Background
Helping consumers to improve the nutritional quality of their diet is a key public health action to prevent cardiovascular diseases (CVDs). The modified version of the Food Standard Agency ...Nutrient Profiling System Dietary Index (FSAm-NPS DI) underpinning the Nutri-Score front-of-pack label has been used in public health strategies to address the deleterious consequences of poor diets. This study aimed to assess the association between the FSAm-NPS DI and some CVD risk factors including body mass index (BMI), waist circumference, plasma glucose levels, triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and diastolic and systolic blood pressure.
Materials and Methods
Dietary intake was assessed at baseline and after 1 year of follow-up using a 143-item validated semi-quantitative food-frequency questionnaire. Dietary indices based on FSAm-NPS applied at an individual level were computed to characterize the diet quality of 5,921 participants aged 55–75 years with overweight/obesity and metabolic syndrome from the PREDIMED-plus cohort. Associations between the FSAm-NPS DI and CVD risk factors were assessed using linear regression models.
Results
Compared to participants with a higher nutritional quality of diet (measured by a lower FSAm-NPS DI at baseline or a decrease in FSAm-NPS DI after 1 year), those participants with a lower nutritional quality of diet (higher FSAm-NPS DI or an increase in score) showed a significant increase in the levels of plasma glucose, triglycerides, diastolic blood pressure, BMI, and waist circumference (β coefficient 95% confidence interval;
P
for trend) (1.67 0.43, 2.90; <0.001; 6.27 2.46, 10.09; <0.001; 0.56 0.08, 1.05; 0.001; 0.51 0.41, 0.60; <0.001; 1.19 0.89, 1.50; <0.001, respectively). No significant associations in relation to changes in HDL and LDL-cholesterol nor with systolic blood pressure were shown.
Conclusion
This prospective cohort study suggests that the consumption of food items with a higher FSAm-NPS DI is associated with increased levels of several major risk factors for CVD including adiposity, fasting plasma glucose, triglycerides, and diastolic blood pressure. However, results must be cautiously interpreted because no significant prospective associations were identified for critical CVD risk factors, such as HDL and LDL-cholesterol, and systolic blood pressure.
Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns.
The aim of this study was to assess the association between the adherence ...to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight.
Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m
(55-75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1: <10%,
= 1495; Q2: 10-15%,
= 1804; Q3: <15-20%,
= 1470; Q4: ≥20%,
= 1589). Diet was assessed using a validated food frequency questionnaire and a 17-item Mediterranean diet questionnaire. Physical activity was assessed by the validated Minnesota-REGICOR and the validated Spanish version of the Nurses' Health Study questionnaire.
Participants reporting higher percentages of desired weight loss (Q3 and Q4) were younger, had higher real and perceived BMI and were more likely to have abdominal obesity. Desired weight loss correlated inversely to physical activity (Q1: 2106 MET min/week; Q4: 1585 MET min/week.
< 0.001) and adherence to Mediterranean diet (Q1: 8.7; Q4: 8.3.
< 0.001).
In older Mediterranean individuals with weight excess, desired weight loss was inversely associated with Mediterranean lifestyle adherence. Deeply rooted aspects of the MedDiet remained similar across groups. Longitudinal research is advised to be able to establish causality.
To evaluate the trend in the prevalence in Spain of obesity, diabetes mellitus, hypertension and hypercholesterolemia.
The Spanish National Health Surveys (ENS) of 1997, 2001, 2003, which select ...representative samples of the Spanish general population were used. In total, 49,113 participants of both sexes were included. Self-reported data about weight and height were used to estimate the body mass index. The prevalence of diabetes, hypertension and hypercholesterolemia was estimated. Linear trend chi2 tests and multivariate logistic regression models adjusted for age, sex and educational level, were estimated.
A significant increasing temporal trend for the prevalence of obesity, diabetes, hypertension and hypercholesterolemia was found for the studied period (1997-2003) according to the ENS. We found that the increased trend in obesity prevalence was restricted to younger participants with a significant interaction.
The prevalence of obesity, diabetes mellitus, hypertension and hypercholesterolemia has increased in Spain between 1997 and 2003.
To investigate the relationship between baseline leisure-time physical activity and changes in leisure activity during follow-up on long-term weight changes.
We evaluated prospectively 11,974 ...participants (university graduates) who participated in a dynamic cohort (Seguimiento Universidad de Navarra cohort) with an average follow-up of 27 months. Self-reported data from validated mailed questionnaires were used. Baseline leisure activity was assessed with a previously validated questionnaire.
After adjusting for age, hours sitting down, smoking status, snacking, fiber intake, and consumption of sugar-sweetened beverages, fast food, and alcohol, participants who decreased their leisure activity during follow-up experienced a significant increase in body mass index (BMI; relative change): for men, 0.9% (95% confidence interval CI = 0.5-1.2%); for women, 1.0% (95% CI = 0.6-1.3%). Participants who increased their leisure activity during follow-up experienced a significant reduction (relative change) in BMI: for men, -0.8% (95% CI = -1.1% to -0.5%); for women, -0.6% (95% CI = -0.9% to -0.4%). This inverse association between changes in leisure activity and weight gain was significantly stronger for participants with a baseline BMI >or=25 kg x m(-2), but the absolute magnitude of this interaction effect was trivial. Baseline physical activity was not significantly associated with weight changes after 2-yr of follow-up.
Longitudinal changes in leisure activity during follow-up were inversely associated with changes in body weight. The true relationships between leisure activity and body weight are likely to have been larger than observed, owing to attenuation of effects by measurement error in self-reported data.
To assess the validity of self-reported body mass index in the National Health Survey.
120 participants were selected and questioned about their weight and height with exactly the same questions that ...the National Health Survey uses. Afterwards, and once informed consent was obtained, participants were weighed and measured, and this data was used as the gold standard.
On average, participants underestimated their weight by 1.39 kg, overestimated their height by 0.55 cm and underestimated their body mass index by 0.71 kg/m2. The sensitivity of self-reported self reported body mass index (BMI) to detect overweight was 77%, the specificity was 97%, the positive predictive value was 0.95 and the negative predictive value was 0.86. The Kappa index was 0.76 and the quadratically weighted Kappa index was 0.85. The correlation coefficient between self-reported and measured BMI was 0.96 and the intra-class correlation coefficient was 0.97.
Self-reported data is an efficient way of obtaining information about BMI, although with limitations, because self-reported data tends to underestimate weight and overestimate height, thus underestimating BMI and the proportion of participants with elevated BMI.
Objetivo. Valorar la validez del índice de masa corporal auto-referido en la Encuesta Nacional de Salud.
Material y métodos. Se seleccionaron 120 participantes. Se recogió su peso y su talla usando ...exactamente las mismas preguntas utilizadas en la Encuesta Nacional de Salud. A continuación, y tras obtener el consentimiento informado, se procedió a la medición del peso y de la talla, que se usaron como gold standard.
Resultados. Por término medio los participantes infraestimaron el peso en 1,39 kg, sobreestimaron la talla en 0,55 cm e infraestimaron el índice de masa corporal (IMC) en 0,71 kg/m2. La sensibilidad del IMC auto-referido para detectar sobrepeso u obesidad fue del 77%, la especificidad del 97%, el valor predictivo positivo 0,95 y el valor predictivo negativo 0,86. El índice Kappa fue 0,76 y el índice Kappa ponderado cuadraticamente 0,85. El coeficiente de correlación entre el IMC medido y reportado fue 0,96 y el coeficiente de correlación intraclase fue 0,97.
Conclusiones. Los datos auto-referidos son una forma eficiente de tener datos sobre el IMC, aunque con limitaciones dado que al subestimar el peso y sobreestimar la altura, se infraestima el IMC y la proporción de individuos con IMC elevado.
Our aim was to investigate prospectively the association between two major cardiovascular risk factors: smoking and weight gain.
We prospectively evaluated 7565 individuals taking part in a dynamic ...cohort study over a median follow-up period of 50 months. Self-reported weight and physical activity levels had been validated previously. The adjusted mean difference in weight gain relative to neversmokers (the reference group) was estimated for different levels of tobacco exposure.
After adjusting for age, baseline body mass index, sedentary lifestyle, changes in physical activity level, total energy intake, fiber intake, food consumption between meals, and sugary soft drink, fast food and alcohol consumption, it was found that individuals who stopped smoking during follow-up had a greater relative weight gain: men 1.63
kg (95% confidence interval CI, 1.07–2.19
kg), and women 1.51
kg (95% CI, 1.11–1.91
kg). In addition, active smokers had a greater weight gain than never-smokers: men 0.49
kg (95% CI, 0.11–0.87
kg), and women 0.36
kg (95% CI, 0.07-0.65
kg).
Individuals who stopped smoking during follow-up and active smokers both experienced significantly greater weight gains than never-smokers. This association between cardiovascular risk factors should be taken into account when developing prevention programs.
El objetivo de este estudio fue evaluar prospectivamente la asociación de dos factores de riesgo cardiovascular, el hábito tabáquico y la ganancia de peso.
Se evaluó prospectivamente a 7.565 participantes de una cohorte dinámica durante una mediana de seguimiento de 50 meses. El peso y la actividad física declarados fueron validados previamente. Como referencia se usó a los nunca fumadores, calculándose diferencias ajustadas de ganancia media de peso para diferentes exposiciones al tabaco.
Tras ajustar por edad, índice de masa corporal inicial, sedentarismo, cambios de actividad física, ingesta energética y de fibra, comidas entre horas, consumo de refrescos, de comida rápida y de alcohol, los participantes que dejaron de fumar durante el seguimiento, presentaron una mayor ganancia relativa de peso: hombres +1,63
kg (intervalo de confianza IC del 95%, 1,07 a 2,19); mujeres +1,51
kg (IC 95%, 1,11 a 1,91). Los fumadores activos presentaron también mayor ganancia de peso que los nunca fumadores: hombres +0,49
kg (IC del 95%, 0,11 a 0,87); mujeres +0,36
kg (IC del 95%, 0,07 a 0,65).
Los participantes que dejaron de fumar durante el seguimiento y los fumadores activos experimentaron mayores ganancias de peso que los nunca fumadores. La asociación de estos dos factores de riesgo cardiovascular debe ser tenida en cuenta en los programas de prevención.
Hipofunción glucocorticoide en la distrofia miotónica Basterra Gortari, Francisco Javier; Pineda Arribas, José Javier; Goñi Iriarte, María José ...
Anales del sistema sanitario de Navarra,
08/2007, Letnik:
30, Številka:
2
Journal Article
Odprti dostop
Introducción. La distrofia miotónica (DM1) es una enfermedad autonómica dominante cuyo defecto genético consiste en una expansión por repeticiones del triplete CTG en un gen que codifica una ...proteín-kinasa serina-treonina AMPc dependiente llamada DMPK. Se trata de una enfermedad multisistémica con conocida repercusión endocrinológica. En cuanto a la función suprarrenal, los resultados descritos han sido variables aunque últimamente se interpretan como indicadores de una hiperactividad del eje hipotálamo-hipófiso-adrenal.
Material y métodos. Se han estudiado 25 pacientes (13 hombres y 12 mujeres) afectos de DM1 a los que se ha analizado: cortisol y ACTH basales, test de estímulo con 0,25 mg de ACTH para cortisol y test de CRH para cortisol y ACTH. Asimismo se valoró el grado de expansión de CTG por Southern blot y PCR. Como grupo control para basales se estudiaron 25 individuos sanos equiparables por edad y sexo, a 11 de los cuales se realizó test de CRH.
Resultado. Se diagnosticó a un paciente de insuficiencia suprarrenal primaria no autoinmune. En el resto de casos no hubo diferencias entre la ACTH basal de pacientes y controles, y la respuesta de cortisol a ACTH fue normal. Los pacientes presentaron un nivel de cortisol basal más bajo (p<0,01) y también mostraron, tras estímulo con CRH, una menor respuesta de cortisol (p<0,05) con cifras medias de ACTH más elevadas.
Conclusiones. Nuestros datos difieren de las últimas publicaciones y apuntan a una hipofunción suprarrenal por falta de eficacia de la ACTH sobre su receptor o a nivel post-receptor. Sugerimos que la etiología puede estar relacionada con el defecto subyacente en el gen que codifica la DMPK.
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