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Talavera-Rodríguez I, Banegas JR, de la Cruz JJ, Martínez-Gómez D, Ruiz-Canela M, Ortolá R, Hershey MS, Artalejo FR, Sotos-Prieto M. Mediterranean lifestyle index and 24-h systolic blood pressure and heart rate in community-dwelling older adults. GeroScience 2024; 46:1357-1369. [PMID: 37561386 PMCID: PMC10828285 DOI: 10.1007/s11357-023-00898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023] Open
Abstract
Specific foods, nutrients, dietary patterns, and physical activity are associated with lower blood pressure (BP) and heart rate (HR), but little is known about the joint effect of lifestyle factors captured in a multidimensional score. We assessed the association of a validated Mediterranean-lifestyle (MEDLIFE) index with 24-h-ambulatory BP and HR in everyday life among community-living older adults. Data were taken from 2,184 individuals (51% females, mean age: 71.4 years) from the Seniors-ENRICA-2 cohort. The MEDLIFE index consisted of 29 items arranged in three blocks: 1) Food consumption; 2) Dietary habits; and 3) Physical activity, rest, and conviviality. A higher MEDLIFE score (0-29 points) represented a better Mediterranean lifestyle adherence. 24-h-ambulatory BP and HR were obtained with validated oscillometric devices. Analyses were performed with linear regression adjusted for the main confounders. The MEDLIFE-highest quintile (vs Q1) was associated with lower nighttime systolic BP (SBP) (-3.17 mmHg [95% CI: -5.25, -1.08]; p-trend = 0.011), greater nocturnal-SBP fall (1.67% [0.51, 2.83]; p-trend = 0.052), and lower HR (-2.04 bpm [daytime], -2.33 bpm [nighttime], and -1.93 bpm [24-h]; all p-trend < 0.001). Results were similar for each of the three blocks of MEDLIFE and by hypertension status (yes/no). Among older adults, higher adherence to MEDLIFE was associated with lower nighttime SBP, greater nocturnal-SBP fall, and lower HR in their everyday life. These results suggest a synergistic BP-related protection from the components of the Mediterranean lifestyle. Future studies should determine whether these results replicate in older adults from other Mediterranean and non-Mediterranean countries.
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Affiliation(s)
- Irene Talavera-Rodríguez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Juan J de la Cruz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdisNa), University of Navarra, 31008, Pamplona, Spain
- CIBEROBN (CIBER of Pathophysiology of Obesity and Nutrition), Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Maria S Hershey
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdisNa), University of Navarra, 31008, Pamplona, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBEROBN (CIBER of Pathophysiology of Obesity and Nutrition), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain.
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
- IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
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Pano O, Sayón-Orea C, Hershey MS, de la O V, Fernández-Lázaro C, Bes-Rastrollo M, Martín-Moreno JM, Sánchez-Villegas A, Martínez JA. The risk of incident depression when assessed with the Lifestyle and Well-Being Index. Public Health 2023; 220:165-171. [PMID: 37329773 DOI: 10.1016/j.puhe.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/05/2023] [Accepted: 05/04/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES Novel findings indicate links between unhealthy lifestyles and depression based on active inflammatory processes. Thus, identifying participants with poor habits could reveal differences in trends of incident depression. This study aimed to examine the association between an objective lifestyle assessment, as measured by the Lifestyle and Well-Being Index (LWB-I), and incident depression in healthy participants of a Spanish cohort. STUDY DESIGN This was a longitudinal analysis of a subsample of 10,063 participants from the Seguimiento Universidad de Navarra cohort study. METHODS Group comparisons and Cox proportional hazard models were conducted using the LWB-I, which categorizes the sample into groups with healthy and unhealthy lifestyles and well-being. The main outcome was incident depression as well as secondary outcomes. RESULTS Those classified to the transition category of LWB-I were associated with a hazard ratio of 0.67 (95% confidence interval: 0.52-0.87), and those in the excellent category showed a hazard ratio of 0.44 (95% confidence interval: 0.33-0.58), which in both groups reflects a significantly lower risk of incident depression compared with the group including those classified in the poor LWB-I level. Moreover, the available sensitivity analyses concerning time of depression diagnosis or antidepressant treatment further supported the role of nutrition and physical activity on incident depression. Interestingly, throughout the follow-up, incident depression was inversely related to healthier daily habits as measured by the LWB-I. CONCLUSIONS A global assessment of lifestyles such as the LWB-I provides valuable insight into the complex relationship between lifestyle factors and their link to depression risk.
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Affiliation(s)
- O Pano
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - C Sayón-Orea
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain; Department of Preventive Medicine and Public Health, School of Medicine-Universidad de Navarra, Pamplona, Spain; Navarra Public Health Institute, Pamplona Navarra, Spain; Biomedical Research Center Network on Obesity and Nutrition (CIBERobn) and Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
| | - M S Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - V de la O
- Department of Preventive Medicine and Public Health, School of Medicine-Universidad de Navarra, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute, Madrid, Spain
| | - C Fernández-Lázaro
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain; Department of Preventive Medicine and Public Health, School of Medicine-Universidad de Navarra, Pamplona, Spain
| | - M Bes-Rastrollo
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain; Department of Preventive Medicine and Public Health, School of Medicine-Universidad de Navarra, Pamplona, Spain; Biomedical Research Center Network on Obesity and Nutrition (CIBERobn) and Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - J-M Martín-Moreno
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario de Valencia, 46010, Valencia, Spain; Department of Preventive Medicine and Public Health, Universitat de Valencia, 46010, Valencia, Spain
| | - A Sánchez-Villegas
- Biomedical Research Center Network on Obesity and Nutrition (CIBERobn) and Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; Faculty of Health Sciences, Universidad Publica de Navarra, Pamplona, Spain; ISFOOD - Institute for Innovation & Sustainable Development in Food Chain. Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - J A Martínez
- Biomedical Research Center Network on Obesity and Nutrition (CIBERobn) and Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute, Madrid, Spain; Department of Food Sciences and Physiology, University of Navarra, Pamplona, Spain
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Sidossis A, Lan FY, Hershey MS, Hadkhale K, Kales SN. Cancer and Potential Prevention with Lifestyle among Career Firefighters: A Narrative Review. Cancers (Basel) 2023; 15:cancers15092442. [PMID: 37173909 PMCID: PMC10177420 DOI: 10.3390/cancers15092442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Career firefighters are at considerable risk for chronic diseases, including an increased risk of various cancers, compared to the general population. Over the last two decades, several systematic reviews and large cohort studies have demonstrated that firefighters have statistically significant increases in overall and site-specific cancer incidence and site-specific cancer mortality compared to the general population. Exposure assessment and other studies have documented exposures to a variety of carcinogens in fire smoke and within the fire station. Other occupational factors such as shift work, sedentary behavior, and the fire service food culture may also contribute to this working population's increased cancer risk. Furthermore, obesity and other lifestyle behaviors such as tobacco use, excessive alcohol consumption, poor diet, inadequate physical activity, and short sleep duration have also been associated with an increased risk of certain firefighting-associated cancers. Putative prevention strategies are proposed based on suspected occupational and lifestyle risk factors.
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Affiliation(s)
- Amalia Sidossis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
| | - Fan-Yun Lan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Occupational Medicine, Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan
| | - Maria S Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
| | - Kishor Hadkhale
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
- Faculty of Social Sciences Health Sciences (Epidemiology), Tampere University, 33100 Tampere, Finland
| | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
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López-Gil JF, García-Hermoso A, Smith L, Gallego A, Victoria-Montesinos D, Ezzatvar Y, Hershey MS, Gutiérrez-Espinoza H, Mesas AE, Jiménez-López E, Sánchez-Miguel PA, López-Benavente A, Moreno-Galarraga L, Chen S, Brazo-Sayavera J, Fernandez-Montero A, Alcaraz PE, Panisello Royo JM, Tárraga-López PJ, Kales SN. A Cluster Randomized Controlled Trial of the Archena Infancia Saludable Project on 24-h Movement Behaviors and Adherence to the Mediterranean Diet among Schoolchildren: A Pilot Study Protocol. Children (Basel) 2023; 10:children10040738. [PMID: 37189987 DOI: 10.3390/children10040738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 05/17/2023]
Abstract
Objective: The aim of this paper is to describe the protocol of pilot cluster randomized controlled trial (RCT) that will evaluate the effects of a lifestyle-based intervention. The Archena Infancia Saludable project will have several objectives. The primary objective of this project is to determine the 6-month effects of a lifestyle-based intervention on adherence to 24-h movement behaviors and Mediterranean diet (MedDiet) in schoolchildren. The secondary objective of this project is to test the intervention effects of this lifestyle-based intervention on a relevant set of health-related outcomes (i.e., anthropometric measurements, blood pressure, perceived physical fitness, sleep habits, and academic performance). The tertiary objective is to investigate this intervention's "halo" effect on parents'/guardians' 24-h movement behaviors and adherence to the MedDiet. Methods: The Archena Infancia Saludable trial will be a cluster RCT submitted to the Clinical Trials Registry. The protocol will be developed according to SPIRIT guidelines for RCTs and CONSORT statement extension for cluster RCTs. A total of 153 eligible parents/guardians with schoolchildren aged 6-13 years will be randomized into an intervention group or a control group. This project focuses on two fundamental pillars: 24-h movement behaviors and MedDiet. It will mainly focus on the relationship between parents/guardians and their children. Behavior change strategies for dietary and 24-h movement behaviors in schoolchildren will be based on healthy lifestyle education for parents/guardians through infographics, video recipes, brief video clips, and videos. Conclusions: Most of the current knowledge on 24-h movement behaviors and adherence to the MedDiet is based on cross-sectional or longitudinal cohort studies, warranting a need to design and conduct RCTs to obtain more robust evidence on the effect of a healthy lifestyle program to increase 24-h movement behaviors and to improve adherence to the MedDiet in schoolchildren.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
- One Health Research Group, Universidad de Las Américas, Quito 170124, Ecuador
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, 31006 Pamplona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Alejandra Gallego
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, 30100 Murcia, Spain
| | | | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
| | - Maria S Hershey
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
| | | | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha (UCLM), 16071 Cuenca, Spain
| | - Pedro Antonio Sánchez-Miguel
- Grupo Análisis Comportamental de la Actividad Física y el Deporte (ACAFYDE), Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, Facultad de Formación del Profesorado, Universidad de Extremadura, 10003 Cáceres, Spain
| | - Alba López-Benavente
- Departamento de Expresión Plástica, Musical y Dinámica, Facultad de Educación, Universidad de Murcia, 30100 Espinardo, Spain
| | - Laura Moreno-Galarraga
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Javier Brazo-Sayavera
- PDU EFISAL, Centro Universitario Regional Noreste, Universidad de la República (UdelaR), Rivera 40000, Uruguay
- Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013 Seville, Spain
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
| | - Pedro Emilio Alcaraz
- Research Center for High Performance Sport, San Antonio Catholic University of Murcia, 30830 Murcia, Spain
- Faculty of Sport Sciences, San Antonio Catholic University of Murcia, 30107 Murcia, Spain
| | | | - Pedro J Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), 02008 Albacete, Spain
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
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Talavera-Rodriguez I, Fernandez-Lazaro CI, Hernández-Ruiz Á, Hershey MS, Galarregui C, Sotos-Prieto M, de la Fuente-Arrillaga C, Martínez-González MÁ, Ruiz-Canela M. Association between an oxidative balance score and mortality: a prospective analysis in the SUN cohort. Eur J Nutr 2023; 62:1667-1680. [PMID: 36781422 DOI: 10.1007/s00394-023-03099-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specific mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates. METHODS Using baseline information on 12 a priori selected dietary and non-dietary lifestyle pro- and antioxidants exposures-vitamins C and E, β-carotenes, selenium, zinc, heme iron, polyphenols, total antioxidant capacity, body mass index, alcohol, smoking, and physical activity-we constructed an equally weighted OBS categorized into quartiles, with higher scores representing greater antioxidant balance. Cox proportional hazards models were fitted to evaluate the association between the OBS and mortality. RESULTS A total of 18,561 participants (mean [SD] age, 38.5 [12.4] years; 40.8% males) were included in the analysis. During a median follow-up of 12.2 years (interquartile range 8.3-14.9), 421 deaths were identified, including 80 deaths from cardiovascular disease (CVD), 215 from cancer, and 126 from other causes. After adjustment for potential confounders, the hazard ratios and 95% confidence interval (CIs) between the highest quartile (predominance of antioxidants) vs. the lowest quartile (reference category) were 0.35 (95% CI 0.22-0.54, P-trend < 0.001) for all-cause mortality, 0.18 (95% CI 0.06-0.51, P-trend = 0.001) for CVD mortality, 0.35 (95% CI 0.19-0.65, P-trend = 0.002) for cancer mortality, and 0.45 (95% CI 0.20-1.02, P-trend = 0.054) for other-cause mortality. CONCLUSION Our findings suggest a strong inverse association between the OBS and all-cause, CVD, and cancer mortality. Individuals exposed to both antioxidant dietary and lifestyle factors may potentially experience the lowest mortality risk. STUDY REGISTRY NUMBER Dynamic Mediterranean Prospective Cohort: the SUN Project; NCT02669602. https://clinicaltrials.gov/ct2/show/NCT02669602 . https://proyectosun.es.
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Affiliation(s)
- Irene Talavera-Rodriguez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, C/ Irunlarrea, 31008, Pamplona, Spain
| | - Cesar I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, C/ Irunlarrea, 31008, Pamplona, Spain.,IdisNA, Navarra Institute for Health Research, 31008, Pamplona, Spain
| | | | - Maria S Hershey
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, C/ Irunlarrea, 31008, Pamplona, Spain.,IdisNA, Navarra Institute for Health Research, 31008, Pamplona, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Cristina Galarregui
- Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008, Pamplona, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029, Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.,IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain
| | - Carmen de la Fuente-Arrillaga
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, C/ Irunlarrea, 31008, Pamplona, Spain.,IdisNA, Navarra Institute for Health Research, 31008, Pamplona, Spain.,CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029, Madrid, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, C/ Irunlarrea, 31008, Pamplona, Spain.,IdisNA, Navarra Institute for Health Research, 31008, Pamplona, Spain.,CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029, Madrid, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, C/ Irunlarrea, 31008, Pamplona, Spain. .,IdisNA, Navarra Institute for Health Research, 31008, Pamplona, Spain. .,CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029, Madrid, Spain.
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Moreno-Montañés J, Gándara E, Moreno-Galarraga L, Hershey MS, López-Gil JF, Kales S, Bes-Rastrollo M, Martínez-González MÁ, Fernandez-Montero A. ACE-Vitamin Index and Risk of Glaucoma: The SUN Project. Nutrients 2022; 14:nu14235129. [PMID: 36501162 PMCID: PMC9735492 DOI: 10.3390/nu14235129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/24/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies regarding antioxidant consumption and glaucoma have shown contradictory results. The aim of this study was to analyze the combined effect of the consumption of three vitamins (A, C and E) on the incidence of glaucoma in the SUN Project. METHODS For this study, 18,669 participants were included. The mean follow-up was 11.5 years. An index including vitamins A, C and E (ACE-Vitamin Index) was calculated. Vitamin intake was extracted from participants' dietary data and vitamin supplements, if taken. Information on glaucoma incidence was collected by previously validated self-reported questionnaires. The association between glaucoma and vitamin intake was assessed by repeated-measures Cox regression using multi-adjusted hazard ratios. RESULTS A total of 251 (1.3%) cases of glaucoma were detected. Participants with a higher ACE-Vitamin Index presented a reduced risk of glaucoma compared to participants with lower consumption (adjusted HR = 0.73; 95% CI, (0.55-0.98)). When each vitamin was analyzed individually, none of them had a significant protective effect. The protective effect of the ACE-Vitamin Index was higher in men and older participants (≥55 year). CONCLUSIONS The consumption of vitamins A, C and E considered separately do not seem to exert a protective effect against glaucoma, but when these vitamins are considered together, they are associated with a lower risk of glaucoma.
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Affiliation(s)
- Javier Moreno-Montañés
- Department of Ophthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Elsa Gándara
- Department of Ophthalmology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Laura Moreno-Galarraga
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Pediatrics, Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Maria S. Hershey
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - José Francisco López-Gil
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- Health and Social Research Center, University of Castilla-La Mancha, 16071 Cuenca, Spain
| | - Stefanos Kales
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02115, USA
| | - Maira Bes-Rastrollo
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Miguel Ángel Martínez-González
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Alejandro Fernandez-Montero
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
- Department of Occupational Medicine, University of Navarra, 31008 Pamplona, Spain
- Correspondence:
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Hershey MS, Sanchez-Villegas A, Sotos-Prieto M, Fernandez-Montero A, Pano O, Lahortiga-Ramos F, Martínez-González MÁ, Ruiz-Canela M. The Mediterranean Lifestyle and the Risk of Depression in Middle-Aged Adults. J Nutr 2022; 152:227-234. [PMID: 34549288 DOI: 10.1093/jn/nxab333] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/01/2021] [Accepted: 09/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Recent evidence has indicated a greater number of protective factors are associated with a greater decreased risk for depression and depressive symptoms compared with individual factors alone. Moreover, adherence to healthy modifiable lifestyle behaviors may lower the risk of depression regardless of underlying genetic risk. OBJECTIVES We longitudinally evaluated the association of the Mediterranean lifestyle (MEDLIFE) with the risk of depression. METHODS We prospectively analyzed data from 15,279 participants (6089 men and 9190 women, mean age 37 y) in the Seguimiento Universidad de Navarra cohort. The MEDLIFE index is composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, each of which was assigned 0 or 1 point. Final scores ranged from 0 to 28 points and were categorized into quartiles of MEDLIFE adherence. Cox proportional regression models determined the association of total MEDLIFE adherence, each item, and block with incident depression. RESULTS After a mean follow-up of 11.7 y, 912 (6%) incident cases of depression were reported. The mean ± SD final score for MEDLIFE adherence was 11.9 ± 2.7 points. The multivariable model showed that compared with the first quartile, the second and third quartiles of MEDLIFE adherence were significantly associated with a decreased relative risk for incident depression (HR: 0.82; 95% CI: 0.69, 0.96 and HR: 0.74; 95% CI: 0.61, 0.89, respectively). The fourth quartile did not show a statistically significant association with incident depression (HR: 0.89; 95% CI: 0.73, 1.09). CONCLUSIONS MEDLIFE adherence may decrease the risk of depression in a Spanish cohort of university graduates. Given no clear association was observed among the highest MEDLIFE adherence, future studies are warranted to better understand the nature of this association. Evidence on MEDLIFE, beyond the Mediterranean diet, may contribute toward more effective prevention strategies for depression.
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Affiliation(s)
- Maria S Hershey
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain
| | - Almudena Sanchez-Villegas
- Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain.,Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Universidad Pública de Navarra, IdiSNA, Pamplona, Spain
| | - Mercedes Sotos-Prieto
- Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
| | - Alejandro Fernandez-Montero
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain.,Department of Occupational Medicine, University of Navarra, Av. Pío XII, 36, Pamplona, Spain
| | - Octavio Pano
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain
| | | | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain.,Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain.,Department of Nutrition, Harvard T. H. Chan School, Boston, MA, USA
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain.,Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
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Hershey MS, Sotos-Prieto M, Andrieu S, Hofman A, Magiatis P, Martinez-Gonzalez MA, Yannakoulia M, Kales S, Scarmeas N. Prevention of Alzheimer's Disease and Cognitive Decline with Diet and Lifestyle: Proceedings of the A. G. Leventis Foundation Conference. J Prev Alzheimers Dis 2022; 10:137-143. [PMID: 36641619 DOI: 10.14283/jpad.2022.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The A. G. Leventis Foundation International Conference, "Prevention of Alzheimer's Disease and Cognitive Decline with Diet and Lifestyle", was held on May 11-12th, 2022 in Nicosia, Cyprus. This conference examined the role of diet and lifestyle for the prevention and treatment of Alzheimer's Disease and other forms of cognitive decline. Speakers from leading academic institutions presented evidence on healthy dietary patterns, with a particular focus on the traditional Mediterranean diet (MedDiet), in association with cognitive outcomes, mainly cognitive decline, dementia, and Alzheimer's disease, from both observational and interventional studies. Moreover, future directions for the potential use of olive oil, rich in polyphenols, for its therapeutic use as a nutraceutical, as well as nutritional interventions with high-quality dietary patterns (i.e. MedDiet) that support existing primarily observational evidence for the prevention of cognitive decline, as well as challenges in designing rigorous clinical trials are summarized and discussed within the conference proceedings.
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Affiliation(s)
- M S Hershey
- Stefanos N. Kales, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA,
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Mata-Fernández A, Hershey MS, Pastrana-Delgado JC, Sotos-Prieto M, Ruiz-Canela M, Kales SN, Martínez-González MA, Fernandez-Montero A. A Mediterranean lifestyle reduces the risk of cardiovascular disease in the "Seguimiento Universidad de Navarra" (SUN) cohort. Nutr Metab Cardiovasc Dis 2021; 31:1728-1737. [PMID: 33895077 DOI: 10.1016/j.numecd.2021.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS A healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDLIFE index including diet, physical activity, and other lifestyle factors) and the incidence of CVD. METHODS AND RESULTS The "Seguimiento Universidad de Navarra" (SUN) project is a prospective, dynamic and multipurpose cohort of Spanish university graduates. We calculated a MEDLIFE score, composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, for 18,631 participants by assigning 1 point for each typical Mediterranean lifestyle factor achieved, for a theoretically possible final score ranging from 0 to 28 points. During an average follow-up of 11.5 years, 172 CVD cases (myocardial infarction, stroke or cardiovascular death) were observed. An inverse association between the MEDLIFE score and the risk of primary cardiovascular events was observed, with multivariable-adjusted hazard ratio (HR) = 0.50; (95% confidence interval, 0.31-0.81) for the highest MEDLIFE scores (14-23 points) compared to the lowest scores (0-9 points), p (trend) = 0.004. CONCLUSION A higher level of adherence to the Mediterranean lifestyle was significantly associated with a lower risk of CVD in a Spanish cohort. Public health strategies should promote the Mediterranean lifestyle to preserve cardiovascular health.
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Affiliation(s)
- Arancha Mata-Fernández
- University of Navarra, Emergency Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Maria S Hershey
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - Juan C Pastrana-Delgado
- University of Navarra, Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, MA, USA; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Miguel Ruiz-Canela
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; Navarra Institute for Health Research (IdisNa), Pamplona, Spain
| | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, MA, USA; Department of Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Miguel A Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; Navarra Institute for Health Research (IdisNa), Pamplona, Spain; Department of Nutrition, Harvard T.H Chan School, Boston, MA, USA
| | - Alejandro Fernandez-Montero
- Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, MA, USA; Navarra Institute for Health Research (IdisNa), Pamplona, Spain; University of Navarra, Department of Occupational Medicine, Pamplona, Spain.
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