Wärnberg, J. (Julia)

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    Mercury exposure and risk of cardiovascular disease: a nested casecontrol study in the PREDIMED (PREvention with MEDiterranean Diet) study
    (Bio Med Central, 2017) Martinez-Gonzalez, M.A. (Miguel Ángel); Fiol, M. (Miquel); Fito, M. (Montserrat); Garcia-Rodriguez, A. (Antonio); Gomez-Gracia, E. (Enrique); Lapetra, J. (José); Muñoz, M.A. (Miguel Angel); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Downer, M.K. (Mary Kathryn); Gutierrez-Bedmar, M. (Mario); Bullo, M. (Monica); Stampfer, M. (Meir); Wärnberg, J. (Julia); Estruch, R. (Ramón); Gea, A. (Alfredo); Serra-Majem, L. (Luis); Corella, D. (Dolores); Salas-Salvado, J. (Jordi); Sorli, J.V. (Jose V.); Aros, F. (Fernando)
    Background: Substantial evidence suggests that consuming 1–2 servings of fish per week, particularly oily fish (e.g., salmon, herring, sardines) is beneficial for cardiovascular health due to its high n-3 polyunsaturated fatty acid content. However, there is some concern that the mercury content in fish may increase cardiovascular disease risk, but this relationship remains unclear. Methods: The PREDIMED trial included 7477 participants who were at high risk for cardiovascular disease at baseline. In this study, we evaluated associations between mercury exposure, fish consumption and cardiovascular disease. We randomly selected 147 of the 288 cases diagnosed with cardiovascular disease during follow-up and matched them on age and sex to 267 controls. Instrumental neutron activation analysis was used to assess toenail mercury concentration. In-person interviews, medical record reviews and validated questionnaires were used to assess fish consumption and other covariates. Information was collected at baseline and updated yearly during follow-up. We used conditional logistic regression to evaluate associations in the total nested case-control study, and unconditional logistic regression for population subsets. Results: Mean (±SD) toenail mercury concentrations (μg per gram) did not significantly differ between cases (0.63 (±0.53)) and controls (0.67 (±0.49)). Mercury concentration was not associated with cardiovascular disease in any analysis, and neither was fish consumption or n-3 fatty acids. The fully-adjusted relative risks for the highest versus lowest quartile of mercury concentration were 0.71 (95% Confidence Interval [CI], 0.34, 1.14; ptrend = 0.37) for the nested case-control study, 0.74 (95% CI, 0.32, 1.76; ptrend = 0.43) within the Mediterranean diet intervention group, and 0.50 (95% CI, 0.13, 1.96; ptrend = 0.41) within the control arm of the trial. Associations remained null when mercury was jointly assessed with fish consumption at baseline and during follow-up. Results were similar in different sensitivity analyses.Conclusions: We found no evidence that mercury exposure from regular fish consumption increases cardiovascular disease risk in a population of Spanish adults with high cardiovascular disease risk and high fish consumption. This implies that the mercury content in fish does not detract from the already established cardiovascular benefits of fish consumption.
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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 Investigators
    Background: 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.
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    Dietary diversity and nutritional adequacy among an older Spanish population with Metabolic Syndrome in the PREDIMED-Plus study: a cross-sectional analysis
    (MDPI, 2019) Buil, P. (Pilar); Portoles, O. (Olga); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Muñoz-Garach, A. (Araceli); Riquelme-Gallego, B. (Blanca); Garcia-Rios, A. (Antonio); Fernandez-Carrion, R. (Rebeca); Gallardo-Alfaro, L. (Laura); Fito, M. (Montserrat); Konieczna, J. (Jadwiga); Palau-Galindo, A. (Antoni); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Moñino, M. (Manuel); Tur, J.A. (Josep A.); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Lapetra, J. (José); Zomeño, M.D. (María Dolores); Bueno-Cavanillas, A. (Aurora); Muñoz, M.A. (Miguel Angel); Basora, J. (Josep); Delgado-Rodriguez, M. (Miguel); Miralles-Gisbert, S. (Salvador); Contreras-Fernandez, E. (Eugenio); Matia, P. (Pilar); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Notario-Barandiaran, L. (Leyre); Perez-Vega, K.A. (Karla Alejandra); Casas, R. (Rosa); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Diaz-Lopez, A. (Andres); Santos-Lozano, J.M. (José M.); Gea, A. (Alfredo); Sanchez-Villegas, A. (Almudena); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Martin, V. (Vicente); Cano-Ibañez, N. (Naomi); Aros, F. (Fernando); Moreno-Rodríguez, A. (Anai)
    Dietary guidelines emphasize the importance of a varied diet to provide an adequate nutrient intake. However, an older age is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases, such as metabolic syndrome (MetS). To assess the association between dietary diversity (DD) and nutrient intake adequacy and to identify demographic variables associated with DD, we cross-sectionally analyzed baseline data from the PREDIMED-Plus trial: 6587 Spanish adults aged 55–75 years, with overweight/obesity who also had MetS. An energy-adjusted dietary diversity score (DDS) was calculated using a 143-item validated semi-quantitative food frequency questionnaire (FFQ). Nutrient inadequacy was defined as an intake below 2/3 of the dietary reference intake (DRI) forat least four of 17 nutrients proposed by the Institute of Medicine (IOM). Logistic regression models were used to evaluate the association between DDS and the risk of nutritionally inadequate intakes. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake: odds ratio (OR) = 28.56 (95% confidence interval (CI) 20.80–39.21). When we estimated food varietyfor each of the food groups, participants in the lowest quartile had a higher risk of inadequate nutrient intake for the groups of vegetables, OR = 14.03 (95% CI 10.55–18.65), fruits OR = 11.62 (95% CI 6.81–19.81), dairy products OR = 6.54 (95% CI 4.64–9.22) and protein foods OR = 6.60 (95% CI 1.96–22.24). As DDS decreased, the risk of inadequate nutrients intake rose. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow(er)s. View Full-Text
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    Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study
    (2020) Fernandez-Garcia, J.C. (José C.); Martinez, J.A. (José Alfredo); Micó-Pérez, R.M. (Rafael Manuel); Garcia-Rios, A. (Antonio); Gallardo-Alfaro, L. (Laura); Fito, M. (Montserrat); Daimiel, L. (Lidia); Vioque, J. (Jesús); Becerra-Tomas, N. (Nerea); Tur, J.A. (Josep A.); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Lapetra, J. (José); Matía-Martín, P. (Pilar); Bueno-Cavanillas, A. (Aurora); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Fernández-Lázaro, C.I. (César I.); Bibiloni, M.M. (Maria del Mar); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Gaforio, J.J. (José Juan); Montemayor, S. (Sofía); Serra-Majem, L. (Luis); Corella, D. (Dolores); Mascaró, C.M. (Catalina M.); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi)
    Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55–75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses’ Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence.
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    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.
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    Nut Consumptions as a Marker of Higher Diet Quality in a Mediterranean Population at High Cardiovascular Risk
    (MDPI AG, 2019) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Garcia-Rios, A. (Antonio); Fernandez-Carrion, R. (Rebeca); Fito, M. (Montserrat); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Zulet, M.A. (María Ángeles); Tur, J.A. (Josep A.); Diez-Espino, J. (Javier); Toledo, E. (Estefanía); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Orozco-Beltrán, D. (Domingo); Lapetra, J. (José); Zomeño, M.D. (María Dolores); Bouzas, C. (Cristina); Bueno-Cavanillas, A. (Aurora); Schröder, H. (Helmut); Basora, J. (Josep); Delgado-Rodriguez, M. (Miguel); López-Miranda, J. (José); Matia, P. (Pilar); Ros, E. (Emilio); Bullo, M. (Monica); Bibiloni, M.M. (Maria del Mar); Julibert, A. (Alicia); Cenoz, J.C. (Juan Carlos); Wärnberg, J. (Julia); Estruch, R. (Ramón); Serra-Majem, L. (Luis); Corella, D. (Dolores); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Martin, V. (Vicente); Aros, F. (Fernando)
    Background: Nut consumption has been associated with improved nutrient adequacy and diet quality in healthy adult populations but this association has never been explored in individuals at high cardiovascular risk. Objective: to assess the associations between consumption of nuts and nutrient adequacy and diet quality in a Mediterranean population at high cardiovascular risk. Design: baseline assessment of nutritional adequacy in participants (n = 6060, men and women, with ages 55⁻75 years old, with overweight/obesity and metabolic syndrome) in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Methods: nut intake was assessed using a validated food frequency questionnaire. Participants who reported consuming zero quantity of nuts were classified as 'non-nut consumers'. 'Nut consumers' were participants who reported consuming any quantity of nuts. Nineteen micronutrients were examined (vitamins B1, B2, B3, B6, B12, A, C, D, E and folic acid; Ca, K, P, Mg, Fe, Se, Cr, Zn, and iodine). The proportion of micronutrient inadequacy was estimated using the estimated average requirements (EAR) or adequate intake (AI) cut-points. Diet quality was also assessed using a 17-item Mediterranean dietary questionnaire (Mediterranean diet score, MDS), a carbohydrate quality index (CQI) and a fat quality index (FQI). Results: eighty-two percent of participants were nut consumers (median of nut consumption 12.6 g/day; interquartile range: 6.0⁻25.2). Nut consumers were less likely to be below the EAR for vitamins A, B1, B2, B6, C, D, E, folic acid, and Ca, Mg, Se and Zn than non-nut consumers. Nut consumers were also more likely to be above the AI for K and Cr than non-nut consumers. Nut consumers had lower prevalence of inadequate micronutrient intakes, but also higher CQI, higher FQI, and better scores of adherence to the Mediterranean diet (Mediterranean diet score, MDS). Conclusions: nut consumers had better nutrient adequacy, diet quality, and adherence to the MedDiet than those non-nut consumers.
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    White blood cell counts as risk markers of developing metabolic syndrome and its components in the PREDIMED study
    (Public Library of Sciences, 2013) Babio, N. (Nancy); Martinez-Gonzalez, M.A. (Miguel Ángel); Salaverria-Lete, I. (Itziar); Ibarrola-Jurado, N. (Nuria); Covas, M.I. (María Isabel); Bullo, M. (Monica); Wärnberg, J. (Julia); Ortega-Calvo, M. (Manuel); Estruch, R. (Ramón); Serra-Majem, L. (Luis); Salas-Salvado, J. (Jordi); Sorli, J.V. (Jose V.)
    BACKGROUND: The Metabolic Syndrome (MetS) is a cluster of metabolic abnormalities that includes hyperglucemia, hypertension, dyslipidemia and central obesity, conferring an increased risk of cardiovascular disease. The white blood cell (WBC) count has been proposed as a marker for predicting cardiovascular risk. However, few prospective studies have evaluated the relationship between WBC subtypes and risk of MetS. METHODS: Participants were recruited from seven PREDIMED study centers. Both a baseline cross-sectional (n = 4,377) and a prospective assessment (n = 1,637) were performed. Participants with MetS at baseline were excluded from the longitudinal analysis. The median follow-up was 3.9 years. Anthropometric measurements, blood pressure, fasting glucose, lipid profile and WBC counts were assessed at baseline and yearly during the follow-up. Participants were categorized by baseline WBC and its subtype count quartiles. Adjusted logistic regression models were fitted to assess the risk of MetS and its components. RESULTS: Of the 4,377 participants, 62.6% had MetS at baseline. Compared to the participants in the lowest baseline sex-adjusted quartile of WBC counts, those in the upper quartile showed an increased risk of having MetS (OR, 2.47; 95%CI, 2.03-2.99; P-trend<0.001). This association was also observed for all WBC subtypes, except for basophils. Compared to participants in the lowest quartile, those in the top quartile of leukocyte, neutrophil and lymphocyte count had an increased risk of MetS incidence. Leukocyte and neutrophil count were found to be strongly associated with the MetS components hypertriglyceridemia and low HDL-cholesterol. Likewise, lymphocyte counts were found to be associated with the incidence of the MetS components low HDL-cholesterol and high fasting glucose. An increase in the total WBC during the follow-up was also associated with an increased risk of MetS. CONCLUSIONS: Total WBC counts, and some subtypes, were positively associated with MetS as well as hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, all components of MetS.
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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).
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    Treatment of obesity in children and adolescents. How nutrition can work?
    (Informa Healthcare, 2008) Martinez, J.A. (José Alfredo); Marcos, A. (Ascensión); Ochoa, M.C. (María Carmen); Wärnberg, J. (Julia); Moreno, L.A. (Luis A.); Marti-del-Moral, A. (Amelia)
    Overweight appears when persistent positive energy imbalances occur for long periods of time. Knowledge of dietary risk factors during childhood and adolescence is needed in order to design preventive measures against the increase in the prevalence of obesity and its consequences but is, however, largely missing. Longitudinal studies in children have not found clear causal associations between energy intake or diet composition and overweight development. Research has been ongoing to develop effective intervention studies for obese children but it is not clear which intervention is the most effective in assisting overweight/obese children to improve body composition without affecting growth rates. The objective of this article is to review the available knowledge on dietary risk factors for the development of childhood obesity, to discuss different dietary treatment strategies, and to propose an evidence-based approach to treat obese adolescents.
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    Egg consumption and risk of cardiovascular disease in the sun project
    (Nature Publishing Group, 2011) Martinez-Gonzalez, M.A. (Miguel Ángel); Fuente-Arrillaga, C. (Carmen) de la; Zazpe, I. (Itziar); Bes-Rastrollo, M. (Maira); Benito-Corchon, S. (Silvia); Beunza, J.J. (Juan José); Wärnberg, J. (Julia); Vazquez-Ruiz, Z. (Zenaida)
    Background/Objective: Egg consumption has been associated with the risk of cardiovascular diseases (CVD), but evidence is scarce and inconsistent. Our aim was to examine the association between egg consumption and incidence of CVD in a prospective dynamic Mediterranean cohort of 14 185 university graduates. Subjects/Methods: Egg intake was assessed using a 136-item validated food frequency questionnaire. The baseline consumption was categorized into no consumption or <1/week, 1/week, 2-4/week, and >4/week. The presence of cardiovascular risk factors was assessed by questionnaire at baseline and the incidence of CVD was assessed using biennial assessments. The median follow-up was 6.1 years. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios (HR) for CVD (myocardial infarction, revascularization procedures or stroke). Outcomes were confirmed by review of medical records. Results: During a median follow-up of 6.1 years, 91 new confirmed cases of CVD were observed. No association was found between egg consumption and the incidence of CVD (HR=1.10, 95% CI: 0.46-2.63) for the highest vs. the lowest category of egg consumption) after adjusting for age, sex, total energy intake, adherence to the Mediterranean food pattern and other cardiovascular risk factors. Results were robust to different analytical scenarios Conclusions: No association between egg consumption and the incidence of CVD was found in this Mediterranean cohort.