Adherence to the Mediterranean diet in first-year university students and its association with lifestyle-related factors: A cross-sectional study

INTRODUCTION

Students' dietary habits are moving from Mediterranean diet guidelines towards unhealthy eating patterns. The aim of this study was to determine adherence to the Mediterranean diet in a sample of Spanish university students and its association with lifestyle factors.

MATERIAL AND METHODS

A descriptive cross-sectional study was conducted with 685 university students who completed a self-report questionnaire. The data collected included demographic characteristics, dietary habits, smoking habits, alcohol consumption and physical activity. Mediterranean diet adherence was assessed by measuring the consumption of the foods that compose this type of diet through a score (range 0-10). Adherence to the Mediterranean diet was considered poor, average, or good.

RESULTS

The mean adherence score for the Mediterranean diet was 4.9 (1.2) points out of 10. A higher degree of adherence to the Mediterranean diet was observed in physically active students (OR=2.31, 95% CI: 1.05-5.10; p=0.038). Students who performed ≥150min/week of physical activity (OR=0.45, 95% CI: 0.33-0.62; p<0.001) and those over 25 years old (OR=0.44, 95% CI: 0.26-0.73; p=0.002) were less prone to low adherence to the Mediterranean diet than sedentary and younger students.

CONCLUSION

The university students have poor adherence to the Mediterranean diet. The results of the current study indicate that age and physical activity are associated with Mediterranean diet adherence. It is urgent to raise awareness among university students and implement intervention programmes promoting a healthy lifestyle.

Food consumption patterns related to excess weight and obesity in Spanish preschoolers

PURPOSE

The aims of this study were (1) to identify the different food consumption patterns among Spanish preschoolers and (2) to examine the association between having a different food consumption pattern and the odds of having excess weight (i.e., overweight or obesity) or obesity among this population.

METHODS

This was a nationwide cross-sectional study with data from the Spanish National Health Survey-2017. All preschoolers (aged 3-5 years) with complete information on all the variables analyzed were selected. The frequency of consumption of the fourteen food groups was evaluated by a food frequency questionnaire. Excess weight/obesity were computed following the World Health Organization criteria. A hierarchical cluster analysis using Ward's method (i.e., based on squared Euclidean distances) and k-means were performed including all food group consumption. A total sample of 663 was included in the cluster analysis.

RESULTS

Three different clusters were established. Compared to the healthiest food consumption pattern (Cluster 1), higher odds of excess weight (OR = 1.51; CI: 95%, 1.02-2.25) and obesity (OR = 1.59; CI: 95%, 1.01-2.51) were found for participants with the unhealthiest food consumption pattern (Cluster 3).

CONCLUSION

Having a food consumption pattern considered unhealthy (i.e., low intake of vegetables/fruits, high consumption of confectionery products, sugar-sweetened beverages, fast-food, and snacks) was associated with presenting excess weight/obesity among Spanish preschoolers.

IMPACT

No studies have examined the specific food consumption patterns associated with excess weight or obesity among Spanish preschoolers. The unhealthiest food consumption pattern was characterized by a food consumption pattern that included a lower intake of vegetables and fruits and a higher consumption of confectionery products, sugar-sweetened beverages, fast-food, and snacks. Having a food consumption pattern considered unhealthy was associated with a higher prevalence of excess weight and obesity in comparison with other healthier food consumption patterns.

Beneficial Impact of Pork Dry-Cured Ham Consumption on Blood Pressure and Cardiometabolic Markers in Individuals with Cardiovascular Risk

Background: Evidence suggests that bioactive peptides reduce hypertension and affect certain metabolic pathways. Methods: Fifty-four volunteers with stage 1 prehypertension and/or hypercholesterolemia and/or basal glucose >100 mg/dL were recruited and randomized to pork dry-cured ham (n = 35) or cooked ham (placebo group; n = 19) for 28 days. After a wash-out period, meat products were changed for 28 additional days. Bioactive peptides composition and enzyme inhibitory activities of both products were characterized. Treatment comparisons for the main effects were made using a two (treatment) × two (times) repeated measures minus the effect of cooked ham (placebo). Results: 24 h mean systolic and diastolic pressures decreased up to 2.4 mmHg in the dry-cured ham period (treatment effect, p = 0.0382 y p = 0.0233, respectively) as well as the number of systolic pressure measures > 135 mmHg (treatment effect, p = 0.0070). Total cholesterol levels also decreased significantly after dry-cured ham intake (p = 0.049). No significant differences were observed between the two treatments for basal glucose, HOMA-IR index and insulin levels (p > 0.05). However, a significant rise of ghrelin levels was observed (treatment effect, p = 0.0350), while leptin plasma values slightly decreased (treatment effect, p = 0.0628). Conclusions: This study suggested the beneficial effects of regular dry-cured ham consumption on the improvement of systolic/diastolic blood pressures and facilitated the maintenance of metabolic pathways, which may be beneficial in the primary prevention of cardiovascular disease.

Multifunctional Peptides from Spanish Dry-Cured Pork Ham: Endothelial Responses and Molecular Modeling Studies

Food peptides contain a very wide range of diversified structures, which explains their diverse range of functional activities. Proatherogenic endothelium is related to vasoconstriction, inflammation, and oxidative stress. In this line, four synthetic bioactive peptides from dry-cured pork ham, previously identified according to their Angiotensin I Converting Enzyme (ACE) inhibitory capacity and high bioavailability, were tested. Among them, KPVAAP displayed an estimated IC₅₀ of 59.22 µM for human ACE inhibition, and docking simulations demonstrated the consistency of the noncompetitive binding with the protein. The addition of synthetic peptides to human endothelial cells significantly prevents the expression of genes related to endothelial dysfunction and inflammation (eNOS, ICAM-1, VCAM-1, IL-6) and lowers NF-κB activation (all p < 0.05). In silico dockings showed that the four bioactive peptides interact with the regulatory subunit NEMO of the NF-κB transcription factor at the same site as other characterized inhibitors (CC2-LZ region). This is the first study linking experimental and computational approaches that shows NF-κB to be the target of biopeptides of food origin. These multifunctional peptides from dry-cured pork ham make them good candidates for further research into their therapeutic or preventive use to attenuate the inflammatory atherosclerotic process.

Correlation of Blood Pressure Variability as Measured By Clinic, Self-measurement at Home, and Ambulatory Blood Pressure Monitoring

BACKGROUND

Blood pressure variability (BPV) has been postulated as a potential predictor of cardiovascular outcomes. No agreement exists as to which measurement method is best for BPV estimation. We attempt to assess the correlation between BPV obtained at the doctor's office, self-measurement at home (SMBP) and ambulatory BP monitoring (ABPM).

METHODS

Eight weekly clinic BP measurements, 2 SMBP series, and 1 24-hour ABPM recording were carried out in a sample of treated hypertensive patients. BPV was calculated using the SD, the "coefficient of variation" and the "average real variability." Determinants of short-, mid-, and long-term BPV (within each measurement method) were also calculated. The different BPV determinants were correlated "intramethod" and "intermethod" by linear regression test.

RESULTS

For the 104 patients (66.5 ± 7.7 years, 58.7% males), the ABPM BPV (SD, systolic/diastolic: 14.5 ± 3.1/9.8 ± 2.5 mm Hg) was higher than the SMBP (12.2 ± 9.8/7.4 ± 5.8 mm Hg; P < 0.001) and clinic BPV (10 ± 8.9/5.9 ± 4.9 mm Hg; P = 0.001). The main BPV correlation between methods was weak, with a maximum R2 = 0.17 (P < 0.001) between clinic and SMBP systolic BPV. The "intramethod" correlation of BPV yielded a maximum R2 = 0.21 (P < 0.001) between morning diastolic SMBP intershift/intermeans variability. The "intermethod" correlation of short-, mid-, and long-term BPV determinants was weak (maximum R2 = 0.22, P < 0.001, between clinic intraday variability/SMBP morning intershift variability).

CONCLUSIONS

The "intramethod" and "intermethod" correlation between BPV determinants was weak or nonexistent, even when comparing determinants reflecting the same type of temporal BPV. Our data suggest that BPV reflects a heterogeneous phenomenon that strongly depends on the estimation method and the time period evaluated.

[Evaluation of cardiovascular risk in the cross-sectional phase of the Mediterranean Study]

INTRODUCTION AND OBJECTIVES

The Mediterranean study quantifies high cardiovascular risk (HCR), consistency between REGICOR (R) and low risk SCORE (LS) scales, altered blood pressure (ABP) values in hypercholesterolemia (HC) without any history of hypertension (HT), high total cholesterol (HTC) values with HT with no background of HC and cardiac and renal damage in hypertensive patients.

PATIENTS AND METHODS

A national, cross-sectional and multicenter study was performed with the participation of 751 physicians. The physicians individually evaluated 7,973 patients with HT and 5,319 with HC. HCR was defined as over 10% with R and 5% with LS. Intra-class correlation coefficient (ICC) and Pearson coefficient (r) were calculated. The percentages of ABP and HTC were quantified. Creatinine (cr) value, glomerular filtration rate using Cockroft-Gault (CG), and prevalence of left ventricular hypertrophy (LVH) were analyzed.

RESULTS

Regarding hypertensive patients: 17.3% HCR with R and 26.1% with LS. ICC = 0.222 (p < 0.0001), r = 0.61 (p < 0.0001), 64.7% HTC. There was no evaluation of LVH in 31.2% and a prevalence of 5.1%, prevalence of lesion and kidney failure (KF) of 4.7% and 1.6% respectively based on CR and 15.9% KF by CG. In HC patients, there was 21.1% of HCR with R and 21.5% with LS; ICC = 0.190 (p < 0.0001), r = 0.64 (p < 0.0001) and 33.7% ABP.

CONCLUSIONS

The SCORE scale identifies more patients with HCR than the REGICOR one in HT patients and a similar amount in HC patients. Consistency between both scales is poor. A significant ABP/HTC was found. In HT patients, the patients who were not evaluated for LVH and the percentage of KF are important.

Antihypertensive activity of verapamil: impact of dietary sodium. The VERSAL Study Group

OBJECTIVE

To define the influence of dietary salt intake on the antihypertensive effect of slow-release verapamil 240 mg once a day in a population with mild-to-moderate essential hypertension.

DESIGN

Parallel, randomized, multicentre study.

METHODS

Patients were advised to follow a moderately low salt diet (Low-salt group). After a 2-week run-in period, those patients with 24-h urinary sodium excretion (UNa) < or = 120 mmol/day and a diastolic blood pressure (DBP) between 90 and 114 mmHg were randomly assigned to verapamil + Low-salt or verapamil + unrestricted-salt diet (High-salt group) for 28 days. Compliance with diets was defined as Low-salt UNa < or = 120 mmol/day and High-salt UNa > 120 mmol/day with UNa increased by > or = 60 mmol/day over the level attained at the end of the run-in period.

RESULTS

Significant reductions in mean systolic blood pressure (SBP) and DBP were found in both the Low-salt (n = 235) and High-salt (n = 183) groups. The therapeutic goal (DBP < 90 mmHg) was achieved in 38.3% of patients in the Low-salt and 44.8% of patients in the High-salt group. Office blood pressure results were confirmed by ambulatory 24-h blood pressure monitoring in a subsample of patients. Verapamil reduced mean blood pressure throughout the nycthemeral cycle without any significant difference between the two groups.

CONCLUSION

The restriction in sodium intake does not have an additive effect on the antihypertensive effect of the slow-channel calcium antagonist verapamil.