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1. High and Low Haemoglobin Levels in Early Pregnancy Are Associated to a Higher Risk of Miscarriage: A Population-Based Cohort Study

Author

Andrés Díaz-López, Victoria Arija, Blanca Ribot, and Josep Basora

Subjects
Adult, medicine.medical_specialty, high Hb concentration, Population, miscarriage, Early pregnancy factor, Article, Miscarriage, Cohort Studies, 03 medical and health sciences, Population based cohort, Hemoglobins, 0302 clinical medicine, Pregnancy, Risk Factors, medicine, Odds Ratio, Humans, TX341-641, 030212 general & internal medicine, education, education.field_of_study, anaemia, 030219 obstetrics & reproductive medicine, Nutrition and Dietetics, biology, Nutrition. Foods and food supply, Obstetrics, business.industry, Incidence (epidemiology), Incidence, Pregnancy Complications, Hematologic, Anemia, medicine.disease, Abortion, Spontaneous, Pregnancy Trimester, First, Low haemoglobin, biology.protein, Gestation, Female, pregnancy loss, business, Food Science, Cohort study
Abstract

To evaluate whether women with anaemia or high haemoglobin (Hb) in early pregnancy would be at higher risk of miscarriage, this population-based cohort study involved 9453 women whose pregnancies were monitored at primary care centres between 2007 and 2012. The computerised clinical histories were used to collect: Hb measurements (up to 14 weeks of gestation), miscarriage before or by 24 weeks of gestation, and other maternal characteristics. The relation between anaemia (Hb &lt, 110 g/L), normal Hb (110–140 g/L, reference), and high Hb concentrations (≥140 g/L) with miscarriage were expressed as adjusted OR with 95%CI. Restricted cubic spline models were applied to evaluate the dose-response relationships. A total of 520 (5.5%) women were recorded as having a miscarriage. The rate of miscarriage in anaemia, normal Hb, and high Hb concentrations was 8.4%, 5.1%, and 10.2%, respectively. Compared with women with normal Hb at the first trimester, the multivariable-adjusted OR for miscarriage was 2.11 (95%CI, 1.38–3.21) for women with anaemia and 1.83 (95%CI, 1.29–2.58) for women with high Hb. Hb concentrations showed a U-shaped association with miscarriage, with the lowest incidence among women with Hb of 120–130 g/L. These data highlight the importance of considering anaemia and high Hb levels in early pregnancy as harmful indicators for miscarriage.

Published
2021

2. Leisure-Time physical activity, sedentary behaviour and diet quality are associated with metabolic syndrome severity: the PREDIMED-Plus Study

Author

Carmen Sayón-Orea, Aurora Bueno-Cavanillas, José Lapetra, Nerea Becerra-Tomás, Carolina Sorto-Sánchez, Maria del Mar Bibiloni, Josep Basora, José Carlos Fernández-García, Ramon Estruch, Dolores Corella, Julia Wärnberg, Jordi Salas-Salvadó, Carmen Saiz, Clotilde Vázquez, Josep Vidal, Xavier Pintó, Pilar Matía-Martín, Ana María Gómez-Pérez, Júlia Muñoz-Martínez, Lucas Tojal-Sierra, Aina M. Galmes-Panades, M. Angeles Zulet, José Manuel Santos-Lozano, José J. Gaforio, Catalina M. Mascaró, Ángel M. Alonso-Gómez, Josep A. Tur, Jadwiga Konieczna, Ana Galera, Lidia Daimiel, Sofía Montemayor, Laura Compañ-Gabucio, Cesar I Fernandez-Lazaro, Ignacio M. Gimenez-Alba, Miguel Ruiz-Canela, Karla Alejandra Pérez-Vega, Tamara Casañas-Quintana, Jesús García-Gavilán, Jesús Vioque, J. Alfredo Martínez, Lluis Serra-Majem, F. Javier Basterra-Gortari, Laura Gallardo-Alfaro, Dora Romaguera, Rafael M. Micó-Pérez, Maria Dolors Zomeño, Jessica Pérez-López, Emilio Ros, Cristina Tercero-Maciá, Montserrat Fitó, Antonio García Ríos, and Sara Castro-Barquero

Subjects
Male, Síndrome metabòlica, Mediterranean diet, humanos, ejercicio físico, 030204 cardiovascular system & hematology, Overweight, Severity of Illness Index, law.invention, chemistry.chemical_compound, 0302 clinical medicine, Sedentarisme, Randomized controlled trial, law, 030212 general & internal medicine, Depression (differential diagnoses), mediana edad, 2. Zero hunger, Metabolic Syndrome, anciano, Nutrition and Dietetics, 4. Education, Middle Aged, 16. Peace & justice, Metabolic syndrome, 3. Good health, Female, medicine.symptom, lcsh:Nutrition. Foods and food supply, medicine.medical_specialty, lcsh:TX341-641, Article, 03 medical and health sciences, Food Preferences, Mediterranean cooking, Leisure Activities, Internal medicine, Cuina mediterrània, medicine, ingesta energética, Humans, índice de gravedad de la enfermedad, Exercise, Metabolic syndrome severity, Aged, business.industry, Cholesterol, Physical activity, actividades de ocio, Sedentary behaviour, Anthropometry, Physical fitness, medicine.disease, Obesity, preferencias alimenticias, Sedentary behavior, Cross-Sectional Studies, chemistry, Depression risk, Sedentary Behavior, business, Energy Intake, Food Science, estudios transversales, Condició física
Abstract

The authors especially thank the PREDIMED-Plus participants for their enthusiastic collaboration, the PREDIMED-Plus personnel for outstanding support, and the personnel of all associated primary care centres for their exceptional effort. CIBEROBN, CIBERESP and CIBERDEM are initiatives of Instituto de Salud Carlos III, Spain. We thank the PREDIMED-Plus Biobank Network, part of the National Biobank Platform of Instituto de Salud Carlos III for storing and managing biological samples., Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55–75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses’ Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund [five coordinated FIS projects led by Jordi Salas-Salvadó and Josep Vidal, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332], the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to Jordi Salas-Salvadó, the European Research Council (Advanced Research Grant 2014–2019, 340918) to Dr. Miguel A. Martínez-González, the Recercaixa Grant to Jordi Salas-Salvadó (2013ACUP00194), Grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a Grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN Grant, EU-COST Action CA16112, a Grant of support to research groups no. 35/2011 from the Balearic Islands Government, Grants from Balearic Islands Health Research Institute IDISBA [FOLIUM, PRIMUS, SYNERGIA, and LIBERI], funds from the European Regional Development Fund (CIBEROBN CB06/03 and CB12/03) and from the European Commission (EAT2BENICE_H2020_SFS2016). Fundació La Marató TV3 (projects no. PI044003 and 201630.10). Laura Gallardo-Alfaro and Catalina M. Mascaró received FPU PhD Grants from the Spanish Ministry of Education. The funding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of the data; in the writing of the manuscript, and in the decision to publish the results.

Published
2020

3. Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study

Author

Josep A. Tur, Itziar Abete, José J. Gaforio, Jordi Salas-Salvadó, Nerea Becerra-Tomás, Francisco J. Tinahones, Albert Goday, Xavier Pintó, Maria Dolors Zomeño, Julia Wärnberg, Alejandro Oncina-Canovas, Carmen Saiz, Jessica Pérez-López, Dolores Corella, Clotilde Vázquez, Lucas Tojal-Sierra, Leyre Notario-Barandiaran, Marga Morey, Lidia Daimiel, Aurora Bueno-Cavanillas, José Manuel Santos-Lozano, José Lapetra, F. Javier Basterra-Gortari, Julia Muñoz, Alicia Julibert, Marian Martín, M. Rosa Bernal-Lopez, Sara Castro-Barquero, Ana Galera, Josep Vidal, Vicente Martín-Sánchez, Miguel Ruiz-Canela, Maria C Belló-Mora, Emilio Ros, Ignacio M. Gimenez-Alba, Antonio García Ríos, Tamara Casañas-Quintana, Ángel M. Alonso-Gómez, Jesús García-Gavilán, Josep Basora, Jesús Vioque, Ramon Estruch, Dora Romaguera, Luis Serra-Majem, Cesar I Fernandez-Lazaro, Pilar Matía-Martín, Escarlata Angullo-Martinez, Cristina Bouzas, Carmen Sayón-Orea, J. Alfredo Martínez, Olga Castañer, Maria del Mar Bibiloni, [Bouzas,C, Bibiloni,MM, Julibert,A, Ruiz-Canela,M, Salas-Salvadó,J, Corella,D, Zomeño,MD, Romaguera,D, Alonso-Gómez,ÁM, Wärnberg,J, Martínez,JA, Serra-Majem,L, Estruch,R, Tinahones,FJ, Lapetra,J, Pintó,X, García Ríos,A, Vázquez,C, Ros,E, Fernandez-Lázaro,CI, Becerra-Tomás,N, Gimenez-Alba,IM, Muñoz,J, Morey,M, Pérez-López,J, Abete,I, Casañas-Quintana,T, Castro-Barquero,S, Bernal-López,MR, Santos-Lozano,JM, Galera,A, Angullo-Martinez,E, Basterra-Gortari,FJ, Basora,J, Saiz,C, Castañer,O, Martín,M, Belló-Mora,MC, Sayón-Orea,C, García-Gavilán,J, Goday,A, Tur,JA] CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Bouzas,C, Tojal-Sierra,L, Tur,JA] Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Guillem Colom Bldg, Campus, Palma de Mallorca, Spain. [Bouzas,C, Tur,JA] Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain. [Ruiz-Canela,M, Sayón-Orea,C] Department of Preventive Medicine and Public Health, IdISNA, University of Navarra, Pamplona, Spain. [Salas-Salvadó,J, García-Gavilán,J] Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, Spain. [Salas-Salvadó,J] Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. [Corella,D, Saiz,C] Department of Preventive Medicine, University of Valencia, Valencia, Spain. [Zomeño,MD, Goday,A] Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain. [Zomeño,MD] Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain. [Vioque,J, Oncina-Canovas,A, Notario-Barandiarán,L] Unit of Nutritional Epidemiology, Miguel Hernández University, ISABIAL-UMH, Alicante, Spain. [Vioque,J, Bueno-Cavanillas,A, Gaforio,JJ, Notario-Barandiarán,L] CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Alonso-Gómez,ÁM, Belló-Mora,MC] Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. [Wärnberg,J, Pérez-López,J] Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain. [Martínez,JA] Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. [Martínez,JA, Abete,I] Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain. [Serra-Majem,L, Casañas-Quintana,T] Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. [Estruch,R, Castro-Barquero,S] Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain. [Tinahones,FJ, Bernal-López,MR] Virgen de la Victoria Hospital, Department of Endocrinology, Biomedical Research Institute of Málaga (IBIMA), University of Málaga, Málaga, Spain. [Lapetra,J, Santos-Lozano,JM] Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. [Pintó,X, Galera,A] Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. [García Ríos,A] Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. [Bueno-Cavanillas,A] Department of Preventive Medicine, University of Granada, Granada, Spain. [Gaforio,JJ] Department of Health Sciences, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaen, Jaen, Spain. [Matía-Martín,P] Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. [Daimiel,L] Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. [Martín-Sánchez,V] CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. [Martín-Sánchez,V] Institute of Biomedicine (IBIOMED), University of León, León, Spain. [Vidal,J] Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain. [Vázquez,C] Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain. [Ros,E] Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. [Angullo-Martinez,E] Escola Graduada Primary Health Care Center, IBSalut, Palma de Mallorca, Spain. [Basterra-Gortari,FJ, Sayón-Orea,C] Servicio Navarro de Salud, Osasunbidea, Pamplona, Spain., The PREDIMED-Plus trial was supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (five coordinated FIS projects led by J.S.-S. and J.Vidal, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332, the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S., the European Research Council (Advanced Research Grant 2013–2018, 340918) to Miguel Ángel Martínez-González, the Recercaixa Grant to J.S.-S. (2013ACUP00194), Grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a Grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN Grant, EU-COST Action CA16112, a Grant of support to research groups no. 35/2011 from the Balearic Islands Government, Grants from Balearic Islands Health Research Institute (IDISBA), funds from the European Regional Development Fund (CIBEROBN CB06/03 and CB12/03) and from the European Commission (EAT2BENICE_H2020_SFS2016). M. Rosa Bernal-López was supported by 'Miguel Servet Type I' program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the European Regional Development Fund. Jordi Salas-Salvadó is partially supported by ICREA under the ICREA Academia programme. Cristina Bouzas received a Fernando Tarongí Bauzà PhD Grant. I.M Gimenez-Alba received a grant FPU from the Ministry of Science, Innovation and Univesities (reference FPU 18/01703). The funding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of the data, and in the writing of the manuscript, and in the decision to publish the results.

Subjects
Male, Mediterranean diet, Obesidad, ejercicio físico, Body Mass Index, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], 0302 clinical medicine, Surveys and Questionnaires, Antineoplastic Combined Chemotherapy Protocols, Medicine, mediana edad, education.field_of_study, anciano, Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Age Factors [Medical Subject Headings], dieta, protocolos de quimioterapia antineoplásica combinada, 3. Good health, Older adults, metotrexato, programas de reducción de peso, Obesitat, lcsh:Nutrition. Foods and food supply, Personas mayores frágiles, Ideal weight, Lifestyles, Check Tags::Male [Medical Subject Headings], lcsh:TX341-641, Article, Estilo de vida, 03 medical and health sciences, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Size::Body Weight::Overweight [Medical Subject Headings], Anthropology, Education, Sociology and Social Phenomena::Human Activities::Exercise [Medical Subject Headings], ifosfamida, Humans, cisplatino, Ifosfamide, education, Exercise, Aged, conducta alimentaria, Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Metabolic Syndrome X [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Life Style [Medical Subject Headings], PREDIMED-Plus, medicine.disease, Obesity, Methotrexate, Check Tags::Female [Medical Subject Headings], Desired weight loss, Metabolic syndrome, Cisplatin, Body mass index, Demography, obesity, cumplimiento del paciente, humanos, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Mass Index [Medical Subject Headings], Ideal Body Weight, desired weight loss, Health Care::Health Care Facilities, Manpower, and Services::Health Promotion::Weight Reduction Programs [Medical Subject Headings], Overweight, Diet, Mediterranean, Mediterranean lifestyle, Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Health Promotion::Healthy People Programs [Medical Subject Headings], Weight loss, 030212 general & internal medicine, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Health Behavior::Patient Compliance [Medical Subject Headings], Abdominal obesity, older adults, Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], 2. Zero hunger, Nutrition and Dietetics, mediterranean lifestyle, sobrepeso, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Diet Therapy::Diet, Mediterranean [Medical Subject Headings], Age Factors, ideal weight, Middle Aged, Peso corporal ideal, Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Size::Body Weight::Ideal Body Weight [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings], Weight Reduction Programs, Body image, Female, medicine.symptom, peso corporal ideal, Estils de vida, doxorrubicina, body image, Population, Imagen corporal, 030209 endocrinology & metabolism, Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Feeding Behavior [Medical Subject Headings], overweight, Healthy Lifestyle, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], business.industry, índice de masa corporal, Feeding Behavior, Dieta mediterránea, Diet, Doxorubicin, Sobrepeso, Patient Compliance, Psychiatry and Psychology::Psychological Phenomena and Processes::Mental Processes::Perception::Body Image [Medical Subject Headings], business, Food Science
Abstract

Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m2 (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1, European Research Council (ERC) 340918, Recercaixa Grant 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Generalitat Valenciana PROMETEO/2017/017, SEMERGEN Grant, European Union (EU) European Cooperation in Science and Technology (COST) CA16112, Balearic Islands Government 35/2011, Balearic Islands Health Research Institute (IDISBA), European Union (EU) CIBEROBN CB06/03 CB12/03 PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056, European Commission Joint Research Centre EAT2BENICE_H2020_SFS2016, "Miguel Servet Type I" program from the ISCIII-Madrid (Spain) CP15/00028, ICREA under the ICREA Academia programme, Fernando Tarongi Bauza PhD Grant, FPU from the Ministry of Science, Innovation and Univesities FPU 18/01703, Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS), Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332

Published
2020

4. The Effectiveness of Different Doses of Iron Supplementation and the Prenatal Determinants of Maternal Iron Status in Pregnant Spanish Women: ECLIPSES Study

Author

Meritxell Pallejà, Victoria Arija, Josep Basora, Nuria Serrat, Estefania Aparicio, Francisca Ruiz, Francesc Fargas, Pilar Coronel, Núria Aranda, Lucía Vázquez, and Mercedes Gimeno

Subjects
Adult, Anemia, Iron, Physiology, lcsh:TX341-641, Article, law.invention, 03 medical and health sciences, Hemoglobins, Young Adult, 0302 clinical medicine, Randomized controlled trial, law, Pregnancy, hemic and lymphatic diseases, medicine, Humans, 030212 general & internal medicine, iron status, Hemochromatosis Protein, iron stores, 030219 obstetrics & reproductive medicine, Nutrition and Dietetics, Anemia, Iron-Deficiency, business.industry, iron supplementation, Pregnancy Complications, Hematologic, serum ferritin, nutritional and metabolic diseases, Prenatal Care, Iron deficiency, hemoglobin, medicine.disease, Hemoconcentration, hfe gene, Treatment Outcome, Iron-deficiency anemia, Spain, randomized controlled trial, Dietary Supplements, Ferritins, Female, Hemoglobin, Iron status, business, HFE gene, lcsh:Nutrition. Foods and food supply, Food Science
Abstract

Iron deficiency (ID), anemia, iron deficiency anemia (IDA) and excess iron (hemoconcentration) harm maternal&ndash, fetal health. We evaluated the effectiveness of different doses of iron supplementation adjusted for the initial levels of hemoglobin (Hb) on maternal iron status and described some associated prenatal determinants. The ECLIPSES study included 791 women, randomized into two groups: Stratum 1 (Hb = 110&ndash, 130g/L, received 40 or 80mg iron daily) and Stratum 2 (Hb &gt, 130g/L, received 20 or 40mg iron daily). Clinical, biochemical, and genetic information was collected during pregnancy, as were lifestyle and sociodemographic characteristics. In Stratum 1, using 80 mg/d instead of 40 mg/d protected against ID on week 36. Only women with ID on week 12 benefited from the protection against anemia and IDA by increasing Hb levels. In Stratum 2, using 20 mg/d instead of 40 mg/d reduced the risk of hemoconcentration in women with initial serum ferritin (SF) &ge, 15 &mu, g/L, while 40 mg/d improved SF levels on week 36 in women with ID in early pregnancy. Mutations in the HFE gene increased the risk of hemoconcentration. Iron supplementation should be adjusted to early pregnancy levels of Hb and iron stores. Mutations of the HFE gene should be evaluated in women with high Hb levels in early pregnancy.

Published
2019

5. Dietary intake in population with metabolic syndrome: is the prevalence of inadequate intake influenced by geographical area? cross-sectional analysis from PREDIMED-Plus Study

Author

Estefanía Toledo, Aurora Bueno-Cavanillas, Clotilde Vázquez, Andrés Díaz-López, Juan Manuel Zazo, Alfredo Gea, Josep A. Tur, M. Dolors Zomeño, Miguel A. Muñoz, Antonio Garcia-Rios, Miguel Ruiz-Canela, Lluis Serra-Majem, J. Alfredo Martínez, Montse Fitó, Lidia Daimiel, Pilar Matía, Jordi Salas-Salvadó, Emilio Ros, Francisco J. Tinahones, Dora Romaguera, Manoli Garcia-de-la-Hera, Laura García-Molina, Josep Vidal, Rebeca Fernández-Carrión, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Antoni Colom, Javier Díez-Espino, Josep Basora, Ramon Estruch, Naomi Cano-Ibáñez, José Lapetra, F. Javier Barón-López, Xavier Pintó, Naiara Cubelos-Fernández, and Angel M Alonso Gómez

Subjects
0301 basic medicine, Male, Síndrome metabòlica, cumplimiento del paciente, Cross-sectional study, humanos, ejercicio físico, Overweight, Diet, Mediterranean, Recommended Dietary Allowances, geografía, Nutrient, Clinical trials, Surveys and Questionnaires, Food choice, Prevalence, Medicine, Micronutrients, mediana edad, Dietoteràpia, Randomized Controlled Trials as Topic, 2. Zero hunger, education.field_of_study, anciano, Nutrition and Dietetics, sobrepeso, Geography, dieta, ensayos clínicos controlados aleatorizados como asunto, prevalencia, PREDIMED-Plus study, Middle Aged, Metabolic syndrome, 3. Good health, estado nutricional, Dietary Reference Intake, Place of residence, Female, medicine.symptom, evaluación nutricional, cantidad dietética recomendada, geographical area, lcsh:Nutrition. Foods and food supply, nutrient adequacy, Population, Nutritional Status, lcsh:TX341-641, metabolic syndrome, Article, 03 medical and health sciences, Environmental health, Humans, place of residence, cardiovascular diseases, Obesity, education, obesidad, Exercise, Aged, Geographical area, 030109 nutrition & dietetics, Nutrient adequacy, business.industry, Dietary intake, Diet therapy, micronutrientes, medicine.disease, Diet, Cross-Sectional Studies, Nutrition Assessment, Spain, Patient Compliance, business, dietary intake, Food Science, Assaigs clínics, estudios transversales
Abstract

Inadequate diet influences chronic diseases such as cardiovascular disease (CVD), the leading cause of death in Spain. CVD figures vary from one geographical region to another, this could be associated with different food choices. Our aim was to analyse the influence of geographical area on nutrient intakes among the Spanish adult population with Metabolic Syndrome (MetS). We analysed cross-sectional baseline data from the PREDIMED-Plus study: 6646 Spanish adults, aged 55&ndash, 75 years, with overweight/obesity and MetS in four geographical areas. A validated 143-item Food Frequency Questionnaire (FFQ) was used to assess energy and nutrient intakes. The prevalence of inadequate nutrient intake was estimated according to Dietary Reference Intakes (DRIs). Multivariable-adjusted logistic regression was used to assess the relationship between geographical area (North, Central, East and South areas) and inadequate nutrient intake. People in the North area consumed significantly lower amounts of vegetables and fish but more sugar and alcohol (p &lt, 0.001) than other areas. Dietary fibre, vitamin A, E, calcium and magnesium intakes were all lower among men of North area than in the other areas (p &lt, 0.001). Sex (women), non-smoker and physical activity were also associated to adequate nutrient intake. Geographical area influences nutrient intakes. Its effect on dietary quality should be taken into account when planning food policies.

Published
2018

6. Polymorphism of the Transcription Factor 7-Like 2 Gene (TCF7L2) Interacts with Obesity on Type-2 Diabetes in the PREDIMED Study Emphasizing the Heterogeneity of Genetic Variants in Type-2 Diabetes Risk Prediction: Time for Obesity-Specific Genetic Risk Scores

Author

Laura Quiles, José V. Sorlí, Miquel Fiol, Fernando Arós, Manuel Ortega-Calvo, Jordi Salas-Salvadó, Josep Basora, Ramon Estruch, Emilio Ros, Olga Portolés, Oscar Coltell, Dolores Corella, Miguel Ángel Martínez-González, Montserrat Fitó, Olga Castañer, Lluis Serra-Majem, Javier Díez Espino, Jose M. Ordovas, Enrique Gómez-Gracia, [Corella, Dolores] Univ Valencia, Sch Med, Dept Prevent Med & Publ Hlth, Valencia 46010, Spain, [Sorli, Jose V.] Univ Valencia, Sch Med, Dept Prevent Med & Publ Hlth, Valencia 46010, Spain, [Quiles, Laura] Univ Valencia, Sch Med, Dept Prevent Med & Publ Hlth, Valencia 46010, Spain, [Portoles, Olga] Univ Valencia, Sch Med, Dept Prevent Med & Publ Hlth, Valencia 46010, Spain, [Corella, Dolores] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Coltell, Oscar] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Sorli, Jose V.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Estruch, Ramon] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Quiles, Laura] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Angel Martinez-Gonzalez, Miguel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Salas-Salvado, Jordi] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Castaner, Olga] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Aros, Fernando] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Ortega-Calvo, Manuel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Serra-Majem, Lluis] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Gomez-Gracia, Enrique] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Portoles, Olga] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Fiol, Miquel] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Diez Espino, Javier] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Basora, Josep] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Fito, Montserrat] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Ros, Emilio] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Ordovas, Jose M.] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr, Madrid 28029, Spain, [Coltell, Oscar] Univ Jaume 1, Dept Comp Languages & Syst, Sch Technol & Expt Sci, Castellon de La Plana 12071, Spain, [Estruch, Ramon] IDIBAPS, Hosp Clin, Dept Internal Med, Barcelona 08036, Spain, [Angel Martinez-Gonzalez, Miguel] Univ Navarra, Dept Prevent Med & Publ Hlth, Navarra Inst Hlth Res IdisNa, Pamplona 31009, Spain, [Salas-Salvado, Jordi] Univ Rovira & Virgili, Human Nutr Unit, Dept Biochem & Biotechnol, IISPV, Reus 43003, Spain, [Basora, Josep] Univ Rovira & Virgili, Human Nutr Unit, Dept Biochem & Biotechnol, IISPV, Reus 43003, Spain, [Castaner, Olga] Hosp del Mar Med Res Inst IMIM, Cardiovasc Risk & Nutr Res Grp, Barcelona 08003, Spain, [Fito, Montserrat] Hosp del Mar Med Res Inst IMIM, Cardiovasc Risk & Nutr Res Grp, Barcelona 08003, Spain, [Aros, Fernando] Hosp Txagorritxu, Dept Cardiol, Vitoria 01009, Spain, [Ortega-Calvo, Manuel] Ctr Salud Palmeritas, Dept Family Med, Dist Sanitario Atenc Primaria Sevilla, Seville 41003, Spain, [Serra-Majem, Lluis] Univ Las Palmas Gran Canaria, Res Inst Biomed & Hlth Sci, Las Palmas Gran Canaria 35001, Spain, [Gomez-Gracia, Enrique] Univ Malaga, Sch Med, Dept Epidemiol, E-29071 Malaga, Spain, [Fiol, Miquel] Hosp Son Espases, Palma Inst Hlth Res IdISPa, Palma De Mallorca 07014, Spain, [Diez Espino, Javier] Univ Navarra, Dept Prevent Med & Publ Hlth, Navarra Inst Hlth Res IdisNA, Serv Navarro Salud Osasunbidea, Pamplona 31009, Spain, [Ros, Emilio] Hosp Clin Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Lipid Clin, Endocrinol & Nutr Serv, E-08036 Barcelona, Spain, [Ordovas, Jose M.] Tufts Univ, Nutr & Genom Lab, JM USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA, [Ordovas, Jose M.] CNIC, Dept Cardiovasc Epidemiol & Populat Genet, Madrid 28029, Spain, [Ordovas, Jose M.] IMDEA Alimentac, Madrid 28049, Spain, Spanish Ministry of Health (Instituto de Salud Carlos III), Ministerio de Economia y Competitividad-Fondo Europeo de Desarrollo Regional, University Jaume I, Generalitat Valenciana, FEDER funds, U.S. Department of Agriculture-Agricultural Research Service (ARS), Alimentació, Nutrició, Creixement i Salut Mental, Departament de Medicina i Cirurgia, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), Jaume I University (España), Generalitat Valenciana (España), Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), and United States Department of Agriculture. Agricultural Research Service

Subjects
0301 basic medicine, Oncology, Male, obesity, endocrine system diseases, Type 2 diabetes, type-2 diabetes, Transcription Factor 7-Like 2, Dieta mediterrània, 0302 clinical medicine, Nutrigenomics, Risk Factors, Prevalence, TCF7L2-predictive value, Disease, Longitudinal Studies, Prospective Studies, Genetic risk, Genetics, Aged, 80 and over, INSULIN-RESISTANCE, Bioquímica y tecnología, Nutrition and Dietetics, Diabetis, Incidence, Middle Aged, Traits, MEDITERRANEAN DIET, Biochemistry and technology, Obesitat, TRIAL, Female, lcsh:Nutrition. Foods and food supply, Transcription Factor 7-Like 2 Protein, Adult, Genetic Markers, medicine.medical_specialty, endocrine system, Population, BODY-FAT, lcsh:TX341-641, 030209 endocrinology & metabolism, MASS, Bioquímica i biotecnologia, Article, Association, 03 medical and health sciences, Genetic Heterogeneity, Predictive Value of Tests, Internal medicine, Diabetes mellitus, medicine, Humans, Genetic Predisposition to Disease, Gene, Aged, Polymorphism, Genetic, business.industry, Common variants, Prevention, nutritional and metabolic diseases, Genetic Variation, PREDIMED study, medicine.disease, 2072-6643, Weight, Predimed, Obesity, TCF7L2, T2D-genetic risk scores, 030104 developmental biology, Diabetes Mellitus, Type 2, Susceptibility loci, business, Food Science
Abstract

Nutrigenetic studies analyzing gene-diet interactions of the TCF7L2-rs7903146 C > T polymorphism on type-2 diabetes (T2D) have shown controversial results. A reason contributing to this may be the additional modulation by obesity. Moreover, TCF7L2-rs7903146 is one of the most influential variants in T2D-genetic risk scores (GRS). Therefore, to increase the predictive value (PV) of GRS it is necessary to first see whether the included polymorphisms have heterogeneous effects. We comprehensively investigated gene-obesity interactions between the TCF7L2-rs7903146 C > T polymorphism on T2D (prevalence and incidence) and analyzed other T2D-polymorphisms in a sub-sample. We studied 7018 PREDIMED participants at baseline and longitudinally (8.7 years maximum follow-up). Obesity significantly interacted with the TCF7L2-rs7903146 on T2D prevalence, associations being greater in non-obese subjects. Accordingly, we prospectively observed in non-T2D subjects (n = 3607) that its association with T2D incidence was stronger in non-obese (HR: 1.81; 95% CI: 1.13-2.92, p = 0.013 for TT versus CC) than in obese subjects (HR: 1.01; 95% CI: 0.61-1.66; p = 0.979; p-interaction = 0.048). Accordingly, TCF7L2-PV was higher in non-obese subjects. Additionally, we created obesity-specific GRS with ten T2D-polymorphisms and demonstrated for the first time their higher strata-specific PV. In conclusion, we provide strong evidence supporting the need for considering obesity when analyzing the TCF7L2 effects and propose the use of obesity-specific GRS for T2D., This study was funded by the Spanish Ministry of Health (Instituto de Salud Carlos III) and the Ministerio de Economia y Competitividad-Fondo Europeo de Desarrollo Regional (projects PI051839, PI070240, PI1001407, G03/140, CIBER 06/03, RD06/0045 PI07-0954, CNIC-06, PI11/02505, SAF2009-12304, AGL2010-22319-C03-03, and PRX14/00527; contract JR14/00008), by the University Jaume I (Project P1-1B2013-54) and by the Generalitat Valenciana (AP111/10, AP-042/11, BEST/2015/087, GVACOMP2011-151, ACOMP/2011/145, ACOMP/2012/190, and ACOMP/2013/159). CIBEROBN is an initiative of Institute of Health Carlos III of Spain which is supported by FEDER funds (CB06/03). This material is based upon work supported by the U.S. Department of Agriculture-Agricultural Research Service (ARS), under Agreement No. 58-1950-4-003. Dolores Corella acknowledges the collaboration of the Real Colegio Complutense at Harvard University, Cambridge. MA, USA. The PREDIMED study was registered at controlled-trials.com (http://www.controlledtrials.com/ISRCTN35739639; ethics approval by the Institutional Review Board of the Hospital Clinic at Barcelona, Spain, 16/07/2002, under the protocol number G03/140). The Institutional Review Board of each participating center approved the study protocol, and all participants provided written informed consent. The Institutional Review Board of the Valencia University (protocol number G03/140, 22/05/2003) approved the PREDIMED-Valencia study protocol, and all participants provided written informed consent.

Published
2016

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