Adherence to dietary guidelines for the Spanish population and risk of overweight/ obesity in the SUN cohort
Keywords: 
Dietary guidelines
Nutrition policies
Incidence of overweight/obesity
Political and economic factors
Issue Date: 
2019
Publisher: 
Public Library of Science (PLoS)
ISSN: 
1932-6203
Note: 
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Citation: 
Gómez-Donoso, C. (Clara); Martinez-Gonzalez, M. A. (Miguel Ángel); Martinez, J.A. (José Alfredo); et al. "Adherence to dietary guidelines for the Spanish population and risk of overweight/ obesity in the SUN cohort". PLOS ONE. 14 (12), 2019, e0226565
Abstract
Dietary guidelines play a key role in setting standards for nutrition policies and promoting healthy eating. Like other public health guidelines, they are often influenced by political and economic factors that could place other concerns ahead of the population’s health. In order to determine their effectiveness on obesity prevention, we prospectively examined the association between adherence to the latest available national dietary guidelines and the incidence of overweight/obesity in a Spanish cohort study. A sample of 11,554 participants of the “Seguimiento Universidad de Navarra” (SUN) cohort, initially free of overweight or obesity, was included in the study. The Spanish Society of Community Nutrition (SENC) food pyramid (FP) score was computed based on the ratio of consumed to recommended daily servings of grains, fruits, vegetables, dairy, protein-rich foods, olive oil, red and processed meat, sweets, salty snacks and spreadable fats, fermented alcoholic beverages and water. The same approach was followed to calculate the SENC hydration pyramid (HP) score, considering the intake of water and different kind of beverages. Adherence was calculated at baseline and after 10 years of follow-up. Cox proportional hazards models were used to assess the incidence of overweight/obesity (BMI �25 kg/m2 ). During a median follow-up of 10.3 years, 2320 incident cases were identified. The highest level of adherence to the SENC FP score was modestly associated with a reduced risk of overweight/obesity (multivariable-adjusted HR for the fifth quintile vs. the first quintile = 0.78; 95% CI: 0.67–0.91; ptrend: 0.007). No consistent trends were found for the SENC HP. In a large prospective cohort of Spanish university graduates, we found an inverse linear association between adherence to the SENC FP and overweight/obesity risk, whereas this was not the case for the HP.

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