The DiSA-UMH Study: a prospective cohort study in health science students from Miguel Hernández University

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Abstract

Introduction: Young adulthood is an important stage to establish dietary habits and lifestyle behaviors that could be linked to the long-term development of chronic diseases in later life. The 3 years follow-up prospective cohort DiSA-UMH study was set up with the main objectives of determining the nutritional status, lifestyle behaviors and health status, assessing the possible changes during the follow-up, and estimating their influence on the occurrence and development of chronic diseases. Material and Methods: Baseline information of 1204 health science students from Universidad Miguel Hernández (UMH) aged between 17 and 35 years was collected during the period from 2006 to 2012. All the participants completed a general questionnaire divided into separate sections that included a food frequency questionnaire, specific questions on physical activity, tobacco consumption, nutritional labelling use, weight, height, health status, and questions about the diagnosis of several diseases. In order to validate self-reported data, several reliability/validity investigations with different subsamples were specifically conducted. After baseline questionnaire, students were asked to obtain anthropometric measurements and fasting blood samples. To evaluate our assessment of dietary intake, between three and nine 24-hour recalls administered by telephone were conducted over one year. Results: The first follow-up period of 3-years finished in 2015 and the second 3-year follow-up period is still ongoing. Although the retention rates during these assessment periods were 59.2% and 52.2% respectively, the losses of follow-up happened in a random way because of characteristics of participants and non-participants during follow-up were similar.

Translated abstract

Introducción: La edad adulta es una etapa importante para el establecimiento de hábitos dietéticos y estilos de vida que pueden estar implicados en el desarrollo de enfermedades crónicas posteriormente. El estudio de cohortes prospectivo con seguimiento a 3 años DiSA-UMH nació con el objetivo de determinar el estado nutricional, estilos de vida y la salud, evaluar los posibles cambios de estos durante el seguimiento y ver cómo influyen en la aparición y desarrollo enfermedades crónicas. Material y Métodos: La información basal de 1204 estudiantes de ciencias de la salud de entre 18 y 35 años de la Universidad Miguel Hernández fue recogida entre los años 2006 y 2012. Todos los participantes autocumplimentaron un cuestionario que incluía un cuestionario de frecuencia de alimentos, preguntas sobre actividad física, consumo de tabaco, alcohol, uso del etiquetado nutricional, peso, talla, tensión arterial sistólica y diastólica y estado de salud, así como preguntas sobre la presencia de diversas enfermedades. Con el fin de validar la información autoaportada, se realizaron específicamente diversos estudios de validación con diferentes submuestras. Tras el cuestionario basal, se les preguntó a los estudiantes para obtener medidas antropométricas y muestra de sangre en ayunas. Para valorar la evaluación de ingesta dietética se recogieron entre 3 y 9 recordatorios de 24 horas realizados por teléfono durante un año. Resultados: En 2015 finalizó el trabajo de campo del primer seguimiento de 3 años, estando aún en marcha el segundo periodo de 3 años de seguimiento. Aunque las tasas de retención durante estos periodos fueron de 59,2% y 52,2% respectivamente, las pérdidas de seguimiento se produjeron de forma aleatoria, ya que las características generales de los que participan y no participan en el seguimiento eran similares.

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Reproducibility and validity of a food frequency questionnaire among pregnant women in a Mediterranean area

Jesús Vioque, Eva María Navarrete-Muñoz, Daniel Gimenez-Monzo … (2013)

Background Studies exploring the role of diet during pregnancy are still scarce, in part due to the complexity of measuring diet and to the lack of valid instruments. The aim of this study was to examine the reproducibility and validity (against biochemical biomarkers) of a semi-quantitative food frequency questionnaire (FFQ) in pregnant women. Methods Participants were 740 pregnant women from a population-based birth cohort study in Valencia (INMA Study). We compared nutrient and food intakes from FFQs estimated for two periods of pregnancy (reproducibility), and compared energy-adjusted intake of several carotenoids, folate, vitamin B12, vitamin C and α-tocopherol of the FFQ in the first trimester with their concentration in blood specimens (validity). Results Significant correlations for reproducibility were found for major food groups and nutrients but not for lycopene (r=0.06); the average correlation coefficients for daily intake were 0.51 for food groups and 0.61 for nutrients. For validity, statistically significant correlations were observed for vitamin C (0.18), α-carotene (0.32), β-carotene (0.22), lutein-zeaxantin (0.29) and β-cryptoxantin(0.26); non-significant correlations were observed for retinol, lycopene, α-tocopherol, vitamin B12 and folate (r≤0.12). When dietary supplement use was considered, correlations were substantially improved for folate (0.53) and to a lesser extent for vitamin B12 (0.12) and vitamin C (0.20). Conclusion This study supports that the FFQ has a good reproducibility for nutrient and food intake, and can provide a valid estimate of several important nutrients during pregnancy.

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Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain.

Carlos A Ramos, J Quiles, J Vioque (2000)

To analyse the association of time watching television (TV) and physical activity with obesity in the Mediterranean area of Spain with the highest prevalence of obesity. Cross-sectional study. Valencia Region in Spain. A representative sample of 814 men and 958 women, aged 15 y and older, participating in a Health and Nutrition Survey conducted in 1994. Height and weight were directly measured during home interviews. The outcome measure was obesity, defined as a body mass index > or = 30 kg/m2. Covariates were self-reported hours of TV viewing, physical activity habits, sleeping duration, age, gender, educational level, smoking and marital status. Prevalence odds ratios (POR) estimated by logistic regression were used as effect measures. Obese people reported to spend more time watching TV (mean +/- s.d.: 3.6 +/- 1.5 h/day) than non-obese ones (3.0 +/- 1.4 h/day), and less sleeping time. In multivariate analysis, obesity was associated with TV viewing, sleeping time and physical activity at work. People watching TV > 4 h/day showed a higher adjusted prevalence odds ratio of obesity, POR = 2.38 (95% confidence interval, 1.54-3. 69), compared with those watching TV or = 9 h/day presented a lower POR of obesity than those sleeping < or = 6 h/day, POR = 0.43 (0.27-0.67). Statistically significant dose-responses were observed for both associations, so that the prevalence odds ratio of obesity was 30% higher for each hour of increased TV viewing and 24% lower for each additional hour of sleeping time. In addition, the prevalence of obesity was lowest among single people, those more physically active at work, and those with a high educational level. Time spent watching television and a low physical activity at work were related to obesity in adults. The inverse association between obesity and sleep duration deserves further research.

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Validity and reproducibility of self-reported total physical activity--differences by relative weight.

Kenneth Norman, D Wolk, A Bergström … (2001)

Physical activity is hypothesized to reduce the risk of obesity and several other chronic diseases and enhance longevity. However, most of the questionnaires used measure only part of total physical activity, occupational and/or leisure-time activity, which might lead to misclassification of total physical activity level and to dilution of risk estimates. We evaluated the validity and reproducibility of a short self-administered physical activity questionnaire, intended to measure long-term total daily 24 h physical activity. The questionnaire included questions on level of physical activity at work, hours per day of walking/bicycling, home/household work, leisure-time activity/inactivity and sleeping and was sent twice during one year (winter/spring and late summer). Two 7-day activity records, performed 6 months apart, were used as the reference method. One-hundred and eleven men, aged 44-78, completed the questionnaire and one or two activity records. The physical activity levels were measured as metabolic equivalents (MET)xh/day. Spearman correlation coefficient between total daily activity score estimated from the first questionnaire and the records (validity) was 0.56 (deattenuated) and between the first and the second questionnaire (reproducibility) 0.65. Significantly higher validity correlations were observed in men with self-reported body mass index below 26 kg/m(2) than in heavier men (r=0.73 vs r=0.39). This study indicates that the average total daily physical activity scores can be estimated satisfactorily in men using this simple self-administered questionnaire.