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      Nutritional Determinants of Quality of Life in a Mediterranean Cohort: The SUN Study

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          Abstract

          Health related quality of life (HRQoL) is a subjective appreciation of how personal characteristics and health influence well-being. This cross-sectional analysis aimed to quantitatively measure the influence of dietary, lifestyle, and demographic factors on HRQoL. A sub-sample of the Seguimiento Universidad de Navarra (SUN) Project, a Mediterranean cohort, was analyzed (n = 15,674). Through self-administered questionnaires the relationship between HRQoL and dietary patterns (Mediterranean-diet (MedDiet) and provegetarian food pattern (FP) assessment), lifestyles (sleeping hours, physical activity) and demographic characteristics were measured. Multivariate linear regression and flexible regression models were used to estimate the pondered effect of personal factors on Short Form-36 (SF-36) scores. Coefficients for MedDiet and provegetarian scores (β-coefficient for global SF-36 score: 0.32 (0.22, 0.42); 0.09 (0.06, 0.12) respectively for every unit increase), physical activity (β: 0.03 (0.02, 0.03) for every metabolic equivalent of task indexes (MET)-h/week) had a positive association to HRQoL. The female sex (β: −3.28 (−3.68, −2.89)), and pre-existing diseases (diabetes, β: −2.27 (−3.48, −1.06), hypertension β: −1.79 (−2.36, −1.22), hypercholesterolemia β: −1.04 (−1.48, −0.59)) account for lower SF-36 scores. Adherence to MedDiet or provegetarian FP, physical activity and sleep are associated with higher HRQoL, whereas the female sex, “other” (versus married status) and the presence of chronic diseases were associated with lower SF-36 scores in this sample.

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          Most cited references43

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          Multimorbidity and quality of life: systematic literature review and meta-analysis

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            Reproducibility of an FFQ validated in Spain.

            To evaluate the reproducibility of a semi-quantitative FFQ used in the Seguimiento Universidad de Navarra (SUN) project. The data that were analysed were collected from an FFQ answered twice by a 326-participant subsample of the SUN project (115 men, 35.3 %; 211 women, 64.7 %), with either less than 1 year or more than 1 year between responses. The questionnaire included 136 items. Pearson correlation coefficients (r) were calculated to evaluate the magnitude of the association between both measures after energy adjustment and correcting for within-person variability. We also evaluated misclassification by quintiles distribution. The highest corrected correlations among participants who answered before 1 year were found for PUFA (r = 0.99). Among participants who answered after 1 year between both questionnaires, olive oil had the highest corrected correlation (r = 0.99). The highest percentage of gross misclassification, lowest quintile in FFQ1 and highest quintile in FFQ2 or highest quintile in FFQ1 and lowest quintile in FFQ2 was for cereals, fish or seafood, and n-3 fatty acids (7.6 %). Alcoholic drinks had the highest percentage of reasonable classification, same or adjacent quintile, in FFQ1 and FFQ2 (86.4 %). Our study suggests that FFQ reproducibility is acceptable for participants who answered the same questionnaire twice less than 1 year apart. Participants who answered FFQ more than 1 year apart showed worse values on reproducibility. We consider this Spanish FFQ as an important, valid and reproducible tool in nutritional epidemiology.
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              Determining minimally important changes in generic and disease-specific health-related quality of life questionnaires in clinical trials of rheumatoid arthritis.

              To define clinically meaningful changes in 2 widely used health-related quality of life (HQL) instruments in studies of patients with rheumatoid arthritis (RA). Patients with RA (n = 693) who were enrolled in 2 double-blind, placebo-controlled clinical trials completed the Short Form 36 (SF-36) modified health survey and the Health Assessment Questionnaire (HAQ) disability index at baseline and 6-week followup assessments. Data on 5 RA severity measures were also collected at baseline and at 6 weeks (patient and physician global assessments, joint swelling and tenderness counts, and global pain assessment). Comparison of changes in the SF-36 scales and HAQ scores was made between groups of patients known to differ in the level of change on each RA severity measure. With few exceptions, changes in the SF-36 and HAQ scores were different between patients who differed in the level of change on each RA severity measure. Changes in the SF-36 and HAQ scores were more strongly related to changes in the patient and physician global assessments and patient pain assessment than to changes in the joint swelling and tenderness counts. Based on these results, minimally important changes in the SF-36 scales and HAQ disability scores were determined, which will be useful in interpreting HQL results in clinical trials.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                31 May 2020
                June 2020
                : 17
                : 11
                : 3897
                Affiliations
                [1 ]Department of Preventive Medicine and Public Health, University of Navarra, School of Medicine-Clínica Universidad de Navarra, 31008 Pamplona, Spain; opano@ 123456alumni.unav.es (O.P.); ageas@ 123456unav.es (A.G.); mbes@ 123456unav.es (M.B.-R.); mamartinez@ 123456unav.es (M.Á.M.-G.)
                [2 ]IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain; jalfmtz@ 123456unav.es
                [3 ]Navarra Public Health Institute, 31003 Navarra, Spain
                [4 ]Área de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Centro de Investigación Biomédica en Red, 28049 Madrid, Spain
                [5 ]Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
                [6 ]Department of Food Sciences and Physiology, University of Navarra, Center for Nutrition Research, 31008 Pamplona, Spain
                [7 ]Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute, 28049 Madrid, Spain
                Author notes
                [* ]Correspondence: msayon@ 123456unav.es ; Tel.: +34-948-425-600
                Author information
                https://orcid.org/0000-0002-9139-4206
                https://orcid.org/0000-0002-3917-9808
                https://orcid.org/0000-0001-5218-6941
                Article
                ijerph-17-03897
                10.3390/ijerph17113897
                7312060
                32486373
                c190cffa-b43f-4cde-8583-7b099e75fd41
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 10 April 2020
                : 28 May 2020
                Categories
                Article

                Public health
                health related quality of life,sf-36,mediterranean,provegetarian,lifestyle
                Public health
                health related quality of life, sf-36, mediterranean, provegetarian, lifestyle

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