Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública(CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Instituto de Investigación Biosanitaria de Granada, IBS GRANADA, Granada, Spain.
Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdisNa), Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Clin Nutr. 2020 Apr;39(4):1161-1173. doi: 10.1016/j.clnu.2019.04.032. Epub 2019 May 2.
Socioeconomic disparities and lifestyle factors are likely to determine the overall quality of the diet. In addition, overeating is compatible with inadequate micronutrient intake and it can lead to adverse health outcomes.
To assess adequacy of dietary nutrient intake and to investigate the influence of socioeconomic and lifestyle factors on nutrient density in a large primary cardiovascular prevention trial conducted in healthy participants with metabolic syndrome (MetS) to assess the cardiovascular effects of an energy-restricted Mediterranean diet (PREDIMED-Plus).
Baseline cross-sectional analysis of the PREDIMED-Plus trial with 6646 Spanish participants (aged 55-75 years in men and 60-75 years in women) with overweight/obesity and MetS. Energy and nutrient intake (for 10 nutrients) were calculated using a validated 143-item Food Frequency Questionnaire (FFQ) and nutrient density was estimated dividing the absolute nutrient intake by total energy intake. The prevalence of inadequate intake was estimated according to dietary reference intakes. Multivariable linear regression models were fitted to examine associations between socioeconomic status or lifestyle factors and nutrient density.
A considerable proportion of the screened participants showed a deficient intake of vitamins A, D, E, B, calcium, magnesium and dietary fibre. Inadequate intake of four or more of the ten nutrients considered was present in 17% of participants. A higher nutrient density was directly and significantly associated with female sex, higher educational level and a better adherence to the Mediterranean diet. Lifestyle factors such as non-smoking and avoidance of sedentary lifestyles were also independently associated with better nutrient density.
Patients with MetS, despite being overweight, exhibited suboptimal nutrient intake, especially among men. Low nutrient density diet can be largely explained by differences in socioeconomic and lifestyle factors. These results highlight the importance of focussing on nutritional education in vulnerable populations, taking into account nutrient requirements.
社会经济差异和生活方式因素可能决定整体饮食质量。此外，暴饮暴食与微量营养素摄入不足兼容，并可能导致不良健康后果。
评估饮食营养素摄入的充足性，并调查社会经济和生活方式因素对代谢综合征（MetS）健康参与者进行的大型一级心血管预防试验中营养素密度的影响，以评估能量限制的地中海饮食（PREDIMED-Plus）对心血管的影响。
对 PREDIMED-Plus 试验进行基线横断面分析，共有 6646 名西班牙参与者（男性年龄 55-75 岁，女性年龄 60-75 岁）超重/肥胖和 MetS。使用经过验证的 143 项食物频率问卷（FFQ）计算能量和营养素摄入（10 种营养素），并通过将绝对营养素摄入量除以总能量摄入量来估算营养素密度。根据膳食参考摄入量估计摄入不足的发生率。拟合多变量线性回归模型，以检查社会经济地位或生活方式因素与营养素密度之间的关联。
相当一部分筛选参与者表现出维生素 A、D、E、B、钙、镁和膳食纤维摄入不足。十种营养素中有四种或更多种摄入不足的参与者占 17%。较高的营养素密度与女性、较高的教育水平和更好地遵循地中海饮食直接且显著相关。非吸烟和避免久坐不动的生活方式等生活方式因素也与更好的营养素密度独立相关。
尽管患有 MetS 的患者超重，但表现出的营养素摄入不足，尤其是男性。低营养素密度饮食在很大程度上可以通过社会经济和生活方式因素的差异来解释。这些结果强调了在弱势群体中关注营养教育的重要性，同时考虑到营养需求。
