Open Access
Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults
(Elsevier, 2024-11-05) Pérez-Vega, Karla-Alejandra; Lassale, Camille; Zomeño, María Dolores; Castañer, Olga; Salas-Salvadó, Jordi; Basterra Gortari, Francisco Javier; Corella, Dolores; Estruch, Ramón; Ros, Emilio; Tinahones, Francisco J.; Blanchart, Gemma; Malcampo, Mireia; Muñoz-Aguayo, Daniel; Schröder, Helmut; Fitó, Montserrat; Hernáez, Álvaro; Ciencias de la Salud; Osasun Zientziak
Objectives: Not skipping breakfast is associated with a better overall diet quality and lower cardiometabolic risk. However, the impact of calorie intake and dietary quality of breakfast on cardiovascular health remains unexplored. We aimed to study the associations between breakfast energy intake and quality and time trajectories of cardiometabolic traits in high cardiovascular risk participants. Design: Prospective observational exploratory study with repeated measurements. Setting: Spanish older adults. Participants: 383 participants aged 55-75 with metabolic syndrome from PREDIMED-Plus, a clinical trial involving a weight-loss lifestyle intervention based on the Mediterranean diet. Measurements: Participants were followed for 36 months. Longitudinal averages of breakfast energy intake and quality were calculated. Three categories were defined for energy intake: 20-30% (reference), <20% (low), and >30% (high). Quality was estimated using the Meal Balance Index; categories were above (reference) or below the median score (low). Natural cubic spline mixed effects regressions described trajectories of cardiometabolic indicators (anthropometry, blood pressure, lipids, glucose, glycated hemoglobin, and kidney function) in breakfast groups. Inter-group differences in predicted values were estimated by linear regressions. Analyses were adjusted for age, sex, PREDIMED-Plus intervention group, education, smoking, physical activity, and total daily kilocalorie intake. Lipid profile analyses were further adjusted for baseline hypercholesterolemia, blood pressure analyses for baseline hypertension, and glucose/glycated hemoglobin analyses for baseline diabetes. Breakfast energy intake analyses were adjusted for breakfast quality, and vice versa. Results: At 36 months, compared to the reference, low- or high-energy breakfasts were associated with differences in body mass index (low: 0.61 kg/m² [95% confidence interval: 0.19; 1.02]; high: 1.18 kg/m² [0.71; 1.65]), waist circumference (low: 2.22 cm [0.96; 3.48]; high: 4.57 cm [3.13; 6.01]), triglycerides (low: 13.8 mg/dL [10.8; 16.8]; high: 28.1 cm [24.7; 31.6]), and HDL cholesterol (low: -2.13 mg/dL [-3.41; -0.85]; high: -4.56 mg/dL [-6.04; -3.09]). At 36 months, low-quality breakfast was associated with higher waist circumference (1.50 cm [0.53; 2.46]), and triglycerides (5.81 mg/dL [3.50; 8.12]) and less HDL cholesterol (-1.66 mg/dL [-2.63; -0.69]) and estimated glomerular filtration rate (-1.22 mL/min/1.73m2 [-2.02; -0.41]). Conclusions: Low- or high-energy and low-quality breakfasts were associated with higher adiposity and triglycerides, and lower HDL cholesterol in high-risk older adults. Low-quality breakfasts were also linked to poorer kidney function.
Open Access
Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult mediterranean population
(Springer, 2024) Baenas, I.; Camacho-Barcia, L.; Granero, R.; Razquin, Cristina; Corella, Dolores; Gómez-Martínez, Carlos; Castañer, Olga; Martínez, J. Alfredo; Alonso Gómez, Ángel M.; Wärnberg, Julia; Vioque, Jesús; Romaguera, Dora; López Miranda, José; Estruch, Ramón; Tinahones, Francisco J.; Lapetra, José; Serra-Majem, Lluis; Cano Ibáñez, Noemí; Tur, Josep A.; Martín-Sánchez, Vicente; Pintó, Xavier; Gaforio, José J.; Matía-Martín, Pilar; Vidal, Josep; Vázquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Jiménez-Murcia, S.; Dalsgaard, S.; García-Arellano, Ana; Babio, Nancy; Sorli, Jose V.; Lassale, Camille; García de la Hera, Manuela; Gómez-Gracia, Enrique; Zulet, María Ángeles; Konieczna, J.; Martín Peláez, Sandra; Tojal-Sierra, Lucas; Basterra Gortari, Francisco Javier; Las Heras-Delgado, Sara de; Portolés, Olga; Muñoz-Pérez, M. Á.; Arenas-Larriva, A. P.; Compañ-Gabucio, Laura María; Eguaras, S.; Shyam, S.; Fitó, Montserrat; Baños, R. M.; Salas-Salvadó, Jordi; Fernández-Aranda, Fernando; Ciencias de la Salud; Osasun Zientziak
Objectives: To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. Methods: n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. Results: The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. Conclusions: This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short–medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.
Open Access
Higher versus lower nut consumption and changes in cognitive performance over two years in a population at risk of cognitive decline: a cohort study
(Elsevier, 2023) Ni, Jiaqi; Nishi, Stephanie K.; Babio, Nancy; Ros, Emilio; Basterra Gortari, Francisco Javier; Corella, Dolores; Castañer, Olga; Martínez, J. Alfredo; Alonso Gómez, Ángel M.; Wärnberg, Julia; Vioque, Jesús; Romaguera, Dora; López Miranda, José; Estruch, Ramón; Tinahones, Francisco J.; Santos Lozano, José Manuel; Serra-Majem, Lluis; Cano Ibáñez, Noemí; Tur, Josep A.; Fernández-García, José Manuel; Pintó, Xavier; Delgado Rodríguez, Miguel; Matía-Martín, Pilar; Vidal, Josep; Vázquez, Clotilde; Daimiel, Lidia; Fernández-Aranda, Fernando; Ruiz Canela, Miguel; Mestres Solà, Cristina; Portolés, Olga; Sala Vila, Aleix; García-Rios, Antonio; Compañ-Gabucio, Laura María; Gómez-Gracia, Enrique; Zulet, María Ángeles; Chaplin, Alice; Casas, Rosa; Martínez Diz, Silvia; Tojal-Sierra, Lucas; Gómez Pérez, Ana María; Toledo, Estefanía; Ríos, Santiago; Ortega Azorín, Carolina; Torre, Rafael de la; Peña-Orihuela, Patricia J.; García de la Hera, Manuela; Sayón-Orea, Carmen; Malcampo, Mireia; Salas-Salvadó, Jordi; Ciencias de la Salud; Osasun Zientziak
Background: Tree nuts and peanuts (henceforth, nuts) are nutrient-dense foods rich in neuroprotective components; thus, their consumption could benefit cognitive health. However, evidence to date is limited and inconsistent regarding the potential benefits of nuts for cognitive function. Objective: To prospectively evaluate the association between nut consumption and 2-y changes in cognitive performance in older adults at cognitive decline risk. Methods: A total of 6,630 participants aged 55 to 75 y (mean age 65.04.9 y, 48.4% women) with overweight/obesity and metabolic syndrome completed a validated semi-quantitative food frequency questionnaire and a comprehensive battery of neuropsychological tests at baseline and a 2-y follow-up. Composite cognitive scores were used to assess global, general, attention, and executive function domains. Nut consumption was categorized as <1, 1 to <3, 3 to <7, and 7 servings/wk (1 serving¼30 g). Multivariable-adjusted linear regression models were fitted to assess associations between baseline nut consumption and 2-y cognitive changes. Results: Nut consumption was positively associated with 2-y changes in general cognitive function (P-trend <0.001). Compared with participants consuming <1 serving/wk of nuts, those categorized as consuming 3 to <7 and 7 servings/wk showed more favorable changes in general cognitive performance (β z-score [95% CI] ¼ 0.06 [0.00,0.12] and 0.13 [0.06,0.20], respectively). No significant changes were observed in the multivariableadjusted models for other cognitive domains assessed. Conclusion: Frequent nut consumption was associated with a smaller decline in general cognitive performance over 2 y in older adults at risk of cognitive decline. Randomized clinical trials to verify our findings are warranted.

Basterra Gortari, Francisco Javier

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