To evaluate the differences in the consumption of fruit and vegetables between groups with different socio-economic status (SES) in the adult population of European countries.
A systematic review of ...published and unpublished surveys of food habits conducted between 1985 and 1999 in 15 European countries. Educational level and occupational status were used as indicators of SES. A pooled estimate of the mean difference between the highest and the lowest level of education and occupation was calculated separately for men and women, using DerSimonian and Laird's random effects model.
The inclusion criteria of studies were: use of a validated method for assessing intake at the individual level; selection of a nationwide sample or a representative sample of a region; and providing the mean and standard deviation of overall fruit and vegetable consumption for each level of education or occupation, and separately for men and women.
Participants in the individual surveys had to be adults (18-85 y).
Eleven studies from seven countries met the criteria for being included in the meta-analysis. A higher SES was associated with a greater consumption of both fruit and vegetables. The pooled estimate of the difference in the intake of fruit was 24.3 g/person/day (95% confidence interval (CI) 14.0-34.7) between men in the highest level of education and those in the lowest level of education. Similarly, this difference was 33.6 g/person/day for women (95% CI 22.5-44.8). The differences regarding vegetables were 17.0 g/person/day (95% CI 8.6-25.5) for men and 13.4 g/person/day (95% CI 7.1-19.7) for women. The results were in the same direction when occupation instead of education was used as an indicator of SES.
Although we cannot exclude over-reporting of intake by those with highest SES, it is unlikely that this potential bias could fully explain the differences we have found. Our results suggest that an unhealthier nutrition pattern may exist among adults belonging to lower socio-economic levels in Europe.
The present study was supported by the European Union's FAIR programme (FAIR-97-3096).
Retention is a key element in HIV prevention programs. In Sub-Saharan Africa most data on retention come from HIV clinical trials or people living with HIV attending HIV treatment and control ...programs. Data from observational cohorts are less frequent. Retention at 6-/12-month follow-up and its predictors were analyzed in OKAPI prospective cohort. From April 2016 to April 2018, 797 participants aged 15-59 years attending HIV Voluntary Counseling and Testing in Kinshasa were interviewed about HIV-related knowledge and behaviors at baseline and at 6- and 12-month follow-ups. Retention rates were 57% and 27% at 6- and 12-month follow up; 22% of participants attended both visits. Retention at 6-month was significantly associated with 12-month retention. Retention was associated with low economic status, being studying, daily/weekly Internet access, previous HIV tests and aiming to share HIV test with partner. Contrarily, perceiving a good health, living far from an antiretroviral center, daily/weekly alcohol consumption and perceiving frequent HIV information were inversely associated with retention. In conclusion, a high attrition was found among people attending HIV testing participating in a prospective cohort in Kinshasa. Considering the low retention rates and the predictors found in this study, more HIV cohort studies in Kinshasa need to be evaluated to identify local factors and strategies that could improve retention if needed.
Mediterranean diet has been related with reduced morbidity and better well-being. The aim of this study was to assess whether the adherence to the Mediterranean diet were associated with mental and ...physical health related to quality of life.
This analysis included 11 015 participants with 4 years of follow-up in the SUN Project (a multipurpose cohort study based on university graduates from Spain). A validated 136-item food frequency questionnaire was used to assess the adherence to the Mediterranean diet at baseline, according to a nine-point score, presented in four categories (low, low-moderate, moderate-high and high). Health-related quality of life (HRQL) was measured after 4 years of follow-up with the Spanish version of the SF-36 Health Survey. Generalized Linear Models were fitted to assess adjusted mean scores, the regression coefficients (β) and their 95% confidence intervals (95% CIs) for the SF-36 domains according to categories of adherence to Mediterranean diet.
Multivariate-adjusted models revealed a significant direct association between adherence to Mediterranean diet and all the physical and most mental health domains (vitality, social functioning and role emotional). Vitality (β=0.50, 95% CI=0.32-0.68) and general health (β=0.45, 95% CI=0.26-0.62) showed the highest coefficients. Mean values for physical functioning, role physical, bodily pain, general health and vitality domains were significantly better with increasing adherence to the Mediterranean diet. Those having improved their initial high diet scores have better scores in physical functioning, general health and vitality.
Adherence to the Mediterranean diet seems to be a factor importantly associated with a better HRQL.
The aim of this dynamic prospective follow-up study was to assess the association between olive oil consumption and the likelihood of weight gain or the incidence of overweight or obesity in a large ...Mediterranean cohort of 7,368 male and female Spanish university graduates (the SUN Project) who were followed for a median period of 28.5 mon. A validated Food Frequency Questionnaire was administered at baseline, and respondents also completed a follow-up questionnaire after 28.5 mon. Changes in participants' consumption of olive oil and their weight were assessed during follow-up. A higher baseline consumption of olive oil was associated with a lower likelihood of weight gain, although the differences were not statistically significant. The adjusted difference in weight gain (kg) was -0.16 95% confidence interval (C1): -0.42 to +0.11 for participants in the upper quintile of olive oil consumption (median: 46 g/d) compared with those in the lowest quintile (median: 6 g/d). For participants with a high baseline consumption of olive oil whose olive oil consumption also increased during follow-up, we found a slightly increased but nonsignificant risk of incidence of over-weight or obesity (adjusted odds ratio=1.19, 95% C1: 0.73 to 1.95). Our study, carried out in a sample of free-living people, shows that a high amount of olive oil consumption is not associated with higher weight gain or a significantly higher risk of developing overweight or obesity in the context of the Mediterranean food pattern.
To ascertain the major dietary patterns in the cohort 'SUN' and to assess the association of several sociodemographic (including age and gender) and lifestyle variables with the adherence to these ...dietary patterns.
This study is a cross-sectional analysis of 3847 subjects (1587 men and 2260 women) belonging to a prospective cohort study based on self-reported questionnaires. A factor analysis based on 30 predefined food groups was conducted to ascertain the major dietary patterns in the cohort. Multiple regression models were fitted to assess the relationship between several sociodemographic and lifestyle variables and the adherence to these dietary patterns (measured using two scores with observed values ranging from -3.2 to +4.6 for the Western pattern and -3.1 to +5.5 for the Mediterranean pattern).
Two major dietary patterns were found. The first pattern was labelled as a 'Western' dietary pattern and the other as a 'Spanish-Mediterranean' dietary pattern. Younger subjects were more likely to follow a 'Western' dietary pattern; the coefficient representing the change for every 10 y increase in age was b=-0.24 (P<0.001) for men and b=-0.12 (P<0.001) for women. More physically active subjects were less likely to follow a 'Western' dietary pattern and more likely to follow a 'Spanish-Mediterranean' dietary pattern.
An association between a higher level of physical activity during leisure time and adherence to a 'Spanish-Mediterranean' diet was apparent. However, the profile of being a young, sedentary and single male was identified as the most likely to exhibit a departure from the traditional 'Spanish-Mediterranean' diet and follow a 'Western' dietary pattern.
To estimate the prevalence of physical activity during leisure time in adults from the 15 member states of the European Union and the relationship with sociodemographic variables.
A representative ...sample, with approximately 1000 adults, aged 15 and upward, was selected from each member state to complete a questionnaire on attitudes to physical activity, body weight, and health by a face-to-face interview, summing a total of 15,239 subjects. The amount of leisure-time physical activity was quantified by assigning metabolic equivalents (METs) to each activity. Multiple linear regression models with MET-h.wk(-1) as the dependent variable were fitted.
Northern European countries showed higher levels of physical activity than southern ones. The highest prevalence (91.9%) was found in Finland, and the lowest (40.7%) in Portugal. A higher percentage of men practiced any leisure-time physical activity and also showed higher mean of MET-h.wk(-1). In both genders, the multivariate models showed a significant trend to higher leisure time activity in participants with higher educational levels and in nonsmokers. Also, an inverse association between body mass index and leisure-time physical activity was found.
The prevalence of any physical activity during leisure time in the adult European population was similar to the U.S. estimates. Nevertheless, the amount of activity is low, and a wide disparity between countries exists. To our knowledge, this is the first study determining the prevalence and amount of leisure-time physical activity, which is the first step to define strategies to persuade populations to increase their physical activity.
There is evidence that a diet rich in fruit and vegetables reduces blood pressure (BP). Characteristically, the Mediterranean diet is rich in plant-derived foods and also in fat, but studies ...conducted in Mediterranean countries to relate diet to BP are scarce. We studied the association between fruit and vegetable consumption and BP in a cross-sectional analysis of 4393 participants in the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Diet was measured using a food-frequency questionnaire previously validated in Spain. Fat represented more than 37% total energy intake. Subjects were considered to have undiagnosed hypertension if they reported systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, and not a medical diagnosis of hypertension. The adjusted prevalence odds ratio of undiagnosed hypertension (upper v. lowest quintile) was 0·58 (95% CI 0·36, 0·91; P for trend 0·01) for vegetable consumption and 0·68 (95% CI 0·43, 1·09; P for trend 0·10) for fruit consumption. Comparing those in the highest quintile of both fruit and vegetable consumption with those in the lowest quintile of both food groups, the prevalence odds ratio was 0·23 (95% CI 0·10, 0·55; P=0·001), after adjusting for risk factors for hypertension and other dietary exposures. In a Mediterranean population with an elevated fat consumption, a high fruit and vegetable intake is inversely associated with BP levels.
A prospective cohort study with university level participants was initiated to study the effect of Mediterranean diet on health.
The objective of this study was to identify possible lifestyle and ...socioeconomic variables associated with the consumption of a Mediterranean dietary pattern (MDP).
This analysis includes 1587 males and 2260 females. MDP was defined "a priori" by summing the standardized residuals of nutrients and foods after adjusting a regression model using total energy intake as the independent variable. Multiple regression and non-parametric locally weighted regression models were adjusted with the relative adherence to the MDP as the dependent variable in males and females.
Women were more compliant than men with the MDP (Coefficient regression (b) = 4.1; Confidence Interval (CI) 95 % = 3.2 to 4.9). The compliance with the MDP was significantly poorer among younger participants both in men and women (p < 0.001 in men and in women). Participants who were more physically active were more likely to fulfill the traditional MDP (p = 0.01 in men and p < 0.001 in women).
Our findings provide evidence supporting the progressive departure from the traditional MDP in younger and highly educated subjects of the Mediterranean area. A more active life-style is associated with a better compliance with the MDP.
Emerging evidence relates some nutritional factors to depression risk. However, there is a scarcity of longitudinal assessments on this relationship.
To evaluate the association between fatty acid ...intake or the use of culinary fats and depression incidence in a Mediterranean population.
Prospective cohort study (1999-2010) of 12,059 Spanish university graduates (mean age: 37.5 years) initially free of depression with permanently open enrolment. At baseline, a 136-item validated food frequency questionnaire was used to estimate the intake of fatty acids (saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), trans unsaturated fatty acids (TFA) and monounsaturated fatty acids (MUFA) and culinary fats (olive oil, seed oils, butter and margarine) During follow-up participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression models were used to calculate Hazard Ratios (HR) of incident depression and their 95% confidence intervals (CI) for successive quintiles of fats.
During follow-up (median: 6.1 years), 657 new cases of depression were identified. Multivariable-adjusted HR (95% CI) for depression incidence across successive quintiles of TFA intake were: 1 (ref), 1.08 (0.82-1.43), 1.17 (0.88-1.53), 1.28 (0.97-1.68), 1.42 (1.09-1.84) with a significant dose-response relationship (p for trend = 0.003). Results did not substantially change after adjusting for potential lifestyle or dietary confounders, including adherence to a Mediterranean Dietary Pattern. On the other hand, an inverse and significant dose-response relationship was obtained for MUFA (p for trend = 0.05) and PUFA (p for trend = 0.03) intake.
A detrimental relationship was found between TFA intake and depression risk, whereas weak inverse associations were found for MUFA, PUFA and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to subtypes of fat intake.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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