BackgroundThis study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults.MethodsThis is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55–75 years, BMI 27–40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults.ResultsInactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05).ConclusionsInactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health.Trial registrationThe trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

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 Nutrients 2020, 12, 1013 3 of 20 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 aim of the study was to evaluate sleep duration and sleep variability in relation to serum uric acid (SUA) concentrations and SUA to creatinine ratio. This is a cross-sectional analysis of baseline data from 1842 elderly participants with overweight/obesity and metabolic syndrome in the (Prevención con Dieta Mediterránea) PREDIMED-Plus trial. Accelerometry-derived sleep duration and sleep variability were measured. Linear regression models were fitted to examine the aforementioned associations. A 1 hour/night increment in sleep duration was inversely associated with SUA concentrations (β = −0.07, p = 0.047). Further adjustment for leukocytes attenuated this association (p = 0.050). Each 1-hour increment in sleep duration was inversely associated with SUA to creatinine ratio (β = −0.15, p = 0.001). The findings of this study suggest that longer sleep duration is associated with lower SUA concentrations and lower SUA to creatinine ratio.

The aim of this study was to identify determinants of the nutrition labelling (NL) use and explore its association with the adherence to Mediterranean Diet (MD) in Spanish health university students. We performed a cross-sectional analysis of the baseline data from 1026 university students aged 17–35 years enrolled in the DiSA-UMH (Dieta, Salud y Antropometría-Universidad Miguel Hernández) cohort study. Students were asked about their NL use by the following question: “Do you usually read the nutrition labelling of packaged foods?” (No, Yes). Dietary intake was assessed using a validated food frequency questionnaire and the adherence to MD was measured by relative Mediterranean Diet score (rMED). Socio-demographic, lifestyle, and anthropometric variables were also collected. Multiple logistic regression models were applied for the analysis. Fifty-eight percent of the students were NL users and were most likely to be women (Odds Ratio (OR): 1.38; 95% Confidence Interval (CI): 1.01–1.89), be older (OR per year: 1.08; 95% CI: 1.03–1.13), be physically active/very active (OR: 1.68; 95% CI: 1.17–2.41), and spend less time watching television (OR per hour: 0.84; 95% CI: 0.74–0.95). After adjusting for potential confounding factors, our findings suggested that those university students who had higher adherence to MD used NL greatly (OR per 2 points increase: 1.30; 95% CI: 1.18–1.43) and had a larger consumption of fish (OR per 100 g/day: 1.94; 95 CI: 1.38–2.71), vegetables (OR per 100 g/day: 1.15; CI 95%: 1.08–1.12), and fruits (OR per 100 g/day: 1.22; 1.11–1.34) and a smaller intake of meats (OR per 100 g/day: 0.76; 95% CI: 0.58–0.99). Our approach contributes to exploring the role of NL use as a suitable tool to make healthier food choices from a different wider perspective based on dietary patterns such as MD, which can also indicate an overall healthy lifestyle. Given the lack of research in Mediterranean areas, further studies focused on exploring the potential role of NL in promoting healthy dietary habits are required.

Scope To examine the association between milk and dairy products intake and the prevalence of cognitive decline among Spanish individuals at high cardiovascular risk. Methods and results Cross‐sectional analyses are performed on baseline data from 6744 adults (aged 55–75 years old). Intake of milk and dairy products is estimated using a food frequency questionnaire grouped into quartiles. The risk of developing cognitive impairment is based on the Mini‐Mental State Examination (MMSE). A higher prevalence of cognitive decline was found in subjects who consumed more grams. Patients with worse MMSE score (10–24) consumed a mean of 395.14 ± 12.21 g, while patients with better MMSE score (27–30) consumed a mean of 341.23 ± 2.73 g (p < 0.05). Those subjects with the lower milk consumption (<220 g/day) had a higher MMSE score (28.35 ± 0.045). Higher intake of fermented dairy products was observed in participants with a lower MMSE score (OR 1.340, p = 0.003). A positive correlation was found between the consumption of whole milk and the MMSE score (r = 0.066, p < 0.001). Conclusions These findings suggest that greater consumption of milk and dairy products could be associated with greater cognitive decline according to MMSE. Conversely, consumption of whole‐fat milk could be linked with less cognitive impairment in the cross‐sectional study.

Tools to assess diet in a reliable and efficient way are needed, particularly in children and adolescents. In this study, we assess the reproducibility and validity of a semiquantitative food frequency questionnaire (FFQ) among adolescents in Spain. We analyzed data of 51 male adolescents aged 15–17 years from a prospective birth cohort study. Participants answered the FFQ twice in a self-administered way over a 12-month period. Reproducibility was assessed by comparing nutrient and food intakes from the FFQs, and validity by comparing nutrient intakes from the average of two FFQs and the average of two 24-Hour Dietary Recalls obtained in the period. Pearson correlation coefficients were calculated. The average of reproducibility correlation coefficients for food group intakes was 0.33, with the highest correlation for vegetable intake (r = 0.81); and the average for nutrient intake was 0.32, with the highest coefficients for α- and β-carotene (r = 0.65). Validity correlation coefficients ranged from 0.07 for carbohydrates to 0.53 for dietary fiber. The average of the validity correlation coefficients was r = 0.32. This study suggests that our FFQ may be a useful tool for assessing dietary intake of most nutrient and food groups among Spanish male adolescents in a self-administered way, despite reproducibility and, particularly validity, being low for some nutrients and food groups.

Coffee consumption is highly prevalent worldwide, and many studies have reported positive and inverse associations of coffee with many diseases. However, factors associated with coffee consumption remain poorly characterized in some populations, such as the elderly. This study aimed to assess the factors associated with total, caffeinated and decaffeinated coffee consumption in an elderly population in Spain. Data were analyzed from 903 participants, aged 65 years and above, from two population-based studies carried out in the Valencia region in Spain (Valencia Nutritional Survey (VNS) and European Eye Study (EUREYE-Study). Total, caffeinated and decaffeinated coffee consumption was assessed through two specific questions using a validated food frequency questionnaire. Information on personal characteristics, anthropometry and lifestyles was collected in personal interviews. Multinomial logistic regression analysis was used to estimate the adjusted relative risk ratios (RRR) and confidence intervals (95% CI). The prevalence of total, caffeinated and decaffeinated coffee consumption was 70%, 38% and 32%, respectively. The consumption of caffeinated coffee was positively associated with: Educational level, RRR = 1.63 (1.09–2.44); body mass index (≥30), RRR = 2.03 (1.05–3.95); tobacco smoking, RRR = 1.96 (1.13–3.39); alcohol intake [≥12 g/day category intake vs. no-alcohol intake, RRR = 6.25 (3.56–10.95)]; and energy intake (p < 0.05). Consumption of caffeinated coffee was negatively associated with: Age (≥75 years), RRR = 0.64 (0.43–0.94); and pre-existing hypertension, RRR = 0.67 (0.45–0.98). The consumption of decaffeinated coffee was positively associated with: Alcohol intake, RRR = 2.63 (1.19–4.64); pre-existing diabetes, RRR = 1.67 (1.06–2.62); and energy intake (p < 0.01). The consumption of coffee is high among elderly people in Spain. It is a novelty in this study with elderly population that tobacco smoking and alcohol drinking were the two main factors associated with higher coffee consumption. Self-reported hypertension was associated with a lower consumption of caffeinated coffee, and pre-existing diabetes was associated with a higher consumption of decaffeinated coffee. These associations should be taken into account when the health effects of coffee consumption are investigated.

Background: Folate is involved in different metabolic processes such as the homocysteine metabolism, regulatory changes in genes related to lipid metabolism and the endothelial function, and its deficiency has been related to the risk of Metabolic Syndrome (MetS). We examined the association between folate intake and a score of MetS and its components among older adults at higher cardiometabolic risk participating in the PREDIMED-Plus trial. Methods:A cross-sectional analysis with 6633 overweight/obesity participants with MetS was conducted. Folate intake (per 100 mcg/day and in quintiles) was estimated using a validated food frequency questionnaire. We calculated a MetS score using the standardized values as shown in the formula: [(body mass index + waist-to-height ratio)/2] + [(systolic blood pressure + diastolic blood pressure)/2] + plasma fasting glucose -HDL cholesterol + plasma triglycerides. The MetS score as continuous variable and its seven components were the outcome variables. Multiple robust linear regression using MM-type estimator was performed to evaluate the association adjusting for potential confounders. Results:We observed that an increase in energy-adjusted folate intake was associated with a reduction of MetS score (β for 100 mcg/day=-0.12; CI 95%: -0.19 to -0.05), and plasma fasting glucose (β=-0.03; CI 95%: -0.05 to -0.02) independently of the adherence to Mediterranean diet and other potential confounders. We also found a positive association with HDL-cholesterol (β=0.07; CI 95%:0.04 to 0.10). These associations were also observed when quintiles of energy-adjusted folate intake were used instead. Conclusion:This study suggests that a higher folate intake may be associated with a lower MetS score, a lower plasma fasting glucose, and a greater HDL cholesterol in high-risk cardio-metabolic subjects.