Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study.

BACKGROUND: The prevalence of overweight/obesity and related manifestations such as metabolic syndrome (MetS) is increasing worldwide. High energy density diets, usually with low nutrient density, are among the main causes. Some high-quality dietary patterns like the Mediterranean diet (MedDiet) have been linked to the prevention and better control of MetS. However, it is needed to show that nutritional interventions promoting the MedDiet are able to improve nutrient intake. OBJECTIVE: To assess the effect of improving MedDiet adherence on nutrient density after 1 year of follow-up at the PREDIMED-Plus trial. METHODS: We assessed 5777 men (55-75 years) and women (60-75 years) with overweight or obesity and MetS at baseline from the PREDIMED-Plus trial. Dietary changes and MedDiet adherence were evaluated at baseline and after 1 year. The primary outcome was the change in nutrient density (measured as nutrient intake per 1000 kcal). Multivariable-adjusted linear regression models were fitted to analyse longitudinal changes in adherence to the MedDiet and concurrent changes in nutrient density. RESULTS: During 1-year follow-up, participants showed improvements in nutrient density for all micronutrients assessed. The density of carbohydrates (- 9.0%), saturated fatty acids (- 10.4%) and total energy intake (- 6.3%) decreased. These changes were more pronounced in the subset of participants with higher improvements in MedDiet adherence. CONCLUSIONS: The PREDIMED-Plus dietary intervention, based on MedDiet recommendations for older adults, maybe a feasible strategy to improve nutrient density in Spanish population at high risk of cardiovascular disease with overweight or obesity.

[Effect of non-pharmacological preventive measures on the incidence of respiratory and gastrointestinal pathologies]. / Efecto de las medidas preventivas no farmacológicas en la incidencia de patología respiratoria y gastrointestinal.

OBJECTIVE: The use of non-pharmacological preventive measures during the COVID-19 pandemic has helped to reduce the incidence of multiple airborne or contact diseases. The objective of this paper was to evaluate the impact that all preventive measures have had on the transmission of different microorganisms, both by respiratory and contact transmission. METHODS: We compared the incidence of different infectious episodes coded with the CIAP-2 code (International Classification of Primary Care second edition of the WONCA International Classification Committee) collected from the computerized history of primary care, both with respiratory tract and digestive tract involvement, in the period from March 2018 to February 2020 (pre-pandemic period) and from March 2020 to February 2022 (pandemic period). The data corresponded to the entire region, with an estimated average population for the four years of 650,000 people. The statistical treatment of the data consisted of a descriptive analysis with the calculation of absolute values and percentages. Rates were calculated and compared using data provided by the National Institute of Statistics as a denominator. The P was obtained by statistical comparison by the exact method. A comparison of rates was made. RESULTS: The incidence in the number of CIAP-2 episodes studied, both corresponding to respiratory and gastrointestinal pathologies, comparing the period March 2018-February 2020 with the period March 2020-February 2022 decreased by 65.81%, from 534,439 cases to 182,707. CONCLUSIONS: The preventive measures applied during the pandemic produce a significant decrease in pathology involving the respiratory or the digestive tract.

OBJETIVO: El uso de medidas preventivas no farmacológicas durante la pandemia de la COVID-19 ayudó a reducir la incidencia de múltiples enfermedades de transmisión aérea o por contacto. El objetivo de este trabajo fue evaluar el impacto que habían tenido todas las medidas preventivas en la transmisión de diferentes microorganismos, tanto por transmisión respiratoria como por contacto. METODOS: Comparamos la incidencia de diferentes episodios infecciosos codificados con el código CIAP-2 (Clasificación Internacional de Atención Primaria, segunda edición, del Comité de Clasificación Internacional WONCA-World Organization of Family Doctors) recogidos de la historia informatizada de Atención Primaria, tanto con afectación del tracto respiratorio como del tracto digestivo, en el período de marzo de 2018 a febrero de 2020 (período prepandemia) y de marzo de 2020 a febrero de 2022 (período de pandemia). Los datos correspondieron a toda la región, con una población media estimada para los cuatro años de 650.000 personas. El tratamiento estadístico de los datos consistió en un análisis descriptivo con el cálculo de valores absolutos y porcentajes. Se calcularon y compararon tasas tomando como denominador los datos proporcionados por el Instituto Nacional de Estadística. La P fue obtenida mediante comparación estadística por el método exacto. Se realizó una comparación de tasas. RESULTADOS: La incidencia en el número de episodios CIAP-2 estudiados, tanto correspondientes a patología respiratoria como gastrointestinal, comparando el periodo de marzo de 2018-febrero de 2020 con el periodo marzo de 2020-febrero de 2022, disminuyó en un 65,81%, pasando de 534.439 casos a 182.707. CONCLUSIONES: Las medidas preventivas aplicadas durante la pandemia producen una disminución significativa de la patología del tracto respiratorio o digestivo.