken in mind.