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      Diet quality, assessed by the Healthy Eating Index-2010, and exercise associated factors of obesity: a cross-sectional study Translated title: Calidad de la dieta, evaluada por el Healty Eating Index-2010, y factores de obesidad asociados con el ejercicio: estudio transversal

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          Abstract

          Abstract Introduction Certain weight management methods may be associated with unhealthy dietary intakes, skewing toward certain dietary components and lacking others. Management of weight should not ignore the quality of the diet, as both obesity and poor diet are associated with higher risk of chronic disease. Objective: To conduct a diet quality and exercise scan and observe their repercussion on BMI, in adults from Spain, Portugal, Uruguay and Mexico. Material and Methods An observational retrospective cohort study was designed, with 1181 adults aged 18-65 years. HEI-2010 score was used to assess diet quality. Data on type, days a week and hours/day of exercise, and participant’s anthropometric measures were collected. Results The mean HEI-2010 score was 65.21. There were no statistically significant differences between HEI-2010 score and BMI [p=0.706], BMI and days of exercise per week [p=0.151], BMI and hours/day of exercise [p=0.590] and BMI and being active [>3 days/week] [p=0.106]. On the contrary, overall exercise influenced BMI significantly [p<0.001]. Conclusions Dietary patterns may help to prevent weight gain and fight overweight and obesity. This study, however, did not observe associations between the quality of the diet nor specifics of exercise with lower BMIs. The quality of the diet of adults in Spain, Portugal, Uruguay and Mexico fell short of recommendations.

          Translated abstract

          Resumen Introducción Ciertos métodos de control de peso pueden estar asociados con ingestas dietéticas poco saludables, inclinándose hacia ciertos componentes de la dieta y omitiendo otros. El manejo del peso no debe ignorar la calidad de la dieta, ya que tanto la obesidad como la mala alimentación están asociadas con un mayor riesgo de enfermedad crónica. Objetivo: Realizar un exploración de la calidad de la dieta y el ejercicio y observar su repercusión en el IMC, en adultos de España, Portugal, Uruguay y Méjico. Material y Métodos Se diseñó un estudio observacional de cohorte retrospectivo, con 1181 adultos de 18 a 65 años. La puntuación HEI-2010 se utilizó para evaluar la calidad de la dieta. Se recopilaron datos sobre el tipo, días a la semana y horas/día de ejercicio, y las medidas antropométricas de los participantes. Resultados La puntuación media del HEI-2010 fue de 65,21. No se encontraron diferencias estadísticamente significativas entre el puntaje HEI-2010 y el IMC [p=0,706], el IMC y los días de ejercicio por semana [p=0,151], las horas/día de ejercicio [p=0,590] y si se es activo [>3 días/semana] [p=0,106]. Por el contrario, el ejercicio influyó significativamente en el IMC [p<0,001]. Conclusiones El control del peso/IMC, al comer menos calorías y hacer ejercicio, puede ser un componente útil en una estrategia de control de peso saludable que contribuya a mejorar la calidad de la dieta.

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          Most cited references28

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          Primary prevention of cardiovascular disease with a Mediterranean diet.

          Observational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events. In a multicenter trial in Spain, we randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years. A total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported. Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. (Funded by the Spanish government's Instituto de Salud Carlos III and others; Controlled-Trials.com number, ISRCTN35739639.).
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            Update of the Healthy Eating Index: HEI-2010.

            The Healthy Eating Index (HEI) is a measure of diet quality in terms of conformance with federal dietary guidance. Publication of the 2010 Dietary Guidelines for Americans prompted an interagency working group to update the HEI. The HEI-2010 retains several features of the 2005 version: (a) it has 12 components, many unchanged, including nine adequacy and three moderation components; (b) it uses a density approach to set standards, eg, per 1,000 calories or as a percentage of calories; and (c) it employs least-restrictive standards; ie, those that are easiest to achieve among recommendations that vary by energy level, sex, and/or age. Changes to the index include: (a) the Greens and Beans component replaces Dark Green and Orange Vegetables and Legumes; (b) Seafood and Plant Proteins has been added to capture specific choices from the protein group; (c) Fatty Acids, a ratio of polyunsaturated and monounsaturated to saturated fatty acids, replaces Oils and Saturated Fat to acknowledge the recommendation to replace saturated fat with monounsaturated and polyunsaturated fatty acids; and (d) a moderation component, Refined Grains, replaces the adequacy component, Total Grains, to assess overconsumption. The HEI-2010 captures the key recommendations of the 2010 Dietary Guidelines and, like earlier versions, will be used to assess the diet quality of the US population and subpopulations, evaluate interventions, research dietary patterns, and evaluate various aspects of the food environment. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
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              Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies.

              Dietary patterns consider synergistic effects compared with isolated foods or nutrients on health outcomes. The aim of this systematic review and meta-analysis was to examine the associations of diet quality as assessed by the Healthy Eating Index (HEI), the Alternate Healthy Eating Index (AHEI), and the Dietary Approaches to Stop Hypertension (DASH) score and the risk of all-cause mortality, cardiovascular mortality or incidence, cancer mortality or incidence, type 2 diabetes mellitus, and neurodegenerative diseases. A literature search was performed using the electronic databases MEDLINE, SCOPUS, and EMBASE with an end date of May 10, 2014. Study-specific risk ratios were pooled using a random effect model by the Cochrane software package Review Manager 5.2. Fifteen cohort studies (34 reports), including 1,020,642 subjects, met the criteria and were included in the meta-analysis. Diets of the highest quality, as assessed by the HEI, AHEI, and DASH score, resulted in a significant risk reduction (RR) for all-cause mortality (RR 0.78, 95% CI 0.76 to 0.80; P<0.00001; I²=61%, 95% CI 20% to 81%), cardiovascular disease (incidence or mortality) (RR 0.78, 95% CI 0.75 to 0.81; P<0.00001; I²=45%, 95% CI 13% to 66%), cancer (incidence or mortality) (RR 0.85, 95% CI 0.82 to 0.88; P<0.00001; I²=77%, 95% CI 68% to 84%), and type 2 diabetes mellitus (RR 0.78, 95% CI 0.72 to 0.85; P<0.00001; I²=74%, 95% CI 52% to 86%). Differences observed for neurodegenerative diseases were not significant. Egger regression tests provided no evidence of publication bias. Diets that score highly on the HEI, AHEI, and DASH are associated with a significant reduction in the risk of all-cause mortality, cardiovascular disease, cancer, and type 2 diabetes mellitus by 22%, 22%, 15%, and 22%, respectively, and therefore is of high public health relevance.
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                Author and article information

                Journal
                renhyd
                Revista Española de Nutrición Humana y Dietética
                Rev Esp Nutr Hum Diet
                Academia Española de Nutrición y Dietética (Pamplona, Navarra, Spain )
                2173-1292
                2174-5145
                June 2021
                : 25
                : 2
                : 189-198
                Affiliations
                [1] Madrid orgnameCentros de Investigación en Nutrición y Salud (Grupo CINUSA) España
                Article
                S2174-51452021000200189 S2174-5145(21)02500200189
                10.14306/renhyd.25.2.1109
                a78fa96f-2951-4c80-907d-dcffba832768

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 15 September 2020
                : 16 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 10
                Product

                SciELO Spain

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                Investigations

                Obesity,Body Mass Index,Diet, Food, and Nutrition,Diet, Healthy,Exercise,Healthy eating index,Índice de Masa Corporal,Nutrición, Alimentación y Dieta,Dieta Saludable,Obesidad,Ejercicio Físico,Índice de alimentación saludable

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