Validación del índice de masa corporal auto-referido en la Encuesta Nacional de Salud

Objective. 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 intraclass 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

Ultra-processed foods and type-2 diabetes risk in the sun project: A prospective cohort study

The association between ultra-processed foods (UPF) consumption and the risk of type 2 diabetes (T2D) has not been much explored. We aimed to evaluate the association between consumption of UPF and the incidence of T2D

Effect of smoking on body weight: longitudinal analysis of the SUN cohort

Our aim was to investigate prospectively the association between two major cardiovascular risk factors: smoking and weight gain. METHODS: 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 never-smokers (the reference group) was estimated for different levels of tobacco exposure. RESULTS: 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). CONCLUSIONS: 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

Increasing trend in the prevalence of morbid obesity in Spain: from 1.8 to 6.1 per thousand in 14 years

Obesity, and especiallymorbid obesity, increases the risk of cardiovascular as well as non-cardiovascular diseases. Our objective was to ascertain the trends in morbid obesity in Spain from 1993 to 2006 using representative data from 106,048 participants in the National Health Surveys. An age-adjusted Poisson regression model stratified by sex was fitted using morbid obesity as the dependent variable. An increasing trend in prevalent morbid obesity from 1.8 to 6.1 per thousand participants was found (increase > 200%). Morbid obesity prevalence was higher in women. After adjusting for age, a monotonically increasing prevalence of morbid obesity was apparent for both men and women: the relative increase was 4% per year in women and 12% per year in men. These trends highlight the importance of preventive actions

A prospective study of eating away-from-home meals and weight gain in a Mediterranean population: the SUN (Seguimiento Universidad de Navarra) cohort

OBJECTIVE: The traditional Mediterranean food pattern is more easily preserved when meals are eaten at home; however, as a result of recent socio-economic changes, away-from-home meal consumption has increased rapidly in Mediterranean countries. Little research has been conducted so far to investigate the long-term health effects of these changes in the Mediterranean area. DESIGN: In a prospective Spanish dynamic cohort of 9182 university graduates (the SUN Study; Seguimiento Universidad de Navarra, University of Navarra Follow-up) with a mean age of 37 years, followed up for an average of 4.4 years, we assessed the association between the frequency of eating out of home and weight gain or incident overweight/obesity. Dietary habits were assessed with an FFQ previously validated in Spain. RESULTS: During follow-up, eating-out consumers (two times or more per week) had higher average adjusted weight gain (+129 g/year, P < 0.001) and higher adjusted risk of gaining 2 kg or more per year (OR = 1.36; 95 % CI 1.13, 1.63) than non-eating-out consumers. Among participants with baseline BMI < 25 kg/m2, we observed 855 new cases of overweight/obesity. Eating away-from-home meals was significantly associated with a higher risk of becoming overweight/obese (hazard ratio = 1.33; 95 % CI 1.13, 1.57). CONCLUSIONS: A higher frequency of meals eaten out of home may play a role in the current obesity epidemic observed in some Mediterranean countries

Fast food consumption and gestational diabetes incidence in the SUN project

Background: Gestational diabetes prevalence is increasing, mostly because obesity among women of reproductive age is continuously escalating. We aimed to investigate the incidence of gestational diabetes according to the consumption of fast food in a cohort of university graduates. Methods: The prospective dynamic ‘‘Seguimiento Universidad de Navarra’’ (SUN) cohort included data of 3,048 women initially free of diabetes or previous gestational diabetes who reported at least one pregnancy between December 1999 and March 2011. Fast food consumption was assessed through a validated 136-item semi-quantitative food frequency questionnaire. Fast food was defined as the consumption of hamburgers, sausages, and pizza. Three categories of fast food were established: low (0–3 servings/month), intermediate (.3 servings/month and #2 servings/week) and high (.2 servings/week). Non-conditional logistic regression models were used to adjust for potential confounders. Results: We identified 159 incident cases of gestational diabetes during follow-up. After adjusting for age, baseline body mass index, total energy intake, smoking, physical activity, family history of diabetes, cardiovascular disease/hypertension at baseline, parity, adherence to Mediterranean dietary pattern, alcohol intake, fiber intake, and sugar-sweetened soft drinks consumption, fast food consumption was significantly associated with a higher risk of incident gestational diabetes, with multivariate adjusted OR of 1.31 (95% conficence interval [CI]:0.81–2.13) and 1.86 (95% CI: 1.13–3.06) for the intermediate and high categories, respectively, versus the lowest category of baseline fast food consumption (p for linear trend: 0.007). Conclusion: Our results suggest that pre-pregnancy higher consumption of fast food is an independent risk factor for gestational diabetes

Reported fried food consumption and the incidence of hypertension in a spanish cohort: the sun project

Reported associations between consumption of fried foods and obesity or weight gain make likely that fried food consumption might also be linked with the development of hypertension. However, evidence from long-term prospective studies is scarce. Therefore, the aim of our study was to longitudinally evaluate this association in a prospective cohort. The SUN project is a Mediterranean cohort study of university graduates conducted in Spain, that started in December 1999 and until now it is permanently open. For the present analyses we included 13,679 participants (5,059 men and 8,620 women), free of hypertension at baseline with a mean age of 36.5 y (SD:10.8). Total fried food consumption was estimated at baseline. The outcome was the incidence of a medical diagnosis of self-reported hypertension during follow-up. To assess the relationship between fried food consumption and the subsequent risk of developing incident hypertension during follow-up, Cox regression models were fitted. During a median follow-up of 6.3 years, 1,232 incident cases of hypertension were identified. After adjusting for potential confounders, the adjusted hazard ratio for developing hypertension was 1.18 (95% CI: 1.03-1.36) and 1.21 (95% CI: 1.04-1.41) for the categories of consumption of 2-4/week and >4/week respectively, compared to those who consumed <2 servings/week (p for trend 0.020). In conclusion, our findings suggest that a more frequent consumption of fried foods at baseline was associated with higher risk of hypertension during follow-up in a cohort of university graduates

Meat Consumption and Risk of Developing Type 2 Diabetes in the SUN Project: A Highly Educated Middle-Class Population

Background Meat consumption has been consistently associated with the risk of diabetes in different populations. The aim of our study was to investigate the incidence of type 2 diabetes according to baseline total meat consumption in a longitudinal assessment of a middle-aged Mediterranean population. Methods We followed 18,527 participants (mean age: 38 years, 61% women) in the SUN Project, an open-enrolment cohort of a highly educated population of middle-class Spanish graduate students. All participants were initially free of diabetes. Diet was assessed at baseline using a semi-quantitative food frequency questionnaire of 136-items previously validated. Incident diabetes was defined according to the American Diabetes Association’s criteria. Results We identified 146 incident cases of diabetes after a maximum of 14 years of follow-up period (mean: 8.7 years). In the fully adjusted model, the consumption of ≥3 servings/day of all types of meat was significantly associated with a higher risk of diabetes (HR: 1.85; 95% CI: 1.03–3.31; p for trend = 0.031) in comparison with the reference category (<2 servings/day). When we separated processed from non-processed meat, we observed a non-significant higher risk associated with greater consumption of processed meat and a non-significant lower risk associated with non-processed meat consumption (p for trend = 0.123 and 0.487, respectively). No significant difference was found between the two types of meat (p = 0.594). Conclusions Our results suggest that meat consumption, especially processed meat, was associated with a higher risk of developing diabetes in our young Mediterranean cohort

Egg consumption and risk of type 2 diabetes in a Mediterranean cohort: the SUN project

Introduction & Aim: The prevalence of diabetes is increasing at an alarming rate in nearly all countries. Some studies from non-Mediterranean populations suggest that higher egg consumption is associated with an increased risk of diabetes. The aim of our study was to prospectively assess the association between egg consumption and the incidence of type 2 diabetes in a large cohort of Spanish university graduates. Methods: In this prospective cohort including 15,956 participants (mean age: 38.5 years) during 6.6 years (median), free of diabetes mellitus at baseline. Egg consumption was assessed at baseline through a semiquantitative food-frequency questionnaire repeatedly validated in Spain. Incident diabetes mellitus diagnosed by a doctor was assessed through biennial follow-up questionnaires and confirmed subsequently by medical reports or records, according to the American Diabetes Association criteria. Analyses were performed through multivariable non-conditional logistic regression. Results: After adjustment for confounders, egg consumption was not associated with the development of diabetes mellitus, comparing the highest versus the lowest quartile of egg consumption (>4 eggs/week vs<1 egg/week): odds ratio= 0.7; 95% CI 0.3-1.7. Conclusion: Egg consumption was not associated with the development of diabetes mellitus in this Mediterranean cohort

One-Year Changes in Urinary Microbial Phenolic Metabolites and the Risk of Type 2 Diabetes—A Case-Control Study

The intake of polyphenols has been associated with a risk reduction of type 2 diabetes. Nevertheless, to the best of our knowledge, the molecules that might be metabolically active after ingestion are only starting to be investigated regarding this metabolic disease. To investigate the association between one-year changes in urinary microbial phenolic metabolites (MPM) and the incidence of type 2 diabetes, we performed a case-control study using data and samples of the PREDIMED trial including 46 incident type 2 diabetes cases of 172 randomly selected participants. Eight urinary MPMs were quantified in urine by liquid chromatography coupled to mass spectrometry and used to assess their associations with type 2 diabetes risk by multivariable logistic regression models. Compared to participants in the lowest tertile of one-year changes in hydroxybenzoic acid glucuronide, those in the highest tertile had a significantly lowered probability of developing type 2 diabetes (OR [95% CI], 0.39 [0.23–0.64]; p < 0.001 for trend). However, when additionally adjusting for fasting plasma glucose, the statistical significance was lost. Changes in the dietary pattern can increase the concentrations of this compound, derived from many (poly)phenol-rich foods, and might be changing the gut microbial population as well, promoting the production of the metabolite.This research was funded by CICYT [AGL2016-75329-R] PID2020-114022RB-I00, CIBEROBN Instituto de Salud Carlos III, ISCIII from the Ministerio de Ciencia, Innovación y Universidades, (AEI/FEDER 10.13039/501100011033, UE), and Generalitat de Catalunya (GC) [2017SGR196]. M.M.-M. is supported by the FPU17/00513 grant. I.D.-L. thanks the Spanish Ministry of Science Innovation and Universities for the Formación de Profesorado Universitario (FPU20/02478) contract. E.P.L.-S. is supported by the FI-SDUR (EM/3345/2020) grant from the Generalitat de Catalunya. I.P.-M. is supported by the FI-SDUR (EMC/2703/2019). Partial funding for open access charge: Universidad de Málaga