Naomi Cano-Ibáñez1, Alfredo Gea2, Miguel Ruiz-Canela2, Dolores Corella3, Jordi Salas-Salvadó4, Helmut Schröder5, Eva Ma Navarrete-Muñoz6, Dora Romaguera7, J Alfredo Martínez8, F Javier Barón-López9, José López-Miranda10, Ramón Estruch11, Blanca Riquelme-Gallego12, Ángel Alonso-Gómez13, Josep A Tur14, Francisco J Tinahones15, Lluis Serra-Majem16, Vicente Martín17, José Lapetra18, Clotilde Vázquez19, Xavier Pintó20, Josep Vidal21, Lidia Daimiel22, José Juan Gaforio23, Pilar Matía24, Emilio Ros25, Rebeca Fernández-Carrión3, Andrés Díaz-López4, M Dolors Zomeño26, Inmaculada Candela6, Jadwiga Konieczna7, Itziar Abete27, Pilar Buil-Cosiales28, Josep Basora4, Montserrat Fitó29, Miguel A Martínez-González30, Aurora Bueno-Cavanillas31. 1. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Biosanitaria de Granada, IBS GRANADA, Granada, Spain. Electronic address: ncaiba@ugr.es. 2. Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNa), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. 3. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain. 4. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Department de Bioquímica I Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain. 5. CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain. 6. CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Nutritional Epidemiology Unit, Miguel Hernández University, ISABIAL-FISABIO, Alicante, Spain. 7. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. 8. Navarra Institute for Health Research (IdisNa), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain; Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. 9. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Public Health, University of Málaga-IBIMA, Málaga, Spain. 10. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain. 11. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. 12. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. 13. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. 14. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain. 15. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain. 16. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. 17. CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institute of Biomedicine (IBIOMED), University of León, León, Spain. 18. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. 19. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain. 20. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Spain. 21. Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, Barcelona, Spain; CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. 22. Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. 23. CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Estudios Avanzados en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain. 24. Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 25. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, Barcelona, Spain. 26. Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain; Human Nutrition Unit, Blanquerna-Ramon Llull University, Barcelona, Spain. 27. Navarra Institute for Health Research (IdisNa), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain. 28. Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain. 29. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain. 30. Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNa), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Harvard TH Chan School of Public Health, Department of Nutrition, Boston, USA. 31. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Biosanitaria de Granada, IBS GRANADA, Granada, Spain.
Abstract
BACKGROUND: Socioeconomic disparities and lifestyle factors are likely to determine the overall quality of the diet. In addition, overeating is compatible with inadequate micronutrient intake and it can lead to adverse health outcomes. OBJECTIVE: To assess adequacy of dietary nutrient intake and to investigate the influence of socioeconomic and lifestyle factors on nutrient density in a large primary cardiovascular prevention trial conducted in healthy participants with metabolic syndrome (MetS) to assess the cardiovascular effects of an energy-restricted Mediterranean diet (PREDIMED-Plus). METHODS: Baseline cross-sectional analysis of the PREDIMED-Plus trial with 6646 Spanish participants (aged 55-75 years in men and 60-75 years in women) with overweight/obesity and MetS. Energy and nutrient intake (for 10 nutrients) were calculated using a validated 143-item Food Frequency Questionnaire (FFQ) and nutrient density was estimated dividing the absolute nutrient intake by total energy intake. The prevalence of inadequate intake was estimated according to dietary reference intakes. Multivariable linear regression models were fitted to examine associations between socioeconomic status or lifestyle factors and nutrient density. RESULTS: A considerable proportion of the screened participants showed a deficient intake of vitamins A, D, E, B9, calcium, magnesium and dietary fibre. Inadequate intake of four or more of the ten nutrients considered was present in 17% of participants. A higher nutrient density was directly and significantly associated with female sex, higher educational level and a better adherence to the Mediterranean diet. Lifestyle factors such as non-smoking and avoidance of sedentary lifestyles were also independently associated with better nutrient density. CONCLUSIONS: Patients with MetS, despite being overweight, exhibited suboptimal nutrient intake, especially among men. Low nutrient density diet can be largely explained by differences in socioeconomic and lifestyle factors. These results highlight the importance of focussing on nutritional education in vulnerable populations, taking into account nutrient requirements.
BACKGROUND: Socioeconomic disparities and lifestyle factors are likely to determine the overall quality of the diet. In addition, overeating is compatible with inadequate micronutrient intake and it can lead to adverse health outcomes. OBJECTIVE: To assess adequacy of dietary nutrient intake and to investigate the influence of socioeconomic and lifestyle factors on nutrient density in a large primary cardiovascular prevention trial conducted in healthy participants with metabolic syndrome (MetS) to assess the cardiovascular effects of an energy-restricted Mediterranean diet (PREDIMED-Plus). METHODS: Baseline cross-sectional analysis of the PREDIMED-Plus trial with 6646 Spanish participants (aged 55-75 years in men and 60-75 years in women) with overweight/obesity and MetS. Energy and nutrient intake (for 10 nutrients) were calculated using a validated 143-item Food Frequency Questionnaire (FFQ) and nutrient density was estimated dividing the absolute nutrient intake by total energy intake. The prevalence of inadequate intake was estimated according to dietary reference intakes. Multivariable linear regression models were fitted to examine associations between socioeconomic status or lifestyle factors and nutrient density. RESULTS: A considerable proportion of the screened participants showed a deficient intake of vitamins A, D, E, B9, calcium, magnesium and dietary fibre. Inadequate intake of four or more of the ten nutrients considered was present in 17% of participants. A higher nutrient density was directly and significantly associated with female sex, higher educational level and a better adherence to the Mediterranean diet. Lifestyle factors such as non-smoking and avoidance of sedentary lifestyles were also independently associated with better nutrient density. CONCLUSIONS:Patients with MetS, despite being overweight, exhibited suboptimal nutrient intake, especially among men. Low nutrient density diet can be largely explained by differences in socioeconomic and lifestyle factors. These results highlight the importance of focussing on nutritional education in vulnerable populations, taking into account nutrient requirements.
Authors: Maria C Patino-Alonso; Marta Gómez Sánchez; Leticia Gómez Sánchez; Rosario Alonso-Domínguez; Natalia Sánchez-Aguadero; Benigna Sánchez Salgado; Emiliano Rodríguez Sánchez; Luis García Ortiz; Manuel A Gómez-Marcos Journal: Nutrients Date: 2020-02-28 Impact factor: 5.717
Authors: Marta Beltrá; Keila Soares-Micoanski; Eva-Maria Navarrete-Muñoz; Ana B Ropero Journal: Int J Environ Res Public Health Date: 2020-10-21 Impact factor: 3.390
Authors: Vanessa M Oddo; Lauren Welke; Andrew McLeod; Lacey Pezley; Yinglin Xia; Pauline Maki; Mary Dawn Koenig; Michelle A Kominiarek; Scott Langenecker; Lisa Tussing-Humphreys Journal: Nutrients Date: 2022-01-11 Impact factor: 5.717