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

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

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

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

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

Enfermedad renal crónica en España: prevalencia y factores relacionados en personas con diabetes mellitus mayores de 64 años

Introducción: La diabetes mellitus tipo 2 y la enfermedad renal crónica (ERC) son afecciones de elevada prevalencia en personas = 65 años y constituyen un importante problema de salud pública. Objetivos: Conocer la prevalencia de la ERC, sus categorías y su relación con diversos factores demográficos y clínicos, en pacientes ancianos con diabetes mellitus tipo 2 en España. Métodos: Estudio epidemiológico, observacional, transversal, multicéntrico, ámbito nacional. Se incluyeron pacientes con diabetes mellitus tipo 2 conocida, edad = 65 años atendidos en Atención Primaria. Se recogieron variables demográficas, antropométricas y analíticas de los últimos 12 meses, incluyendo el cociente albúmina-creatinina y el filtrado glomerular estimado para evaluar la función renal. Resultados: La prevalencia de ERC fue del 37, 2% (IC95%, 34, 1-40, 3%), de insuficiencia renal del 29, 7% (IC95%, 26, 8-32, 6%) y de elevación de la albuminuria del 20, 6% (IC95%, 17, 3-23, 9%), moderadamente elevada 17, 8% (IC95%, 14, 7-20, 9%), severamente elevada 2, 8% (IC95%, 1, 4-4, 2%). La prevalencia de las categorías de ERC fueron: G1 1, 3% (IC95%, 0, 6-2%), G2 6, 2% (IC95%, 4, 6-7, 8%), G3a 17, 2% (IC95%, 14, 8-19, 6%), G3b 9, 8% (IC95%, 7, 9-11, 7%), G4 2% (IC95%, 1, 1-2, 9%) y G5 0, 7% (IC95%, 0, 2-1, 2%). En el análisis multivariante, después de ajustar por el resto de variables, la ERC se asoció a mayor edad OR 5, 13, (IC95%, 3, 15-8, 35), alta comorbilidad OR 3, 36 (IC95%, 2, 2-5, 12) y la presencia de tratamiento antihipertensivo OR 2, 43 (IC95%, 1, 48-4, 02). Conclusiones: La ERC es frecuente en la población diabética = 65 años y se asocia con mayor edad, alta comorbilidad e hipertensión tratada. No se ha encontrado asociación con el género y años de evolución de la diabetes. Introduction: Type 2 diabetes mellitus and chronic kidney disease (CKD) are conditions which have a high prevalence in individuals >= 65 years of age and represent a major public health problem. Objectives: To determine the prevalence of CKD, its categories and its relationship with various demographic and clinical factors in elderly patients with type 2 diabetes mellitus in Spain. Methods: Observational, cross-sectional, multicenter, Spanish epidemiological study. Patients with known type 2 diabetes mellitus, age >= 65 years of age treated in Primary Care were included. We collected demographic, anthropometric and analytical variables from the previous 12 months, including the albumin-to-creatinine ratio and estimated glomerular filtration rate to evaluate renal function. Results: The prevalence of CKD was 37.2% (95% CI, 34.1-40.3%), renal failure was 29.7% (95% CI, 26.8-32.6%) and increased albuminuria was 20.6% (95% CI, 17.3-23.9%), moderately increased albuminuria was 17.8% (95% CI, 14.7-20.9%) and severely increased albuminuria was 2.8% (95% CI, 1.4-4.2%). In turn, the prevalence of CKD categories were: G1 1.3% (95% CI, 0.6-2%), G2 6.2% (95% CI, 4.6-7.8%), G3a 17.2% (95% CI, 14.8-19.6%), G3b 9.8% (95% CI, 7.9-11.7%), G4 2% (95% CI, 1.1-2.9%) and G5 0.7% (95% CI, 0.2-1.2%). In the multivariate analysis, after adjusting for the remaining variables, CKD was associated with elderly age (OR 5.13, 95% CI, 3.15-8.35), high comorbidity (OR 3.36. 95% CI, 2.2-5.12) and presence of antihypertensive treatment (OR 2.43. 95% CI, 1.48-4.02). Conclusions: CKD is frequent in the diabetic population >= 65 years of age and is associated with elderly age, high comorbidity and with treated hypertension. No relationship has been found with gender and time in years since onset of diabetes

BDNF and NGF Signalling in Early Phases of Psychosis: Relationship with Inflammation and Response to Antipsychotics after 1 Year

Previous studies have indicated systemic deregulation of the proinflammatory or anti-inflammatory balance in individuals with first-episode psychosis (FEP) that persists 12 months later. To identify potential risk/protective factors and associations with symptom severity, we assessed possible changes in plasma levels of neurotrophins (brain-derived neurotrophic factor BDNF] and nerve growth factor NGF]) and their receptors in peripheral blood mononuclear cells (PBMCs). Expression of the 2 forms of BDNF receptors (active TrkB-FL and inactiveTrkB-T1) in PBMCs of FEP patients changed over time, TrkB-FL expression increasing by 1 year after diagnosis, while TrkB-T1 expression decreased. The TrkB-FL/TrkB-T1 ratio (hereafter FL/T1 ratio) increased during follow-up in the nonaffective psychosis group only, suggesting different underlying pathophysiological mechanisms in subgroups of FEP patients. Further, the expression of the main NGF receptor, TrkA, generally increased in patients at follow-up. After adjusting for potential confounders, baseline levels of inducible isoforms of nitric oxide synthase, cyclooxygenase, and nuclear transcription factor were significantly associated with the FL/T1 ratio, suggesting that more inflammation is associated with higher values of this ratio. Interestingly, the FL/T1 ratio might have a role as a predictor of functioning, a regression model of functioning at 1 year suggesting that the effect of the FL/T1 ratio at baseline on functioning at 1 year depended on whether patients were treated with antipsychotics. These findings may have translational relevance; specifically, it might be useful to assess the expression of TrkB receptor isoforms before initiating antipsychotic treatment in FEPs

BDNF and NGF signalling in early phases of psychosis: relationship with inflammation and response to antipsychotics after a 1 year

Previous studies have indicated systemic deregulation of the proinflammatory or anti-inflammatory balance in individuals with first-episode psychosis (FEP) that persists 12 months later. To identify potential risk/protective factors and associations with symptom severity, we assessed possible changes in plasma levels of neurotrophins (brain-derived neurotrophic factor [BDNF] and nerve growth factor [NGF]) and their receptors in peripheral blood mononuclear cells (PBMCs). Expression of the 2 forms of BDNF receptors (active TrkB-FL and inactiveTrkB-T1) in PBMCs of FEP patients changed over time, TrkB-FL expression increasing by 1 year after diagnosis, while TrkB-T1 expression decreased. The TrkB-FL/TrkB-T1 ratio (hereafter FL/T1 ratio) increased during follow-up in the nonaffective psychosis group only, suggesting different underlying pathophysiological mechanisms in subgroups of FEP patients. Further, the expression of the main NGF receptor, TrkA, generally increased in patients at follow-up. After adjusting for potential confounders, baseline levels of inducible isoforms of nitric oxide synthase, cyclooxygenase, and nuclear transcription factor were significantly associated with the FL/T1 ratio, suggesting that more inflammation is associated with higher values of this ratio. Interestingly, the FL/T1 ratio might have a role as a predictor of functioning, a regression model of functioning at 1 year suggesting that the effect of the FL/T1 ratio at baseline on functioning at 1 year depended on whether patients were treated with antipsychotics. These findings may have translational relevance; specifically, it might be useful to assess the expression of TrkB receptor isoforms before initiating antipsychotic treatment in FEP

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