Dieta mediterránea y enfermedad cardiovascular: resultados del estudio piloto del proyecto SUN

Fundamento: La dieta mediterránea ha sido propuesta como modelo de patrón dietético para la prevención de la cardiopatía isquémica. El proyecto SUN (“Seguimiento Universidad de Navarra”) es un estudio epidemiológico prospectivo de cohortes, que se inició en el año 2000 y que va dirigido a identificar determinantes dietéticos y no dietéticos implicados en estas enfermedades. La viabilidad del proyecto, se comprobó con un estudio piloto en dos fases. Métodos: La primera fase del estudio piloto contó con la participación de voluntarios en los que se valoraron las exposiciones dietéticas y no dietéticas mediante un cuestionario autoadministrado y por entrevista personal. Para la segunda fase, se seleccionó una muestra aleatoria de 600 graduados y se les envió el cuestionario por correo. Para estimar la variabilidad inter-sujetos se calcularon los percentiles 10, 25, 50, 75 y 90 de consumo para los principales alimentos y nutrientes considerados. Resultados: Los participantes entendieron y respondieron adecuadamente los cuestionarios. El tiempo medio empleado en contestar el cuestionario fue de 55,0 minutos (IC 95%=50,7-59,3). Se encontró una amplia variabilidad inter-sujetos entre los percentiles 10 y 90 en el consumo de los principales alimentos que pueden considerarse indicadores de la dieta mediterránea, como son el aceite de oliva, las frutas, las verduras y el vino. Conclusiones: La submuestra presentó una participación relativamente aceptable. Se halló un patrón de dieta mediterránea con una variabilidad inter-sujetos suficientemente amplia como para poder encontrar asociaciones entre el consumo de alimentos y la incidencia de las principales enfermedades cardiovasculares

Dietary patterns and total mortality in a Mediterranean cohort: the SUN project

BACKGROUND: Different dietary patterns have been associated with several health outcomes, including morbidity and mortality. There is little evidence on the association between empirically derived dietary patterns and all-cause mortality in Southern European populations. OBJECTIVE: The aim of our study was to prospectively evaluate the association between an empirically derived dietary pattern and all-cause mortality. DESIGN: The Seguimiento Universidad de Navarra (SUN) Project is an ongoing, multipurpose, prospective and dynamic Spanish cohort. PARTICIPANTS/SETTING: Participants were a prospective cohort of 16,008 middle-aged Spanish adults. All of them were university graduates (alumni) (59.6% women, mean age 38 years). Usual diet was assessed at baseline with a validated semiquantitative food frequency questionnaire. MAIN OUTCOME MEASURES: Deaths were confirmed by review of medical records and of the National Death Index. STATISTICAL ANALYSIS: Dietary patterns were ascertained through a factor (principal component) analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to the three main dietary patterns identified with factor analysis. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios and 95% CIs for mortality. RESULTS: Three major dietary patterns were identified. They were labelled Western dietary pattern (rich in red and processed meat, potatoes, and fast food), Mediterranean dietary pattern (rich in vegetables, fish and seafood, fruits, and olive oil), and alcoholic beverages dietary pattern. During follow-up, 148 deaths were reported (mean age at death 54.5 years). After adjustment for potential confounders, the lowest risk of all-cause mortality was found in the tertile of highest adherence to the Mediterranean dietary pattern (adjusted hazard ratio for third vs first tertile 0.53, 95% CI 0.34 to 0.84) (P for trend <0.01). The Western dietary pattern and alcoholic beverages dietary pattern showed no significant association with mortality. CONCLUSIONS: Greater adherence to an empirically derived dietary pattern approaching the traditional Mediterranean diet was associated with a reduction in the risk of all-cause mortality among middle-aged Mediterranean adults

Determinants of the adherence to an "a priori" defined Mediterranean dietary pattern

Background: A prospective cohort study with university level participants was initiated to study the effect of Mediterranean diet on health. Aims: The objective of this study was to identify possible lifestyle and socioeconomic variables associated with the consumption of a Mediterranean dietary pattern (MDP). Method: This analysis includes 1587 males and 2260 females. MDP was defined “a priori” by summing the standardized residuals of nutrients and foods after adjusting a regression model using total energy intake as the independent variable. Multiple regression and non-parametric locally weighted regression models were adjusted with the relative adherence to the MDP as the dependent variable in males and females. Results: Women were more compliant than men with the MDP (Coefficient regression (b) = 4.1; Confidence Interval (CI) 95 % = 3.2 to 4.9). The compliance with the MDP was significantly poorer among younger participants both in men and women (p < 0.001 in men and in women). Participants who were more physically active were more likely to fulfill the traditional MDP (p = 0.01 in men and p < 0.001 in women). Conclusions: Our findings provide evidence supporting the progressive departure from the traditional MDP in younger and highly educated subjects of the Mediterranean area. A more active life-style is associated with a better compliance with the MDP

The Effect of Conservation Agriculture and Environmental Factors on CO2 Emissions in a Rainfed Crop Rotation

There are many factors involved in the release of CO2 emissions from the soil, such as the type of soil management, the soil organic matter, the soil temperature and moisture conditions, crop phenological stage, weather conditions, residue management, among others. This study aimed to analyse the influence of these factors and their interactions to determine the emissions by evaluating the environmental cost expressed as the kg of CO2 emitted per kg of production in each of the crops and seasons studied. For this purpose, a field trial was conducted on a farm in Seville (Spain). The study compared Conservation Agriculture, including its three principles (no-tillage, permanent soil cover, and crop rotations), with conventional tillage. Carbon dioxide emissions measured across the four seasons of the experiment showed an increase strongly influenced by rainfall during the vegetative period, in both soil management systems. The results of this study confirm that extreme events of precipitation away from the normal means, result in episodes of high CO2 emissions into the atmosphere. This is very important because one of the consequences for future scenarios of climate change is precisely the increase of extreme episodes of precipitation and periods extremely dry, depending on the area considered. The total of emission values of the different plots of the study show how the soils under the conventional system (tillage) have been emitting 67% more than soils under the conventional agriculture system during the 2010/11 campaign and 25% for the last campaign where the most appreciable differences are observed

Daily physical activity and macronutrient distribution of low-calorie diets jointly affect body fat reduction in obese women.

Inadequate dietary patterns and sedentary lifestyles are believed to be important factors in predisposing people to obesity. This study analyzed the potential interaction between habitual physical activity and the carbohydrate (CHO)-fat distribution in 2 hypocaloric diets and the impact of such interplay on body composition changes. Forty healthy obese women, 20–50 years old, were randomly assigned to a high- or low-CHO energy-restricted diet, which was low or high in fat, respectively, during 10 weeks. Baseline and final measurements were performed to assess dietary habits, resting metabolic rate, and body composition changes. Physical activity was measured with a triaxial accelerometer and with a questionnaire. There were no significant differences in anthropometric and metabolic variables between both dietary groups at baseline. However, there was a positive correlation between total free-living physical activity and arm muscle preservation after 10 weeks (r = 0.371; p = 0.024). Interestingly, an interaction between macronutrient (CHO–fat distribution) intake and physical activity was found, since less-active subjects with a high-CHO–low-fat diet showed a greater fat loss than those more active with a lower-CHO–high-fat diet, whereas more-active subjects with a high-CHO–low-fat diet showed a smaller fat loss than those receiving a low-CHO–high-fat diet. Physical activity and the macronutrient content of energyrestricted diets, when designed to promote body fat mass reduction, should be considered together to better predict the outcome

Influence of different organoclays on the curing, morphology, and dynamic mechanical properties of an epoxy adhesive

The thermal, mechanical, and adhesive properties of nanoclay-modified adhesives were investigated. Two organically modified montmorillonites: Cloisite 93A (C93A) and Nanomer I.30E (I.30E) were used as reinforcement of an epoxy adhesive. C93A and I.30E are modified with tertiary and primary alkyl ammonium cations, respectively. The aim was to study the influence of the organoclays on the curing, and on the mechanical and adhesive properties of the nanocomposites. A specific goal was to compare their behavior with that of Cloisite30B/epoxy and Cloisite15A/ epoxy nanocomposites that we have previously studied. Both C30B and C15A are modified with quaternary alkyl ammonium cations. Differential scanning calorimetry results showed that the clays accelerate the curing reaction, an effect that is related to the chemical structure of the ammonium cations. The three Cloisite/nanocomposites showed intercalated clay structures,the interlayer distance was independent of the clay content. The I.30E/epoxy nanocomposites presented exfoliated structure due to the catalytic effect of the organic modifier. Clay-epoxy nanocompo-sites showed lower glass transition temperature (Tg) and higher values of storage modulus than neat epoxy thermoset, with no significant differences between exfoliated or intercalated nanocom-posites. The shear strength of aluminum joints using clay/epoxy adhesives was lower than with the neat epoxy adhesive. The wáter aging was less damaging for joints with I.30E/epoxy adhesive

Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I).

Abstract Background: Depression assessment in population studies is usually based on depressive symptoms scales. However, the use of scales could lead to the choice of an arbitrary cut-off point depending on the sample characteristics and on the patient diagnosis. Thus, the use of a medical diagnosis of depression could be a more appropriate approach. Objective: To validate a self-reported physician diagnosis of depression using the Structured Clinical Interview for DSM-IV (SCID-I) as Gold Standard and to assess the factors associated to a valid self-reported diagnosis. Methods: The SUN Project is a cohort study based on university graduates followed-up through postal questionnaires. The response to the question included in the questionnaire: Have you ever been diagnosed of depression by a physician? was compared to that obtained through the SCID-I applied by a psychiatrist or a clinical psychologist. The percentages of confirmed depression and non-depression were assessed for the overall sample and according to several characteristics. Logistic regression models were fitted to ascertain the association between different factors and a correct classification regarding depression status. Results: The percentage of confirmed depression was 74.2%; 95% confidence interval (95% CI) =63.3-85.1. Out of 42 participants who did not report a depression diagnosis in the questionnaire, 34 were free of the disease (%confirmed non-depression=81.1%; 95% CI=69.1- 92.9). The probability of being a true positive was higher among ex- smokers and non-smokers and among those overweight or obese but the differences were not statistically significant. Conclusion: The validity of a self-reported diagnosis of depression in the SUN cohort is adequate. Thus, this question about depression diagnosis could be used in further investigations regarding this disease in this graduate cohort study

EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol

Introduction: Mobile technology, when included within multicomponent interventions, could contribute to more effective weight loss. The objective of this project is to assess the impact of adding the use of the EVIDENT 3 application, designed to promote healthy living habits, to traditional modification strategies employed for weight loss. Other targeted behaviors (walking, caloric-intake, sitting time) and outcomes (quality of life, inflammatory markers, measurements of arterial aging) will also be evaluated. Methods: Randomized, multicentre clinical trial with 2 parallel groups. The study will be conducted in the primary care setting and will include 700 subjects 20 to 65 years, with a body mass index (27.5-40kg/m2), who are clinically classified as sedentary. The primary outcome will be weight loss. Secondary outcomes will include change in walking (steps/d), sitting time (min/wk), caloric intake (kcal/d), quality of life, arterial aging (augmentation index), and pro-inflammatory marker levels. Outcomes will be measured at baseline, after 3 months, and after 1 year. Participants will be randomly assigned to either the intervention group (IG) or the control group (CG). Both groups will receive the traditional primary care lifestyle counseling prior to randomization. The subjects in the IG will be lent a smartphone and a smartband for a 3-month period, corresponding to the length of the intervention. The EVIDENT 3 application integrates the information collected by the smartband on physical activity and the self-reported information by participants on daily food intake. Using this information, the application generates recommendations and personalized goals for weight loss. Discussion: There is a great diversity in the applications used obtaining different results on lifestyle improvement and weight loss. The populations studied are not homogeneous and generate different results. The results of this study will help our understanding of the efficacy of new technologies, combined with traditional counseling, towards reducing obesity and enabling healthier lifestyles. Ethicsanddissemination: The study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca ("CREC of Health Area of Salamanca") on April 2016. A SPIRIT checklist is available for this protocol. The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number NCT03175614

Obesity risk is associated with carbohydrate intake in women carrying the Gln27Glu beta2-adrenoceptor polymorphism.

Interindividual differences in the response to dietary intake are, in some cases, genotype dependent. Moreover, genotype-environment interactions may appear when the impact of lifestyle factors (e.g., diet) on a phenotype (e.g., BMI > 30 kg/m2) differs by genotype. A case-control study (obese subjects vs. normal weight controls) was conducted to assess a possible effect modification on obesity risk of the Gln27Glu polymorphism for the ß2-adrenoceptor gene depending on dietary intake. The sample included 159 subjects with BMI > 30 kg/m2 and 154 controls with BMI 49% energy (E)] had a higher obesity risk (OR = 2.56, P = 0.051). The product-term introduced in the logistic model to assess effect modification revealed a marginally significant interaction (P = 0.058) between both factors. Furthermore, a high intake of CHO (E > 49%) was associated with higher insulin levels among women carrying the Gln27Glu polymorphism (P < 0.01). This gene-nutrient interaction emphasizes the importance of examining the outcome of some obesity-related mutations depending on lifestyle (including diet) and may explain the heterogeneity of findings from previous studies