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      Beneficial changes in food consumption and nutrient intake after 10 years of follow-up in a Mediterranean cohort: the SUN project

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          Abstract

          Background

          The assessment of changes in dietary habits provides interesting information on whether or not the observed trends are in line with accepted nutritional guidelines. The objective was to evaluate within-subject longitudinal changes in food consumption and nutrient intake and in a 10-year follow-up study.

          Methods

          The SUN ( Seguimiento Universidad de Navarra) project is a prospective Spanish cohort study. Diet was assessed using a 136-item food-frequency questionnaire (FFQ), previously validated in Spain. The participants were 3036 university graduates (55.8 % women) of Spain and the main outcome measures the changes in dietary quality and in food consumption and nutrient intake. Paired t-tests and conditional logistic regression models were used to evaluate within-subject longitudinal dietary changes and the risk of inadequacy respectively, after 10 years of follow-up.

          Results

          During follow-up, participants showed a relevant and significant increase (p < 0.001) in the consumption of fruits (7.4 %), vegetables (8.6 %), low-fat dairy products (35.2 %), lean meat (12.4 %), fish (2.9 %), whole grains (53.2 %), nuts (52.4 %) and a significant decrease in legumes (−7.4 %), whole-fat dairy products (−44.2 %), red meat (−17.6 %), sugar-sweetened beverages (−58.7 %) and wine (−11.9 %). With respect to nutrients, we found a higher proportion of carbohydrates (3.6 %) and fiber (7.4 %) and a decrease in total energy intake (2.7 %), total fat (−4.5 %), SFA (−9.4 %), MUFA (−4.9 %), PUFA (−12.7 %), w-3 and w-6 fatty acids (−9.1 and −20.5 % respectively) and cholesterol (−9.6 %).

          Conclusions

          In this Mediterranean cohort study, mainly beneficial changes in the consumption of most foods and macronutrients were observed after 10 years of follow-up.

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          Most cited references40

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          The Mediterranean Diet and Nutritional Adequacy: A Review

          The Mediterranean dietary pattern, through a healthy profile of fat intake, low proportion of carbohydrate, low glycemic index, high content of dietary fiber, antioxidant compounds, and anti-inflammatory effects, reduces the risk of certain pathologies, such as cancer or Cardiovascular Disease (CVD). Nutritional adequacy is the comparison between the nutrient requirement and the intake of a certain individual or population. In population groups, the prevalence of nutrient inadequacy can be assessed by the probability approach or using the Estimated Average Requirement (EAR) cut-point method. However, dietary patterns can also be used as they have moderate to good validity to assess adequate intakes of some nutrients. The objective of this study was to review the available evidence on the Nutritional Adequacy of the Mediterranean Diet. The inclusion of foods typical of the Mediterranean diet and greater adherence to this healthy pattern was related to a better nutrient profile, both in children and adults, with a lower prevalence of individuals showing inadequate intakes of micronutrients. Therefore, the Mediterranean diet could be used in public health nutrition policies in order to prevent micronutrient deficiencies in the most vulnerable population groups.
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            Projected Prevalence of Inadequate Nutrient Intakes in Europe

            Background: The purpose of this study was to analyze the prevalence of nutrient intake inadequacy in Europe, applying the Nordic Nutritional Recommendations in the context of the EURRECA Network of Excellence. Methods: Nutrient data was obtained from the European Nutrition and Health Report II. Those nutritional surveys using a validated food frequency questionnaire or diet history and a food diary/ register with at least 7 days of registers or with an adjustment for intraindividual variability were included. The nutrients analyzed were: vitamin C, vitamin D, vitamin B 12 , folic acid, calcium, iron, zinc, selenium, copper, and iodine. The estimated average requirement cut point was applied to estimate inadequacy. The Nordic and Institute of Medicine nutrient recommendations were used as references. Results: The mean prevalence of inadequacy was below 11% for zinc, iron, and vitamin B 12 (only in the elderly), and it was 11–20% for copper in adults and the elderly and for vitamin B 12 in adults and vitamin C in the elderly. The prevalence was above 20% for vitamin D, folic acid, calcium, selenium, and iodine in adults and the elderly and for vitamin C in adults. Conclusions: Vitamin C, vitamin D, folic acid, calcium, selenium, and iodine were the nutrients showing a higher prevalence of inadequate intakes in Europe.
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              Longitudinal analysis of dietary patterns in Chinese adults from 1991 to 2009.

              In the present study, we aimed to identify the changes or stability in the structure of dietary patterns and tracking, trends and factors related to the adherence to these dietary patterns in China from 1991 to 2009. We analysed dietary data collected during seven waves of the China Health and Nutrition Survey and included 9253 adults with complete dietary data for three or more waves. Dietary intake assessment was carried out over a 3 d period with 24 h recalls and a household food inventory. Using factor analysis in each wave, we found that the structure of the two dietary patterns identified remained stable over the studied period. The traditional southern dietary pattern was characterised by high intakes of rice, fresh leafy vegetables, low-fat red meat, pork, organ meats, poultry and fish/seafood and low intakes of wheat flour and maize/coarse grains and the modern high-wheat dietary pattern was characterised by high intakes of wheat buns/breads, cakes/cookies/pastries, deep-fried wheat, nuts/seeds, starchy root/tuber products, fruits, eggs/egg products, soya milk, animal-based milk and instant noodles/frozen dumplings. Temporal tracking (maintenance of a relative position over time) was higher for the traditional southern dietary pattern, whereas adherence to the modern high-wheat dietary pattern had an upward trend over time. Higher income, education and urbanicity levels were positively associated with both the dietary patterns, but the association became weaker in the later years. These results suggest that even in the context of rapid economic changes in China, the way people chose to combine their foods remained relatively stable. However, the increasing popularity of the modern high-wheat dietary pattern, a pattern associated with several energy-dense foods, is a cause of concern.
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                Author and article information

                Contributors
                0034 948 425 600 , cfuente@unav.es
                0034 948 425 600 , izazpe@unav.es
                0034 948 425 600 , ssantiago@unav.es
                0034 948 425 600 , mbes@unav.es
                0034 948 425 600 , mcanela@unav.es
                0034 948 425 600 , ageas@alumni.unav.es
                + 34 948 42 56 00 , mamartinez@unav.es
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                1 March 2016
                1 March 2016
                2016
                : 16
                : 203
                Affiliations
                [ ]Department of Preventive Medicine and Public Health School of Medicine- Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31080 Pamplona, Navarra Spain
                [ ]CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
                [ ]Navarra’s Health Research Institute (IDISNA), Pamplona, Spain
                [ ]Department of Nutrition and Food Sciences and Physiology, School of Pharmacy, University of Navarra, Irunlarrea 1, 31080 Pamplona, Navarra Spain
                Article
                2739
                10.1186/s12889-016-2739-0
                4774086
                26932495
                6168521e-9666-428f-b1a3-034595e08886
                © de la Fuente-Arrillaga et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 August 2015
                : 15 January 2016
                Funding
                Funded by: Spanish Ministry of Health and European Regional Development Fund (FEDER) (Grants PI10/02993, PI10/02658,PI13/00615, PI14/01668, PI14/01798, PI14/01764, RD06/0045,G03/140), the Navarra Regional Government (45/2011, 122/2014),and the University of Navarra.
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                longitudinal changes,sun cohort,food consumption and nutrient intake
                Public health
                longitudinal changes, sun cohort, food consumption and nutrient intake

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