Basterra-Gortari, F.J. (Francisco Javier)

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    Vitamin D and risk of developing type 2 diabetes in the SUN project: a prospective cohort study
    (Springer Nature, 2024) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Bes-Rastrollo, M. (Maira); Valer-Martínez, A. (Ana); Basterra-Gortari, F.J. (Francisco Javier); Sayon-Orea, C. (Carmen)
    Purpose: Vitamin D deficiency has been associated with multiple chronic diseases, including metabolic disorders such as insulin resistance and type 2 diabetes (T2D). The aim of the study was to analyze the association between validated predicted serum vitamin D status and the risk of developing T2D in a large prospective cohort based on a Mediterranean population. Methods: The SUN project is a prospective and dynamic Spanish cohort that gathers university graduates who have answered lifestyle questionnaires, including a validated Food Frequency Questionnaire. The association between predicted serum vitamin D and the risk of T2D was assessed through Cox regression models according to quartiles (Q) of predicted vitamin D at baseline. The models were adjusted for potential confounders and sensitivity analyses were performed to ensure the robustness of our findings. Results: Our study included a total of 18,594 participants and after a total follow-up of 238,078 person-years (median follow-up of 13.5 years), 209 individuals were diagnosed with incident T2D. We found a significant inverse association between predicted levels of serum vitamin D and the risk of developing T2D, after adjusting for potential confounders and performing different sensitivity analyses (hazard ratio Q4 vs. Q1: 0.48, 95% CI 0.26-0.88; p for trend = 0.032). Conclusion: The outcomes suggest that higher levels of vitamin D at baseline may be associated with a reduced risk of developing T2D.
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    Ultra-processed foods and type-2 diabetes risk in the sun project: A prospective cohort study
    (Elsevier, 2020) Martinez-Gonzalez, M.A. (Miguel Ángel); Llavero-Valero, M. (María); Fuente-Arrillaga, C. (Carmen) de la; Bes-Rastrollo, M. (Maira); Escalada, J. (Javier); Basterra-Gortari, F.J. (Francisco Javier)
    The association between ultra-processed foods (UPF) consumption and the risk of type 2 diabetes (T2D) has not been much explored. We aimed to evaluate the association between consumption of UPF and the incidence of T2D.
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    Effect of dietary phenolic compounds on incidence of type 2 diabetes in the "Seguimiento Universidad de Navarra" (SUN) cohort
    (2023) Martinez-Gonzalez, M.A. (Miguel Ángel); Toledo, E. (Estefanía); Bes-Rastrollo, M. (Maira); Vitelli-Storelli, F. (Facundo); Vazquez-Ruiz, Z. (Zenaida); Basterra-Gortari, F.J. (Francisco Javier)
    The global incidence of type 2 diabetes (T2D) has been steadily increasing in recent decades. The Mediterranean dietary pattern has shown a preventive effect on the risk of T2D. Evaluating the association between bioactive compounds such as phenolic compounds (PC) in a Mediterranean cohort could help to better understand the mechanisms implicated in this protection. We evaluated the association between dietary intake of PC and the risk of T2D in a relatively young cohort of 17,821 Spanish participants initially free of T2D, through the University of Navarra Follow-up Project (Seguimiento Universidad de Navarra or SUN cohort) after 10 years of median follow-up using time-dependent Cox models. Intake of PC was estimated at baseline and repeatedly at 10-year follow-up using a 136-item validated food frequency and the Phenol-Explorer database. The incidence of T2D was identified by a biennial follow-up, and only medically confirmed cases were included. During 224,751 person-years of follow-up, 186 cases of T2D were confirmed. A suboptimal intake of stilbenes was independently associated with a higher risk of T2D in subjects over 50 years (HR: 1.75, 95% CI: 1.06-2.90, p value < 0.05) after adjusting for potential confounders. Our results suggest that a moderate-high intake of stilbenes can decrease the risk of developing T2D in subjects over 50 years in our cohort.
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    Association between pre-conceptional carbohydrate quality index and the incidence of gestational diabetes: the SUN cohort study
    (Cambridge University Press on behalf of The Nutrition Society, 2023) Martinez-Gonzalez, M.A. (Miguel Ángel); Bes-Rastrollo, M. (Maira); Santiago, S. (Susana); Fernández-González, E. (Elena); Suescun-Elizalde, D. (David); Gea, A. (Alfredo); Basterra-Gortari, F.J. (Francisco Javier)
    The aim of the study was to investigate the association between pre-gestational carbohydrate quality index (CQI) and the incidence of gestational diabetes mellitus (GDM). Data from the ‘Seguimiento Universidad de Navarra’ (SUN) cohort were used, which includes 3827 women who notified at least one pregnancy between December 1999 and December 2019. We used a validated semicuantitative 136-item FFQ to evaluate dietary exposures at baseline and at 10-year follow-up. The CQI was defined by four criteria: glycaemic index, whole-grain/total-grain carbohydrate, dietary fibre intake and solid/total carbohydrate ratio. We fitted generalised estimating equations with repeated measurements of the CQI to assess its relationship with incident GDM. A total of 6869 pregnancies and 202 new cases of incident GDM were identified. The inverse association between the global quality of carbohydrate and the development of GDM was not statistically significant: OR the highest v. the lowest CQI category: 0·67, 95 % CI (0·40, 1·10), Pfor trend = 0·10. Participants at the highest CQI category and with daily carbohydrate amounts ≥50 % of total energy intake had the lowest incidence of GDM (OR = 0·29 (95 % CI (0·09, 0·89)) compared with those with the lowest quality (lowest CQI) and quantity (≤40 %). Further studies are needed to overcome the limitations of our study. Those studies should jointly consider the quality and the quantity of dietary carbohydrates, as the quality might be of importance, especially in women with a higher intake of carbohydrates.
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    Soft drink consumption and gestational diabetes risk in the SUN
    (2018) Martinez-Gonzalez, M.A. (Miguel Ángel); Bes-Rastrollo, M. (Maira); Irala, J. (Jokin) de; Donazar, M. (Mikel); Basterra-Gortari, F.J. (Francisco Javier); Lopez-del-Burgo, C. (Cristina)
    Background & aims: Gestational diabetes mellitus (GDM) prevalence is increasing worldwide. To the best of our knowledge the specific evaluation of soft drink consumption as a risk factor for developing GDM has only been conducted in the Nurses' Health Study II. Objective: To investigate the incidence of GDM according to soft drink consumption in the SUN project. Design: The “Seguimiento Universidad de Navarra” (SUN) project is a prospective and dynamic cohort which included data of 3396 women who notified at least one pregnancy between December 1999 and March 2012. A validated 136-item semi-quantitative food frequency questionnaire was used to assess soft drink consumption. Four categories of sugar-sweetened soft drink (SSSD) and diet soft drink (DSD) consumption (servings) were established: rarely or never (<1/month), low (1e3/month), intermediate (>3/month and 1/week) and high (2/week). Potential confounders were adjusted through non- conditional logistic regression models. Results: During the follow-up, we identified 172 incident cases of GDM. After adjusting for age, baseline body mass index, family history of diabetes, smoking, total energy intake, physical activity, parity, fast- food consumption, adherence to Mediterranean dietary pattern, alcohol intake, multiple pregnancy, cardiovascular disease/hypertension at baseline, fiber intake, following special diet and snacking, SSSD consumption was significantly associated with an increased risk of incident GDM, with multivariable adjusted odds ratios (OR) of 2.03 (95% confidence interval [CI]: 1.25e3.31) and 1.67 (95% CI: 1.01e2.77) for the highest and intermediate categories, respectively, versus the lowest category (p for linear trend: 0.006). Conversely, DSD consumption was not associated with GDM incidence (adjusted OR: 0.82; 95% CI: 0.52e1.31) for the highest versus the lowest category (p for linear trend: 0.258). Additional sensitivity analyses did not change the results. Conclusion: Higher consumption of SSSDs before pregnancy was an independent risk factor for GDM, however, no association was observed between DSD consumption and GDM risk.
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    Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study
    (BMJ Publishing Group Ltd, 2008) Martinez-Gonzalez, M.A. (Miguel Ángel); Fuente-Arrillaga, C. (Carmen) de la; Bes-Rastrollo, M. (Maira); Benito-Corchon, S. (Silvia); Beunza, J.J. (Juan José); Tortosa, A. (A.); Vazquez-Ruiz, Z. (Zenaida); Basterra-Gortari, F.J. (Francisco Javier); Nuñez-Cordoba, J.M. (Jorge M.)
    Objective To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes among initially healthy participants. Design Prospective cohort study with estimates of relative risk adjusted for sex, age, years of university education, total energy intake, body mass index, physical activity, sedentary habits, smoking, family history of diabetes, and personal history of hypertension. Setting Spanish university department. Participants 13 380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years. Main outcome measures Dietary habits assessed at baseline with a validated 136 item food frequency questionnaire and scored on a nine point index. New cases of diabetes confirmed through medical reports and an additional detailed questionnaire posted to those who self reported a new diagnosis of diabetes by a doctor during follow-up. Confirmed cases of type 2 diabetes. Results Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3). In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis. Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.
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    Reported fried food consumption and the incidence of hypertension in a spanish cohort: the sun project
    (Cambridge University Press, 2014) Martinez-Gonzalez, M.A. (Miguel Ángel); Zazpe, I. (Itziar); Bes-Rastrollo, M. (Maira); Gea, A. (Alfredo); Basterra-Gortari, F.J. (Francisco Javier); Sayon-Orea, C. (Carmen)
    Reported associations between consumption of fried foods and obesity or weight gain make likely that fried food consumption might also be linked with the development of hypertension. However, evidence from long-term prospective studies is scarce. Therefore, the aim of our study was to longitudinally evaluate this association in a prospective cohort. The SUN project is a Mediterranean cohort study of university graduates conducted in Spain, that started in December 1999 and until now it is permanently open. For the present analyses we included 13,679 participants (5,059 men and 8,620 women), free of hypertension at baseline with a mean age of 36.5 y (SD:10.8). Total fried food consumption was estimated at baseline. The outcome was the incidence of a medical diagnosis of self-reported hypertension during follow-up. To assess the relationship between fried food consumption and the subsequent risk of developing incident hypertension during follow-up, Cox regression models were fitted. During a median follow-up of 6.3 years, 1,232 incident cases of hypertension were identified. After adjusting for potential confounders, the adjusted hazard ratio for developing hypertension was 1.18 (95% CI: 1.03-1.36) and 1.21 (95% CI: 1.04-1.41) for the categories of consumption of 2-4/week and >4/week respectively, compared to those who consumed <2 servings/week (p for trend 0.020). In conclusion, our findings suggest that a more frequent consumption of fried foods at baseline was associated with higher risk of hypertension during follow-up in a cohort of university graduates.
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    Association between dietary fibre intake and fruit, vegetable or whole-grain consumption and the risk of CVD: results from the PREvención con DIeta MEDiterránea (PREDIMED) trial
    (Cambridge Core, 2016) Babio, N. (Nancy); Buil, P. (Pilar); Farras, M. (Marta); Martinez-Gonzalez, M.A. (Miguel Ángel); Fito, M. (Montserrat); Gonzalez, J.I. (José I.); Moñino, M. (Manuel); Zazpe, I. (Itziar); Diez-Espino, J. (Javier); Gomez-Gracia, E. (Enrique); Toledo, E. (Estefanía); Ros, E. (Emilio); Ortega-Calvo, M. (Manuel); Estruch, R. (Ramón); Lamuela-Raventos, R.M. (Rosa Maria); Serra-Majem, L. (Luis); Corella, D. (Dolores); Basterra-Gortari, F.J. (Francisco Javier); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Aros, F. (Fernando); Marti-del-Moral, A. (Amelia)
    Prospective studies assessing the association between fibre intake or fibre-rich food consumption and the risk of CVD have often been limited by baseline assessment of diet. Thus far, no study has used yearly repeated measurements of dietary changes during follow-up. Moreover, previous studies included healthy and selected participants who did not represent subjects at high cardiovascular risk. We used yearly repeated measurements of diet to investigate the association between fibre intake and CVD in a Mediterranean cohort of elderly adults at high cardiovascular risk. We followed-up 7216 men (55–80 years) and women (60–80 years) initially free of CVD for up to 7 years in the PREvención con DIeta MEDiterránea study (registered as ISRCTN35739639). A 137-item validated FFQ was repeated yearly to assess diet. The primary end point, confirmed by a blinded ad hoc Event Adjudication Committee, was a composite of cardiovascular death, myocardial infarction and stroke. Time-dependent Cox’s regression models were used to estimate the risk of CVD according to baseline dietary exposures and to their yearly updated changes. We found a significant inverse association for fibre (Pfor trend =0·020) and fruits (Pfor trend=0·024) in age-sex adjusted models, but the statistical significance was lost in fully adjusted models. However, we found a significant inverse association with CVD incidence for the sum of fruit and vegetable consumption. Participants who consumed in total nine or more servings/d of fruits plus vegetables had a hazard ratio 0·60 (95% CI 0·40, 0·96) of CVD in comparison with those consuming <5 servings/d.
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    A prospective study of eating away-from-home meals and weight gain in a Mediterranean population: the SUN (Seguimiento Universidad de Navarra) cohort
    (Cambridge University Press, 2010) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Bes-Rastrollo, M. (Maira); Sanchez-Villegas, A. (Almudena); Basterra-Gortari, F.J. (Francisco Javier); Marti-del-Moral, A. (Amelia)
    OBJECTIVE: The traditional Mediterranean food pattern is more easily preserved when meals are eaten at home; however, as a result of recent socio-economic changes, away-from-home meal consumption has increased rapidly in Mediterranean countries. Little research has been conducted so far to investigate the long-term health effects of these changes in the Mediterranean area. DESIGN: In a prospective Spanish dynamic cohort of 9182 university graduates (the SUN Study; Seguimiento Universidad de Navarra, University of Navarra Follow-up) with a mean age of 37 years, followed up for an average of 4.4 years, we assessed the association between the frequency of eating out of home and weight gain or incident overweight/obesity. Dietary habits were assessed with an FFQ previously validated in Spain. RESULTS: During follow-up, eating-out consumers (two times or more per week) had higher average adjusted weight gain (+129 g/year, P < 0.001) and higher adjusted risk of gaining 2 kg or more per year (OR = 1.36; 95 % CI 1.13, 1.63) than non-eating-out consumers. Among participants with baseline BMI < 25 kg/m2, we observed 855 new cases of overweight/obesity. Eating away-from-home meals was significantly associated with a higher risk of becoming overweight/obese (hazard ratio = 1.33; 95 % CI 1.13, 1.57). CONCLUSIONS: A higher frequency of meals eaten out of home may play a role in the current obesity epidemic observed in some Mediterranean countries.
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    Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study
    (MDPI, 2020) Castañer, O. (Olga); Martinez, J.A. (José Alfredo); Oncina-Canovas, A. (Alejandro); Garcia-Rios, A. (Antonio); Tojal-Sierra, L. (Lucas); Gimenez-Alba, I.M. (Ignacio Manuel); Martín-Sánchez, V. (Vicente); Martín, M. (Marian); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); García-Gavilán, J.F. (Jesús F.); Vioque, J. (Jesús); Becerra-Tomas, N. (Nerea); Tur, J.A. (Josep A.); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Lapetra, J. (José); Zomeño, M.D. (María Dolores); Matía-Martín, P. (Pilar); Bouzas, C. (Cristina); Angullo-Martínez, E. (Escarlata); Bueno-Cavanillas, A. (Aurora); Casañas-Quintana, T. (Tamara); Basora, J. (Josep); Belló-Mora, M.C. (María C.); Castro-Barquero, S. (Sara); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Notario-Barandiaran, L. (Leyre); Fernández-Lázaro, C.I. (César I.); Bibiloni, M.M. (Maria del Mar); Julibert, A. (Alicia); Goday, A. (Albert); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Saiz, C. (Carmen); Gaforio, J.J. (José Juan); Santos-Lozano, J.M. (José M.); Pérez-Lopez, J. (Jessica); Serra-Majem, L. (Luis); Corella, D. (Dolores); Basterra-Gortari, F.J. (Francisco Javier); Abete, I. (Itziar); Vidal, J. (Josep); Pinto, X. (Xavier); Muñoz, J. (Julia); Salas-Salvado, J. (Jordi); Morey, M. (Marga); Bernal-López, M.R. (María Rosa); Galera, A. (Ana); Sayon-Orea, C. (Carmen)
    Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m2 (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1: <10%, n = 1495; Q2: 10–15%, n = 1804; Q3: <15–20%, n = 1470; Q4: ≥20%, n = 1589).