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Martinez-Gomez J, Fernandez-Alvira JM, De Cos-Gandoy A, Bodega P, De Miguel M, Carral V, Laveriano-Santos EP, Tresserra-Rimbau A, Carvajal I, Estruch R, Lamuela-Raventos RM, Santos-Beneit G, Fuster V, Fernandez-Jimenez R. Sleep duration and its association with cardiometabolic outcomes among adolescents enrolled in the SI Program in Spain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sleep duration has been inversely associated with increased prevalence of overweight/obesity in childhood and adolescence [1, 2]. However, large studies linking over time objectively measured sleep duration and other cardiometabolic outcomes in adolescence are lacking.
Purpose
To evaluate sleep duration and its association with cardiometabolic outcomes in a large cohort of adolescents aged 12 to 16 years from the SI! Program for Secondary Schools trial in Spain [3], together with its relationship with sociodemographic variables.
Methods
Seven-day actigraphic recording was performed in 1229 adolescents at baseline (49.7% girls; 12.5 (0.4) years), 1058 at first follow-up (51.1% girls; 13.9 (0.4) years), and 895 at second follow-up (52.3% girls; 15.8 (0.4) years). Three groups were defined: very short sleep duration (<7 h), short sleep duration (7 to 8 h), and reference sleep duration (≥8 h) [4]. Overweight/obesity were determined according to BMI age- and sex-adjusted percentiles. Continuous Metabolic Syndrome (MetS) score was calculated as the sum of the age-and-gender specific z-scores of mean arterial pressure (MAP) (MAP = ((systolic BP − diastolic BP)/3) + diastolic BP), waist circumference, and fasting blood measures of high-density lipoprotein cholesterol (HDL-c) levels multiplied by −1, triglycerides, and glucose levels [5]. Associations between sleep duration and cardiometabolic outcomes were analyzed using generalized linear and Poisson distribution adjusted models.
Results
At 12 years of age, only 34.2% of the adolescents met sleep recommendations (sleep hours ≥8), and this percentage decreased with advancing age (23.4% and 19.4% at approximately 14 and 16 years of age, respectively) (Figure 1). Boys and individuals from migrant families tended to sleep shorter. Moreover, sleep duration was directly associated with sleep quality and efficiency. After adjusting for potential cofounders, very short sleepers (<7h) had a higher prevalence ratio (PR) of overweight/obesity at baseline (PR: 1.21 [95% CI: 1.16 to 1.27]) and at first follow-up (PR: 1.72 [95% CI: 1.08 to 2.74]) than the reference group (≥8 h) (Figure 2). Similarly, very short sleepers showed higher mean MetS scores at baseline (0.98 [95% CI: 0.43 to 1.54] and at first follow-up (0.76 [95% CI: 0.24 to 1.27]) as compared with the reference group. Short sleepers showed similar trends with associations of weaker magnitude, as they were the overall associations between sleep duration and cardiometabolic outcomes at second follow-up.
Conclusions
Most adolescents, and particularly those with a migrant background, did not meet sleep recommendations. Moreover, a shorter sleep duration was associated with cardiometabolic outcomes, particularly at 12 and 14 years of age and when sleeping less than 7 hours. Health promotion programs should emphasize the importance of good sleep habits.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): 1. Fundaciό la Maratό de TV3.2. SHE Foundation and “la Caixa” Foundation.
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Affiliation(s)
- J Martinez-Gomez
- Spanish National Centre for Cardiovascular Research, Cardiovascular and Health Imaging Lab , Madrid , Spain
| | | | | | - P Bodega
- SHE Foundation , Barcelona , Spain
| | | | - V Carral
- SHE Foundation , Barcelona , Spain
| | - E P Laveriano-Santos
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences , Barcelona , Spain
| | - A Tresserra-Rimbau
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences , Barcelona , Spain
| | | | - R Estruch
- Barcelona Hospital Clinic, Department of Internal Medicine , Barcelona , Spain
| | - R M Lamuela-Raventos
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences , Barcelona , Spain
| | | | - V Fuster
- Spanish National Centre for Cardiovascular Research , Madrid , Spain
| | - R Fernandez-Jimenez
- Spanish National Centre for Cardiovascular Research, Cardiovascular and Health Imaging Lab , Madrid , Spain
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Martinez-Gomez J, De Cos-Gandoy A, Santos-Beneit G, Tresserra-Rimbau A, Bodega P, De Miguel M, Laveriano-Santos EP, Ramirez-Garza SL, Fernandez-Alvira JM, Orrit X, Carvajal I, Estruch R, Lamuela-Raventos RM, Fuster V, Fernandez-Jimenez R. Cardiovascular health trajectories among adolescents enrolled in the SI Program in Spain: a longitudinal study. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): 1. Fondo de Investigación Sanitaria- Instituto de Salud Carlos III2. SHE Foundation and “la Caixa” Foundation.
Background
There is a paucity of data on adolescents’ cardiovascular health (CVH) profiles and longitudinal trajectories.
Purpose
To identify CVH trajectories in a large cohort of Spanish adolescents aged 12 to 16 years and their relationship with sociodemographic variables.
Methods
This study collected data at approximately 12, 14 and 16 years of age from 1078 adolescents attending 24 secondary schools enrolled in the SI! Program for Secondary Schools trial in Spain [1]. The status (non-ideal = 0 points; ideal = 1 point) of each CVH individual metric (smoking status, body mass index, physical activity, dietary habits, blood pressure, total cholesterol, and blood glucose) was determined following the criteria established by the American Heart Association [2]. An overall CVH score was constructed summing the number of ideal CVH metrics (ranged thus from 0 to 7 points), and poor, intermediate, or ideal overall CVH score was defined as ≤3, 4-5, or 6-7 ideal metrics, respectively [3]. CVH trajectories were identified using latent class trajectory modeling with the Stata command traj [4]. Next, individuals were assigned to the trajectory group they were most likely to belong based on the posterior predictive probabilities of group membership.
Results
Among 1078 adolescents with a baseline mean (SD) age of 12.5 (0.4) years, 48.5% girls, four distinct CVH trajectory groups were identified: low-stable (56 adolescents [5.0%]), low-rise (232 [21.3%]), intermediate-decline (136 [18.2%]) and intermediate-stable (654 [55.5%]) (Figure 1). Adolescents belonging to the intermediate-stable and the low-stable trajectories showed the highest and lowest overall CVH mean (SD) scores at baseline [4.8 (0.8) and 2.6 (0.9), respectively] (Figure 2). Similar differences were observed for the analysis of overall CVH score as a categorical variable (poor, intermediate, ideal). Sociodemographic differences between CVH trajectories were identified, with the highest proportion of girls, high-income and non-migrant families within the intermediate-stable trajectory.
Conclusions
In a large cohort of adolescents, ~55% of adolescents showed an intermediate CVH score at baseline and did not decline over time. The characterization of distinct CVH trajectories and sociodemographic differences between them may help tailoring health promotion programs for adolescents.
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Affiliation(s)
- J Martinez-Gomez
- Spanish National Centre for Cardiovascular Research, Cardiovascular and Health Imaging Lab, Madrid, Spain
| | | | | | - A Tresserra-Rimbau
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, Barcelona, Spain
| | - P Bodega
- SHE Foundation, Barcelona, Spain
| | | | - EP Laveriano-Santos
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, Barcelona, Spain
| | - SL Ramirez-Garza
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, Barcelona, Spain
| | - JM Fernandez-Alvira
- Spanish National Centre for Cardiovascular Research, Cardiovascular Imaging and Population Studies, Madrid, Spain
| | - X Orrit
- SHE Foundation, Barcelona, Spain
| | | | - R Estruch
- Barcelona Hospital Clinic, Department of Internal Medicine, Barcelona, Spain
| | - RM Lamuela-Raventos
- University of Barcelona, Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, Barcelona, Spain
| | - V Fuster
- Spanish National Centre for Cardiovascular Research, Cardiovascular Imaging and Population Studies, Madrid, Spain
| | - R Fernandez-Jimenez
- Spanish National Centre for Cardiovascular Research, Cardiovascular and Health Imaging Lab, Madrid, Spain
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3
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Henríquez-Sánchez P, Sánchez-Villegas A, Ruano-Rodríguez C, Gea A, Lamuela-Raventós RM, Estruch R, Salas-Salvadó J, Covas MI, Corella D, Schröder H, Gutiérrez-Bedmar M, Santos-Lozano JM, Pintó X, Arós F, Fiol M, Tresserra-Rimbau A, Ros E, Martínez-González MA, Serra-Majem L. Correction to: Dietary total antioxidant capacity and mortality in the PREDIMED study. Eur J Nutr 2021; 61:569-571. [PMID: 34878602 DOI: 10.1007/s00394-021-02726-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- P Henríquez-Sánchez
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain. .,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - A Sánchez-Villegas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - C Ruano-Rodríguez
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - A Gea
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
| | - R M Lamuela-Raventós
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Nutrition and Food Science Department, XaRTA, INSA, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - R Estruch
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - J Salas-Salvadó
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Human Nutrition Unit, School of Medicine, University Rovira i Virgili, Reus, Spain
| | - M I Covas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos II, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - D Corella
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
| | - H Schröder
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
| | - M Gutiérrez-Bedmar
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Malaga, Málaga, Spain
| | - J M Santos-Lozano
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain
| | - X Pintó
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - F Arós
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - M Fiol
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Institute of Health Sciences, University of Balearic Islands, Palma de Mallorca, Spain.,Hospital Son Espases, Palma de Mallorca, Spain
| | - A Tresserra-Rimbau
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Nutrition and Food Science Department, XaRTA, INSA, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - E Ros
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, Barcelona, Spain
| | - M A Martínez-González
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
| | - L Serra-Majem
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Garcia-Arellano A, Martínez-González MA, Ramallal R, Salas-Salvadó J, Hébert JR, Corella D, Shivappa N, Forga L, Schröder H, Muñoz-Bravo C, Estruch R, Fiol M, Lapetra J, Serra-Majem L, Ros E, Rekondo J, Toledo E, Razquin C, Ruiz-Canela M, Alonso A, Barrio Lopez M, Basterra-Gortari F, Benito Corchon S, Bes-Rastrollo M, Beunza J, Carlos S, Cervantes S, de Irala J, de la Rosa P, de la Fuente C, Donat-Vargas C, Donazar M, Fernandez Montero A, Gea A, Goni-Ochandorena E, Guillen-Grima F, Lahortiga F, Llorca J, Lopez del Burgo C, Mari-Sanchıs A, Marti A, Mendonça R, Nuñez-Cordoba J, Pimenta A, Rico A, Ruiz Zambrana A, Sayon-Orea C, Toledo-Atucha J, Vazquez Ruiz Z, Zazpe Garcıa I, Sánchez- Tainta A, Buil-Cosiales P, Díez-Espino J, Sanjulian B, Martínez J, Marti A, Serrano-Martínez M, Basterra-Gortari F, Extremera-Urabayen J, Garcia-Pérez L, Arroyo-Azpa C, Barcena A, Oreja-Arrayago C, Lasanta-Sáez M, Cia-Lecumberri P, Elcarte-Lopez T, Artal-Moneva F, Esparza-López J, Figuerido-Garmendia E, Tabar-Sarrias J, Fernández- Urzainqui L, Ariz-Arnedo M, Cabeza-Beunza J, Pascual-Pascual P, Martínez-Mazo M, Arina-Vergara E, Macua-Martínez T, Pascual Pascual P, Garcés Ducar M, Martí Massó R, Villanueva Moreno R, Parra-Osés A, Serra-Mir M, Pérez-Heras A, Viñas C, Casas R, Medina-Remon A, Villanueva P, Baena J, García M, Oller M, Amat J, Duaso I, García Y, Iglesias C, Simón C, Quinzavos L, Parra L, Liroz M, Benavent J, Clos J, Pla I, Amorós M, Bonet M, Martín M, Sánchez M, Altirriba J, Manzano E, Altés A, Cofán M, Valls-Pedret C, Sala-Vila A, Doménech M, Bulló M, Basora-Gallisa J, González R, Molina C, Mena G, Martínez P, Ibarrola N, Sorlí J, García Roselló J, Martin F, Tort N, Isach A, Babio N, Salas-Huetos A, Becerra-Tomás N, Rosique- Esteban N, Hernandez P, Canudas S, Papandreou C, Ferreira C, Cabre M, Mestres G, Paris F, Llauradó M, Pedret R, Basells J, Vizcaino J, Segarra R, Giardina S, Guasch-Ferré M, Díaz-López A, Fernández-Ballart J, Balanza R, Tello S, Vila J, de la Torre R, Muñoz-Aguayo D, Elosua R, Marrugat J, Schröder H, Molina N, Maestre E, Rovira A, Castañer O, Farré M, Sorli J, Carrasco P, Ortega-Azorín C, Asensio E, Osma R, Barragán R, Francés F, Guillén M, González J, Sáiz C, Portolés O, Giménez F, Coltell O, Fernández-Carrión R, Guillem-Sáiz P, González-Monje I, Quiles L, Pascual V, Riera C, Pages M, Godoy D, Carratalá-Calvo A, Sánchez-Navarro S, Valero-Barceló C, Salaverria I, Hierro TD, Algorta J, Francisco S, Alonso A, San Vicente J, Casi A, Sanz E, Felipe I, Rekondo J, Loma-Osorio A, Fernandez-Crehuet J, Garcia-Rodriguez A, Wärnberg J, Benitez Pont R, Bianchi Alba M, Navajas R, Gómez-Huelgas R, Martínez-González J, Velasco García V, de Diego Salas J, Baca Osorio A, Gil Zarzosa J, Sánchez Luque J, Vargas López E, Romaguera D, García-Valdueza M, Proenza A, Prieto R, Frontera G, Munuera S, Vivó M, Bestard F, Munar J, Coll L, Fiol F, Ginard M, Jover A, García J, Santos-Lozano J, Ortega-Calvo M, Leal M, Martínez E, Mellado L, Miró-Moriano L, Domínguez-Espinaco C, Vaquero- Diaz S, Iglesias P, Román P, Corchado Y, Lozano-Rodríguez J, Lamuela-Raventós R, López- Sabater M, Castellote-Bargalló A, Quifer-Rada P, Tresserra-Rimbau A, Alvarez-Pérez J, Díez Benítez E, Bautista Castaño I, Maldonado Díaz I, Sanchez-Villegas A, Férnandez- Rodríguez M, Sarmiendo de la Fe F, Simón García C, Falcón Sanabria I, Macías Gutiérrez B, Santana Santana A, de la Cruz E, Galera A, Pintó-Salas X, Trias F, Sarasa I, Rodríguez M, Corbella X, Corbella E, Goday A, Muñoz M, Cabezas C, Vinyoles E, Rovira M, Garcia L, Baby P, Ramos A, Mengual L, Roura P, Yuste M, Guarner A, Rovira A, Santamaria M, Mata M, de Juan C, Brau A, Fernandez M, Gutierrez E, Murillo C, Garcia J, Tafalla M, Bobe I, Díaz A, Araque M, Solis E, Cervello T, Montull I, Tur J, Portillo M, Sáez G. Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies. Clin Nutr 2019; 38:1221-1231. [PMID: 30651193 DOI: 10.1016/j.clnu.2018.05.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/24/2018] [Accepted: 05/02/2018] [Indexed: 12/22/2022]
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Henríquez-Sánchez P, Sánchez-Villegas A, Ruano-Rodríguez C, Gea A, Lamuela-Raventós RM, Estruch R, Salas-Salvadó J, Covas MI, Corella D, Schröder H, Gutiérrez-Bedmar M, Santos-Lozano JM, Pintó X, Arós F, Fiol M, Tresserra-Rimbau A, Ros E, Martínez-González MA, Serra-Majem L. Dietary total antioxidant capacity and mortality in the PREDIMED study. Eur J Nutr 2015; 55:227-36. [PMID: 25663609 DOI: 10.1007/s00394-015-0840-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/18/2015] [Indexed: 12/23/2022]
Affiliation(s)
- P Henríquez-Sánchez
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
| | - A Sánchez-Villegas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - C Ruano-Rodríguez
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - A Gea
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
| | - R M Lamuela-Raventós
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Nutrition and Food Science Department, XaRTA, INSA, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - R Estruch
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - J Salas-Salvadó
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Human Nutrition Unit, School of Medicine, University Rovira i Virgili, Reus, Spain
| | - M I Covas
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos II, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - D Corella
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
| | - H Schröder
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group, Institut Municipal d'Investigació Medica (IMIM)-Institut de Recerca del Hospital del Mar, Barcelona, Spain
| | - M Gutiérrez-Bedmar
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Malaga, Málaga, Spain
| | - J M Santos-Lozano
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain
| | - X Pintó
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - F Arós
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - M Fiol
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Health Sciences, University of Balearic Islands, Palma de Mallorca, Spain
- Hospital Son Espases, Palma de Mallorca, Spain
| | - A Tresserra-Rimbau
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Nutrition and Food Science Department, XaRTA, INSA, School of Pharmacy, University of Barcelona, Barcelona, Spain
| | - E Ros
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, Barcelona, Spain
| | - M A Martínez-González
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
| | - L Serra-Majem
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Medina-Remón A, Tresserra-Rimbau A, Pons A, Tur JA, Martorell M, Ros E, Buil-Cosiales P, Sacanella E, Covas MI, Corella D, Salas-Salvadó J, Gómez-Gracia E, Ruiz-Gutiérrez V, Ortega-Calvo M, García-Valdueza M, Arós F, Saez GT, Serra-Majem L, Pinto X, Vinyoles E, Estruch R, Lamuela-Raventos RM. Effects of total dietary polyphenols on plasma nitric oxide and blood pressure in a high cardiovascular risk cohort. The PREDIMED randomized trial. Nutr Metab Cardiovasc Dis 2015; 25:60-67. [PMID: 25315667 DOI: 10.1016/j.numecd.2014.09.001] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [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: 07/07/2014] [Revised: 08/26/2014] [Accepted: 09/01/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM Hypertension is one of the main cardiovascular risk factors in the elderly. The aims of this work were to evaluate if a one-year intervention with two Mediterranean diets (Med-diet) could decrease blood pressure (BP) due to a high polyphenol consumption, and if the decrease in BP was mediated by plasma nitric oxide (NO) production. METHODS AND RESULTS An intervention substudy of 200 participants at high cardiovascular risk was carried out within the PREDIMED trial. They were randomly assigned to a low-fat control diet or to two Med-diets, one supplemented with extra virgin olive oil (Med-EVOO) and the other with nuts (Med-nuts). Anthropometrics and clinical parameters were measured at baseline and after one year of intervention, as well as BP, plasma NO and total polyphenol excretion (TPE) in urine samples. Systolic and diastolic BP decreased significantly after a one-year dietary intervention with Med-EVOO and Med-nuts. These changes were associated with a significant increase in TPE and plasma NO. Additionally, a significant positive correlation was observed between changes in urinary TPE, a biomarker of TP intake, and in plasma NO (Beta = 4.84; 95% CI: 0.57-9.10). CONCLUSIONS TPE in spot urine sample was positively correlated with plasma NO in Med-diets supplemented with either EVOO or nuts. The statistically significant increases in plasma NO were associated with a reduction in systolic and diastolic BP levels, adding to the growing evidence that polyphenols might protect the cardiovascular system by improving the endothelial function and enhancing endothelial synthesis of NO.
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Affiliation(s)
- A Medina-Remón
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Spain; CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain
| | - A Tresserra-Rimbau
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Nutrition and Food Science Department, XaRTA, INSA, Pharmacy School, University of Barcelona, Barcelona, Spain
| | - A Pons
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Spain
| | - J A Tur
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Spain
| | - M Martorell
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Spain
| | - E Ros
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - P Buil-Cosiales
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, and Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - E Sacanella
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Spain; CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain
| | - M I Covas
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Cardiovascular Risk and Nutrition Research Group, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - D Corella
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Preventive Medicine and Public Health, Nutrition and Food Sciences, School of Medicine, University of Valencia, Spain
| | - J Salas-Salvadó
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Human Nutrition Unit, School of Medicine, IISPV, University Rovira i Virgili, Reus, Spain
| | - E Gómez-Gracia
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Epidemiology, School of Medicine, University of Malaga, Spain
| | - V Ruiz-Gutiérrez
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Nutrition and Lipids Metabolism, Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Sevilla, Spain
| | - M Ortega-Calvo
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Family Medicine, Primary Care Division of Sevilla, Esperanza Macarena Health Center, Sevilla, Spain
| | - M García-Valdueza
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Institut Universitari d'Investigació en Ciències de la Salut(IUNICS), Palma de Mallorca, Spain
| | - F Arós
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Clinical Trials Unit, Hospital Universitario de Araba(HUA), Vitoria, Spain
| | - G T Saez
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Biochemistry and Molecular Biology Service of Clinical Analysis, Hospital General Universitario, Universitat de Valencia, Spain
| | - L Serra-Majem
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Institute of Biomedical and Health Sciences of Las Palmas, IUIBS, University of Las Palmas de Gran Canaria, Spain
| | - X Pinto
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, University of Barcelona, Spain
| | - E Vinyoles
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Mina Primary Care Center, University of Barcelona, Spain
| | - R Estruch
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Spain; CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain
| | - R M Lamuela-Raventos
- CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Nutrition and Food Science Department, XaRTA, INSA, Pharmacy School, University of Barcelona, Barcelona, Spain.
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Tresserra-Rimbau A, Rimm EB, Medina-Remón A, Martínez-González MA, de la Torre R, Corella D, Salas-Salvadó J, Gómez-Gracia E, Lapetra J, Arós F, Fiol M, Ros E, Serra-Majem L, Pintó X, Saez GT, Basora J, Sorlí JV, Martínez JA, Vinyoles E, Ruiz-Gutiérrez V, Estruch R, Lamuela-Raventós RM. Inverse association between habitual polyphenol intake and incidence of cardiovascular events in the PREDIMED study. Nutr Metab Cardiovasc Dis 2014; 24:639-647. [PMID: 24552647 DOI: 10.1016/j.numecd.2013.12.014] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [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: 11/06/2013] [Revised: 12/19/2013] [Accepted: 12/30/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Epidemiologic and biological evidence supports an inverse association between polyphenol consumption and the risk of cardiovascular disease (CVD). However, no previous studies have prospectively evaluated the relationship between polyphenol intake and the incidence of CVD in such a comprehensive way. The aim was to evaluate the association between intakes of total polyphenol and polyphenol subgroups, and the risk of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes) in the PREDIMED study. METHODS AND RESULTS The present work is an observational study within the PREDIMED trial. Over an average of 4.3 years of follow-up, there were 273 confirmed cases of CVD among the 7172 participants (96.3%) who completed a validated 137-item food frequency questionnaire (FFQ) at baseline. Polyphenol consumption was calculated by matching food consumption data from the FFQ with the Phenol-Explorer database on polyphenol content of each reported food. After multivariate adjustment, a 46% reduction in risk of CVD risk was observed comparing Q5 vs. Q1 of total polyphenol intake (HR = 0.54; 95% confidence interval [CI] = 0.33-0.91; P-trend = 0.04). The polyphenols with the strongest inverse associations were flavanols (HR = 0.40; CI 0.23-0.72; P-trend = 0.003), lignans (HR = 0.51; CI 0.30-0.86; P-trend = 0.007), and hydroxybenzoic acids (HR = 0.47; CI 0.26-0.86; P-trend 0.02). CONCLUSION Greater intake of polyphenols, especially from lignans, flavanols, and hydroxybenzoic acids, was associated with decreased CVD risk. Clinical trials are needed to confirm this effect and establish accurate dietary recommendations.
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Affiliation(s)
- A Tresserra-Rimbau
- Department of Nutrition and Food Science, XaRTA, INSA, Pharmacy School, University of Barcelona (UB), Barcelona, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain
| | - E B Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - A Medina-Remón
- Department of Nutrition and Food Science, XaRTA, INSA, Pharmacy School, University of Barcelona (UB), Barcelona, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain
| | - M A Martínez-González
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - R de la Torre
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research, Barcelona, Spain
| | - D Corella
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Epidemiology, Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
| | - J Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Human Nutrition Unit, School of Medicine, IISPV, University Rovira i Virgili, Reus, Spain
| | - E Gómez-Gracia
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Epidemiology, School of Medicine, University of Malaga, Málaga, Spain
| | - J Lapetra
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain
| | - F Arós
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - M Fiol
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Institut Universitari d'Investigació en Ciències de la Salut, Palma de Mallorca, Spain
| | - E Ros
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain
| | - L Serra-Majem
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Palmas de Gran Canaria, Spain
| | - X Pintó
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Lipid Unit, Department of Internal Medicine, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, FIPEC, Barcelona, Spain
| | - G T Saez
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Biochemistry, School of Medicine, University of Valencia, Valencia, Spain
| | - J Basora
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Primary Care Division, Catalan Institute of Health, Institut d'Investigació en Atenció Primària Jordi Gol, Reus, Spain
| | - J V Sorlí
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Valencian Institute of Health, Valencia, Spain
| | - J A Martínez
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Nutrition and Food Sciences, Physiology and Toxicology, University of Navarra, Pamplona, Spain
| | - E Vinyoles
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; La Mina Primary Care Center, UB, Barcelona, Spain
| | - V Ruiz-Gutiérrez
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Nutrition and Lipids Metabolism, Instituto de la Grasa, Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - R Estruch
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain; Department of Internal Medicine, Hospital Clínic, IDIBAPS, UB, Barcelona, Spain
| | - R M Lamuela-Raventós
- Department of Nutrition and Food Science, XaRTA, INSA, Pharmacy School, University of Barcelona (UB), Barcelona, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Spain.
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8
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Tresserra-Rimbau A, Medina-Remón A, Pérez-Jiménez J, Martínez-González MA, Covas MI, Corella D, Salas-Salvadó J, Gómez-Gracia E, Lapetra J, Arós F, Fiol M, Ros E, Serra-Majem L, Pintó X, Muñoz MA, Saez GT, Ruiz-Gutiérrez V, Warnberg J, Estruch R, Lamuela-Raventós RM. Dietary intake and major food sources of polyphenols in a Spanish population at high cardiovascular risk: the PREDIMED study. Nutr Metab Cardiovasc Dis 2013; 23:953-959. [PMID: 23332727 DOI: 10.1016/j.numecd.2012.10.008] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [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: 08/03/2012] [Revised: 09/20/2012] [Accepted: 10/12/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Epidemiological data have shown an inverse association between the consumption of polyphenol-rich foods and the risk of cardiovascular disease or overall mortality. A comprehensive estimation of individual polyphenol intake in nutritional cohorts is needed to gain a better understanding of this association. The aim of this study was to estimate the quantitative intake of polyphenols and the major dietary sources in the PREDIMED (PREvención con DIeta MEDiterránea) cohort using individual food consumption records. METHODS AND RESULTS The PREDIMED study is a large, parallel-group, multicentre, randomised, controlled 5-year feeding trial aimed at assessing the effects of the Mediterranean diet on the primary prevention of cardiovascular disease. A total of 7200 participants, aged 55-80 years, completed a validated 1-year food frequency questionnaire (FFQ) at baseline. Polyphenol consumption was calculated by matching food consumption data from the FFQ with the recently developed Phenol-Explorer database on polyphenol content in foods. The mean total polyphenol intake was 820 ± 323 mg day⁻¹ (443 ± 218 mg day⁻¹ of flavonoids and 304 ± 156 mg day⁻¹ of phenolic acids). Hydroxycinnamic acids were the phenolic group with the highest consumption and 5-caffeoylquinic acid was the most abundantly ingested individual polyphenol. The consumption of olives and olive oil was a differentiating factor in the phenolic profile of this Spanish population compared with other countries. CONCLUSION In Mediterranean countries, such as Spain, the main dietary source of polyphenols is coffee and fruits, but the most important differentiating factor with respect to other countries is the consumption of polyphenols from olives and olive oil.
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Affiliation(s)
- A Tresserra-Rimbau
- Nutrition and Food Science Department, XaRTA, INSA, Pharmacy School, University of Barcelona (UB), Barcelona, Spain; CIBER CB06/03 Fisiopatología de la Obesidad y la Nutrición, Madrid, Spain; RETICS RD06/0045, Instituto de Salud Carlos III, Madrid, Spain
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