Relationship between body image disturbance and incidence of depression: the SUN prospective cohort.

Background: Body image disturbance is an increasing probleminWestern societies and is associated with a number of mental health outcomes including anorexia, bulimia, bodydysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression. Methods: This study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates,whowere followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study). The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI) and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR) and its 95% Confidence Interval (95% CI), using logistic regression models. Results: The cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively), whereas women who overestimated their body size had a high percentage of underweight (87.6%). The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95), but this effect disappeared after adjusting for possible confounding variables. The proportion of participants who correctly perceived their body size was high (53.3%) and gross misperception was seldom found, with most cases selecting only one silhouette below (42.7%) or above (2.6%) their actual BMI. Conclusion: We found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain

Non-use of primary care routine consultations for individuals with hypertension

The objectives of this study were to identify, among individuals with hypertension, sociodemographic factors associated with non-use of routine medical appointments available in primary care and check if non-use of consultations interferes with noncompliance with pharmacotherapy, uncontrolled blood pressure and hospitalization. This is a cross-sectional study with random and stratified sampling. A total of 422 individuals living in the city of Maringá, Paraná, were interviewed. There were crude and adjusted analyses using logistic regression, estimating odds ratios and 95% confidence intervals. It was found that, in the six months preceding the interview, 47 (11.1%) individuals did not use routine appointments. Being male, nonwhite and using only public health services were associated with non-use of consultations. Most of those who did not use consultations also failed to comply with pharmacotherapy and presented dysregulated blood pressure. Healthcare professionals need to develop strategies in order to increase attendance of hypertensive individuals to medical appointments, giving priority to population groups of men, nonwhite individuals and those who use public health services. Greater use of consultations can assist in blood pressure control and reduce complications

Association between yogurt consumption and the risk of metabolic syndrome over 6 years in the SUN study

Background: The role of yogurt consumption in the development of metabolic syndrome (MetS) is not fully understood and the available epidemiologic evidence is scarce. The aim of our study was to assess the association between total, whole-fat, or low-fat yogurt consumption and the risk of developing MetS. Methods: Yogurt consumption was assessed at baseline through a 136-item validated FFQ. MetS was defined following the harmonized definition for MetS according to the AHA and the IDF criteria. Logistic regression models were used. Results: During the first 6-y of follow-up of the SUN cohort, 306 incident cases of MetS were identified. Frequent consumption [≥875 g/week (≥7 servings/week) versus ≤ 250 g/week (2 servings/week)] of total, whole-fat and low-fat yogurt consumption showed non-significant inverse associations with MetS [OR = 0.84 (95% CI: 0.60-1.18); 0.98 (95% CI: 0.68-1.41); and 0.63 (95% CI: 0.39-1.02) respectively]. Only one component of the MetS, central adiposity, was inversely associated with total and whole-fat yogurt consumption [OR = 0.85 (95% CI: 0.74-0.98) and 0.85 (95% CI: 0.73-0.99) respectively]. In the joint assessment of exposure to total yogurt consumption and fruit consumption, those in the highest category of total yogurt consumption, and having a high fruit consumption (above the median ≥264.5 g/day) exhibited a significantly lower risk of developing MetS [OR = 0.61 (95% CI: 0.38-0.99)] compared with those in the lowest category of total yogurt consumption and had fruit consumption below the study median. Conclusion: No significant association between yogurt consumption and MetS was apparent. Only one component out of the 5 MetS criteria, central adiposity, was inversely associated with high yogurt consumption. The combination of high consumption of both yogurt and fruit was inversely associated with the development of MetS

Snacking between main meals is associated with a higher risk of metabolic syndrome in a Mediterranean cohort: the SUN Project (Seguimiento Universidad de Navarra)

OBJECTIVE: To evaluate the association of snacking between main meals with the risk of developing metabolic syndrome. DESIGN: A dynamic prospective cohort study (the SUN Project; Seguimiento Universidad de Navarra). Snack consumption was evaluated using the question: 'Do you have the habit of snacking between main meals?' Metabolic syndrome was defined according to the updated harmonizing criteria. We estimated multivariable-adjusted relative risks (RR) of metabolic syndrome and their 95 % confidence intervals using Poisson regression models. An exploratory factor analysis was also used to identify patterns of snacking. SETTING: University of Navarra, Spain. SUBJECTS: The study included 6851 university graduates, initially free of metabolic syndrome, and followed-up them for a median of 8·3 years. RESULTS: Among our participants, 34·6% reported usual snacking between main meals. The cumulative incidence of metabolic syndrome was 5·1 % (9·5% among men and 2·8% among women). Snacking between main meals was significantly associated with higher risk for developing metabolic syndrome after multivariable adjustment (RR=1·44; 95%CI 1·18, 1·77). Higher adherence to an 'unhealthy snacking pattern' was also independently associated with increased incidence of metabolic syndrome (fourth quartile of adherence compared with non-snacking: RR=1·68; 95% CI 1·23, 2·29; P for trend <0·001). CONCLUSIONS: Our findings suggest that avoidance of snacking between main meals can be included among the preventive approaches to reduce the risk of metabolic syndrome development, especially when snacks contain foods of poor nutritional quality

Relationship between body image disturbance and incidence of depression: the SUN prospective cohort.

Background: Body image disturbance is an increasing probleminWestern societies and is associated with a number of mental health outcomes including anorexia, bulimia, bodydysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression. Methods: This study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates,whowere followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study). The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI) and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR) and its 95% Confidence Interval (95% CI), using logistic regression models. Results: The cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively), whereas women who overestimated their body size had a high percentage of underweight (87.6%). The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95), but this effect disappeared after adjusting for possible confounding variables. The proportion of participants who correctly perceived their body size was high (53.3%) and gross misperception was seldom found, with most cases selecting only one silhouette below (42.7%) or above (2.6%) their actual BMI. Conclusion: We found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain

Non-use of primary care routine consultations for individuals with hypertension

The objectives of this study were to identify, among individuals with hypertension, sociodemographic factors associated with non-use of routine medical appointments available in primary care and check if non-use of consultations interferes with noncompliance with pharmacotherapy, uncontrolled blood pressure and hospitalization. This is a cross-sectional study with random and stratified sampling. A total of 422 individuals living in the city of Maringá, Paraná, were interviewed. There were crude and adjusted analyses using logistic regression, estimating odds ratios and 95% confidence intervals. It was found that, in the six months preceding the interview, 47 (11.1%) individuals did not use routine appointments. Being male, nonwhite and using only public health services were associated with non-use of consultations. Most of those who did not use consultations also failed to comply with pharmacotherapy and presented dysregulated blood pressure. Healthcare professionals need to develop strategies in order to increase attendance of hypertensive individuals to medical appointments, giving priority to population groups of men, nonwhite individuals and those who use public health services. Greater use of consultations can assist in blood pressure control and reduce complications

Total polyphenol intake, polyphenol subtypes and incidence of cardiovascular disease: The SUN cohort study

Background and aims: Polyphenol-rich diets have been associated with reduced risk of cardiovascular disease (CVD). However, few prospective epidemiological studies have examined the relationship between classes of ingested polyphenols and risk of CVD. Our aim was to eval- uate the association between polyphenol intake and risk of major cardiovascular events in a pro- spective Spanish cohort. Methods and results: We included 17,065 university graduates (60.7% women, mean age: 37.2 years, age range: 20e89) followed-up for a mean of 10.1 years. Polyphenol intake was assessed at baseline using a validated semi-quantitative 136-item food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for incident cardiovascular events (myocardial infarction, stroke or cardiovascular death). Cherries, chocolate, coffee, apples, and olives were the major sources of variability in polyphenol intake. Participants with higher flavonoids intake (fifth quintile) had a 47% lower incidence of cardiovascular events compared to those in the lowest quintile (HR: 0.53, 95% CI: 0.29e0.98; P for trend Z 0.09) after adjusting for potential confounders. The results were non-significant for other polyphenol types. Conclusion: The intake of flavonoids showed an inverse association with risk of cardiovascular events in a prospective cohort of Spanish middle-aged adult university graduates. Registration number for clinical trials: NCT02669602 in Clinical Trials. a 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Feder- ico II University. Published by Elsevier B.V. All rights reserved