Dietary Intake in Population with Metabolic Syndrome: Is the Prevalence of Inadequate Intake Influenced by Geographical Area? Cross-Sectional Analysis from PREDIMED-Plus Study

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 55–75 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 < 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 < 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.

Adherence to the Mediterranean Diet Is Inversely Associated with the Prevalence of Metabolic Syndrome in Older People from the North of Spain

“…Vegetable consumption according to the recommendations was low (17.0%), coinciding with the consumption data of the Spanish population, where it was indicated that, although it is the elderly population that consumes the most vegetables, Cantabria is the Spanish region where vegetable consumption is the lowest [ 39 ]. This also coincides with the results of the PREDIMED-Plus study [ 85 ], according to which vegetable consumption in the northern area was significantly lower than in the other areas studied. Vegetable consumption was higher in women (21.1%) relative to men (10.7%, p < 0.05; Table S1 ), which could be related to the fact that it is common for women to make dietary modifications with the objective of body weight control, significantly raising their vegetable consumption relative to men [ 34 ].…”

Dietary Fat Intake and Metabolic Syndrome in Older Adults

“…Women with MetS showed more energy intake from protein than those without MetS (18% vs. 16.9%, respectively) ( p < 0.01), but both were within recommended ranges [26,27]. A similar nutrient distribution among Spanish population with MetS [32] and healthy adults has been previously shown [8]. Differences were also previously observed between subjects with and without MetS for total energy intake, sugar intake, dietary glycemic load, percentage of dietary protein, PUFA, and fiber intake [33].…”

“…Total sugar intake was also quantified in the ANIBES study: results were higher in children (17.18%) and adolescents (16.33%) and markedly lower in adults (15.34%) and older adults (12.97%) [8]. The inhabitants of Northern Spain, especially men, consumed more sugar and sweets than adult from other Spanish areas [32]. Conversely, the World Health Organization (WHO) recommended <10% of energy intake be provided by sugars [34], whereas <5% has been recommended in the United Kingdom [35].…”

The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription

“…Research aimed at evaluating the combined benefits achieved by associating the Mediterranean eating pattern with systematic induction of weight loss is also under way. A large randomized clinical trial, PREDIMED-PLUS, conducted by the same team of Spanish investigators as PREDIMED and using the same type of Mediterranean-style dietary interventions combined with a three-point weight-loss intervention consisting of restriction of energy intake, physical activity recommendations, and behavioral modifications, finished randomization of 6874 participants in December 2016 and is expected to close in March 2022; design of the study, some baselines, and cross-sectional analyses in PREDIMED-PLUS have recently been published [102,103,104,105,106].…”