Pilar Guallar-Castillón - Academia.edu (original) (raw)
Papers by Pilar Guallar-Castillón
Nutrients, 2022
Background: Chronic kidney disease entails a high disease burden that is progressively increasing... more Background: Chronic kidney disease entails a high disease burden that is progressively increasing due to population aging. However, evidence on the effect of the Mediterranean diet on renal function is limited, in particular among older adults in Mediterranean countries. Methods: Prospective cohort study with 975 community-dwelling adults aged ≥ 60 recruited during 2008–2010 in Spain and followed up to 2015. At baseline, food consumption was obtained using a validated dietary history. Two Mediterranean dietary patterns were used: (i) An a priori-defined pattern, the Mediterranean Diet Adherence Screener (MEDAS score: low adherence: 0–5 points; moderate: 6–8 points; high: 9–14 points); (ii) An a posteriori Mediterranean-like dietary pattern, based on 36 food groups, which was generated using factor analysis. Renal function decline was calculated as an estimated glomerular filtration rate (eGFR) decrease ≥1 mL/min/1.73 m2 per year of follow-up. Results: A total of 104 cases of renal f...
Mayo Clinic Proceedings, 2019
Objective: To assess the prospective association between ultra-processed food consumption and all... more Objective: To assess the prospective association between ultra-processed food consumption and allcause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. Patients and Methods: A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31 th , 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. Results: Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend¼.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend¼.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. Conclusion: A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. Trial Registration: clinicaltrials.gov Identifier: NCT01133093
Revista Española de Cardiología, 2017
Có mo citar este artículo: Martínez-Gó mez D, et al. Validez concurrente de la histó rica pregunt... more Có mo citar este artículo: Martínez-Gó mez D, et al. Validez concurrente de la histó rica pregunta de actividad física en el tiempo libre de la Encuesta Nacional de Salud para los adultos mayores. Rev Esp Cardiol. 2017.
Clinical nutrition (Edinburgh, Scotland), Jun 24, 2016
Several studies have found that moderate alcohol intake is associated with lower risk of function... more Several studies have found that moderate alcohol intake is associated with lower risk of functional limitations in older adults. However, no previous investigation has assessed this association in older adults from Mediterranean countries, who show characteristic drinking patterns. Data were taken from the UAM and the Seniors-ENRICA cohorts in Spain, comprising community-dwelling people aged ≥60 years. At baseline, participants in both cohorts were classified as non-drinkers, ex-drinkers, moderate drinkers and heavy drinkers (the threshold between moderate and heavy intake was ≥40 g/day in men and ≥24 g/day in women). The Seniors-ENRICA cohort allowed assessment of a Mediterranean Drinking Pattern (MDP), defined as moderate alcohol intake, with wine preference (≥80% of alcohol consumed as wine) and drinking only with meals. The incidence of limitation in mobility, agility, and instrumental activities of daily living (IADL) was ascertained in each cohort at the end of a 3.5-year foll...
PloS one, 2016
In older adults, the Mediterranean diet is associated with lower risk of chronic diseases, but it... more In older adults, the Mediterranean diet is associated with lower risk of chronic diseases, but its association with health-related quality of life (HRQL) is still uncertain. This study assessed the association between the Mediterranean diet and HRQL in 2 prospective cohorts of individuals aged ≥60 years in Spain. The UAM-cohort (n = 2376) was selected in 2000/2001 and followed-up through 2003. At baseline, diet was collected with a food frequency questionnaire, which was used to develop an 8-item index of Mediterranean diet (UAM-MDP). The Seniors-ENRICA cohort (n = 1911) was recruited in 2008/2010 and followed-up through 2012. At baseline, a diet history was used to obtain food consumption. Mediterranean diet adherence was measured with the PREDIMED score and the Trichopoulou's Mediterranean Diet Score (MSD). HRQL was assessed, at baseline and at the end of follow-up, with the physical and mental component summaries (PCS and MCS) of the SF-36 questionnaire in the UAM-cohort, and...
Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departam... more Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina Preventiva y Salud Pública. Fecha de lectura: 2 de Noviembre 2010 Bibliografía: 83-93
![Research paper thumbnail of [Demography, healht-related life style and history of tobacco consumption among occasional smokers in Spain]](https://attachments.academia-assets.com/99479333/thumbnails/1.jpg)
](Revista española de salud pública
This study describes the sociodemographic characteristics, health-related lifestyle, and history ... more This study describes the sociodemographic characteristics, health-related lifestyle, and history of tobacco consumption of the occasional smokers in Spain, and examines whether they show differences against daily smokers. Data were obtained from the National Health Survey of Spain, carried out in 1993 through household interviews on a sample representative of the non-institutionalised population aged 16 year and older. Analyses were performed with logistic regression and adjusted for sociodemographic, health-state and life-style variables. Out of the 6,668 smokers in the survey, occasional smokers were 9.2%, while daily smokers of < or = 5 cigarettes and > 5 cigarettes were 9.9% and 80.9%, respectively. As compared with daily smokers of > 5 cigarettes, occasional smokers were more frequently women (odds ratio (0R): 2.12; CI95%: 1.72-2.61), younger (OR aged 25-44 versus 16-24 years: 0.75; 0.58-0.96), with lower alcohol consumption (p for linear trend: 0.0349), and higher lei...
Scientific Reports
Evidence of the role of cooking methods on inflammation and metabolic health is scarce due to the... more Evidence of the role of cooking methods on inflammation and metabolic health is scarce due to the paucity of large-size studies. Our aim was to evaluate the association of cooking methods with inflammatory markers, renal function, and other hormones and nutritional biomarkers in a general population of older adults. In a cross sectional analysis with 2467 individuals aged ≥ 65, dietary and cooking information was collected using a validated face-to-face dietary history. Eight cooking methods were considered: raw, boiling, roasting, pan-frying, frying, toasting, sautéing, and stewing. Biomarkers were analyzed in a central laboratory following standard procedures. Marginal effects from generalized linear models were calculated and percentage differences (PD) of the multivariable-adjusted means of biomarkers between extreme sex-specific quintiles (Q) of cooking methods consumption were computed ([Q5 − Q1/Q1] × 100). Participants’ mean age was 71.6 years (53% women). Significant PD for ...
Age and Ageing, 2016
Background: leptin resistance, which may develop during the ageing process, stimulates the produc... more Background: leptin resistance, which may develop during the ageing process, stimulates the production of proinflammatory cytokines and insulin resistance that could impair the muscle function. However, the role of leptin on physical functioning among older adults has not yet been elucidated. Objective: to examine the association between serum leptin levels and physical function impairment in older adults. Design and setting: prospective study of 1,556 individuals 60 years and older from the Seniors-ENRICA cohort, who were free of physical function limitation at baseline. Main outcome measure: serum leptin was measured in 2008-10, and incident functional limitation was assessed through 2012. Self-reported limitations in agility and mobility were assessed with the Rosow and Breslau scale, limitation in the lower extremity function was measured with the Short Physical Performance Battery, and impairment in the overall physical performance with the physical component summary of the SF-12. Results: after adjustment for potential confounders and compared to individuals in the lowest quartile of leptin concentration, those in the highest quartile showed increased risk of impaired physical function; the odds ratio (95% confidence interval) and P-trend was: 1.95 (1.11-3.43), P = 0.006 for self-reported impaired mobility; 1.76 (1.08-2.87), P = 0.02 for self-reported impaired agility; 1.48 (1.02-2.15), P = 0.04 for limitation in the lower extremity function; and 1.97 (1.20-3.22), P = 0.01, for decreased overall physical performance. These associations were only modestly explained by C-reactive protein and insulin resistance. Moreover, the associations held across groups with varying health status and were independent of estimated total body fat. Leptin concentration and risk of impaired physical function 819
PloS one, 2017
Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older... more Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older adults but its impact on health-related quality of life (HRQL) is uncertain. This is a cohort study of 2,388 individuals aged !60 recruited in 2000-2001, whose data were updated in 2003 and 2009. At baseline, participants reported both traditional HB (non-smoking, being very or moderately active, healthy diet) and non-traditional HB (sleeping 7-8 h/d, being seated <8 h/d, and seeing friends every day). HRQL was measured with the SF-36 questionnaire at baseline, in 2003 (short-term) and in 2009 (long-term); a higher score on the SF-36 represents better HRQL. Linear regression models were used to assess the association between HB at baseline and HRQL in 2003 and 2009, with adjustment for the main confounders including baseline HRQL. In the short-term, being physically active, sleeping 7-8 h/d, and being seated <8 h/d was associated with better HRQL. Compared to having 1 of these HB, the β (95% confidence interval) for the score on the physical component summary of the SF-36 in 2003 was 1.42 (0.52-2.33) for 2 HB, and 2.06 (1.09-3.03) for 3 HB, p-trend <0.001. Corresponding figures for the mental component summary score were 1.89 (0.58-3.21) for 2 HB and 3.35 (1.95-4.76) for 3 HB, p-trend <0.001. Non-smoking, a healthy diet or seeing friends did not show an association with HRQL. In the long-term, being physically active was the only HB associated with better physical HRQL. As a conclusion, a greater number of HB, particularly more physical activity, adequate sleep duration, and sitting less, were associated with better short-term HRQL in older adults. However, in the long-term, being physically active was the only HB associated with better physical HRQL.
Revista Espa de Cardiologia
Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public he... more Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public health problem, associated with significant mortality, morbidity, and healthcare expenditures, particularly among those aged ≥65 years. The case mix of HF is changing over time with a growing proportion of cases presenting with preserved ejection fraction for which there is no specific treatment. Despite progress in reducing HFrelated mortality, hospitalizations for HF remain frequent and rates of readmissions continue to rise. To prevent hospitalizations, a comprehensive characterization of predictors of readmission in patients with HF is imperative and must integrate the impact of multimorbidity related to coexisting conditions. New models of patient-centered care that draw on community-based resources to support HF patients with complex coexisting conditions are needed to decrease hospitalizations.
Journal of the American Medical Directors Association, 2015
There is emerging evidence of the role of diabetes as a risk factor for frailty. However, the mec... more There is emerging evidence of the role of diabetes as a risk factor for frailty. However, the mechanisms of this association are uncertain. Prospective cohort study of 1750 noninstitutionalized individuals aged 60 years or older recruited in 2008-2010. At baseline, information was obtained on health behaviors, morbidity, cardiometabolic biomarkers, and antidiabetic treatments. Individuals were considered diabetic if they reported a physician diagnosis or had fasting serum glucose of 126 mg/dL or higher. Study participants were followed through 2012 to assess incident frailty, defined as at least 3 of the 5 Fried criteria. At baseline, the cohort included 346 individuals with diabetes and 1404 without diabetes. Over a mean 3.5-year follow-up, 115 cases of incident frailty were ascertained. After adjustment for age, sex, and education, participants with diabetes showed an increased risk of frailty (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.42-3.37). Additional adjustment for health behaviors and abdominal obesity yielded a 29.7% reduction in the OR (OR 1.83, 95% CI 1.16-2.90). Subsequent adjustment for morbidity produced an additional 8.4% reduction (OR 1.76, 95% CI 1.10-2.82), and for cardiometabolic biomarkers, a further 44% reduction (OR 1.32, 95% CI 0.70-2.49). In particular, adjustment for HbA1c, lipoproteins, and triglycerides accounted for the greatest reductions. Finally, additional adjustment for oral antidiabetic medication reduced the OR to 1.01 (95% CI 0.46-2.20), whereas adjustment for nutritional therapy increased the OR to 1.64 (95% CI 0.77-3.49). Diabetes mellitus is associated with higher risk of frailty; this association is partly explained by unhealthy behaviors and obesity and, to a greater extent, by poor glucose control and altered serum lipid profile among diabetic individuals. Conversely, diabetes nutritional therapy reduces the risk of frailty.
Gaceta sanitaria / S.E.S.P.A.S
Revista Española de Cardiología, 2012
PLoS ONE, 2013
Objectives: Obesity-related eating behaviors (OREB) are associated with higher energy intake. Tot... more Objectives: Obesity-related eating behaviors (OREB) are associated with higher energy intake. Total energy intake can be decomposed into the following constituents: food portion size, food energy density, the number of eating occasions, and the energy intake from energy-rich beverages. To our knowledge this is the first study to examine the association between the OREB and these energy components.
Current Hypertension Reports, 2004
Journal of epidemiology and community health, 2011
Background This study evaluates the influence of socioeconomic position (SEP) over the life cours... more Background This study evaluates the influence of socioeconomic position (SEP) over the life course on change in health-related quality of life (HRQoL) in older adults. Methods A prospective cohort of 2117 individuals aged 60 years and over. In 2001, SEP was measured over the < An additional table is published online only. To view this file please visit the journal online
Revista española de salud pública
Counselling for tobacco quitting could be improved by informing smokers about the likelihood of s... more Counselling for tobacco quitting could be improved by informing smokers about the likelihood of success in quitting over time since the start of an intervention for smoking cessation. This study assessed the change in the probability of success in tobacco quitting during the course of two simple medical interventions for smoking cessation. Prospective study in three worksites in the Basque Country (Spain), which underwent two interventions for quitting. Intervention 1 consisted of sporadic, brief (30 seconds-1 minute) and unstructured medical advice to quit. Intervention 2 consisted of brief (5-8 minutes) structured medical counselling for tobacco quitting in a first visit, followed by reinforcement advice on 3 occasions during 3 months, accompanied by nicotine patches individualized according to nicotine dependence. Results are expressed as a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;relative measure of success&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; or rate of proportions (RP) calculated as the predictive value of achieving tobacco abstinence at 12 months for those with tobacco abstinence at 2 days, 15 days and 3 months from the start of each intervention divided by the percentage abstinent at 12. For the 103 smokers subjected to intervention 1, RP was 1.7 (CI 95%: 1.0-3.4) at 2 days, 2.3 (1.2-4.6) at 15 days, and 3.4 (1.8-6.5) at 3 months. For the 114 subjects who underwent intervention 2, RP was 1.3 (1.0-2.1) at 2 days, 1.9 (1.2-2.8) at 15 days, and 2.6 (1.8-3.8) at 3 months. Results did not change materially after stratification by number of cigarettes smoked, or nicotine dependence. Remaining abstinent from tobacco smoking at 3 months after the start of a quitting intervention increases the likelihood of success in quitting at 12 months.
Nutrients, 2022
Background: Chronic kidney disease entails a high disease burden that is progressively increasing... more Background: Chronic kidney disease entails a high disease burden that is progressively increasing due to population aging. However, evidence on the effect of the Mediterranean diet on renal function is limited, in particular among older adults in Mediterranean countries. Methods: Prospective cohort study with 975 community-dwelling adults aged ≥ 60 recruited during 2008–2010 in Spain and followed up to 2015. At baseline, food consumption was obtained using a validated dietary history. Two Mediterranean dietary patterns were used: (i) An a priori-defined pattern, the Mediterranean Diet Adherence Screener (MEDAS score: low adherence: 0–5 points; moderate: 6–8 points; high: 9–14 points); (ii) An a posteriori Mediterranean-like dietary pattern, based on 36 food groups, which was generated using factor analysis. Renal function decline was calculated as an estimated glomerular filtration rate (eGFR) decrease ≥1 mL/min/1.73 m2 per year of follow-up. Results: A total of 104 cases of renal f...
Mayo Clinic Proceedings, 2019
Objective: To assess the prospective association between ultra-processed food consumption and all... more Objective: To assess the prospective association between ultra-processed food consumption and allcause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. Patients and Methods: A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31 th , 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. Results: Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend¼.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend¼.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. Conclusion: A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. Trial Registration: clinicaltrials.gov Identifier: NCT01133093
Revista Española de Cardiología, 2017
Có mo citar este artículo: Martínez-Gó mez D, et al. Validez concurrente de la histó rica pregunt... more Có mo citar este artículo: Martínez-Gó mez D, et al. Validez concurrente de la histó rica pregunta de actividad física en el tiempo libre de la Encuesta Nacional de Salud para los adultos mayores. Rev Esp Cardiol. 2017.
Clinical nutrition (Edinburgh, Scotland), Jun 24, 2016
Several studies have found that moderate alcohol intake is associated with lower risk of function... more Several studies have found that moderate alcohol intake is associated with lower risk of functional limitations in older adults. However, no previous investigation has assessed this association in older adults from Mediterranean countries, who show characteristic drinking patterns. Data were taken from the UAM and the Seniors-ENRICA cohorts in Spain, comprising community-dwelling people aged ≥60 years. At baseline, participants in both cohorts were classified as non-drinkers, ex-drinkers, moderate drinkers and heavy drinkers (the threshold between moderate and heavy intake was ≥40 g/day in men and ≥24 g/day in women). The Seniors-ENRICA cohort allowed assessment of a Mediterranean Drinking Pattern (MDP), defined as moderate alcohol intake, with wine preference (≥80% of alcohol consumed as wine) and drinking only with meals. The incidence of limitation in mobility, agility, and instrumental activities of daily living (IADL) was ascertained in each cohort at the end of a 3.5-year foll...
PloS one, 2016
In older adults, the Mediterranean diet is associated with lower risk of chronic diseases, but it... more In older adults, the Mediterranean diet is associated with lower risk of chronic diseases, but its association with health-related quality of life (HRQL) is still uncertain. This study assessed the association between the Mediterranean diet and HRQL in 2 prospective cohorts of individuals aged ≥60 years in Spain. The UAM-cohort (n = 2376) was selected in 2000/2001 and followed-up through 2003. At baseline, diet was collected with a food frequency questionnaire, which was used to develop an 8-item index of Mediterranean diet (UAM-MDP). The Seniors-ENRICA cohort (n = 1911) was recruited in 2008/2010 and followed-up through 2012. At baseline, a diet history was used to obtain food consumption. Mediterranean diet adherence was measured with the PREDIMED score and the Trichopoulou's Mediterranean Diet Score (MSD). HRQL was assessed, at baseline and at the end of follow-up, with the physical and mental component summaries (PCS and MCS) of the SF-36 questionnaire in the UAM-cohort, and...
Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departam... more Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina Preventiva y Salud Pública. Fecha de lectura: 2 de Noviembre 2010 Bibliografía: 83-93
Revista española de salud pública
This study describes the sociodemographic characteristics, health-related lifestyle, and history ... more This study describes the sociodemographic characteristics, health-related lifestyle, and history of tobacco consumption of the occasional smokers in Spain, and examines whether they show differences against daily smokers. Data were obtained from the National Health Survey of Spain, carried out in 1993 through household interviews on a sample representative of the non-institutionalised population aged 16 year and older. Analyses were performed with logistic regression and adjusted for sociodemographic, health-state and life-style variables. Out of the 6,668 smokers in the survey, occasional smokers were 9.2%, while daily smokers of < or = 5 cigarettes and > 5 cigarettes were 9.9% and 80.9%, respectively. As compared with daily smokers of > 5 cigarettes, occasional smokers were more frequently women (odds ratio (0R): 2.12; CI95%: 1.72-2.61), younger (OR aged 25-44 versus 16-24 years: 0.75; 0.58-0.96), with lower alcohol consumption (p for linear trend: 0.0349), and higher lei...
Scientific Reports
Evidence of the role of cooking methods on inflammation and metabolic health is scarce due to the... more Evidence of the role of cooking methods on inflammation and metabolic health is scarce due to the paucity of large-size studies. Our aim was to evaluate the association of cooking methods with inflammatory markers, renal function, and other hormones and nutritional biomarkers in a general population of older adults. In a cross sectional analysis with 2467 individuals aged ≥ 65, dietary and cooking information was collected using a validated face-to-face dietary history. Eight cooking methods were considered: raw, boiling, roasting, pan-frying, frying, toasting, sautéing, and stewing. Biomarkers were analyzed in a central laboratory following standard procedures. Marginal effects from generalized linear models were calculated and percentage differences (PD) of the multivariable-adjusted means of biomarkers between extreme sex-specific quintiles (Q) of cooking methods consumption were computed ([Q5 − Q1/Q1] × 100). Participants’ mean age was 71.6 years (53% women). Significant PD for ...
Age and Ageing, 2016
Background: leptin resistance, which may develop during the ageing process, stimulates the produc... more Background: leptin resistance, which may develop during the ageing process, stimulates the production of proinflammatory cytokines and insulin resistance that could impair the muscle function. However, the role of leptin on physical functioning among older adults has not yet been elucidated. Objective: to examine the association between serum leptin levels and physical function impairment in older adults. Design and setting: prospective study of 1,556 individuals 60 years and older from the Seniors-ENRICA cohort, who were free of physical function limitation at baseline. Main outcome measure: serum leptin was measured in 2008-10, and incident functional limitation was assessed through 2012. Self-reported limitations in agility and mobility were assessed with the Rosow and Breslau scale, limitation in the lower extremity function was measured with the Short Physical Performance Battery, and impairment in the overall physical performance with the physical component summary of the SF-12. Results: after adjustment for potential confounders and compared to individuals in the lowest quartile of leptin concentration, those in the highest quartile showed increased risk of impaired physical function; the odds ratio (95% confidence interval) and P-trend was: 1.95 (1.11-3.43), P = 0.006 for self-reported impaired mobility; 1.76 (1.08-2.87), P = 0.02 for self-reported impaired agility; 1.48 (1.02-2.15), P = 0.04 for limitation in the lower extremity function; and 1.97 (1.20-3.22), P = 0.01, for decreased overall physical performance. These associations were only modestly explained by C-reactive protein and insulin resistance. Moreover, the associations held across groups with varying health status and were independent of estimated total body fat. Leptin concentration and risk of impaired physical function 819
PloS one, 2017
Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older... more Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older adults but its impact on health-related quality of life (HRQL) is uncertain. This is a cohort study of 2,388 individuals aged !60 recruited in 2000-2001, whose data were updated in 2003 and 2009. At baseline, participants reported both traditional HB (non-smoking, being very or moderately active, healthy diet) and non-traditional HB (sleeping 7-8 h/d, being seated <8 h/d, and seeing friends every day). HRQL was measured with the SF-36 questionnaire at baseline, in 2003 (short-term) and in 2009 (long-term); a higher score on the SF-36 represents better HRQL. Linear regression models were used to assess the association between HB at baseline and HRQL in 2003 and 2009, with adjustment for the main confounders including baseline HRQL. In the short-term, being physically active, sleeping 7-8 h/d, and being seated <8 h/d was associated with better HRQL. Compared to having 1 of these HB, the β (95% confidence interval) for the score on the physical component summary of the SF-36 in 2003 was 1.42 (0.52-2.33) for 2 HB, and 2.06 (1.09-3.03) for 3 HB, p-trend <0.001. Corresponding figures for the mental component summary score were 1.89 (0.58-3.21) for 2 HB and 3.35 (1.95-4.76) for 3 HB, p-trend <0.001. Non-smoking, a healthy diet or seeing friends did not show an association with HRQL. In the long-term, being physically active was the only HB associated with better physical HRQL. As a conclusion, a greater number of HB, particularly more physical activity, adequate sleep duration, and sitting less, were associated with better short-term HRQL in older adults. However, in the long-term, being physically active was the only HB associated with better physical HRQL.
Revista Espa de Cardiologia
Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public he... more Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public health problem, associated with significant mortality, morbidity, and healthcare expenditures, particularly among those aged ≥65 years. The case mix of HF is changing over time with a growing proportion of cases presenting with preserved ejection fraction for which there is no specific treatment. Despite progress in reducing HFrelated mortality, hospitalizations for HF remain frequent and rates of readmissions continue to rise. To prevent hospitalizations, a comprehensive characterization of predictors of readmission in patients with HF is imperative and must integrate the impact of multimorbidity related to coexisting conditions. New models of patient-centered care that draw on community-based resources to support HF patients with complex coexisting conditions are needed to decrease hospitalizations.
Journal of the American Medical Directors Association, 2015
There is emerging evidence of the role of diabetes as a risk factor for frailty. However, the mec... more There is emerging evidence of the role of diabetes as a risk factor for frailty. However, the mechanisms of this association are uncertain. Prospective cohort study of 1750 noninstitutionalized individuals aged 60 years or older recruited in 2008-2010. At baseline, information was obtained on health behaviors, morbidity, cardiometabolic biomarkers, and antidiabetic treatments. Individuals were considered diabetic if they reported a physician diagnosis or had fasting serum glucose of 126 mg/dL or higher. Study participants were followed through 2012 to assess incident frailty, defined as at least 3 of the 5 Fried criteria. At baseline, the cohort included 346 individuals with diabetes and 1404 without diabetes. Over a mean 3.5-year follow-up, 115 cases of incident frailty were ascertained. After adjustment for age, sex, and education, participants with diabetes showed an increased risk of frailty (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.42-3.37). Additional adjustment for health behaviors and abdominal obesity yielded a 29.7% reduction in the OR (OR 1.83, 95% CI 1.16-2.90). Subsequent adjustment for morbidity produced an additional 8.4% reduction (OR 1.76, 95% CI 1.10-2.82), and for cardiometabolic biomarkers, a further 44% reduction (OR 1.32, 95% CI 0.70-2.49). In particular, adjustment for HbA1c, lipoproteins, and triglycerides accounted for the greatest reductions. Finally, additional adjustment for oral antidiabetic medication reduced the OR to 1.01 (95% CI 0.46-2.20), whereas adjustment for nutritional therapy increased the OR to 1.64 (95% CI 0.77-3.49). Diabetes mellitus is associated with higher risk of frailty; this association is partly explained by unhealthy behaviors and obesity and, to a greater extent, by poor glucose control and altered serum lipid profile among diabetic individuals. Conversely, diabetes nutritional therapy reduces the risk of frailty.
Gaceta sanitaria / S.E.S.P.A.S
Revista Española de Cardiología, 2012
PLoS ONE, 2013
Objectives: Obesity-related eating behaviors (OREB) are associated with higher energy intake. Tot... more Objectives: Obesity-related eating behaviors (OREB) are associated with higher energy intake. Total energy intake can be decomposed into the following constituents: food portion size, food energy density, the number of eating occasions, and the energy intake from energy-rich beverages. To our knowledge this is the first study to examine the association between the OREB and these energy components.
Current Hypertension Reports, 2004
Journal of epidemiology and community health, 2011
Background This study evaluates the influence of socioeconomic position (SEP) over the life cours... more Background This study evaluates the influence of socioeconomic position (SEP) over the life course on change in health-related quality of life (HRQoL) in older adults. Methods A prospective cohort of 2117 individuals aged 60 years and over. In 2001, SEP was measured over the < An additional table is published online only. To view this file please visit the journal online
Revista española de salud pública
Counselling for tobacco quitting could be improved by informing smokers about the likelihood of s... more Counselling for tobacco quitting could be improved by informing smokers about the likelihood of success in quitting over time since the start of an intervention for smoking cessation. This study assessed the change in the probability of success in tobacco quitting during the course of two simple medical interventions for smoking cessation. Prospective study in three worksites in the Basque Country (Spain), which underwent two interventions for quitting. Intervention 1 consisted of sporadic, brief (30 seconds-1 minute) and unstructured medical advice to quit. Intervention 2 consisted of brief (5-8 minutes) structured medical counselling for tobacco quitting in a first visit, followed by reinforcement advice on 3 occasions during 3 months, accompanied by nicotine patches individualized according to nicotine dependence. Results are expressed as a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;relative measure of success&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; or rate of proportions (RP) calculated as the predictive value of achieving tobacco abstinence at 12 months for those with tobacco abstinence at 2 days, 15 days and 3 months from the start of each intervention divided by the percentage abstinent at 12. For the 103 smokers subjected to intervention 1, RP was 1.7 (CI 95%: 1.0-3.4) at 2 days, 2.3 (1.2-4.6) at 15 days, and 3.4 (1.8-6.5) at 3 months. For the 114 subjects who underwent intervention 2, RP was 1.3 (1.0-2.1) at 2 days, 1.9 (1.2-2.8) at 15 days, and 2.6 (1.8-3.8) at 3 months. Results did not change materially after stratification by number of cigarettes smoked, or nicotine dependence. Remaining abstinent from tobacco smoking at 3 months after the start of a quitting intervention increases the likelihood of success in quitting at 12 months.