Sociodemographic and Lifestyle Determinants of Adherence to Current Dietary Recommendations and Diet Quality in Middle-Aged Spanish Premenopausal Women

Background: A healthy diet when approaching menopause could prevent some of the symptoms associated with the climacteric. Few studies examine adherence to current healthy dietary recommendations in middle-aged premenopausal women. Our objective was to analyze the diet quality and the adherence to the Spanish Society of Community Nutrition (SENC) dietary recommendations in middle-aged Spanish premenopausal women, and to identify the associated sociodemographic and lifestyle factors. Methods: This is a cross-sectional study based on 1251 premenopausal women, aged 39-50, who attended to Madrid City Council Medical Diagnostic Center. Women completed an epidemiological and a food frequency questionnaire. Degree of adherence to the SENC recommendations was estimated with a score that evaluated null (0 points) and full (1 point) adherence of each specific recommendation. Associations were explored using an ordinal logistic multivariable regression model. Results: Regarding food groups, the worst adherence was found for sweets, red/processed meat, olive oil and eggs. Most of the participants exceeded the recommended caloric intake from proteins and fats, and practically all of them showed vitamin D intake deficiency. The overall score ranged from 2 to 12 (out of 15), with a median of 6.0 (interquartile range: 5.0-7.0). Former smokers (OR: 1.38; 95%CI: 1.08-1.78), as well as those with higher educational level (ORSSecondary:1.68; 95%CI: 0.97-2.93, ORUniversity:1.82; 95%IC: 1.05-3.14), with two or more children (OR: 1.31; 95%IC: 1.00-1.72), with higher caloric intake (OR>2188.2kcal/day: 8.22; 95%CI: 6.19-10.92) and with greater physical activity (OR≥21METS-h/week: 1.29; 95%CI: 0.95-1.76) showed greater adherence. Conclusions: Almost two-thirds of middle-aged premenopausal participants showed low or moderate compliance with SENC recommendations. Education, smoking, parity, and physical activity were associated with the degree of adherence to these recommendations.This study was funded by the Spanish Ministry of Health (EC11–273) and by the Instituto de Salud Carlos III (PI15CIII/0029). The article presents independent research.S

Evaluating the Applicability of Data-Driven Dietary Patterns to Independent Samples with a Focus on Measurement Tools for Pattern Similarity

BACKGROUND: Diet is a key modifiable risk for many chronic diseases, but it remains unclear whether dietary patterns from one study sample are generalizable to other independent populations. OBJECTIVE: The primary objective of this study was to assess whether data-driven dietary patterns from one study sample are applicable to other populations. The secondary objective was to assess the validity of two criteria of pattern similarity. METHODS: Six dietary patterns-Western (n=3), Mediterranean, Prudent, and Healthy- from three published studies on breast cancer were reconstructed in a case-control study of 973 breast cancer patients and 973 controls. Three more internal patterns (Western, Prudent, and Mediterranean) were derived from this case-control study's own data. STATISTICAL ANALYSIS: Applicability was assessed by comparing the six reconstructed patterns with the three internal dietary patterns, using the congruence coefficient (CC) between pattern loadings. In cases where any pair met either of two commonly used criteria for declaring patterns similar (CC ≥0.85 or a statistically significant [P0.9) to their corresponding dietary pattern derived from the case-control study's data. Similar associations with risk for breast cancer were found in all pairs of dietary patterns that had high CC but not in all pairs of dietary patterns with statistically significant correlations. CONCLUSIONS: Similar dietary patterns can be found in independent samples. The P value of a correlation coefficient is less reliable than the CC as a criterion for declaring two dietary patterns similar. This study shows that diet scores based on a particular study are generalizable to other populations.This study was funded by Fundación Científica Asociación Española Contra el Cáncer (Scientific Foundation of the Spanish Association Against Cancer), the Spanish Ministry of Economy and Competitiveness (IJCI-2014-20900); Fundación Cerveza y Salud 2005 (Beer and Health Foundation 2005), Sociedad Española de Oncología Médica (Spanish Society of Medical Oncology), Federación de Mujeres con Cáncer de Mama (Association of Women with Breast Cancer) (EPY 1169-10 grant) and Association of Women with Breast Cancer from Elche (EPY 1394/15 grant)

Nutrición en Salud Pública

Este libro es fruto de una revisión y actualización ampliadas de los manuales docentes de «Nutrición en Salud Pública» y «La alimentación y el consumidor», editados en 2007 y 2013 respectivamente por la Escuela Nacional de Sanidad del Instituto de Salud Carlos III.La salud pública es el arte y la ciencia de prevenir la enfermedad, prolongar la vida y promover la salud a través de los esfuerzos organizados de la sociedad. La nutrición es la ciencia que estudia la forma en que el organismo utiliza la energía de los alimentos para mantenerse y crecer, mediante el análisis de los procesos por los cuales ingiere, digiere, absorbe, transporta, utiliza y extrae los nutrientes esenciales para la vida, y su interacción con la salud y la enfermedad. Por tanto, la nutrición en salud pública (public health nutrition) es la ciencia que estudia la relación entre dieta y salud y sienta las bases para el diseño, ejecución y evaluación de intervenciones nutricionales a nivel comunitario y poblacional con el objeto de mejorar el estado de salud de las poblaciones. La pandemia de obesidad, una enfermedad estrechamente relacionada con la nutrición, es uno de ejemplos paradigmáticos del carácter multidisciplinar e intersectorial de la salud pública. Hace décadas, la obesidad era considerada una enfermedad endocrina, de tipo glandular, dentro del dominio biomédico del especialista en endocrinología. Después se pasó a considerar algunos factores personales de riesgo, como los hábitos alimentarios y de actividad física, entrando en el dominio de la medicina preventiva, que centra sus esfuerzos en los factores biomédicos individuales, como la ingesta de calorías o el sedentarismo, y del entorno familiar. La salud pública va más allá, considerando factores ambientales, sociales y culturales que afectan a las preferencias alimentarias y los hábitos de vida, como los sistemas de producción de alimentos y fijación del precio de los mismos, el uso de subsidios y tasas, la publicidad alimentaria, el nivel socioeconómico de las familias, el diseño urbanístico (cantidad de espacios verdes, parques, carriles bici) o los sistemas de transporte urbano, entre otros muchos. El abordaje de elementos tan variados requiere del concurso de especialistas en múltiples disciplinas: profesionales sanitarios, abogados, economistas, periodistas, urbanistas, sociólogos, etc. Aunque ningún individuo puede ser experto en todas las especialidades relacionadas con la salud pública, el profesional bien formado debe conocer el rol de cada una de esas disciplinas en la formulación de una intervención de salud pública, estar familiarizado con el lenguaje y los postulados básicos de dichas disciplinas, y haber practicado la implementación de intervenciones a cargo de equipos multidisciplinarios

Principal components analysis in clinical studies

In multivariate analysis, independent variables are usually correlated to each other which can introduce multicollinearity in the regression models. One approach to solve this problem is to apply principal components analysis (PCA) over these variables. This method uses orthogonal transformation to represent sets of potentially correlated variables with principal components (PC) that are linearly uncorrelated. PCs are ordered so that the first PC has the largest possible variance and only some components are selected to represent the correlated variables. As a result, the dimension of the variable space is reduced. This tutorial illustrates how to perform PCA in R environment, the example is a simulated dataset in which two PCs are responsible for the majority of the variance in the data. Furthermore, the visualization of PCA is highlighted.The study was funded by Zhejiang Engineering Research Center of Intelligent Medicine (2016E10011) from the First Affiliated Hospital of Wenzhou Medical University

Cancer mortality in towns in the vicinity of incinerators and installations for the recovery or disposal of hazardous waste

BACKGROUND: Waste treatment plants release toxic emissions into the environment which affect neighboring towns. OBJECTIVES: To investigate whether there might be excess cancer mortality in towns situated in the vicinity of Spanish-based incinerators and installations for the recovery or disposal of hazardous waste, according to the different categories of industrial activity. METHODS: An ecologic study was designed to examine municipal mortality due to 33 types of cancer, across the period 1997-2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Besag-York-Mollié (BYM) regression models with Integrated Nested Laplace approximations for Bayesian inference, and Mixed Poisson regression models, we assessed the risk of dying from cancer in a 5-kilometer zone around installations, analyzed the effect of category of industrial activity, and conducted individual analyses within a 50-kilometer radius of each installation. RESULTS: Excess cancer mortality (BYM model: relative risk, 95% credible interval) was detected in the total population residing in the vicinity of these installations as a whole (1.06, 1.04-1.09), and, principally, in the vicinity of incinerators (1.09, 1.01-1.18) and scrap metal/end-of-life vehicle handling facilities, in particular (1.04, 1.00-1.09). Special mention should be made of the results for tumors of the pleura (1.71, 1.34-2.14), stomach (1.18, 1.10-1.27), liver (1.18, 1.06-1.30), kidney (1.14, 1.04-1.23), ovary (1.14, 1.05-1.23), lung (1.10, 1.05-1.15), leukemia (1.10, 1.03-1.17), colon-rectum (1.08, 1.03-1.13) and bladder (1.08, 1.01-1.16) in the vicinity of all such installations. CONCLUSIONS: Our results support the hypothesis of a statistically significant increase in the risk of dying from cancer in towns near incinerators and installations for the recovery or disposal of hazardous waste.This study was funded by Spain's Health Research Fund (Fondo de Investigación Sanitaria — FIS 080662 and FIS CP11/0012) and ISCIII EPY 1398/09, and formed as part of the MEDEA project (Mortalidad en áreas pequeñas Españolas y Desigualdades socio-Económicas y Ambientales — Mortality in small Spanish areas and socio-economic and environmental inequalities).S

La importancia de que el aceite de oliva sea virgen para prevenir el cáncer de mama

Artículo de divulgación publicado en The Conversation España el día 31/03/2022.No basta con tomar aceite de oliva en lugar de otro vegetal. También debería ser virgen, incluso si es para freír, porque la evidencia afirma que así podría disminuir el riesgo de cáncer de mama.N

Serum Phospholipid Fatty Acids Levels, Anthropometric Variables and Adiposity in Spanish Premenopausal Women

This study investigates the still uncertain association between serum phospholipid fatty acids (PL-FA), and anthropometric and adiposity variables. A cross-sectional study was conducted with 1443 Spanish premenopausal women. Participants answered an epidemiological and a food frequency questionnaire. Anthropometric variables were measured using a bioimpedance scale. Serum PL-FAs levels were determined by gas chromatography-mass spectrometry. The association between body mass index (BMI), weight gain, body fat percentage, visceral fat index, and waist circumference with serum PL-FAs and desaturation indices was evaluated using multivariable linear regression models. BMI was positively associated with the relative concentration of saturated fatty acids (SFAs) (β = 0.94, q-val = 0.001), and with palmitoleic, dihomo-γ-linolenic (DGLA), arachidonic (AA) and α-linolenic acids, and was inversely associated with oleic, gondoic, trans-vaccenic, linoleic and γ-linolenic acids. Total fat percentage was positively associated with DGLA and AA, and inversely with linoleic and γ-linolenic acids. Low relative concentrations of some SFAs and high levels of n-6 PUFAs were associated with greater waist circumference. While the oleic/stearic and AA/DGLA acid ratios were inversely associated with BMI, DGLA/linoleic acid ratio was positively related to almost all variables. In addition to BMI, total fat percentage and waist circumference were also associated with certain individual fatty acids.This research was funded by the Carlos III Institute of Health (AESI intramural health action PI15CIII/0029). The article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health.S

Serum Phospholipid Fatty Acids and Mammographic Density in Premenopausal Women.

The role of fatty acids (FAs) on mammographic density (MD) is unclear, and available studies are based on self-reported dietary intake. This study assessed the association between specific serum phospholipid fatty acids (PLFAs) and MD in premenopausal women. The cross-sectional study DDM-Madrid recruited 1392 Spanish premenopausal women, aged 39-50 y, who attended a screening in a breast radiodiagnosis unit of Madrid City Council. Women completed lifestyle questionnaires and FFQs. Percentage MD was estimated using a validated computer tool (DM-Scan), and serum PLFA percentages were measured by GC-MS. Multivariable linear regression models were used to quantify the association of FA tertiles with MD. Models were adjusted for age, education, BMI, waist circumference, parity, oral contraceptive use, previous breast biopsies, and energy intake, and they were corrected for multiple testing. Women in the third tertile of SFAs showed significantly higher MD compared with those in the first tertile (βT3vsT1 = 7.53; 95% CI: 5.44, 9.61). Elevated relative concentrations of palmitoleic (βT3vsT1 = 3.12; 95% CI: 0.99, 5.25) and gondoic (βT3vsT1 = 2.67; 95% CI: 0.57, 4.77) MUFAs, as well as high relative concentrations of palmitelaidic (βT3vsT1 = 5.22; 95% CI: 3.15, 7.29) and elaidic (βT3vsT1 = 2.69; 95% CI: 0.59, 4.79) trans FAs, were also associated with higher MD. On the contrary, women with elevated relative concentrations of n-6 (ω-6) linoleic (βT3vsT1 = -5.49; 95% CI; -7.62, -3.35) and arachidonic (βT3vsT1 = -4.68; 95% CI: -6.79, -2.58) PUFAs showed lower MD. Regarding desaturation indices, an elevated palmitoleic to palmitic ratio and a low ratio of oleic to steric and arachidonic to dihomo-γ-linolenic acids were associated with higher MD. Spanish premenopausal women with high relative concentrations of most SFAs and some MUFAs and trans FAs showed an increased MD, whereas those with high relative concentrations of some n-6 PUFAs presented lower density. These results, which should be confirmed in further studies, underscore the importance of analyzing serum FAs individually.S

Atlas municipal de mortalidade por cancro em Portugal e Espanha (2003–2012), AMOCAPE

El 'Atlas of Cancer Mortality in Portugal and Spain 2003–2012', muestra la distribución espacial de la mortalidad municipal por distintos tipos cáncer para el periodo 2003-2012. Ha sido desarrollado por la Unidad de Epidemiología del Cáncer y Ambiental del Centro Nacional de Epidemiología del ISCIII, que forma parte del CIBERESP, y por el Departamento de Epidemiología del Instituto Nacional De Saúde Doutor Ricardo Jorge de Portugal. El estudio de la distribución geográfica del riesgo de fallecer por cáncer es una de las herramientas que se usan en epidemiología para generar hipótesis sobre la posible implicación de factores ambientales en el origen de los tumores.This project is partially supported by research grant from the Spanish Health Research Fund (FIS) of the National Institute of Health Carlos III (ISCIII), Spain (Project PI17CIII/00040: “Spatial distribution of municipal cancer mortality in Spain (SICAMSA)” (“Distribución Espacial de la Mortalidad municipal por CÁncer en ESpaña (DEMOCAES)”).Introduction. Methods. Results: Oesophagus (ICD-10 C15) Stomach (ICD-10 C16) Colorectal (ICD-10 C18–C21) Pancreas (ICD-10 C25) Larynx (ICD-10 C32) Lung (ICD-10 C33–C34) Female Breast (ICD-10 C50) Prostate (ICD-10 C61) Bladder (ICD-10 C67) Leukaemia (ICD-10 C91–C95) References. Annexes: Annex I and Annex IIN