Jesús Vioque - Academia.edu (original) (raw)

Papers by Jesús Vioque

Forensic Science International: Genetics, 2012

International Journal of Cancer, 2014

High mammographic density (MD) is one of the main risk factors for development of breast cancer. ... more High mammographic density (MD) is one of the main risk factors for development of breast cancer. To date, however, relatively few studies have evaluated the association between MD and diet. In this cross-sectional study, we assessed the association between MD (measured using Boyd's semiquantitative scale with five categories: <10%, 10-25%, 25-50%, 50-75% and >75%) and diet (measured using a food frequency questionnaire validated in a Spanish population) among 3,548 peri-and postmenopausal women drawn from seven breast cancer screening programs in Spain. Multivariate ordinal logistic regression models, adjusted for age, body mass index (BMI), energy intake and protein consumption as well as other confounders, showed an association between greater calorie intake and greater MD [odds ratio (OR) 5 1.23; 95% confidence interval (CI) 5 1.10-1.38, for every increase of 500 cal/day], yet high consumption of olive oil was nevertheless found to reduce the prevalence of high MD (OR 5 0.86;95% CI 5 0.76-0.96, for every increase of 22 g/day in olive oil consumption); and, while greater intake of whole milk was likewise associated with higher MD (OR 5 1.10; 95%CI 1.00-1.20, for every increase of 200 g/day), higher consumption of protein (OR 5 0.89; 95% CI 0.80-1.00, for every increase of 30 g/day) and white meat (p for trend 0.041) was found to be inversely associated with MD. Our study, the largest to date to assess the association between diet and MD, suggests that MD is associated with modifiable dietary factors, such as calorie intake and olive oil consumption. These foods could thus modulate the prevalence of high MD, and important risk marker for breast cancer.

Background: Mercury (Hg) is a ubiquitous pollutant that negatively affects fetal and child neurod... more Background: Mercury (Hg) is a ubiquitous pollutant that negatively affects fetal and child neurodevelopment at accidental high-dose exposure. Some studies indicate that Mediterranean populations could be at risk of prenatal exposure to mercury through fish consumption. Objectives: To assess the prenatal exposure to total mercury (T-Hg), both inorganic and organic, in newborns by analyzing the T-Hg concentration in cord blood, and to evaluate the role of maternal fish consumption in this exposure. Methods: In the context of a multi-center project (INMA project), a prospective birth cohort was set up in Valencia, Spain, from 2005 to 2006. A total of 253 newborns were included in this study. We compared cord blood T-Hg concentration by levels of fish intake assessed by a food frequency questionnaire completed at 28-32 weeks of gestation. Maternal covariates were obtained through a questionnaire. Results: The geometric mean of T-Hg at birth was 9.9 μg/L (95% CI: 9.0, 10.8). Seventy five percent of cord blood samples were above the estimated level assumed to be without appreciable harm (5.8 μg/L). Women who consumed a portion of large oily fish, lean fish, or mixed fried fish two or more times per week had mean cord blood levels 1.6, 1.4 and 1.3 times higher, respectively, than those who rarely or never consumed fish. Other factors such as the mother's age, country of origin, smoking and season of delivery were also significantly and independently associated with cord blood T-Hg concentrations.

…, 2010

Background: An adequate iodine intake during pregnancy is essential for the synthesis of maternal... more Background: An adequate iodine intake during pregnancy is essential for the synthesis of maternal thyroid hormones and normal brain development in the fetus. Scant evidence is available on the effects and safety of iodine supplementation during pregnancy in areas with adequate or mildly deficient iodine intake. We examined the association of maternal iodine intake and supplementation with thyroid function before 24 weeks of gestation in population-based samples from 3 different areas in Spain. Methods: A cross-sectional study of 1844 pregnant women (gestational age range 8 -23 weeks) was carried out in 3 areas in Spain (Guipúzcoa, Sabadell, Valencia), during the period 2004 -2008. We measured levels of free thyroxine and thyroid-stimulating hormone (TSH) in serum, iodine in a spot urine sample, and questionnaire estimates of iodine intake from diet, iodized salt and supplements. Adjusted associations were assessed by multiple linear regression and logistic regression analyses. Results: There was an increased risk of TSH above 3 U/mL in women who consumed 200 g or more of iodine supplements daily compared with those who consumed less than 100 g/day (adjusted odds ratio ϭ 2.5 ͓95% confidence interval ϭ 1.2 to 5.4͔). We observed no association between urinary iodine and TSH levels. Pregnant women from the area with the highest median urinary iodine (168 g/L) and highest supplement coverage (93%) showed the lowest values of serum free thyroxine. (geometric mean ϭ 10.09 pmol/L ͓9.98 to 10.19͔). Conclusions: Iodine supplement intake in the first half of pregnancy may lead to maternal thyroid dysfunction in iodine-sufficient or mildly iodine-deficient populations.

British Journal of …, 2011

Dietary intake of specific nutrients or food groups during pregnancy could influence fetal growth... more Dietary intake of specific nutrients or food groups during pregnancy could influence fetal growth, but scant evidence is available on effects of dietary patterns. The aim of this study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on fetal growth in two population-based mother -child cohorts in Spain and Greece. We studied 2461 mother -newborn pairs from the Spanish multi-centre 'INMA' study (Atlantic area: INMA-Atlantic; Mediterranean area: INMA-Mediterranean), and 889 pairs from the 'RHEA' study in Crete, Greece. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Fetal growth restriction was based on a customised model, and multivariate log-binomial and linear regression models were used to adjust for several confounders. MD scores differ significantly between the cohorts with women in INMA-Atlantic reporting higher intakes of fish and dairy products, while women in the Mediterranean area reported higher intakes of cereals, vegetables and fruits. Women with high MD adherence had a significantly lower risk of delivering a fetal growth -restricted infant for weight (risk ratios: 0·5; 95 % CI 0·3, 0·9) in the INMA-Mediterranean cohort. Stratified analysis by smoking revealed that higher MD adherence increased birth weight and birth length in smoking mothers, whereas this effect was not apparent in non-smoking mothers. The results of the present study show that several types of MD exist across European Mediterranean regions. High MD adherence may modify the detrimental effect of smoking on birth size, but overall effects of diet were not universal for the studies in this analysis.

Paediatric and perinatal epidemiology, Jan 7, 2015

Maternal clinical thyroid disorders can cause reproductive complications. However, the effects of... more Maternal clinical thyroid disorders can cause reproductive complications. However, the effects of mild thyroid dysfunctions are not yet well established. The aim was to evaluate the association of maternal thyroid function during the first half of pregnancy with birthweight and preterm delivery. We analysed data on 2170 pregnant women and their children from a prospective population-based cohort study in four Spanish areas. Mid-gestation maternal serum and urine samples were gathered to determine thyroid-stimulating hormone (TSH), free thyroxine (fT4 ), and urinary iodine concentration (UIC). Thyroid status was defined according to percentile distribution as: euthyroid (TSH and fT4 >5th and <95th percentiles); hypothyroxinaemia (fT4 < 5th percentile and TSH normal), hypothyroidism (TSH > 95th percentile and fT4 normal or <5th percentile), hyperthyroxinaemia (fT4 > 95th percentile and TSH normal), and hyperthyroidism (TSH < 5th percentile and fT4 normal or >...

Journal of Epidemiology & Community Health, 2010

Monitoring iodine status during pregnancy is essential to prevent iodine-related disorders. The o... more Monitoring iodine status during pregnancy is essential to prevent iodine-related disorders. The objectives of this study are to estimate iodine intake and excretion, to assess their association and to evaluate the compliance of the recommendations in a multicentre cohort of pregnant women. Cross-sectional data on maternal iodine nutritional status, compiled between weeks 8 and 22 of gestation in three Spanish areas (Valencia, Gipuzkoa and Sabadell), were analysed. Information on iodine intake from diet, salt and supplements was estimated through questionnaires. Spot urine samples were analysed for urinary iodine concentration (UIC). Tobit regression analysis was used to assess the association between iodine intake and UIC. 1522 women were included in the study. Median UIC was 134 (IQR 80-218) μg/l in Valencia, 168 (IQR 108-272) μg/l in Gipuzkoa and 94 (IQR 57-151) μg/l in Sabadell. 48.9% of Valencian women consumed iodine supplements, 93.3% in Gipuzkoa and 11.0% in Sabadell. Prevalence of iodised salt consumption was 50.5% in the whole sample. UIC was associated with intake of supplements, iodised salt, dietary iodine and water. UIC levels were lower than expected according to the estimated iodine intake. Median UIC reflected iodine deficiency according to WHO reference levels, except in Gipuzkoa where supplements are widely consumed. It is necessary to strengthen iodised salt consumption since it is already far from the objective proposed of coverage of 90% of households. More data would be valuable to assess the correspondence between iodine intake and excretion during pregnancy.

Environmental Research, 2015

Background Diabetes has been defi ned on the basis of diff erent biomarkers, including fasting pl... more Background Diabetes has been defi ned on the basis of diff erent biomarkers, including fasting plasma glucose (FPG), 2-h plasma glucose in an oral glucose tolerance test (2hOGTT), and HbA 1c. We assessed the eff ect of diff erent diagnostic defi nitions on both the population prevalence of diabetes and the classifi cation of previously undiagnosed individuals as having diabetes versus not having diabetes in a pooled analysis of data from population-based health examination surveys in diff erent regions.

Objectives: We examined the use of low (<400 μg/ day, including no use) and high folic acid suppl... more Objectives: We examined the use of low (<400 μg/ day, including no use) and high folic acid supplement (FAS) dosages (≥1000 μg/day) among pregnant women in Spain, and explored factors associated with the use of these non-recommended dosages. Design: Population-based cohort study. Setting: Spain. Participants: We analysed data from 2332 pregnant women of the INMA study, a prospective mother-child cohort study in Spain. Main outcome measures: We assessed usual dietary folate and the use of FAS from preconception to the 3rd month (first period) and from the 4th to the 7th month (second period), using a validated food frequency questionnaire. We used multinomial logistic regression to estimate relative risk ratios (RRRs).

BACKGROUND: Maternal vitamin D status during fetal development may influence offspring growth and... more BACKGROUND: Maternal vitamin D status during fetal development may influence offspring growth and risk of obesity; however, evidence in humans is limited. OBJECTIVE: To investigate whether maternal circulating 25-hydroxyvitamin D3 (25(OH)D3) concentration in pregnancy is associated with offspring prenatal and postnatal growth and overweight. METHODS: Plasma 25(OH)D3 concentration was measured in pregnant women (median weeks of gestation 14.0, range 13.0–15.0) from the INMA (INfancia y Medio Ambiente) cohort (Spain, 2003–2008) (n = 2358). Offspring femur length (FL), biparietal diameter (BPD), abdominal circumference (AC) and estimated fetal weight (EFW) were evaluated at 12, 20 and 34 weeks of gestation by ultrasound examinations. Fetal overweight was defined either as AC or as EFW ⩾ 90th percentile. Child's anthropometry was recorded at ages 1 and 4 years. Rapid growth was defined as a weight gain z-score of 40.67 from birth to ages 6 months and 1 year. Age-and sex-specific z-scores for body mass index (BMI) were calculated at ages 1 and 4 years (World Health Organization referent); infant's overweight was defined as a BMI z-score ⩾ 85th percentile. RESULTS: We found no association of maternal 25(OH)D3 concentration with FL and a weak inverse association with BPD at 34 weeks. Maternal deficit of 25(OH)D3 (o 20 ng ml − 1) was associated with increased risk of fetal overweight defined as AC ⩾ 90th percentile (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.01–2.21; P = 0.041) or either as EFW ⩾ 90th percentile (OR = 1.47, 95% CI: 1.00–2.16; P = 0.046). No significant associations were found with rapid growth. Deficit of 25(OH)D3 in pregnancy was associated with an increased risk of overweight in offspring at age 1 year (OR = 1.42, 95% CI: 1.02–1.97; P = 0.039); however, the association was attenuated at age 4 years (OR = 1.19, 95% CI: 0.83–1.72; P = 0.341). CONCLUSIONS: Vitamin D deficiency in pregnancy may increase the risk of prenatal and early postnatal overweight in offspring. Clinical trials are warranted to determine the role of vitamin D in the early origins of obesity.

IMPORTANCE This study used longitudinal data to examine potential associations between hours of t... more IMPORTANCE This study used longitudinal data to examine potential associations between hours of television viewing and sleep duration in children. OBJECTIVE To examine the association between hours of television viewing and sleep duration in preschool and school-aged children. DESIGN, SETTING, AND PARTICIPANTS Longitudinal, multicenter study among birth cohorts in Menorca, Sabadell, and Valencia from the Spanish Infancia y Medio Ambiente (environment and childhood) project. The study sample included 1713 children (468 from Menorca, 560 from Sabadell, and 685 from Valencia). EXPOSURE Parent-reported child television viewing duration measured in hours per day at 2 and 4 years of age in Sabadell and Valencia and at 6 and 9 years of age in Menorca. MAIN OUTCOMES AND MEASURES Parent-reported child sleep duration measured in hours per day at 2 and 4 years of age in Sabadell and Valencia and at 6 and 9 years of age in Menorca. RESULTS In cross-sectional analysis, children with longer periods of television viewing reported at baseline (1.5 hours per day) had shorter sleep duration. Longitudinally, children with reported increases in television viewing duration over time (from <1.5 to 1.5 hours per day) had a reduction in sleep duration at follow-up visits. Results were similar when examining television viewing duration as a continuous variable, with each 1 hour per day of increased viewing decreasing sleep duration at follow-up visits (β = −0.11; 95% CI, –0.18 to −0.05). Associations were similar when television viewing duration was assessed during weekends and after adjusting for potential intermediate factors (child executive function and attention-deficit/hyperactivity disorder symptoms) and confounders (child physical activity level, parental mental health status, maternal IQ, and maternal marital status). CONCLUSIONS AND RELEVANCE Children spending longer periods watching television had shorter sleep duration. Changes in television viewing duration were inversely associated with changes in sleep duration in longitudinal analysis. Parents should consider avoiding long periods of daily television exposure among preschool and school-aged children.

There is growing concern that chemical agents could impair the anthropometric development of the ... more There is growing concern that chemical agents could impair the anthropometric development of the fetus. However, epidemiological studies have reported inconsistent results.

Objective: To evaluate the association between mercury exposure and thyroid-stimulating hormone (... more Objective: To evaluate the association between mercury exposure and thyroid-stimulating hormone (TSH), total triiodothyronine (TT3) and free thyroxine (FT4) levels during pregnancy as well as to explore if there is any synergic action between mercury and intake of iodine from different sources. Methods: The study population was 1407 pregnant women participating in the Spanish INMA birth cohort study. Total mercury concentrations were analyzed in cord blood. Thyroid hormones (THs) were measured in serum samples collected at 13.2 71.5 weeks of gestation. The association between mercury and TH levels was evaluated with multivariate linear regression models. Effect modification caused by iodine intake from supplements and diet was also evaluated. Results: The geometric means of TSH, TT3, FT4 and mercury were 1.1 μU/L, 2.4 nmol/L, 10.5 pmol/L and 7.7 μg/L, respectively. Mercury levels were marginally significantly associated with TT3 (β: À 0.05; 95%CI: À 0.10, 0.01), but were neither associated with TSH nor FT4. The inverse association between mercury and TT3 levels was stronger among the iodine supplement consumers (À 0.08; 95%CI: À 0.15, À 0.02, interaction p-value¼ 0.07). The association with FT4 followed the same pattern, albeit not significant. Conclusion: Prenatal mercury exposure was inversely associated with TT3 levels among women who took iodine supplements during pregnancy. These results could be of public health concern, although further research is needed.

Background: In Spain, few studies have evaluated prenatal exposure to heavy metals. The objective... more Background: In Spain, few studies have evaluated prenatal exposure to heavy metals. The objective of this study was to describe lead, mercury and cadmium concentrations in blood from a sample of newborn–mother-father trios, as well as to investigate the association between metals in cord blood and parental variables. We also explored the relationship between cord blood metal concentrations and child characteristics at birth.

Nutricion hospitalaria, 2015

To assess nutrient intakes and compliance with nutritional recommendations in pregnant women acco... more To assess nutrient intakes and compliance with nutritional recommendations in pregnant women according to selected sociodemographic characteristics and lifestyles. Cross-sectional study based on data from Spanish INMA cohort which recruited 2,585 pregnant women between 2003 and 2008 from four different regions of Spain. Sociodemographic information and anthropometry was collected and dietary intake was assessed through Food Frequency Questionnaires. The adequacy of food group intake was assessed considering current recommendations and from the Spanish Society of Nutrition. Moreover, intake of vitamin A, vitamin C and vitamin E, were compared with the Dietary Reference Intakes of the US Institute of Medicine. Percentage of women that did not fulfil the recommendations for cereals and legumes (3-4 servings/day) was 70.0%, for fruit intake (2-3 servings/day) it was 39.2%, for vegetables (2-4 servings/day) 47.3% and for dairy (3-4 servings/day) it was 51.6%. Intake of fruit and vegetabl...

Background: In exocrine pancreatic cancer (EPC) mechanistic relationships may exist among some or... more Background: In exocrine pancreatic cancer (EPC) mechanistic relationships may exist among some organochlorine compounds (OCs) and mutations in the K-ras oncogene, as well as among the latter and dietary factors. Objective: To analyze (1) the relationship between food intake and serum concentrations of OCs in EPC patients and (2) the relative influence of food and OCs on the frequency of K-ras mutations in EPC. Patients and methods: Incident cases of EPC were prospectively identified, and interviewed face-to-face during hospital admission (N = 135 patients with data on OCs and diet, and N = 97 with additional information on K-ras status). OCs were measured by high-resolution gas chromatography with electron-capture detection. Results: Consumption of milk and other dairy products was positively associated with concentrations of p,p 0 -DDT, PCB 138 and PCB 153 (log-transformed bs = 0.652, 0.588 and 0.317, respectively; all p < 0.05). When adjusted by OCs, dairy products were no longer associated with K-ras. By contrast, after adjusting by consumption of dairy products, patients with the highest concentrations of p,p 0 -DDT and some PCBs remained more likely to have a K-ras-mutated EPC than patients with lower concentrations (OR for upper tertile of PCB 138 = 5.5, 95% CI: 1.3-23.4). Conclusions: Dairy products were a source of OCs. The association between dairy products and K-ras mutations was not independent of OCs. By contrast, the association between OCs and K-ras was not confounded by dairy products. OCs may be more likely to contribute to the occurrence of K-ras mutations than nutrients contained in dairy products.

Environmental Research, 2015

JAMA Pediatrics, 2014

Forensic Science International: Genetics, 2012

International Journal of Cancer, 2014

…, 2010

British Journal of …, 2011

Paediatric and perinatal epidemiology, Jan 7, 2015

Journal of Epidemiology & Community Health, 2010

Environmental Research, 2015

Nutricion hospitalaria, 2015

Environmental Research, 2015

JAMA Pediatrics, 2014