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Title: Diet quality and nutrient density in subjects with metabolic syndrome: Influence of socioeconomic status and lifestyle factors. A cross-sectional assessment in the PREDIMED-Plus study
Authors: Cano-Ibáñez, Naomi
Gea, Alfredo
Ruiz-Canela, Miguel
Corella, Dolores
Salas-Salvadó, Jordi
Schröder, Helmut
Navarrete-Muñoz, Eva M.
Romaguera, Dora
Martínez, J. Alfredo
Barón-López, F. Javier
López-Miranda, José
Estruch, Ramón
Riquelme-Gallego, Blanca
Alonso-Gómez, Ángel
Tur, Josep A.
Tinahones, Francisco J.
Serra-Majem, Lluis 
Martín, Vicente
Lapetra, José
Vázquez, Clotilde
Pintó, Xavier
Vidal, Josep
Daimiel, Lidia
Gaforio, José Juan
Matía, Pilar
Ros, Emilio
Fernández-Carrión, Rebeca
Díaz-López, Andrés
Zomeño, M. Dolors
Candela, Inmaculada
Konieczna, Jadwiga
Abete, Itziar
Buil-Cosiales, Pilar
Basora, Josep
Fitó, Montserrat
Martínez-González, Miguel A.
Bueno-Cavanillas, Aurora
UNESCO Clasification: 3206 Ciencias de la nutrición
Keywords: Diet Quality
Lifestyle Factors
Mediterranean Diet
Metabolic Syndrome
Nutrient Density, et al
Issue Date: 2019
Project: Efecto de la Dieta Mediterránea Hopocalórica y Promoción de la Actividad Física en Prevención Primaria Cardiovascular.Estudio Piloto Sobre Marcadores Intermedios. 
Efecto de Una Pérdida de Peso Con Dieta Mediterránea Hipocalórica y Promoción de la Actividad Física en la Prevención Primaria Cardiovascular 
Sistema Inmune Inespecífico en Dorada (Sparus Aurata): Activación Del Sistema Interferón y Papel de la Actividad Bh4. Pi042004/153 
Neuroprotección Por Bloqueo de la Capacidad de Transactivadora Nf-Kb y Factores Relacionados. 
Journal: Clinical Nutrition 
Abstract: 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. Objective: 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). Methods: 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. Results: A considerable proportion of the screened participants showed a deficient intake of vitamins A, D, E, B 9 , 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. Conclusions: 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.
ISSN: 0261-5614
DOI: 10.1016/j.clnu.2019.04.032
Source: Clinical Nutrition [ISSN 0261-5614], v. 39(4), p. 1161-1173
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