Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis

Department of Internal Medicine, Institut d´Investigacion Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain

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Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, 29016 Málaga, Spain

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Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain

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Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain

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Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain

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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

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Department of Health Sciences, University of Jaen, 23071 Jaen, Spain

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Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain

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Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain

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Department of Endocrinology, Institut d‘ Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain

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CIBER Diabetes y enfermedades metabólicas (CIBERDEM), ISCIII, 28029 Madrid, Spain

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Department of Endocrinology, Fundación Jiménez-Díaz, 28040 Madrid, Spain

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Lipid Clinic, Department of Endocrinology and Nutrition, IDIBAPS, Hospital Clinic, 08036 Barcelona, Spain

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Primary Care, Health Service of Navarra-Osasunbidea, 31002 Pamplona, Spain

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Unidad Gestión Clínica de Prevención, Promoción y Vigilancia de la Salud, Distrito Atención Primaria Costa del Sol, Servicio Andaluz de Salud. Red de Investigación Servicios De Salud en Enfermedades Crónicas (REDISSEC), 29651 Málaga, Spain

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Department of Medicine. University of Sevilla, 41004 Sevilla, Spain

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Primary Care Division of Barcelona, Institut Català de la Salud-IDIAP Jordi Gol, 08007 Barcelona, Spain

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ABS Reus V. Centre d’Assistència Primària Marià Fortuny, SAGESSA, 43203 Reus, Spain

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Nutrients 2019, 11(5), 958; https://doi.org/10.3390/nu11050958

Received: 16 March 2019 / Revised: 22 April 2019 / Accepted: 24 April 2019 / Published: 26 April 2019

(This article belongs to the Special Issue Diet Diversity and Diet Quality)

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Abstract

Dietary guidelines emphasize the importance of a varied diet to provide an adequate nutrient intake. However, an older age is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases, such as metabolic syndrome (MetS). To assess the association between dietary diversity (DD) and nutrient intake adequacy and to identify demographic variables associated with DD, we cross-sectionally analyzed baseline data from the PREDIMED-Plus trial: 6587 Spanish adults aged 55–75 years, with overweight/obesity who also had MetS. An energy-adjusted dietary diversity score (DDS) was calculated using a 143-item validated semi-quantitative food frequency questionnaire (FFQ). Nutrient inadequacy was defined as an intake below 2/3 of the dietary reference intake (DRI) forat least four of 17 nutrients proposed by the Institute of Medicine (IOM). Logistic regression models were used to evaluate the association between DDS and the risk of nutritionally inadequate intakes. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake: odds ratio (OR) = 28.56 (95% confidence interval (CI) 20.80–39.21). When we estimated food varietyfor each of the food groups, participants in the lowest quartile had a higher risk of inadequate nutrient intake for the groups of vegetables, OR = 14.03 (95% CI 10.55–18.65), fruits OR = 11.62 (95% CI 6.81–19.81), dairy products OR = 6.54 (95% CI 4.64–9.22) and protein foods OR = 6.60 (95% CI 1.96–22.24). As DDS decreased, the risk of inadequate nutrients intake rose. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow(er)s. View Full-Text

Keywords: dietary diversity; nutrient adequacy; metabolic syndrome; aging; PREDIMED-Plus study

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Cano-Ibáñez, N.; Gea, A.; Martínez-González, M.A.; Salas-Salvadó, J.; Corella, D.; Zomeño, M.D.; Romaguera, D.; Vioque, J.; Aros, F.; Wärnberg, J.; Martínez, J.A.; Serra-Majem, L.; Estruch, R.; Tinahones, F.J.; Lapetra, J.; Pintó, X.; Tur, J.A.; García-Ríos, A.; Riquelme-Gallego, B.; Delgado-Rodríguez, M.; Matía, P.; Daimiel, L.; Martín, V.; Vidal, J.; Vázquez, C.; Ros, E.; Buil-Cosiales, P.; Díaz-López, A.; Fernández-Carrión, R.; Fitó, M.; Konieczna, J.; Notario-Barandiaran, L.; Alonso-Gómez, Á.M.; Contreras-Fernández, E.; Abete, I.; Sánchez-Villegas, A.; Casas, R.; Muñoz-Garach, A.; Santos-Lozano, J.M.; Gallardo-Alfaro, L.; Basora, J.; Portoles, O.; Muñoz, M.Á.; Moñino, M.; Miralles Gisbert, S.; Moreno Rodríguez, A.; Ruiz-Canela, M.; Palau Galindo, A.; Pérez-Vega, K.A.; Bueno-Cavanillas, A. Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis. Nutrients 2019, 11, 958. https://doi.org/10.3390/nu11050958

AMA Style

Cano-Ibáñez N, Gea A, Martínez-González MA, Salas-Salvadó J, Corella D, Zomeño MD, Romaguera D, Vioque J, Aros F, Wärnberg J, Martínez JA, Serra-Majem L, Estruch R, Tinahones FJ, Lapetra J, Pintó X, Tur JA, García-Ríos A, Riquelme-Gallego B, Delgado-Rodríguez M, Matía P, Daimiel L, Martín V, Vidal J, Vázquez C, Ros E, Buil-Cosiales P, Díaz-López A, Fernández-Carrión R, Fitó M, Konieczna J, Notario-Barandiaran L, Alonso-Gómez ÁM, Contreras-Fernández E, Abete I, Sánchez-Villegas A, Casas R, Muñoz-Garach A, Santos-Lozano JM, Gallardo-Alfaro L, Basora J, Portoles O, Muñoz MÁ, Moñino M, Miralles Gisbert S, Moreno Rodríguez A, Ruiz-Canela M, Palau Galindo A, Pérez-Vega KA, Bueno-Cavanillas A. Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis. Nutrients. 2019; 11(5):958. https://doi.org/10.3390/nu11050958

Chicago/Turabian Style

Cano-Ibáñez, Naomi, Alfredo Gea, Miguel A. Martínez-González, Jordi Salas-Salvadó, Dolores Corella, M. D. Zomeño, Dora Romaguera, Jesús Vioque, Fernando Aros, Julia Wärnberg, J. A. Martínez, Lluis Serra-Majem, Ramón Estruch, Francisco J. Tinahones, José Lapetra, Xavier Pintó, Josep A. Tur, Antonio García-Ríos, Blanca Riquelme-Gallego, Miguel Delgado-Rodríguez, Pilar Matía, Lidia Daimiel, Vicente Martín, Josep Vidal, Clotilde Vázquez, Emilio Ros, Pilar Buil-Cosiales, Andrés Díaz-López, Rebeca Fernández-Carrión, Montserrat Fitó, Jadwiga Konieczna, Leyre Notario-Barandiaran, Ángel M. Alonso-Gómez, Eugenio Contreras-Fernández, Itziar Abete, Almudena Sánchez-Villegas, Rosa Casas, Araceli Muñoz-Garach, José M. Santos-Lozano, Laura Gallardo-Alfaro, Josep Basora, Olga Portoles, Miguel Á. Muñoz, Manuel Moñino, Salvador Miralles Gisbert, Anai Moreno Rodríguez, Miguel Ruiz-Canela, Antoni Palau Galindo, Karla A. Pérez-Vega, and Aurora Bueno-Cavanillas. 2019. "Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis" Nutrients 11, no. 5: 958. https://doi.org/10.3390/nu11050958

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Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis

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