Garcia-Arellano, A. (Ana)
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- Association of monetary diet cost of foods and diet quality in Spanish older adults(Frontiers, 2023) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Riquelme-Gallego, B. (Blanca); Pastor, R. (Rosario); Tinahones, F.J. (Francisco J.); Vioque, J. (Jesús); Bes-Rastrollo, M. (Maira); Romaguera, D. (Dora); Romero-Secin, A. (Anny); Lapetra, J. (José); Bouzas, C. (Cristina); Schröder, H. (Helmut); López-Miranda, J. (José); Ruiz-Canela, M. (Miguel); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Salas-Salvado, J. (Jordi); Monserrat-Mesquida, M. (Margalida); Garcia, S. (Silvia); Garcia-Arellano, A. (Ana)Background: A major barrier to a healthy diet may be the higher price of healthy foods compared to low-quality foods. Objectives: This study aimed to assess the association between the monetary cost of food and diet quality in Spanish older adults at high risk of cardiovascular disease. Methods: Cross-sectional analysis was carried out in Spanish older adults (n = 6,838; 48.6% female). A validated food frequency questionnaire was used to assess dietary intake. Metabolic syndrome severity, adherence to the Mediterranean diet (MedDiet), adherence to a provegetarian dietary pattern, and dietary inflammatory index were assessed. The economic cost of the foods was obtained from the Spanish Ministry of Agriculture Fisheries and Food database (2015–2017, the period of time when the participants were recruited). The total cost of diet adjusted per 1,000 kcal was computed. Results: The healthier dietary pattern was associated with a higher cost of the diet. Higher adherence to the MedDiet, anti-inflammatory diet, and the healthy version of the provegetarian dietary pattern were related to higher costs of the diet. Conclusion: Higher diet quality was associated with a higher dietary cost of the diet per 1,000 kcal/day. Food prices can be an important component of interventions and policies aimed at improving people's diets and preventing diet-related chronic diseases.
- Dietary inflammatory index and incidence of cardiovascular disease in the SUN cohort(Public Library of Science, 2015) Martinez-Gonzalez, M.A. (Miguel Ángel); Shivappa, N. (Nitin); Toledo, E. (Estefanía); Hernandez-Hernandez, A. (Aitor); Ramallal, R. (Raul); Ruiz-Canela, M. (Miguel); Hebert, J.R. (James R.); Garcia-Arellano, A. (Ana)BACKGROUND: Diet is known to play a key role in atherogenesis and in the development of cardiovascular events. Dietary factors may mediate these processes acting as potential modulators of inflammation. Potential Links between inflammatory properties of diet and the occurrence of cardiovascular events have not been tested previously. OBJECTIVE: We aimed to assess the association between the dietary inflammatory index (DII), a method to assess the inflammatory potential of the diet, and incident cardiovascular disease. METHODS: In the prospective, dynamic SUN cohort, 18,794 middle-aged, Spanish university graduates were followed up for 8.9 years (median). A validated 136-item food-frequency questionnaire was used to calculate the DII. The DII is based on scientific evidence about the relationship between diet and inflammatory biomarkers (C-reactive protein, IL-1β, IL-4, IL-6, IL-10 and TNF-α). Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the DII and incident cardiovascular disease (myocardial infarction, stroke or cardiovascular death). RESULTS: The risk for cardiovascular events progressively increased with each increasing quartile of DII (ptrend = 0.017). The multivariable-adjusted HR for participants in the highest (most pro-inflammatory) vs. the lowest quartile of the DII was 2.03 (95% CI 1.06-3.88). CONCLUSIONS: A pro-inflammatory diet was associated with a significantly higher risk for developing cardiovascular events.
- Dietary inflammatory index and incidence of cardiovascular disease in the PREDIMED study(MDPI, 2015) Babio, N. (Nancy); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Fiol, M. (Miquel); Fito, M. (Montserrat); Gonzalez, J.I. (José I.); Shivappa, N. (Nitin); Lapetra, J. (José); Schröder, H. (Helmut); Ramallal, R. (Raul); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Estruch, R. (Ramón); PREDIMED; Serra-Majem, L. (Luis); Corella, D. (Dolores); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Hebert, J.R. (James R.); Aros, F. (Fernando); Gomez-Garcia, E. (Enrique); Garcia-Arellano, A. (Ana)Previous studies have reported an association between a more pro-inflammatory diet profile and various chronic metabolic diseases. The Dietary Inflammatory Index (DII) was used to assess the inflammatory potential of nutrients and foods in the context of a dietary pattern. We prospectively examined the association between the DII and the incidence of cardiovascular disease (CVD: myocardial infarction, stroke or cardiovascular death) in the PREDIMED (Prevención con Dieta Mediterránea) study including 7216 high-risk participants. The DII was computed based on a validated 137-item food frequency questionnaire. Multivariate-adjusted hazard ratios (HR) and 95% confidence intervals of CVD risk were computed across quartiles of the DII where the lowest (most anti-inflammatory) quartile is the referent. Risk increased across the quartiles (i.e., with increasing inflammatory potential): HRquartile2 = 1.42 (95%CI = 0.97–2.09); HRquartile3 = 1.85 (1.27–2.71); and HRquartile4 = 1.73 (1.15–2.60). When fit as continuous the multiple-adjusted hazard ratio for each additional standard deviation of the DII was 1.22 (1.06–1.40). Our results provide direct prospective evidence that a pro-inflammatory diet is associated with a higher risk of cardiovascular clinical events.
- A 14-item mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial(Public Library of Science, 2012) Buil-Cosiales, P. (Pilar); Martinez-Gonzalez, M.A. (Miguel Ángel); Fiol, M. (Miquel); Gomez-Gracia, E. (Enrique); Toledo, E. (Estefanía); Lapetra, J. (José); Muñoz, M.A. (Miguel Angel); Schröder, H. (Helmut); Ruiz-Gutierrez, V. (Valentina); Covas, M.I. (María Isabel); Ros, E. (Emilio); Wärnberg, J. (Julia); Estruch, R. (Ramón); Lamuela-Raventos, R.M. (Rosa Maria); Serra-Majem, L. (Luis); Corella, D. (Dolores); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Aros, F. (Fernando); Garcia-Arellano, A. (Ana)Objective: Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes. Design: Cross-sectional assessment of all participants in the ‘‘PREvencio´n con DIeta MEDiterra´nea’’ (PREDIMED) trial. Subjects: 7,447 participants (55–80 years, 57% women) free of cardiovascular disease, but with either type 2 diabetes or $3 cardiovascular risk factors. Trained dietitians used both a validated 14-item questionnaire and a full-length validated 137-item food frequency questionnaire to assess dietary habits. Trained nurses measured weight, height and waist circumference. Results: Strong inverse linear associations between the 14-item tool and all adiposity indexes were found. For a two-point increment in the 14-item score, the multivariable-adjusted differences in WHtR were 20.0066 (95% confidence interval, – 0.0088 to 20.0049) for women and –0.0059 (–0.0079 to –0.0038) for men. The multivariable-adjusted odds ratio for a WHtR.0.6 in participants scoring $10 points versus #7 points was 0.68 (0.57 to 0.80) for women and 0.66 (0.54 to 0.80) for men. High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity. Conclusions: A brief 14-item tool was able to capture a strong monotonic inverse association between adherence to a good quality dietary pattern (Mediterranean diet) and obesity indexes in a population of adults at high cardiovascular risk.
- Obesity indexes and total mortality among elderly subjects at high cardiovascular risk: The PREDIMED study(Public Library of Science, 2014) Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Eguaras, S. (Sonia); Fiol, M. (Miquel); Fito, M. (Montserrat); Recondo, J. (Javier); Seaz-Tormo, G. (G.); Gomez-Gracia, E. (Enrique); Toledo, E. (Estefanía); Bes-Rastrollo, M. (Maira); Ros, E. (Emilio); Bullo, M. (Monica); Estruch, R. (Ramón); Santos-Lozano, J.M. (José M.); Lamuela-Raventos, R.M. (Rosa Maria); Serra-Majem, L. (Luis); Corella, D. (Dolores); Pinto, X. (Xavier); Garcia-Arellano, A. (Ana)Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. METHODS: We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. RESULTS: After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78-1.34), 1.30 (0.97-1.75) and 1.55 (1.06-2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88-1.59), 1.02 (0.74-1.41) and 1.57 (1.19-2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. CONCLUSIONS: Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN35739639.
- Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMEDPlus study(Springer Science and Business Media LLC, 2019) Fernandez-Garcia, J.C. (José C.); Castañer, O. (Olga); Portoles, O. (Olga); Martinez, J.A. (José Alfredo); Martinez-Gonzalez, M.A. (Miguel Ángel); Micó-Pérez, R.M. (Rafael Manuel); Fiol, M. (Miquel); Riquelme-Gallego, B. (Blanca); Garcia-Rios, A. (Antonio); Fito, M. (Montserrat); Fiol, F. (Francisca); Konieczna, J. (Jadwiga); Daimiel, L. (Lidia); Tinahones, F.J. (Francisco J.); Compañ-Gabucio, L. (Laura); Vaquero-Luna, J. (Jessica); Vioque, J. (Jesús); Barón-López, F.J. (F. Javier); Becerra-Tomas, N. (Nerea); Tur, J.A. (Josep A.); Varela-Mato, V. (Veronica); Benavente-Marín, J.C. (Juan Carlos); Romaguera, D. (Dora); Vázquez, C. (Clotilde); Lapetra, J. (José); Matía-Martín, P. (Pilar); Papandreou, C. (Christopher); Schröder, H. (Helmut); Galmes-Panades, A.M. (Aina M.); Razquin, C. (Cristina); Ros, E. (Emilio); Ruiz-Canela, M. (Miguel); Mira-Castejón, L.A. (Luis Alfredo); Perez-Vega, K.A. (Karla Alejandra); Tomaino, L. (Laura); Casas, R. (Rosa); Alonso-Gomez, A. (Ángel); Wärnberg, J. (Julia); Estruch, R. (Ramón); Diaz-Lopez, A. (Andres); Asensio, E.M. (Eva M.); Gaforio, J.J. (José Juan); Santos-Lozano, J.M. (José M.); Serra-Majem, L. (Luis); Corella, D. (Dolores); Abete, I. (Itziar); Mascaró, C.M. (Catalina M.); Vidal, J. (Josep); Pinto, X. (Xavier); Salas-Salvado, J. (Jordi); Galera, A. (Ana); Garcia-Arellano, A. (Ana); Moreno-Rodríguez, A. (Anai)Background: This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods: This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results: Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). Conclusions: Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health.