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- Dietary Fat Intake and the Risk of Depression: The SUN Project(Public Library of Science, 2011-01-26) Martinez-Gonzalez, M.A. (Miguel Ángel); Toledo, E. (Estefanía); Irala, J. (Jokin) de; Verberne, L. (Lisa); Ruiz-Canela, M. (Miguel); Sanchez-Villegas, A. (Almudena); Serra-Majem, L. (Luis)Emerging evidence relates some nutritional factors to depression risk. However, there is a scarcity of longitudinal assessments on this relationship. Objective: To evaluate the association between fatty acid intake or the use of culinary fats and depression incidence in a Mediterranean population. Material and Methods: Prospective cohort study (1999–2010) of 12,059 Spanish university graduates (mean age: 37.5 years) initially free of depression with permanently open enrolment. At baseline, a 136-item validated food frequency questionnaire was used to estimate the intake of fatty acids (saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), trans unsaturated fatty acids (TFA) and monounsaturated fatty acids (MUFA) and culinary fats (olive oil, seed oils, butter and margarine) During follow-up participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression models were used to calculate Hazard Ratios (HR) of incident depression and their 95% confidence intervals (CI) for successive quintiles of fats. Results: During follow-up (median: 6.1 years), 657 new cases of depression were identified. Multivariable-adjusted HR (95% CI) for depression incidence across successive quintiles of TFA intake were: 1 (ref), 1.08 (0.82–1.43), 1.17 (0.88–1.53), 1.28 (0.97–1.68), 1.42 (1.09–1.84) with a significant dose-response relationship (p for trend = 0.003). Results did not substantially change after adjusting for potential lifestyle or dietary confounders, including adherence to a Mediterranean Dietary Pattern. On the other hand, an inverse and significant dose-response relationship was obtained for MUFA (p for trend = 0.05) and PUFA (p for trend = 0.03) intake. Conclusions: A detrimental relationship was found between TFA intake and depression risk, whereas weak inverse associations were found for MUFA, PUFA and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to subtypes of fat intake.
- Coffee consumption and the risk of depression in a middle-aged cohort: the SUN project(2018) Navarro-Echeverría, A. M. (Adela María); Martinez-Gonzalez, M.A. (Miguel Ángel); Martin-Calvo, N. (Nerea); Toledo, E. (Estefanía); Sanchez-Villegas, A. (Almudena); Abasheva, D. (Daria); Ruiz-Estigarribia, L. (Liz)Coffee is one of the most widely consumed drinks around the world, while depression is considered the major contributor to the overall global burden of disease. However, the investigation on coffee consumption and depression is limited and results may be confounded by the overall dietary pattern. We assessed the relationship between coffee intake and the risk of depression, controlling for adherence to the Mediterranean diet. We studied 14,413 university graduates of the Seguimiento Universidad de Navarra' (SUN) cohort, initially free of depression. We evaluated coffee consumption using a validated food-frequency questionnaire (FFQ). Incident depression cases were adjudicated only if the participant met two criteria simultaneously: (a) validated physician-diagnosed depression together with (b) new onset of habitual antidepressant use. Both criteria were needed; participants meeting only one of them were not classified as cases. Participants who drank at least four cups of coffee per day showed a significantly lower risk of depression than participants who drank less than one cup of coffee per day (HR: 0.37 (95% CI 0.15-0.95)). However, overall, we did not observe an inverse linear dose-response association between coffee consumption and the incidence of depression (p for trend = 0.22).
- 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.
- Perception of body image as indicator of weight status in the European union(Wiley Blackwell, 2001) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Gibney, M.J. (M.J.); Irala, J. (Jokin) de; Kearney, J. (J.); Sanchez-Villegas, A. (Almudena); Madrigal, H. (H.)Objective To identify the factors associated with an adequate perception of body image in relation to body weight. Material and methods An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women). Body Mass Index (BMI) was grouped into four categories, perceived body image was assessed using the nine silhouettes drawing scheme. A multivariable logistic regression model for each sex was used to adjust for potentially confounding variables. Results Underweight men and women classi®ed themselves better than other groups (92.9% of correct answers among men and 79.3% among women). Overall, women classi®ed themselves better than men (57.6% vs. 32.7%). Discussion Perceived body image as a method of assessment for body weight has different validity depending on sociodemographic or attitudinal categories. Perceived body image as an estimate of the nutritional status has a limited individualized application. Thus, perhaps it could be applied as a proxy measure of adiposity among slim males and among slim and overweight females, but not among the other groups.
- 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
- Nutritional assessment interpretation on 22.007 Spanish community-dwelling elders through the Mini Nutritional Assessment test(Cambridge University Press, 2009) Astiasarán, I. (Iciar); Martinez, J.A. (José Alfredo); Ansorena-Artieda, D. (Diana); Martinez-Gonzalez, M.A. (Miguel Ángel); Cuervo, M. (Marta); García, A. (Aquilino); Sanchez-Villegas, A. (Almudena)Objectives: To evaluate the prevalence of undernutrition among community-dwelling elderly people in Spain using the Mini Nutritional Assessment (MNA) and to analyse its distribution according to age, gender and residence region. Design: Cross-sectional study assessing the nutritional status of elderly persons through both the short form and the full version of the MNA test. Setting: Pharmacy offices across the whole country (Spain) were enrolled to recruit participants. Subjects: A total of 22 007 participants (8014 men and 13 993 women), aged >= 65 years, assessed during the last two months of 2005. Results: According to MNA screening, 4.3% subjects were classified as undernourished (MNA score <17) and 25.4% were at risk of undernutrition (MNA score >= 17 to <= 23.5). The MNA short form correlated strongly with the full MNA version (r = 0.85). MNA total score was significantly higher in men than in women (25.4 (SD 3.7) v. 24.6 (SD 3.9); P < 0.001) and lower in the oldest than in the youngest subjects (P < 0.001) in both genders. According to regional distribution, the best nutritional status was found in elderly from the north of Spain excluding the north-west area. Conclusions: Female gender, older age and living in the south half or northwest of the country were associated with higher rates of undernutrition among community-dwelling elderly persons in Spain.
- Dieta mediterránea y enfermedad cardiovascular: resultados del estudio piloto del proyecto SUN(Ediciones Universidad de Navarra., 2002) Martinez-Gonzalez, M.A. (Miguel Ángel); Irala, J. (Jokin) de; Sanchez-Villegas, A. (Almudena)Fundamento: La dieta mediterránea ha sido propuesta como modelo de patrón dietético para la prevención de la cardiopatía isquémica. El proyecto SUN (“Seguimiento Universidad de Navarra”) es un estudio epidemiológico prospectivo de cohortes, que se inició en el año 2000 y que va dirigido a identificar determinantes dietéticos y no dietéticos implicados en estas enfermedades. La viabilidad del proyecto, se comprobó con un estudio piloto en dos fases. Métodos: La primera fase del estudio piloto contó con la participación de voluntarios en los que se valoraron las exposiciones dietéticas y no dietéticas mediante un cuestionario autoadministrado y por entrevista personal. Para la segunda fase, se seleccionó una muestra aleatoria de 600 graduados y se les envió el cuestionario por correo. Para estimar la variabilidad inter-sujetos se calcularon los percentiles 10, 25, 50, 75 y 90 de consumo para los principales alimentos y nutrientes considerados. Resultados: Los participantes entendieron y respondieron adecuadamente los cuestionarios. El tiempo medio empleado en contestar el cuestionario fue de 55,0 minutos (IC 95%=50,7-59,3). Se encontró una amplia variabilidad inter-sujetos entre los percentiles 10 y 90 en el consumo de los principales alimentos que pueden considerarse indicadores de la dieta mediterránea, como son el aceite de oliva, las frutas, las verduras y el vino. Conclusiones: La submuestra presentó una participación relativamente aceptable. Se halló un patrón de dieta mediterránea con una variabilidad inter-sujetos suficientemente amplia como para poder encontrar asociaciones entre el consumo de alimentos y la incidencia de las principales enfermedades cardiovasculares.
- Dietary patterns and total mortality in a Mediterranean cohort: the SUN project(Elsevier, 2013) Martinez-Gonzalez, M.A. (Miguel Ángel); Sanchez-Tainta, A. (Ana); Zazpe, I. (Itziar); Toledo, E. (Estefanía); Sanchez-Villegas, A. (Almudena)BACKGROUND: Different dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations. OBJECTIVE: The aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality. DESIGN: The Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort. PARTICIPANTS/SETTING: Participants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire. MAIN OUTCOME MEASURES: Deaths were confirmed by review of medical records and of the National Death Index. STATISTICAL ANALYSIS: Dietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality. RESULTS: Three major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality. CONCLUSIONS: Greater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults.
- 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.
- Health-related quality of life and mortality in the 'Seguimiento Universidad de Navarra' prospective cohort study(2023) Martinez-Gonzalez, M.A. (Miguel Ángel); Jiménez-Moleón, J.J. (José Juan); Toledo, E. (Estefanía); López-Herreros, J. (J.); Ruiz-Canela, M. (Miguel); Gea-Sánchez, A. (Alfredo); Dierssen-Sotos, T. (T.); Sanchez-Villegas, A. (Almudena)Objective: To study the association between health-related quality of life (HRQoL) and all-cause mortality in a healthy middle-aged Mediterranean cohort. Methods: We included 15,390 participants -mean age 42.8 years at first HRQoL ascertainment, all university graduates-. HRQoL was assessed with the self-administered Medical Outcomes Study Short Form-36 (SF-36) twice, with a 4-year gap. We used multivariable-adjusted Cox regression models to address the relation between self-reported health and Physical or Mental Component Summary (PCS-36 or MCS-36) and mortality, and their interaction with prior comorbidities or adherence to the Mediterranean diet (MedDiet). Results: Over 8.7 years of median follow-up time, 266 deaths were identified. Hazard ratio (HR) for the excellent vs. poor/fair category in self-reported health was 0.30 (95 % confidence interval (CI), 0.16-0.57) in the model with repeated measurements of HRQoL. Both the PCS-36 (HRquartile4(Q4)vs.Q1 0.57 [95%CI, 0.36-0.90], ptrend < 0.001; HRper+10points: 0.64 [95%CI, 0.54-0.75]) and the MCS-36 (HRQ4vs.Q1 0.67 [95%CI, 0.46-0.97], ptrend = 0.025; HRper+10points: 0.86 [95%CI, 0.74-0.99]) were inversely associated with mortality in the model with repeated measurements of HRQoL. Previous comorbidities or adherence to the MedDiet did not modify these associations. Conclusions: Self-reported HRQoL -assessed as self-reported health, PCS-36 and MCS-36- obtained with the Spanish version of the SF-36 were inversely associated with mortality risk, regardless of the presence of previous comorbidities or adherence to the MedDiet.