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. 2019 Apr 26;11(5):958.
doi: 10.3390/nu11050958.

Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis

Naomi Cano-Ibáñez  1   2   3 , Alfredo Gea  4   5   6 , Miguel A Martínez-González  7   8   9   10 , Jordi Salas-Salvadó  11   12   13   14 , Dolores Corella  15   16 , M Dolors Zomeño  17   18 , Dora Romaguera  19   20 , Jesús Vioque  21   22 , Fernando Aros  23   24 , Julia Wärnberg  25   26 , J Alfredo Martínez  27   28   29 , Lluis Serra-Majem  30   31 , Ramón Estruch  32   33 , Francisco J Tinahones  34   35 , José Lapetra  36   37 , Xavier Pintó  38   39 , Josep A Tur  40   41 , Antonio García-Ríos  42   43 , Blanca Riquelme-Gallego  44 , Miguel Delgado-Rodríguez  45   46 , Pilar Matía  47   48 , Lidia Daimiel  49 , Vicente Martín  50   51 , Josep Vidal  52   53 , Clotilde Vázquez  54   55 , Emilio Ros  56   57 , Pilar Buil-Cosiales  58   59   60 , Andrés Díaz-López  61   62   63   64 , Rebeca Fernández-Carrión  65   66 , Montserrat Fitó  67   68   69 , Jadwiga Konieczna  70   71 , Leyre Notario-Barandiaran  72   73 , Ángel M Alonso-Gómez  74   75 , Eugenio Contreras-Fernández  76 , Itziar Abete  77   78 , Almudena Sánchez-Villegas  79   80 , Rosa Casas  81   82 , Araceli Muñoz-Garach  83   84 , José Manuel Santos-Lozano  85   86   87 , Laura Gallardo-Alfaro  88 , Josep Basora  89   90   91   92 , Olga Portoles  93   94 , Miguel Ángel Muñoz  95 , Manuel Moñino  96   97 , Salvador Miralles Gisbert  98   99 , Anai Moreno Rodríguez  100 , Miguel Ruiz-Canela  101   102   103 , Antoni Palau Galindo  104   105   106   107 , Karla Alejandra Pérez-Vega  108 , Aurora Bueno-Cavanillas  109   110   111
Affiliations

Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis

Naomi Cano-Ibáñez et al. Nutrients. .

Abstract

Dietary guidelines emphasize the importance of a varied diet to provide an adequate nutrient intake. However, an older age is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases, such as metabolic syndrome (MetS). To assess the association between dietary diversity (DD) and nutrient intake adequacy and to identify demographic variables associated with DD, we cross-sectionally analyzed baseline data from the PREDIMED-Plus trial: 6587 Spanish adults aged 55-75 years, with overweight/obesity who also had MetS. An energy-adjusted dietary diversity score (DDS) was calculated using a 143-item validated semi-quantitative food frequency questionnaire (FFQ). Nutrient inadequacy was defined as an intake below 2/3 of the dietary reference intake (DRI) forat least four of 17 nutrients proposed by the Institute of Medicine (IOM). Logistic regression models were used to evaluate the association between DDS and the risk of nutritionally inadequate intakes. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake: odds ratio (OR) = 28.56 (95% confidence interval (CI) 20.80-39.21). When we estimated food varietyfor each of the food groups, participants in the lowest quartile had a higher risk of inadequate nutrient intake for the groups of vegetables, OR = 14.03 (95% CI 10.55-18.65), fruits OR = 11.62 (95% CI 6.81-19.81), dairy products OR = 6.54 (95% CI 4.64-9.22) and protein foods OR = 6.60 (95% CI 1.96-22.24). As DDS decreased, the risk of inadequate nutrients intake rose. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow(er)s.

Keywords: PREDIMED-Plus study; aging; dietary diversity; metabolic syndrome; nutrient adequacy.

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Conflict of interest statement

J.S.-S. reports serving on the board of and receiving grant support through his institution from International Nut and Dried Fruit Council; receiving consulting personal fees from Danone, Font Vella Lanjarón, Nuts for Life, and Eroski; and receiving grant support through his institution from Nut and Dried Fruit Foundation and Eroski. E.R., reports grants, non-financial support, and other fees from California Walnut Commission and Alexion; personal fees and non-financial support from Merck, Sharp & Dohme; personal fees, non-financial support and other fees from Aegerion, and Ferrer International; grants and personal fees from Sanofi Aventis; grants from Amgen and Pfizer and; personal fees from Akcea, outside of the submitted work. X.P., reports serving on the board of and receiving consulting personal fees from Sanofi Aventis, Amgen, and Abbott laboratories; receiving lecture personal fees from Esteve, Lacer and Rubio laboratories. L.D. reports grants from Fundación Cerveza y Salud. All other authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow-chart of participants.
See this image and copyright information in PMC

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