Dietary Intake in Population with Metabolic Syndrome: Is the Prevalence of Inadequate Intake Influenced by Geographical Area? Cross-Sectional Analysis from PREDIMED-Plus Study
by
Naomi Cano-Ibáñez 1,2,*
, Aurora Bueno-Cavanillas 1,2, Miguel A. Martínez-González 3,4,5, Dolores Corella 5,6, Jordi Salas-Salvadó 5,7, M. Dolors Zomeño 8,9, Manoli García-de-la-Hera 2,10, Dora Romaguera 5,11, J. Alfredo Martínez 5,12,13, F. Javier Barón-López 5,14, Antonio García-Ríos 5,15, Ramón Estruch 5,16, Laura García-Molina 1,2, Ángel Alonso Gómez 5,17, Josep A. Tur 5,18, Francisco Tinahones 5,19, Lluis Serra-Majem 5,20, Naiara Cubelos-Fernández 21, José Lapetra 5,22, Clotilde Vázquez 5,23, Xavier Pintó 5,24, Josep Vidal 25,26, Lidia Daimiel 13, José Juan Gaforio 2,27, Pilar Matía 28, Emilio Ros 5,29, Javier Diez-Espino 3,5,30, Rebeca Fernández-Carrión 5,6, Josep Basora 5,7, Montse Fitó 5,8, Juan Manuel Zazo 2,10, Antoni Colom 5,11, Estefanía Toledo 3,5, Andrés Díaz-López 5,7, Miguel Ángel Muñoz 31, Miguel Ruiz-Canela 3,4,5 and Alfredo Gea 3,5
Naomi Cano-Ibáñez 1,2,*, Aurora Bueno-Cavanillas 1,2, Miguel A. Martínez-González 3,4,5, Dolores Corella 5,6, Jordi Salas-Salvadó 5,7, M. Dolors Zomeño 8,9, Manoli García-de-la-Hera 2,10, Dora Romaguera 5,11, J. Alfredo Martínez 5,12,13, F. Javier Barón-López 5,14, Antonio García-Ríos 5,15, Ramón Estruch 5,16, Laura García-Molina 1,2, Ángel Alonso Gómez 5,17, Josep A. Tur 5,18, Francisco Tinahones 5,19, Lluis Serra-Majem 5,20, Naiara Cubelos-Fernández 21, José Lapetra 5,22, Clotilde Vázquez 5,23, Xavier Pintó 5,24, Josep Vidal 25,26, Lidia Daimiel 13, José Juan Gaforio 2,27, Pilar Matía 28, Emilio Ros 5,29, Javier Diez-Espino 3,5,30, Rebeca Fernández-Carrión 5,6, Josep Basora 5,7, Montse Fitó 5,8, Juan Manuel Zazo 2,10, Antoni Colom 5,11, Estefanía Toledo 3,5, Andrés Díaz-López 5,7, Miguel Ángel Muñoz 31, Miguel Ruiz-Canela 3,4,5 and Alfredo Gea 3,5
1
Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain
2
CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain
3
Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain
4
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
5
CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain
6
Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
7
Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain
8
Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain
9
Human Nutrition Unit, Blanquerna-Ramon Llull University, 08001 Barcelona, Spain
10
Miguel Hernández University, ISABIAL-FISABIO, 03202 Alicante, Spain
11
Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
12
Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain
13
Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
14
Department of Public Health, University of Málaga-IBIMA, 29016 Málaga, Spain
15
Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain
16
Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
17
Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country (UPV/EHU), 48940 Vitoria-Gasteiz, Spain
18
Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
19
Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, 29010 Málaga, Spain
20
Institute for Biomedical Research, University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain
21
Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
22
Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria, 41013 Sevilla, Spain
23
Department of Endocrinology, Fundación Jiménez-Díaz, 28040 Madrid, Spain
24
Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain
25
Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
26
CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
27
Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaén, 23071 Jaén, Spain
28
Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
29
Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigació Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain
30
Servicio Navarro de Salud, Osasunbidea, 31002 Pamplona, Spain
31
Primary Care Division of Barcelona, Institut Català de la Salud-IDIAP Jordi Gol, 08007 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(11), 1661; https://doi.org/10.3390/nu10111661
Received: 15 October 2018 / Revised: 28 October 2018 / Accepted: 31 October 2018 / Published: 4 November 2018
Inadequate diet influences chronic diseases such as cardiovascular disease (CVD), the leading cause of death in Spain. CVD figures vary from one geographical region to another; this could be associated with different food choices. Our aim was to analyse the influence of geographical area on nutrient intakes among the Spanish adult population with Metabolic Syndrome (MetS). We analysed cross-sectional baseline data from the PREDIMED-Plus study: 6646 Spanish adults, aged 55–75 years, with overweight/obesity and MetS in four geographical areas. A validated 143-item Food Frequency Questionnaire (FFQ) was used to assess energy and nutrient intakes. The prevalence of inadequate nutrient intake was estimated according to Dietary Reference Intakes (DRIs). Multivariable-adjusted logistic regression was used to assess the relationship between geographical area (North, Central, East and South areas) and inadequate nutrient intake. People in the North area consumed significantly lower amounts of vegetables and fish but more sugar and alcohol (p < 0.001) than other areas. Dietary fibre, vitamin A, E, calcium and magnesium intakes were all lower among men of North area than in the other areas (p < 0.001). Sex (women), non-smoker and physical activity were also associated to adequate nutrient intake. Geographical area influences nutrient intakes. Its effect on dietary quality should be taken into account when planning food policies.
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Keywords:
dietary intake; PREDIMED-Plus study; metabolic syndrome; place of residence; geographical area; nutrient adequacy
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MDPI and ACS Style
Cano-Ibáñez, N.; Bueno-Cavanillas, A.; Martínez-González, M.A.; Corella, D.; Salas-Salvadó, J.; Zomeño, M.D.; García-de-la-Hera, M.; Romaguera, D.; Martínez, J.A.; Barón-López, F.J.; García-Ríos, A.; Estruch, R.; García-Molina, L.; Alonso Gómez, Á.; Tur, J.A.; Tinahones, F.; Serra-Majem, L.; Cubelos-Fernández, N.; Lapetra, J.; Vázquez, C.; Pintó, X.; Vidal, J.; Daimiel, L.; Gaforio, J.J.; Matía, P.; Ros, E.; Diez-Espino, J.; Fernández-Carrión, R.; Basora, J.; Fitó, M.; Zazo, J.M.; Colom, A.; Toledo, E.; Díaz-López, A.; Muñoz, M.Á.; Ruiz-Canela, M.; Gea, A. Dietary Intake in Population with Metabolic Syndrome: Is the Prevalence of Inadequate Intake Influenced by Geographical Area? Cross-Sectional Analysis from PREDIMED-Plus Study. Nutrients 2018, 10, 1661.
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