Martín-Sánchez, V. (Vicente)
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- Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk(MDPI AG, 2019) Babio, N. (Nancy); Portoles, O. (Olga); Martinez-Gonzalez, M.A. (Miguel Ángel); Eguaras, S. (Sonia); Sorto-Sánchez, C. (Carolina); Fiol, M. (Miquel); Fito, M. (Montserrat); Tojal-Sierra, L. (Lucas); Martín-Sánchez, V. (Vicente); Konieczna, J. (Jadwiga); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Becerra-Tomas, N. (Nerea); Tur, J.A. (Josep A.); Toledo, E. (Estefanía); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Barrubés, L. (Laura); Orozco-Beltrán, D. (Domingo); Lapetra, J. (José); Zomeño, M.D. (María Dolores); Matía-Martín, P. (Pilar); Bouzas, C. (Cristina); Schröder, H. (Helmut); López-Miranda, J. (José); Coltell, O. (Oscar); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Bibiloni, M.M. (Maria del Mar); Perez-Vega, K.A. (Karla Alejandra); Julibert, A. (Alicia); Casas, R. (Rosa); Carabaño-Moral, R. (Rosa); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); García-Molina, L. (Laura); Estruch, R. (Ramón); Gaforio, J.J. (José Juan); Martinez, A. (Alfredo); Ugarriza, L. (Lucía); Santos-Lozano, J.M. (José M.); Sanchez-Villegas, A. (Almudena); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Torres-Collado, L. (Laura); Bernal-López, M.R. (María Rosa); Galera, A. (Ana); PREDIMED-PLUS InvestigatorsBackground: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.
- Sleep Duration is Inversely Associated with Serum Uric Acid Concentrations and Uric Acid to Creatinine Ratio in an Elderly Mediterranean Population at High Cardiovascular Risk(MDPI AG, 2019) Babio, N. (Nancy); Fernandez-Garcia, J.C. (José C.); Castañer, O. (Olga); Oncina-Canovas, A. (Alejandro); Corbella, E. (Emili); Martinez-Gonzalez, M.A. (Miguel Ángel); Muñoz-Garach, A. (Araceli); Salaverria-Lete, I. (Itziar); Garcia-Rios, A. (Antonio); Tojal-Sierra, L. (Lucas); Martín-Sánchez, V. (Vicente); Pérez-Farinós, N. (Napoleón); Daimiel, L. (Lidia); Quifer, M. (Mireia); Compañ-Gabucio, L. (Laura); Vioque, J. (Jesús); Barón-López, F.J. (F. Javier); Becerra-Tomas, N. (Nerea); Tur, J.A. (Josep A.); Colom, A. (Antoni); Diez-Espino, J. (Javier); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Lapetra, J. (José); Matía-Martín, P. (Pilar); Bueno-Cavanillas, A. (Aurora); Papandreou, C. (Christopher); Schröder, H. (Helmut); Delgado-Rodriguez, M. (Miguel); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Bullo, M. (Monica); Bibiloni, M.M. (Maria del Mar); Casas, R. (Rosa); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Diaz-Lopez, A. (Andres); Cenoz-Osinaga, J.C. (Juan C.); Asensio, E.M. (Eva M.); Martinez, A. (Alfredo); Santos-Lozano, J.M. (José M.); Torras, L. (Laura); Sanchez-Villegas, A. (Almudena); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Sorli, J.V. (Jose V.); Morey, M. (Marga)The aim of the study was to evaluate sleep duration and sleep variability in relation to serum uric acid (SUA) concentrations and SUA to creatinine ratio. This is a cross-sectional analysis of baseline data from 1842 elderly participants with overweight/obesity and metabolic syndromein the (Prevención con Dieta Mediterránea) PREDIMED-Plus trial. Accelerometry-derived sleep duration and sleep variability were measured. Linear regression models were fitted to examine the aforementioned associations. A 1 hour/night increment in sleep duration was inversely associated with SUA concentrations (β = 0.07, p = 0.047). Further adjustment for leukocytes attenuated this association (p = 0.050). Each 1-hour increment in sleep duration was inversely associated with SUA to creatinine ratio (β = 0.15, p = 0.001). The findings of this study suggest that longer sleep duration is associated with lower SUA concentrations and lower SUA to creatinine ratio.
- An energy-reduced mediterranean diet, physical activity, and body composition: An interim subgroup snalysis of the PREDIMED-Plus randomized clinical trial(JAMA, 2023) Babio, N. (Nancy); Buil, P. (Pilar); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Fiol, M. (Miquel); Marcos-Delgado, A. (Alba); Fito, M. (Montserrat); Hu, F.B. (Frank B.); Martín-Sánchez, V. (Vicente); Konieczna, J. (Jadwiga); Olbeyra, R. (Romina); García-Gavilán, J.F. (Jesús F.); Moñino, M. (Manuel); Romaguera, D. (Dora); Galmes-Panades, A.M. (Aina M.); Ruiz-Canela, M. (Miguel); Casas, R. (Rosa); Estruch, R. (Ramón); Abete, I. (Itziar); Vidal, J. (Josep); Salas-Salvado, J. (Jordi)Importance: Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. Objective: To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. Design, setting, and participants: The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. Intervention: Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. Main outcomes and measures: The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imputation was performed to include data of participants lost to follow-up (intention-to-treat analyses). Results: A total of 1521 individuals were included (mean [SD] age, 65.3 [5.0] years; 52.1% men). In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, -0.94% [95% CI, -1.19 to -0.69]; 3 years, -0.38% [95% CI, -0.64 to -0.12] and visceral fat storage after 1 year, -126 g [95% CI, -179 to -73.3 g]; 3 years, -70.4 g [95% CI, -126 to -15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95% CI, 0.09%-0.60%]). The intervention group was more likely to show improvements of 5% or more in baseline body components (absolute risk reduction after 1 year, 13% for total fat mass, 11% for total lean mass, and 14% for visceral fat mass; after 3-years: 6% for total fat mass, 6% for total lean mass, and 8% for visceral fat mass). The number of participants needed to treat was between 12 and 17 to attain at least 1 individual with possibly clinically meaningful improvements in body composition. Conclusions and relevance: The findings of this trial suggest a weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity significantly reduced total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome. Continued follow-up is warranted to confirm the long-term consequences of these changes on cardiovascular clinical end points.
- 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).
- Dietary polyphenol Intake is associated with HDL-Cholesterol and a better profile of other components of the metabolic syndrome: a PREDIMED-Plus sub-study(MDPI, 2020) Buil, P. (Pilar); Martinez, J.A. (José Alfredo); Garcia-Rios, A. (Antonio); Fito, M. (Montserrat); Martín-Sánchez, V. (Vicente); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Martin-Calvo, N. (Nerea); Tur, J.A. (Josep A.); Romaguera, D. (Dora); Tresserra-Rimbau, A. (Anna); Lapetra, J. (José); Rubín-García, M. (María); Castro-Barquero, S. (Sara); Vitelli-Storelli, F. (Facundo); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Doménech, M. (Mónica); Serra-Majem, L. (Luis); Corella, D. (Dolores); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi)Dietary polyphenol intake is associated with improvement of metabolic disturbances. The aims of the present study are to describe dietary polyphenol intake in a population with metabolic syndrome (MetS) and to examine the association between polyphenol intake and the components of MetS. This cross-sectional analysis involved 6633 men and women included in the PREDIMED (PREvención con DIeta MEDiterranea-Plus) study. The polyphenol content of foods was estimated from the Phenol-Explorer 3.6 database. The mean of total polyphenol intake was 846 ± 318 mg/day. Except for stilbenes, women had higher polyphenol intake than men. Total polyphenol intake was higher in older participants (>70 years of age) compared to their younger counterparts. Participants with body mass index (BMI) >35 kg/m2 reported lower total polyphenol, flavonoid, and stilbene intake than those with lower BMI. Total polyphenol intake was not associated with a better profile concerning MetS components, except for high-density lipoprotein cholesterol (HDL-c), although stilbenes, lignans, and other polyphenols showed an inverse association with blood pressure, fasting plasma glucose, and triglycerides. A direct association with HDL-c was found for all subclasses except lignans and phenolic acids. To conclude, in participants with MetS, higher intake of several polyphenol subclasses was associated with a better profile of MetS components, especially HDL-c.
- Long daytime napping is associated with increased adiposity and type 2 diabetes in an elderly population with metabolic syndrome(MDPI AG, 2019) Babio, N. (Nancy); Buil, P. (Pilar); Fernandez-Garcia, J.C. (José C.); Castañer, O. (Olga); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Trias, F. (Ferran); Muñoz-Garach, A. (Araceli); Garcia-Rios, A. (Antonio); Gallardo-Alfaro, L. (Laura); Fito, M. (Montserrat); Martín-Sánchez, V. (Vicente); Pérez-Farinós, N. (Napoleón); Konieczna, J. (Jadwiga); González-Botella, A. (Andrés); Daimiel, L. (Lidia); Vaquero-Luna, J. (Jessica); Vioque, J. (Jesús); Barón-López, F.J. (F. Javier); Becerra-Tomas, N. (Nerea); García Hera, M (Manoli) de la; Tur, J.A. (Josep A.); Martinez-Lacruz, R. (Raul); Toledo, E. (Estefanía); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Lapetra, J. (José); Matía-Martín, P. (Pilar); Bueno-Cavanillas, A. (Aurora); Papandreou, C. (Christopher); Schröder, H. (Helmut); Delgado-Rodriguez, M. (Miguel); Galmes-Panades, A.M. (Aina M.); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Bullo, M. (Monica); Casas, R. (Rosa); Goday, A. (Albert); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Diaz-Lopez, A. (Andres); Santos-Lozano, J.M. (José M.); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Barragán-Arnal, R. (Rocío); Bautista-Castaño, I. (Inmaculada); Moreno-Rodríguez, A. (Anai)Research examining associations between objectively-measured napping time and type 2 diabetes (T2D) is lacking. This study aimed to evaluate daytime napping in relation to T2D and adiposity measures in elderly individuals from the Mediterranean region. A cross-sectional analysis of baseline data from 2190 elderly participants with overweight/obesity and metabolic syndrome, in the PREDIMED-Plus trial, was carried out. Accelerometer-derived napping was measured. Prevalence ratios (PR) and 95% confidence intervals (CI) for T2D were obtained using multivariable-adjusted Cox regression with constant time. Linear regression models were fitted to examine associations of napping with body mass index (BMI) and waist circumference (WC). Participants napping ≥90 min had a higher prevalence of T2D (PR 1.37 (1.06, 1.78)) compared with those napping 5 to <30 min per day. Significant positive associations with BMI and WC were found in those participants napping ≥30 min as compared to those napping 5 to <30 min per day. The findings of this study suggest that longer daytime napping is associated with higher T2D prevalence and greater adiposity measures in an elderly Spanish population at high cardiovascular risk.
- Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-plus trial(Springer, 2022) Buil, P. (Pilar); Castañer, O. (Olga); Martinez, J.A. (José Alfredo); Oncina-Canovas, A. (Alejandro); Martinez-Gonzalez, M.A. (Miguel Ángel); Garcia-Rios, A. (Antonio); Fito, M. (Montserrat); Tojal-Sierra, L. (Lucas); Martín-Sánchez, V. (Vicente); Pérez-Farinós, N. (Napoleón); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); García-Gavilán, J.F. (Jesús F.); Vioque, J. (Jesús); Moñino, M. (Manuel); Ortega-Azorin, C. (Carolina); Zulet, M.A. (María Ángeles); Becerra-Tomas, N. (Nerea); Tur, J.A. (Josep A.); Toledo, E. (Estefanía); Romaguera, D. (Dora); Muralidharan, J. (Jananee); San-Julián-Aranguren, B. (Beatriz); Vázquez, C. (Clotilde); Sacanella, E. (Emilio); Lapetra, J. (José); Matía-Martín, P. (Pilar); Bueno-Cavanillas, A. (Aurora); Schröder, H. (Helmut); Delgado-Rodriguez, M. (Miguel); López-Miranda, J. (José); Goicolea-Güemez, L. (Leire); Razquin, C. (Cristina); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Fernández-Lázaro, C.I. (César I.); Goday, A. (Albert); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Vazquez-Ruiz, Z. (Zenaida); Santos-Lozano, J.M. (José M.); Serra-Majem, L. (Luis); Corella, D. (Dolores); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Sorli, J.V. (Jose V.); Bernal-López, M.R. (María Rosa)Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energyreduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defned as dietary changes from baseline of≥5 points for participants with baseline scores<13 points or any increase if baseline score was≥13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efcacy in modifying diet (OR6-month: 1.51, 95% CI 1.25–1.83; OR12-month: 1.66, 95% CI 1.37–2.01), higher baseline fber intake (OR6-month: 1.62, 95% CI 1.07–2.46; OR12-month: 1.62, 95% CI 1.07–2.45), having>3 chronic conditions (OR6-month: 0.65, 95% CI 0.53–0.79; OR12-month: 0.76, 95% CI 0.62–0.93), and sufering depression (OR6-month: 0.80, 95% CI 0.64–0.99; OR12-month: 0.71, 95% CI 0.57–0.88). Conclusion Our results suggested that recruitment of individuals with high perceived self-efcacy to dietary change, and those who initially follow diets relatively richer in fber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifcally depression, should receive specifc tailored interventions.
- Ultra-processed foods consumption as a promoting factor of greenhouse gas emissions, water, energy, and land use: A longitudinal assessment(2023) Buil, P. (Pilar); Castañer, O. (Olga); Martinez-Gonzalez, M.A. (Miguel Ángel); González-Palacios, S. (Sandra); Fito, M. (Montserrat); Pastor, R. (Rosario); Alvarez-Alvarez, L. (Laura); Tojal-Sierra, L. (Lucas); Martín-Sánchez, V. (Vicente); Gonzalez, J.I. (José I.); Martínez-Hernández, J.A. (J. Alfredo); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Tur, J.A. (Josep A.); Shyam, S. (Sangeetha); Toledo, E. (Estefanía); Bes-Rastrollo, M. (Maira); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Matía-Martín, P. (Pilar); Bouzas, C. (Cristina); Rubín-García, M. (María); Delgado-Rodriguez, M. (Miguel); López-Miranda, J. (José); Coltell, O. (Oscar); Khoury, N. (Nadine); Perez, K.A. (Karla Alejandra); Ros, E. (Emili); Wärnberg, J. (Julia); Estruch, R. (Ramón); Santos-Lozano, J.M. (José M.); Barcelo, C.; Bernal-Lopez, M. R; Casas, R.; Garcia-Rios, A.; Goicolea-Guemez, L.; Gomez-Gracia, E.; Konieczna, J.; Masso-Guijarro, P.; Zulet-Alzórriz, M. (María de los Ángeles); Serra-Majem, L. (Luis); Corella, D. (Dolores); Zomeño-Fajardo, M.D. (Maria Dolores); Martinez-Rodriguez, M.A. (Maria Angeles); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Pena-Orihuela, P.J. (Patricia J.); Cano-Ibañez, N. (Naomi); Monserrat-Mesquida, M. (Margalida); Garcia, S. (Silvia)Background: Dietary patterns can produce an environmental impact. Changes in people's diet, such as the increased consumption of ultra-processed food (UPF) can not only influence human health but also environment sustainability. Objectives: Assessment of the impact of 2-year changes in UPF consumption on greenhouse gas emissions and water, energy and land use. Design: A 2-year longitudinal study after a dietary intervention including 5879 participants from a Southern European population between the ages of 55-75 years with metabolic syndrome. Methods: Food intake was assessed using a validated 143-item food frequency questionnaire, which allowed classifying foods according to the NOVA system. In addition, sociodemographic data, Mediterranean diet adherence, and physical activity were obtained from validated questionnaires. Greenhouse gas emissions, water, energy and land use were cal-culated by means of the Agribalyse & REG; 3.0.1 database of environmental impact indicators for food items. Changes in UPF consumption during a 2-year period were analyzed. Statistical analyses were conducted using computed General Lin-ear Models. Results: Participants with major reductions in their UPF consumption reduced their impact by -0.6 kg of CO2eq and -5.3 MJ of energy. Water use was the only factor that increased as the percentage of UPF was reduced. Conclusions: Low consumption of ultra-processed foods may contribute to environmental sustainability. The processing level of the consumed food should be considered not only for nutritional advice on health but also for environmental protection. Trial registration: ISRCTN, ISRCTN89898870. Registered 05 September 2013, http://www.isrctn.com/ ISRCTN89898870.
- Increased ultra-processed food consumption is associated with worsening of cardiometabolic risk factors in adults with metabolic syndrome: Longitudinal analysis from a randomized trial(2023) Martinez, J.A. (José Alfredo); Oncina-Canovas, A. (Alejandro); Martinez-Gonzalez, M.A. (Miguel Ángel); González-Palacios, S. (Sandra); Garcia-Rios, A. (Antonio); Atzeni, A. (Alessandro); García-Hera, M. (Manuela) de la; Tojal-Sierra, L. (Lucas); Martín-Sánchez, V. (Vicente); Palau, A. (Antoni); Konieczna, J. (Jadwiga); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Compañ-Gabucio, L. (Laura); Vioque, J. (Jesús); Malcampo, M. (Mireia); Barón-López, F.J. (F. Javier); Garcidueñas-Fimbres, T.E. (Tany E.); Zulet, M.A. (María Ángeles); Tur, J.A. (Josep A.); Bes-Rastrollo, M. (Maira); Romaguera, D. (Dora); Gómez-Perez, A.M. (Ana María); Vázquez, C. (Clotilde); Lapetra, J. (José); Matía-Martín, P. (Pilar); Schröder, H. (Helmut); Delgado-Rodriguez, M. (Miguel); López-Miranda, J. (José); Ruiz-Canela, M. (Miguel); Perez-Vega, K.A. (Karla Alejandra); Casas, R. (Rosa); Ros, E. (Emili); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Saiz, C. (Carmen); Serra-Majem, L. (Luis); Corella, D. (Dolores); Basterra-Gortari, F.J. (Francisco Javier); Zomeño-Fajardo, M.D. (Maria Dolores); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Pena-Orihuela, P.J. (Patricia J.); Cano-Ibañez, N. (Naomi); Garrido-Garrido, E.M. (Eva M.); Torres-Collado, L. (Laura); Sorli, J.V. (Jose V.)Background and aims: The association between changes in ultra-processed food (UPF) consumption and car-diometabolic risk (CMR) factors remains understudied. We evaluated the association between changes in UPF consumption over 12 months of follow-up and changes in CMR factors in adults diagnosed with metabolic syndrome.Methods: We analysed data from 5373 adults (aged 55-75 years) participating in the PREDIMED-Plus trial. Diet was evaluated at baseline, 6-and 12-month visits using a validated food frequency questionnaire, and UPF consumption (in grams/day and percentage of total daily dietary intake in grams) was categorized based on NOVA classification. We used mixed-effects linear models with repeated measurements at baseline, 6 and 12 months of follow-up to assess the associations between changes in UPF consumption and changes in CMR factors adjusting for sociodemographic and lifestyles variables.Results: In multivariable-adjusted models, when comparing the highest versus the lowest quartile of UPF con-sumption, positive associations were found for several CMR factors: weight (kg, & beta; = 1.09; 95% confidence in-terval 0.91 to 1.26); BMI (kg/m2, & beta; = 0.39; 0.33 to 0.46); waist circumference (cm, & beta; = 1.03; 0.81 to 1.26); diastolic blood pressure (mm Hg, & beta; = 0.67; 0.29 to 1.06); fasting blood glucose (mg/dl, & beta; = 1.66; 0.61 to 2.70); HbA1c (%, & beta; = 0.04; 0.01 to 0.07); triglycerides (mg/dl, & beta; = 6.79; 3.66 to 9.91) and triglycerides and glucose index (& beta; = 0.06; 0.04 to 0.08).Conclusions: Higher UPF consumption was associated with adverse evolution in objectively measured CMR factors after 12 months of follow-up in adults with metabolic syndrome. Further research is needed to explore whether these changes persist for longer periods.