Sandra Gonzalez-Palacios

Mediterranean dietary pattern in pregnant women and offspring risk of overweight and abdominal obesity in early childhood: The INMA birth cohort study

Animal models have suggested that maternal diet quality may reduce offspring obesity risk regardless of maternal body weight; however, evidence from human studies is scarce.

Validez del peso y talla auto-referido en población universitaria y factores asociados a las discrepancias entre valores declarados y medidos

INTRODUCTION Obesity is an important public health problem related to a higher risk of death from chronic degenerative diseases such as diabetes, cardiovascular diseases and several types of cancer. In epidemiological studies of big sample size, only self-reported weight and height can be collected for feasibility reasons and body mass index (BMI) estimates may be questioned. OBJECTIVES In this study we compare self-reported and measured weight, height and BMI in a mostly young population of university students, and explore factors associated with discrepancies between self-reported and measured data. METHODS In the period 2006-2012, 628 University students (476 women) from health sciences subject gave consent to participate in this study. Self-reported weight and height were collected by questionnaire and compared with weight and height measured afterward in health exams wearing light clothes and using standardized protocols. The validity of self-reported anthropometric estimates was explored by correlation coefficients and sensitivity, specificity, predictive values and kappa to detect measured overweight/obesity (BMI ≥ 25 kg/m²). Multiple linear regression was used to explore the factors related to the discrepancies between self-reported and measured data. RESULTS The mean of self-reported weight, height and BMI was 62.5 kg, 167.6 cm and 22.1 kg/m² and the mean of measured data was 62.6 kg, 167.4 cm y 22.2 kg/m² respectively. Correlations between self-reported and measured data were r = 0.97 for weight, 0.96 for height and 0.95 for BMI. The sensitivity to detect overweight (IMC ≥ 25 kg/m²) using self-reported data was 81.0%, the specificity was 98.5%, the predictive value was 90.6% and the kappa index was 0.75. The discrepancy between measured and self-reported weight, height and BMI was associated with a higher age, and a higher sleeping time was also associated to discrepancies in self-reported and measured height. CONCLUSIONS Despite the self-reported weight and BMI may underestimate the true weight and BMI, and self-reported height overestimate, the validity of self-reported anthropometric measures is adequate to use be used in epidemiological studies among young people with a high educational level.

Reproducibility and Validity of a Food Frequency Questionnaire Designed to Assess Diet in Children Aged 4-5 Years

Background The food frequency questionnaire (FFQ) is the most efficient and cost-effective method to investigate the relationship between usual diet and disease in epidemiologic studies. Although FFQs have been validated in many adult populations worldwide, the number of valid FFQ in preschool children is very scarce. The aim of this study was to evaluate the reproducibility and validity of a semi-quantitative FFQ designed for children aged 4 to 5 years. Materials and methods In this study, we have included 169 children aged 4–5 years from the INMA project in Valencia, a population-based prospective cohort study of mothers and children in Spain. The 105-items FFQ was administered twice to the parents or care-givers of children over a 9-month period. Reproducibility was explored by comparing intake of nutrients by the FFQs, while validity was examined by comparing the nutrient values from the FFQs with the average nutrient values of three 24 hour dietary recall (24hDR) taken in the period, and also, with the concentration in blood specimens for several vitamins (carotenoids, folate, vitamin B12, vitamin C and α-tocopherol). Pearson correlation coefficients and de-attenuated correlation coefficients were calculated and we also evaluated misclassification by quintile distribution. Results All correlation coefficients for reproducibility for nutrients and major food groups were statistically significant; the average correlation coefficients for daily intake were 0.43 for food groups and 0.41 for nutrients. The average correlation coefficients for validity for daily intakes against 24hDR was r = 0.30, and the average for de-attenuated correlation coefficients was r = 0.44. When evaluating validity against the blood concentration of vitamins, statistically significant correlations were observed for vitamin C (0.35), lycopene (0.31), β-Cryptoxantin (0.40), and vitamin E (0.29); the average of correlation coefficients was r = 0.21. Conclusion Despite some low to moderate correlations for reproducibility and validity, overall this study suggests that the FFQ may be a good method for assessing a wide range of food groups and nutrients intake in children aged 4–5 years.

Mediterranean diet and quality of life: Baseline cross-sectional analysis of the PREDIMED-PLUS trial

We assessed if a 17-item score capturing adherence to a traditional Mediterranean diet (MedDiet) was associated with better health-related quality of life among older Spanish men and women with overweight or obesity harboring the metabolic syndrome. We analyzed baseline data from 6430 men and women (age 55–70 years) participating in the PREDIMED-Plus study. PREDIMED-Plus is a multi-centre randomized trial testing an energy-restricted MedDiet combined with promotion of physical activity and behavioral therapy for primary cardiovascular prevention compared to a MedDiet alone. Participants answered a 36-item questionnaire about health-related quality of life (HRQoL) and a 17-item questionnaire that assessed adherence to an MedDiet. We used ANCOVA and multivariable-adjusted linear regression models to compare baseline adjusted means of the quality of life scales according to categories of adherence to the MedDiet. Higher adherence to the MedDiet was independently associated with significantly better scores in the eight dimensions of HRQoL. Adjusted differences of > = 3 points between the highest and the lowest dietary adherence groups to the MedDiet were observed for vitality, emotional role, and mental health and of > = 2 points for the other dimensions. In conclusion, this study shows a positive association between adherence to a MedDiet and several dimensions of quality of life.

Nutrition Labelling Use and Higher Adherence to Mediterranean Diet: Results from the DiSA-UMH Study

The aim of this study was to identify determinants of the nutrition labelling (NL) use and explore its association with the adherence to Mediterranean Diet (MD) in Spanish health university students. We performed a cross-sectional analysis of the baseline data from 1026 university students aged 17–35 years enrolled in the DiSA-UMH (Dieta, Salud y Antropometría-Universidad Miguel Hernández) cohort study. Students were asked about their NL use by the following question: “Do you usually read the nutrition labelling of packaged foods?” (No, Yes). Dietary intake was assessed using a validated food frequency questionnaire and the adherence to MD was measured by relative Mediterranean Diet score (rMED). Socio-demographic, lifestyle, and anthropometric variables were also collected. Multiple logistic regression models were applied for the analysis. Fifty-eight percent of the students were NL users and were most likely to be women (Odds Ratio (OR): 1.38; 95% Confidence Interval (CI): 1.01–1.89), be older (OR per year: 1.08; 95% CI: 1.03–1.13), be physically active/very active (OR: 1.68; 95% CI: 1.17–2.41), and spend less time watching television (OR per hour: 0.84; 95% CI: 0.74–0.95). After adjusting for potential confounding factors, our findings suggested that those university students who had higher adherence to MD used NL greatly (OR per 2 points increase: 1.30; 95% CI: 1.18–1.43) and had a larger consumption of fish (OR per 100 g/day: 1.94; 95 CI: 1.38–2.71), vegetables (OR per 100 g/day: 1.15; CI 95%: 1.08–1.12), and fruits (OR per 100 g/day: 1.22; 1.11–1.34) and a smaller intake of meats (OR per 100 g/day: 0.76; 95% CI: 0.58–0.99). Our approach contributes to exploring the role of NL use as a suitable tool to make healthier food choices from a different wider perspective based on dietary patterns such as MD, which can also indicate an overall healthy lifestyle. Given the lack of research in Mediterranean areas, further studies focused on exploring the potential role of NL in promoting healthy dietary habits are required.

El Estudio DiSA-UMH: Estudio de cohorte prospectivo en estudiantes de ciencias de la salud de la Universidad Miguel Hernández

Introduction: Young adulthood is an important stage to establish dietary habits and lifestyle behaviors that could be linked to the long-term development of chronic diseases in later life. The 3 years follow-up prospective cohort DiSA-UMH study was set up with the main objectives of determining the nutritional status, lifestyle behaviors and health status, assessing the possible changes during the follow-up, and estimating their influence on the occurrence and development of chronic diseases. Material and Methods: Baseline information of 1204 health science students from Universidad Miguel Hernández (UMH) aged between 17 and 35 years was collected during the period from 2006 to 2012. All the participants completed a general questionnaire divided into separate sections that included a food frequency questionnaire, specific questions on physical activity, tobacco consumption, nutritional labelling use, weight, height, health status, and questions about the diagnosis of several diseases. In order to validate self-reported data, several reliability/validity investigations with different subsamples were specifically conducted. After baseline questionnaire, students were asked to obtain anthropometric measurements and fasting blood samples. To evaluate our assessment of dietary intake, between three and nine 24-hour recalls administered by telephone were conducted over one year. Results: The first follow-up period of 3-years finished in 2015 and the second 3-year follow-up period is still ongoing. Although the retention rates during these assessment periods were 59.2% and 52.2% respectively, the losses of follow-up happened in a random way because of characteristics of participants and non-participants during follow-up were similar. KEYWORDS

Coffee Drinking and Associated Factors in an Elderly Population in Spain

Coffee consumption is highly prevalent worldwide, and many studies have reported positive and inverse associations of coffee with many diseases. However, factors associated with coffee consumption remain poorly characterized in some populations, such as the elderly. This study aimed to assess the factors associated with total, caffeinated and decaffeinated coffee consumption in an elderly population in Spain. Data were analyzed from 903 participants, aged 65 years and above, from two population-based studies carried out in the Valencia region in Spain (Valencia Nutritional Survey (VNS) and European Eye Study (EUREYE-Study). Total, caffeinated and decaffeinated coffee consumption was assessed through two specific questions using a validated food frequency questionnaire. Information on personal characteristics, anthropometry and lifestyles was collected in personal interviews. Multinomial logistic regression analysis was used to estimate the adjusted relative risk ratios (RRR) and confidence intervals (95% CI). The prevalence of total, caffeinated and decaffeinated coffee consumption was 70%, 38% and 32%, respectively. The consumption of caffeinated coffee was positively associated with: Educational level, RRR = 1.63 (1.09–2.44); body mass index (≥30), RRR = 2.03 (1.05–3.95); tobacco smoking, RRR = 1.96 (1.13–3.39); alcohol intake [≥12 g/day category intake vs. no-alcohol intake, RRR = 6.25 (3.56–10.95)]; and energy intake (p < 0.05). Consumption of caffeinated coffee was negatively associated with: Age (≥75 years), RRR = 0.64 (0.43–0.94); and pre-existing hypertension, RRR = 0.67 (0.45–0.98). The consumption of decaffeinated coffee was positively associated with: Alcohol intake, RRR = 2.63 (1.19–4.64); pre-existing diabetes, RRR = 1.67 (1.06–2.62); and energy intake (p < 0.01). The consumption of coffee is high among elderly people in Spain. It is a novelty in this study with elderly population that tobacco smoking and alcohol drinking were the two main factors associated with higher coffee consumption. Self-reported hypertension was associated with a lower consumption of caffeinated coffee, and pre-existing diabetes was associated with a higher consumption of decaffeinated coffee. These associations should be taken into account when the health effects of coffee consumption are investigated.