Compliance with dietary guidelines in the Spanish population. Results from the Catalan Nutrition Survey

Compliance with the European and national nutritional objectives in a Mediterranean population

OBJECTIVE

To analyze compliance with the current European and Spanish nutritional objectives in a representative sample from Catalonia, a Spanish Mediterranean region; and to examine relationships between diet and plasma fatty acid composition.

DESIGN

Cross-sectional nutritional survey.

SETTING

Population based random sample derived from the Catalan Nutrition Survey.

SUBJECTS

A total of 516 healthy adult men (n=203) and women (n=313).

METHODS

Dietary habits were assessed by means of a quantitative food frequency questionnaire. A physical exam included height, weight, waist and hip circumferences, and a fasting blood draw.

RESULTS

Gender differences were observed in nutrient and energy intakes. Women showed a better compliance with the nutritional recommendations for monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid (PUFA) than did men. Men showed a better compliance for saturated fatty acid (SFA) and carbohydrate than did women. However, the SFA:MUFA:PUFA ratio was similar in both gender (1.6:2.3:1.0 for men; 1.7:2.5:1.0 for women). The highest compliance was observed for nutritional goals of sodium, calcium and fruit and vegetable intakes for both genders. In addition, the present study showed that levels of certain fatty acids in plasma are clearly associated with dietary intake of foods rich in these components. The highest correlations were found for n-3 long chain polyunsaturated fatty acids with blue fish intake in both men and women (r (men)=0.36 and r (women)=0.42; P<0.001).

CONCLUSIONS

The diet followed in Catalonia seems to ensure compliance with most of the intermediate nutritional objectives for the Spanish population. However, a reduction in the SFA intake and an increase in the carbohydrate intake could be recommended in order to reduce the current prevalence of overweight and obesity in this Mediterranean region.

SPONSORSHIP

This study was supported by the Catalan Department of Health, the Nutrition Catalan Centre of the Institute of Catalan Studies, and Mercadona SA.

Mediterranean Diet and Health: Is all the Secret in Olive Oil?

OBJECTIVE

The purpose of this study was to review and analyze the synergies of olive oil related food consumption and nutrient intake in a Mediterranean region.

DESIGN

Cross sectional study by face to face interview.

SETTING

Population based random sample derived from the Catalan Nutrition Survey.

SUBJECTS

1600 individuals between 18 and 60 years of age.

INTERVENTION

Two 24-hour recalls were administered to measure food and nutrient intakes. Food group consumption and nutrient intakes ratios between the highest(greater than 13.5% of total calories, 4th quartile)and lowest quartiles (less than 6.8% of total calories,1st quartile) of olive oil consumption were calculated.

RESULTS

Comparing the highest quartile of olive oil consumption to the lowest, the highest ratios by food group consumption were observed for eggs, vegetables and fish in both men and women and non fried potatoes in women only. Lower ratios were associated in both sexes with soft drinks, commercially baked goods, processed meat and full fat milk and nuts in women only, and fried potatoes in men only. Analysis by nutrients showed higher ratios for carotenoids,monounsaturated fatty acids, vitamin E and folic acid in both sexes and Vitamin C and polyunsaturated fatty acids in women only. Lower ratios were seen for mono,di and polysaccharides, saturated fat, retinol and sodium in both genders and calcium niacin, thiamin,riboflavin and fibre in men only.

CONCLUSION

Olive oil is a key contributor to the healthy aspects attributed to the Mediterranean diet, since its own health attributes may be added to those of foods that it's commonly served with (fish, vegetables), thus contributing to its thrombosis related disease preventive properties. As such, nutritional objectives in Mediterranean countries should address reducing saturated fats, without modifying quantities of olive oil,and increasing fish, vegetables and nuts.

Food Consumption Patterns in a Mediterranean Region: Does the Mediterranean Diet Still Exist?

AIMS

To assess the food consumption patterns in the adult population of a Mediterranean region: the Balearic Islands (BI).

METHODS

A cross-sectional nutritional survey was carried out in the BI between 1999 and 2000. A random sample (n = 1,200) of the adult population (16-65 years) was interviewed. Dietary habits were assessed by means of 24-hour recall during 2 non-consecutive days, the first in the warm season and the second in the cold season, and a quantitative food frequency questionnaire. Anthropometric measurements were also obtained.

RESULTS

Current food patterns in the BI are characterized by a prominent consumption of dairy products, vegetables, fruit, bread, soft drinks and meat. According to the dietary guidelines for the Spanish population, only appropriate consumption of olive oil and other fats, dairy products, nuts, and soft drinks have been achieved. Intakes of fruit, vegetables, fish, eggs, pulses, cereals and potatoes are below desirable levels. On the other side, intakes of sugary products, sweets and cakes are higher than desirable. Alcohol intake, in the context of the Mediterranean diet, can be considered as acceptable.

CONCLUSIONS

The dietary patterns observed among the BI population are in harmony with the actual dietary trends in Spain and other Mediterranean countries. Mediterranean dietary habits still exist, but a progressive departure from the traditional Mediterranean diet is being observed mainly in younger generations. It would be desirable to increase the consumption of fish, vegetables, fruit, cereals and pulses and decrease the intake of food sources containing saturated fat.

Olive oil and the Mediterranean diet: beyond the rhetoric

OBJECTIVE

The purpose of this study was to analyze the association of food, nutrient and energy intakes with olive oil consumption in Spain.

DESIGN

Cross-sectional study by face-to-face interview.

SETTING

Population-based random sample derived from the Catalan Nutrition Survey.

SUBJECTS

In total, 1600 individuals between 18 and 60 y of age.

INTERVENTION

Two 24-h recalls were administered to measure food and nutrient intakes. Food consumption and nutrient intakes were analyzed comparing the highest and lowest quartiles of olive oil consumption.

RESULTS

Those with the highest consumption of olive oil (greater than 13.5% of total calories, fourth quartile) consumed less cereal, baked goods, whole milk, sausages, candy, fruit juice and soft drinks, but more fish, eggs, vegetables and added fats, as compared to those with the lowest olive oil consumption (less than 6.8% of total calories, first quartile). The group with the greatest olive oil consumption also demonstrated high total fat intake, although saturated fats showed a lower percentage of total energy intake. Vitamin intake was more adequate in those with the highest consumption of olive oil.

CONCLUSION

Olive oil is a key contributor to the healthy aspects attributed to the Mediterranean diet, and as such, nutritional objectives in Mediterranean countries should address reducing saturated fats, without modifying quantities of olive oil.

Spanish children's diet: compliance with nutrient and food intake guidelines

OBJECTIVE

To compare the diet of Spanish children against the nutrient and food intake guidelines. To calculate an index of overall diet quality and check its validity against nutrient intake.

DESIGN AND SETTING

Cross-sectional study in four cities in Spain, where information on food and nutrient intake was obtained from schoolchildren through a food frequency questionnaire.

PARTICIPANTS

The sample included 1112 children (overall response rate of 85%) attending public and private schools and aged 6-7 y. Children were selected through random cluster sampling in schools, and stratified by sex and socioeconomic level.

MAIN OUTCOME MEASURES

Mean nutrient intake, number of food servings, and the percentage of children who meet recommended nutrient and food-serving intake levels. The overall dietary quality was assessed using the Healthy Eating Index (HEI).

RESULTS

Mean micronutrient intake exceeded 100% of the recommended dietary allowances, except for vitamin B6, which registered a mean intake of 77.1%. For almost all children, intake of saturated fat was above, and that of carbohydrate below, the recommended level, in contrast to the relatively high compliance with the recommendations for poly- and monounsaturated fatty acid, salt and fiber intake (69.7, 43.7, 40.7, and 30.1%, respectively). Consumption of food servings for each of the five American pyramid food groups came close to or exceeded USDA guidelines, with the exception of cereals, with 5.4 servings per day. The mean score obtained in the HEI was 64.6. Children who complied with all the food guide pyramid recommendations registered a higher dietary variety and a healthier nutritional profile.

CONCLUSIONS

Children aged 6-7 y show scant compliance with the macronutrient goals for healthy eating. Micronutrient intake is adequate in general, yet there are small groups of children with risk of deficient intake of vitamins B6 and D. While Spanish children's eating habits are reasonably in line with American food guide pyramid guidelines, consumptions of cereals and fruit should be improved.

A comparison of five questionnaires to assess alcohol consumption in a Mediterranean population

OBJECTIVE

To evaluate the reliability of alcohol consumption measured by five different dietary methods in the Catalan Nutrition Survey (1992-1993).

DESIGN

The different questionnaires used were: (1) two 7-day food records, (2) five items addressing alcoholic beverages in a 76-item food-frequency questionnaire, (3) a 1-week recall of 13 alcoholic beverages, (4) a 13-item alcoholic beverages frequency questionnaire and (5) two 24-hour recalls.

SUBJECTS

Ninety-three of the 120 adults (aged 20 to 70 years) initially recruited completed the questionnaires and provided a peripheral blood sample.

RESULTS

Mean daily alcohol intakes as assessed by the questionnaires were very similar. Beer was the alcoholic beverage most frequently consumed, followed by wine and liquor. Eighty-two per cent of the study population consumed less than 20 g of alcohol per day. No biochemical parameters were significantly correlated with alcohol intake estimated from the questionnaires.

CONCLUSIONS

We found a satisfactory level of reproducibility and validity in the pattern of alcohol consumption across different levels and types of alcoholic beverage intake. We also found that the self-administered 13-item questionnaire and the 1-week recall were the best techniques to measure moderate or low alcohol consumption, suggesting that the two methods are the most suitable to assess overall alcohol intake in the general population.

Nutrition, physical activity and health status in Europe: an overview

INTRODUCTION

The European diet is characterized by a wide variation in every aspect of eating from the timing of meals to the composition of meals. In general, there is a tendency in terms of dietary advice towards lower fat intakes in order to reduce saturated fatty acid intake and to reduce the risk of obesity. Such diets are most successful and yield the most favourable metabolic profile when there is an adequate level of physical activity.

OBJECTIVE

The aim of the present paper was to explore how the composition of dietary fat changes across the EU with low- and high-fat diets and to explore levels of physical activity and attitudes to physical activity across the EU.

DESIGN

The paper draws on data contained in reports and supplements of the Institute of European Food Studies in the EU.

RESULTS

There is a clear trend for southern EU states to have higher MUFA intakes and lower SFA intakes than northern ELJ states. However, for both geographic regions, the fatty acid composition of dietary fat was similar in groups with lower or higher dietary fat intakes. Physical activity was ranked low by consumers (n= 15,000) for its importance in relation to health and the prevention of weight-gain. Some 47% agreed that their present level of physical activity is sufficient. 78% agreed that being 13 kg heavier would not be detrimental to health and 30% agreed that the main benefit of physical activity was to relieve stress.

CONCLUSIONS

(i) The present strategy of lowering dietary fat intake does not alter dietary fat composition and (ii) there is a high level of ignorance among consumers of the benefits of physical activity and the adverse effects of excess body-weight.

Optimal macronutrient balance

There is at present a justifiable debate as to the optimum level of total dietary fat which will reduce the risk of obesity without an elevation of plasma triacylglycerol or a depression of plasma HDL-cholesterol. Total plasma cholesterol and LDL-cholesterol levels are lowered and risk of fatal myocardial infarction is lowered when either saturated or trans-unsaturated fatty acids are replaced isoenergetically by either monounsaturated or polyunsaturated fatty acids. The triacylglycerol-raising and HDL-lowering effects of low-fat high-carbohydrate diets can be overcome with low intakes of n-3 polyunsaturated fatty acids and moderate exercise. Whilst a reduction in dietary fat is being attained in many countries, the reduction is uniform across all fatty acids, leaving dietary fat composition unchanged. The ability of low-fat diets to reduce cholesterol and cause a fall in body weight is not influenced by the carbohydrate ratio starch: sugars in the diet. However, weight-gain susceptibility to high intakes of dietary fat and the plasma cholesterol responsiveness to diet are considerably influenced by common genetic polymorphisms.