A qualitative look at the research in the Spanish Journal of Human Nutrition and Dietetics

Los estudios cualitativos en nutrición y dietética se presentan como una oportunidad para dar respuesta a la necesidad de expandir el conocimiento, complementando a otros diseños de investigación. Esta conjunción de aportes permitiría mejorar los procesos de toma de decisiones y acciones de la alimentación y estilos de vida saludables, lo que favorece el bienestar de poblaciones en distintas trayectorias vitales. Por ello, desde la RENHyD se invita a la comunidad científica a incorporar el acercamiento cualitativo en sus estudios, desde la promoción del uso de los criterios consolidados de guías internacionales como COREQ, para incrementar la transparencia al momento de reportar resultados de proyectos de investigación cualitativa10. La flexibilidad ante diversos acercamientos en la metodología de la investigación científica es crucial para la comprensión de los interrogantes “qué” y los “por qué” en el campo de la nutrición humana y la dietética. Por lo tanto, el esfuerzo realizado por los/as autores/as para dar un abordaje mixto en los artículos remitidos a la revista, también se tendrá en consideración

Replacement of watching television with physical activity and the change in gestational diabetes mellitus risk: A case–control study

Objective: To evaluate the effect of replacing 1 h/week of watching television with 1 h/week of light to moderate (LMPA) or vigorous physical activity (VPA) before and during pregnancy on the risk of gestational diabetes mellitus (GDM). Methods: A case–control study was conducted in pregnant women. Physical activity and television watching before and during pregnancy were assessed using the Paffenbarger Physical Activity Questionnaire. Each type of activity was classified according to intensity (metabolic equivalent of task; MET): less than 6 METs is LMPA, 6 METs or more is VPA. The duration of physical activity and watching television was calculated, and logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals for their association with GDM risk. The isotemporal substitution model was used to calculate the effect of replacing 1 h/week of watching television with the same duration of physical activity. Results: The GDM cases (n = 290) spent less time performing VPA than controls without GDM (n = 1175) and more time watching television during pregnancy (P < 0.05). During pregnancy, the risk of GDM increased for each hour of watching television (aOR = 1.02; 95% confidence interval 1.00–1.03). Women who spent more time watching television during pregnancy were likely to develop GDM (aOR>14 h/week vs. 0–6 h/week = 2.03; 95% confidence interval 1.35–3.08). Replacing 1 h/week of watching television with 1 h/week of VPA during pregnancy could decrease the chance of developing GDM (aOR = 0.66; 95% confidence interval 0.43–1.00). Conclusions: A simple change of 1 h/week of watching television for 1 h/week of VPA in pregnant women may reduce the risk of GDM considerablyFIS Scientific Research Project, Grant/ Award Number: PI 03/1207Junta de Andalucía Excellence Project, Grant/ Award Number: CTS 05/942Universidad de Granada/CBU

Ejaculation Frequency and Prostate Cancer: CAPLIFE Study

Purpose To evaluate the association between ejaculation frequency (EF) during four stages of life and prostate cancer (PCa) according to tumor aggressiveness, PCa stage, and urinary symptomatology. Materials and Methods A total of 456 incident PCa cases histologically confirmed, and 427 controls aged 40–80 years from the CAPLIFE study were analyzed. This study is a population-based case-control study carried out in the south of Spain. Average EF was measured for: (1) 20s, (2) 30s, (3) 40s, and (4) one year before the interview. EF was categorized into: (1) 0–3, (2) 4, and (3) >4 ejaculations/month. Sociodemographic, lifestyle, and medical information were also collected. To estimate the association between EF and PCa, adjusted ORs (aORs) and 95% CIs were calculated by logistic regression models. Results A year before the interview, PCa cases ejaculated less frequently than the controls. An inverse association was observed between the EF a year before and PCa, aOR=1.64 (95% CI 1.03–2.61) for men with 4 ejaculations/month, and aOR=2.38 (95% CI 1.57–3.60) for men with 0–3 ejaculations/month, compared to men with >4. The association was higher for cases with ISUP 3–5 (aOR=2.76 [95% CI 1.34–5.67] for men with 0–3 ejaculations/month) or with a locally advanced-metastatic tumor (aOR=4.70 [95% CI 1.55–14.29]). Moreover, men with moderate urinary symptoms and 0–3 ejaculations/month had the highest risk, aOR=3.83 (95% CI 1.84–7.95). Conclusions A low EF could be associated with a higher risk of PCa, especially for cases with ISUP 3–5 or with a locally advanced-metastatic tumor.Regional Ministry of Health and Families of Andalusia/Consejería de Salud y Familias, Junta de Andalucía (PI-0514-2016)

Serum copper levels and risk of major adverse cardiovascular events: a systematic review and meta-analysis

Background: Despite the fact that several studies have investigated the association between serum copper levels (S-Cu) and the risk of cardiovascular diseases, this relationship remains unclear. The aims of this study were to investigate the association between S-Cu and risk of major adverse cardiovascular events (MACE), including total stroke, ischemic stroke, hemorrhagic stroke, myocardial infarction and cardiovascular mortality, and identify potential sources of results heterogeneity. Methods: We carried out a systematic review and meta-analysis. The selection criteria were: (1) Observational studies (cohort studies, case-control studies and hybrid studies); (2) Studies containing quantitative data about the relationship between S-Cu and risk of MACE; (3) Estimating association measures; and (4) Studies written in English, French or Spanish. Overall pooled Odds ratio (pOR) and 95% confidence intervals (95% CI) of MACE for the highest vs. lowest S-Cu category were calculated using random-effects models. Results: Sixteen studies with a total of 41,322 participants were included in the meta-analysis: 10 prospective cohort studies, 5 nested case-control studies and 1 case-control study. Comparing highest vs. lowest category, high S-Cu levels were associated with total stroke (pOR: 1.49, 95% CI 1.22–1.82; I2=0%, p=0.54), myocardial infarction (pOR: 1.31, 95% CI 1.17–1.46; I2=0.0%, p=0.92) and cardiovascular mortality (pOR: 1.60, 95% CI 1.39–1.86; I2=0.0%, p=0.54). Subgroup analysis showed that studies with a hybrid design had higher risks for cardiovascular mortality (pOR: 3.42, 95% CI 1.98–5.92) and ischemic stroke (pOR: 1.54, 95% CI 1.30–1.83). Conclusion: High S-Cu levels were associated with an increased risk of total stroke, myocardial infarction and cardiovascular mortality. Hybrid studies seems to modify the strength of the association between S-Cu and the risk of cardiovascular mortality and ischemic strok

Dietary Diversity and Prostate Cancer in a Spanish Adult Population: CAPLIFE Study

The authors wish to thank all subjects who participated in the study as well as all CAPLIFE collaborators. The authors also thank Ingrid de Ruiter for English editing support.Dietary diversity (DD) is a key component of a high-quality diet, providing the adequate nutrient requirements. However, the role of DD on prostate cancer (PCa) is still uncertain. The aim of this study was to evaluate the relationship between DD, adequate nutrient intake and PCa, according to the aggressiveness of the tumor. The CAPLIFE (CAP: prostate cancer; LIFE: lifestyles) study is a population-based case-control study including a total of 402 incident PCa cases and 302 controls. The DD score (DDS), adjusted by total energy intake, was collected through a validated food frequency questionnaire. Nutrient adequacy was defined according to European Dietary Recommendation Intake for men. The aggressiveness of PCa was determined according to the International Society of Urology Pathology classification. The association between DDS, nutrient intake and PCa was assessed by logistic regression models with adjustment for potential confounding factors. DDS was similar for PCa cases and controls, independent of PCa aggressiveness. According to each food group DDS, the protein group showed the highest mean score in all the subgroups analyzed. However, no differences were observed for each of the DDS components. The DDS, the variety of the group’s food intake, and the adequate nutrient intake, were not associated with PCa.Regional Ministry of Health of Andalusia (Consejeria de Salud de la Junta de Andalucia) PI-0514-201

Replacement of watching television with physical activity and the change in gestational diabetes mellitus risk: A case–control study

Abstract Objective: To evaluate the effect of replacing 1 h/week of watching television with 1 h/week of light to moderate (LMPA) or vigorous physical activity (VPA) before and during pregnancy on the risk of gestational diabetes mellitus (GDM). Methods: A case–control study was conducted in pregnant women. Physical activity and television watching before and during pregnancy were assessed using the Paffenbarger Physical Activity Questionnaire. Each type of activity was classified according to intensity (metabolic equivalent of task; MET): less than 6 METs is LMPA, 6 METs or more is VPA. The duration of physical activity and watching television was calculated, and logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals for their association with GDM risk. The isotemporal substitution model was used to calculate the effect of replacing 1 h/week of watching television with the same duration of physical activity. Results: The GDM cases (n= 290) spent less time performing VPA than controls without GDM (n= 1175) and more time watching television during pregnancy (P< 0.05). During pregnancy, the risk of GDM increased for each hour of watching television (aOR = 1.02; 95% confidence interval 1.00–1.03). Women who spent more time watching television during pregnancy were likely to develop GDM (aOR>14 h/week vs. 0–6 h/week= 2.03; 95% confidence interval 1.35–3.08). Replacing 1 h/week of watching television with 1 h/week of VPA during pregnancy could decrease the chance of developing GDM (aOR = 0.66; 95% confidence interval 0.43–1.00). Conclusions: A simple change of 1 h/week of watching television for 1 h/week of VPA in pregnant women may reduce the risk of GDM considerably

Compliance with the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and Prostate Cancer

We thank all subjects who participated in the study and all CAPLIFE collaborators and the Ingrid de Ruiter, MBChB, for English language and editing support. The results of this study are part of the doctoral thesis of Macarena Lozano-Lorca.The etiology of prostate cancer (PCa) remains largely unknown. Compliance with the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) cancer prevention recommendations and its relationship to PCa was evaluated. A total of 398 incident PCa cases and 302 controls were included. The selection criteria for both cases and controls were: (i) age between 40–80 years; and (ii) residence in the coverage area of the reference hospitals for 6 months or more prior to recruitment. A score to measure the compliance with the recommendations of 2018 WCRC/AICR criteria was built. The level of compliance was used as a continuous variable and categorized in terciles. The aggressiveness of PCa was determined according to the ISUP classification. Adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models. A slight protective tendency was observed between the level of compliance with the preventive recommendations and PCa risk, aOR = 0.81 (95% CI 0.69–0.96) for the total cases of PCa. This association also was observed when the aggressiveness was considered. In addition, limiting consumption of “fast foods”, sugar-sweetened drinks, and alcohol were independently associated with lower risk of PCa.This research was funded by Regional Ministry of Health of Andalusia/Consejería de Salud of the Junta de Andalucía (PI-0514-2016) and Instituto de Salud Carlos III-FEDER (PI15/00914)

Factors associated with the development of second primary tumours in head and neck cancer patients

ACKNOWLEDGEMENTS Funding for open access charge: Universidad de Granada/CBUA. Study concepts: RBR. Study design: RBR, ISB, PR. Acquisition of data: RM, COR, ROR, MLL. Data analysis and interpretation: RBR, ISB, PR y JPA. Manuscript preparation: ISB, PR, RBR. Manuscript review: ISB, PR, RM, COR, ROR, MLL, JPA, RBR. Manuscript final approval: ISB, PR, RM, COR, ROR, MLL, JPA, RBR. Being accountable for all aspects of the work: ISB, PR, RM, COR, ROR, MLL, JPA, RBR.Introduction: The development of second primary tumours (SPTs) is one of the main causes of low survival in patients with head and neck cancer (HNC). The aim of this study was to review the evidence about factors associated with developing SPTs in patients with HNC. Methods: An updated systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and the search was performed in Pubmed and Scopus. Only original articles with a cohort or case-control design were included. Article quality was assessed with the Newcastle-Ottawa scale. Results: Thirty-six and two case-control studies were included, with quality medium (n = 5) to high (n = 33). Tobacco showed a significant association with SPT development, with risks ranging from 1.41 (95%CI: 1.04-1.91) to 5.52 (95%CI: 2.91-10.49). Regarding alcohol, risks ranged from 1.46 (95%CI: 1.12-1.91) to 21.3 (95%CI: 2.9-156). Location of the index tumour in the hypopharynx/oropharynx, absence of human papillomavirus and presence of a premalignant lesion also increased the risk of SPTs. More controversy was found for sex, age and other clinical factors of the tumour. Conclusion: Toxic lifestyle habits and clinical factors were associated with the risk of SPTs in HNC patients. These findings may improve individualised prevention strategies in its follow-up.Spanish Ministry of Science, Innovation and Universities through the grant ‘Ramon y Cajal’Universidad de Granada/CBUA (Funding for open access charge