Leyre López-González1, Nerea Becerra-Tomás2, Nancy Babio3, Miguel Ángel Martínez-González4, Andrés Díaz-López5, Dolores Corella6, Albert Goday7, Dora Romaguera8, Jesús Vioque9, Ángel M Alonso-Gómez10, Julia Wärnberg11, J Alfredo Martínez12, Luís Serra-Majem13, Ramón Estruch14, Francisco Tinahones15, José Lapetra16, Xavier Pintó17, Josep A Tur18, José López-Miranda19, Aurora Bueno-Cavanillas20, Miguel Delgado-Rodríguez21, Pilar Matía-Martín22, Lidia Daimiel23, Laura Álvarez-Álvarez24, Josep Vidal25, Clotilde Vázquez26, Emilio Ros27, Zenaida Vázquez-Ruiz28, Silvia Canudas5, Rebeca Fernández Carrión6, Olga Castañer7, M Ángeles Zulet29, Lucas Tojal Sierra30, María Julia Ajejas Bazán31, Carmen M López García32, Marian Martín8, Antonio García-Ríos19, Rosa Casas14, Ana M Gómez-Pérez33, José Manuel Santos-Lozano16, Estíbaliz Goñi34, Patricia Guillem-Saiz6, Camile Lassale7, Itziar Abete29, Itziar Salaverria Lete35, Sonia Eguaras36, Helmut Schröder37, Jordi Salas-Salvadó5. 1. 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. 2. Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain. Electronic address: nerea.becerra@urv.cat. 3. Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain. Electronic address: nancy.babio@urv.cat. 4. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 5. Universitat Rovira i Virgili, Department de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain. 6. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain. 7. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital Del Mar Research Institute (IMIM), Barcelona, Spain. 8. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Spain. 9. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain. 10. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Osakidezta Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. 11. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Nursing, School of Health Sciences, University of Málaga, Research Biomedical Institute of Málaga (IBIMA), Málaga, Spain. 12. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain; Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. 13. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain. 14. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Institut D´Investigació Biomédica August Pi I Sunyer (IDIBAPS), University of Barcelona, Villaroel, 170, 08036, Barcelona, Spain. 15. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology. Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain. 16. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. 17. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona Spain. 18. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain. 19. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. 20. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Granada, Granada, Spain. 21. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain. 22. Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 23. Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. 24. Department of Preventive Medicine and Public Health University of León, León, Spain. 25. CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, IDIBAPS, Hospital Clínic, University of Barcelona, Barcelona, Spain. 26. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Endocrinology and Nutrition, Instituto de Investigaciones Sanitarias Fundación Jiménez-Díaz, Madrid, Spain. 27. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. 28. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain. 29. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain. 30. Bioaraba Health Research Institute, Osakidezta Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. 31. Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University, Madrid, Spain. 32. Centro de Salud Santa Pola, Alicante, Spain. 33. Virgen de la Victoria Hospital, Department of Endocrinology. Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain. 34. University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain. 35. Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Vitoria-Gasteiz, Spain. 36. University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain. 37. Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital Del Mar Research Institute (IMIM), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Abstract
BACKGROUND AND AIMS: Previous studies, mainly focused on quantity rather than variety, have shown beneficial associations between the amount of fruit and vegetable consumed, diet quality and healthy lifestyle. The aim is to evaluate the association between fruit and vegetable consumption, diet quality and lifestyle in an elderly Mediterranean population, considering both variety and the combination of quantity and variety (QV). METHODS: A cross-sectional analysis of 6647 participants (51.6% of males) was conducted in the framework of the PREDIMED-Plus study. A variety score was created as the sum of vegetables and/or fruits consumed at least once per month using food frequency questionnaires. Dietary Reference Intakes (EAR and IA values) were used to estimate the prevalence of inadequate intake of dietary fiber and micronutrients. Logistic regression models were performed to examine the association between fruit and vegetable consumption and not meeting the DRIs, by tertiles of fruit and vegetable variety and QV categories. RESULTS: Participants with higher fruit and vegetable variety score reported a significant higher intake of fiber, vitamins, minerals and flavonoids and were significantly more likely to be physically active and non-smoker. Besides, higher variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.13 (0.11-0.16)], two or more [(0.17 (0.14-0.21)], three or more [(0.15 (0.13-0.18)] and four or more [(0.11 (0.10-0.14)] micronutrients in our participants. Higher quantity and variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.05 (0.04-0.06)], two or more [(0.08 (0.06-0.10)], three or more [(0.08 (0.06-0.09)] and four or more [(0.06 (0.05-0.07)] micronutrients. CONCLUSION: Greater variety in fruit and vegetable intake was associated with better nutrient adequacy, diet quality and healthier lifestyle in an elderly Mediterranean population.
BACKGROUND AND AIMS: Previous studies, mainly focused on quantity rather than variety, have shown beneficial associations between the amount of fruit and vegetable consumed, diet quality and healthy lifestyle. The aim is to evaluate the association between fruit and vegetable consumption, diet quality and lifestyle in an elderly Mediterranean population, considering both variety and the combination of quantity and variety (QV). METHODS: A cross-sectional analysis of 6647 participants (51.6% of males) was conducted in the framework of the PREDIMED-Plus study. A variety score was created as the sum of vegetables and/or fruits consumed at least once per month using food frequency questionnaires. Dietary Reference Intakes (EAR and IA values) were used to estimate the prevalence of inadequate intake of dietary fiber and micronutrients. Logistic regression models were performed to examine the association between fruit and vegetable consumption and not meeting the DRIs, by tertiles of fruit and vegetable variety and QV categories. RESULTS:Participants with higher fruit and vegetable variety score reported a significant higher intake of fiber, vitamins, minerals and flavonoids and were significantly more likely to be physically active and non-smoker. Besides, higher variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.13 (0.11-0.16)], two or more [(0.17 (0.14-0.21)], three or more [(0.15 (0.13-0.18)] and four or more [(0.11 (0.10-0.14)] micronutrients in our participants. Higher quantity and variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.05 (0.04-0.06)], two or more [(0.08 (0.06-0.10)], three or more [(0.08 (0.06-0.09)] and four or more [(0.06 (0.05-0.07)] micronutrients. CONCLUSION: Greater variety in fruit and vegetable intake was associated with better nutrient adequacy, diet quality and healthier lifestyle in an elderly Mediterranean population.
Authors: Leyre López-González; Nerea Becerra-Tomás; Nancy Babio; Miguel Ángel Martínez-González; Stephanie K Nishi; Dolores Corella; Albert Goday; Dora Romaguera; Jesús Vioque; Ángel M Alonso-Gómez; Julia Wärnberg; J Alfredo Martínez; Luís Serra-Majem; Ramon Estruch; M Rosa Bernal-López; José Lapetra; Xavier Pintó; Josep A Tur; José López-Miranda; Aurora Bueno-Cavanillas; Miguel Delgado-Rodríguez; Pilar Matía-Martín; Lidia Daimiel; Vicente Martín-Sánchez; Josep Vidal; Clotilde Vázquez; Emilio Ros; Zenaida Vázquez-Ruiz; Francisco M Martín-Luján; José V Sorlí; Olga Castañer; M Angeles Zulet; Lucas Tojal-Sierra; Rosa Carabaño-Moral; Josefa Román-Maciá; Elena Rayó; Antonio García-Ríos; Rosa Casas; Ana M Gómez-Pérez; José M Santos-Lozano; Pilar Buil-Cosiales; Eva M Asensio; Camille Lassale; Itziar Abete; Itziar Salaverria-Lete; Carmen Sayón-Orea; Helmut Schröder; Jordi Salas-Salvadó Journal: Eur J Clin Nutr Date: 2022-04-11 Impact factor: 4.884