Association of monetary diet cost of foods and diet quality in Spanish older adults

Background

A major barrier to a healthy diet may be the higher price of healthy foods compared to low-quality foods.

Objectives

This study aimed to assess the association between the monetary cost of food and diet quality in Spanish older adults at high risk of cardiovascular disease.

Methods

Cross-sectional analysis was carried out in Spanish older adults (n = 6,838; 48.6% female). A validated food frequency questionnaire was used to assess dietary intake. Metabolic syndrome severity, adherence to the Mediterranean diet (MedDiet), adherence to a provegetarian dietary pattern, and dietary inflammatory index were assessed. The economic cost of the foods was obtained from the Spanish Ministry of Agriculture Fisheries and Food database (2015-2017, the period of time when the participants were recruited). The total cost of diet adjusted per 1,000 kcal was computed.

Results

The healthier dietary pattern was associated with a higher cost of the diet. Higher adherence to the MedDiet, anti-inflammatory diet, and the healthy version of the provegetarian dietary pattern were related to higher costs of the diet.

Conclusion

Higher diet quality was associated with a higher dietary cost of the diet per 1,000 kcal/day. Food prices can be an important component of interventions and policies aimed at improving people's diets and preventing diet-related chronic diseases.

Clinical trial registry number

The trial was registered in 2014 at the International Standard Randomized Controlled Trial (ISRCT; http://www.isrctn.com/ISRCTN89898870) with the number 89898870.

Comparative study of the B-SAQ, OAB-V8 and OAB-V3 questionnaires as screening tools for overactive bladders in clinical practice

OBJECTIVE

To compare the capacity shown by 3 self-assessment questionnaires validated in Spanish (B-SAQ, OAB-V8 and OAB-V3) for the screening of patients with overactive bladder (OAB) in clinical practice.

MATERIAL AND METHOD

A noninterventional observational study was conducted of men and women older than 30 years evaluated in primary care consultations. The clinical diagnosis of OAB was conducted through a case history review, physical examination, urine analysis, ultrasonography and voiding diary. The presence of coping strategies and discomfort was investigated. The differential diagnosis was established in patients with symptoms not due to OAB. We assessed the correlation between the clinical tests and diagnosis (kappa <.4 poor; .4-.6 moderate; >.6 good; >.8 excellent) and ROC curves to define the capacity to screen the assessed questionnaires.

RESULTS

A total of 411 patients were investigated. OAB was detected in 207 (50.4%) patients, other causes for the lower urinary tract symptoms were detected in 63 (15.3%), and 141 (34.3%) patients had no diagnosis. The voiding diary suggested OAB in 197 (47.9%) patients. The correlation between the clinical diagnosis and the diagnosis based on the voiding diary was .702. The correlation between the clinical diagnosis and B-SAQ, OAB-V8 and OAB-V3 was .59, .673 and .732, respectively. The area under the curve (AUC) was .799 for B-SAQ; .837 for OAB-V8 and .867 for OAB-V3 (OAB-V3 vs. OAB-V8, P=.02; OAB-V3 vs. B-SAQ, P<.0001). The AUC for the voiding diary was .852 (OAB-V3 vs. diary, P=.47).

CONCLUSIONS

OAB-V3 is a simple questionnaire with excellent performance for screening OAB in a specific population and that is superior to the OAB-V8 and B-SAQ. The accuracy of the voiding diary for the same indication is equivalent to that of the OAB-V3 in our setting.

Parenteral nutrition and immature neonates. Comparative study of neonates weighing under 1000 and 1000-1250 g at birth

We studied the nutritional requirements of 53 neonates with a birth-weight of 1250 g or less and analysed the parenteral and enteral nutrition provided, the weight-gain curves, the incidence of prior pathology and complications. We compared those weighing under 1000 g at birth (n=25) with those weighing 1001-1250 g (n=28). All neonates received central parenteral nutrition at an average age of 42.3 h. The liquid requirements of the lower birth-weight group were significantly greater. No differences were found in the supply of glucose, proteins, lipids and calories until after the first 15 days of life, when the <1000 g group required a greater liquid and caloric intake. Parenteral nutrition was suspended earlier for the >1000 g group (32.6 vs. 48.1 days). Maximum weight loss (12.56%) for the two groups occurred at 5.23 days. No differences in weight gain (g/kg/day) between the groups were observed. The >1000 g group began enteral nutrition significantly earlier and presented greater tolerance. The incidence of complications (bronchopulmonary dysplasia, enterocolitis, nosocomial sepsis, Candidas A sepsis, osteopenia) was greater in the lower birth-weight group, as was that of hyaline membrane disease and mechanically assisted respiration. There were no differences in the incidence of intracraneal haemorrhage, ductus arteriosus, early sepsis, delayed intrauterine growth or hypoglucemia.

CONCLUSIONS

The severity of the initial pathology and the greater incidence of complications among the lower birth-weight neonates (<1000 g) influenced both the need for parenteral nutrition and the reduced tolerance to enteral nutrition. Although the rate of weight gain was similar for the two groups, the <1000 g group required a longer period of parenteral nutrition.

Rehospitalization because of respiratory syncytial virus infection in premature infants younger than 33 weeks of gestation: a prospective study. IRIS Study Group

OBJECTIVE

To collect data on hospitalization for respiratory syncytial virus (RSV) infections and presumptive risk factors for rehospitalization among premature infants in Spain.

DESIGN

Observational, prospective, longitudinal, multicenter study.

SETTING

Fourteen Spanish neonatal units with an annual birth cohort of 57,000 infants.

PATIENTS

All children (n = 680) born < or =32 weeks of gestational age between April 1, 1998, and March 31, 1999, and discharged from the hospital before March 31, 1999, were included in the study. A total of 96 were excluded because of administration of prophylactic treatment (n = 55) or were lost to follow-up (n = 41). Five children died during the study period, but death was related to RSV in only 1 case.

METHODS AND MAIN OUTCOME MEASURES

Neonatal and demographic data were recorded at the initial visit. Infants were prospectively followed at monthly intervals up to March 31, 1999. In patients rehospitalized for respiratory disorders, further data about RSV status and morbidity were collected. A comparison was made between children rehospitalized for RSV infection and those who were not. The influence of factors on the probability of rehospitalization for RSV infection was assessed by logistic regression analysis.

RESULTS

Of the 584 evaluable patients 118 (20.2%) were rehospitalized for respiratory disease during the study period. The causative pathogen was identified in 89 (75.4%) hospital admissions. Of these 59 (66.3%) were a result of RSV infection in 53 children; 6 were reinfections. In a logistic regression model significant independent prognostic variables included: lower risk of RSV hospitalization with increase gestational age [odds ratio (OR), 0.85; 95% confidence interval (CI), 0.72 to 0.99; P < 0.047]; higher risk with chronic lung disease (OR = 3.1; 95% CI 1.22 to 7.91; P < 0.016); and living with school age siblings (OR = 1.86; 95% CI 1.01 to 3.4; P < 0.048).

CONCLUSION

This large descriptive study has enabled us to define the influence of specific risk factors that increase the risk of rehospitalization for RSV infection in preterm infants. Such studies help to define the appropriate role of available prophylactic interventions and establish treatment guidelines.

Beta-2-microglobulin in the assessment of renal function in full term newborns following perinatal asphyxia

In order to evaluate the clinical usefulness of serum and urinary beta 2 microglobulin (beta 2-m) determination as a marker of renal damage following perinatal asphyxia, twenty asphyxiated and twenty healthy full term newborns were studied. Renal function was monitored on the first and third day after birth by traditional tests such as creatinine (Cr), endogenous creatinine clearance (Ccr), and fractional Na excretion (FeNa), as well as by serum and urinary beta 2 microglobulin. The value of different tests for the diagnosis of oliguria and of acute renal failure was determined. Eleven asphyxiated neonates developed oliguria and five ARF in contrast to none of the controls. Both traditional tests of renal function, and determinations of beta 2-m with the exception of serum beta 2-m, were significantly different (p less than 0.01) between controls and asphyxiated neonates. When stratified analysis was performed, only serum cr, urinary beta 2-m/cr ratio, and Fe beta 2-m were able to discriminate oliguria from preserved diuresis on the first day of life. For ARF, only Ccr and Fe beta 2-m were different, again on the first day of life. Urinary beta 2-m/creatinine ratio and Fe beta 2-m appear to be more sensitive and specific for the early detection of proximal tubular renal dysfunction following perinatal asphyxia than usual tests of renal function.