Abstract
Objective: To ascertain the major dietary patterns in the cohort ‘SUN’ and to assess the association of several sociodemographic (including age and gender) and lifestyle variables with the adherence to these dietary patterns.
Design: This study is a cross-sectional analysis of 3847 subjects (1587 men and 2260 women) belonging to a prospective cohort study based on self-reported questionnaires. A factor analysis based on 30 predefined food groups was conducted to ascertain the major dietary patterns in the cohort. Multiple regression models were fitted to assess the relationship between several sociodemographic and lifestyle variables and the adherence to these dietary patterns (measured using two scores with observed values ranging from −3.2 to +4.6 for the Western pattern and −3.1 to +5.5 for the Mediterranean pattern).
Results: Two major dietary patterns were found. The first pattern was labelled as a ‘Western’ dietary pattern and the other as a ‘Spanish-Mediterranean’ dietary pattern. Younger subjects were more likely to follow a ‘Western’ dietary pattern; the coefficient representing the change for every 10 y increase in age was b=−0.24 (P<0.001) for men and b=−0.12 (P<0.001) for women. More physically active subjects were less likely to follow a ‘Western’ dietary pattern and more likely to follow a ‘Spanish-Mediterranean’ dietary pattern.
Conclusion: An association between a higher level of physical activity during leisure time and adherence to a ‘Spanish-Mediterranean’ diet was apparent. However, the profile of being a young, sedentary and single male was identified as the most likely to exhibit a departure from the traditional ‘Spanish-Mediterranean’ diet and follow a ‘Western’ dietary pattern.
Sponsorship: Departments of Health and Education of the Navarre Regional Government and FIS (Fondo de Investigaciones Sanitarias) of the Spanish Ministry of Health.
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References
Ainsworth, BE, Haskell, WL, Whitt, MC, Irwin, ML, Swartz, AM, Strath, SJ, O'Brien, WL, Bassett, DR Jr, Schmitz, KH, Emplaincourt, PO, Jacobs, DR Jr & Leon, AS (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med. Sci. Sports Exerc., 32, (Suppl 9) S498–S504.
American Heart Association (2000). Heart and Stroke Statistical Update, Dallas, TX: American Heart Association
Boyle, RG, O'Connor, P, Pronk, N & Tan, A (2000). Health behaviors of smokers, ex smokers, and never smokers in a HMO. Prev. Med., 31, 177–182.
Chen, H, Ward, MH, Graubard, BI, Heineman, EF, Markin, RM, Potischman, NA, Russell, RM, Weisenburger, DD & Tucker, KL (2002). Dietary patterns and adenocarcinoma of the esophagus and distal stomach. Am. J. Clin. Nutr., 75, 137–144.
Erickson, KL (2002). Dietary pattern analysis: a different approach to analyzing an old problem, cancer of the esophagus and stomach. Am. J. Clin. Nutr., 75, 5–7.
Gandini, S, Merzenich, H, Robertson, C & Boyle, P (2000). Meta-analysis of studies on breast cancer risk and diet: the role of fruit and vegetable consumption and the intake of associated micronutrients. Eur. J. Cancer, 36, 636–646.
Hu, FB, Rimm, EB, Stampfer, MJ, Ascherio, A, Spiegelman, D & Willett, WC (2000). Prospective study of major dietary patterns and risk of coronary heart disease in men. Am. J. Clin. Nutr., 72, 912–921.
Huijbregts, P, Feskens, E, Rasanen, L, Fidanza, F, Nissinen, A, Menotti, A & Kromhout, D (1997). Dietary pattern and 20 y mortality in elderly men in Finland, Italy, and the Netherlands: longitudinal cohort study. Br. Med. J., 315, 13–17.
Jacques, PF & Tucker, KL (2001). Are dietary patterns useful for understanding the role of diet in chronic disease?. Am. J. Clin. Nutr., 73, 1–2.
Joshipura, KJ, Ascherio, A, Manson, JE, Stampfer, MJ, Rimm, EB, Speizer, FE, Hennekens, CH, Spiegelman, D & Willett, WC (1999). Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA, 282, 1233–1239.
Kant, AK & Thompson, FE (1997). Measures of overall diet quality from a food frequency questionnaire: National Health Interview Survey, 1992. Nutr. Res., 17, 1443–1456.
Kris-Etherton, P, Eckel, RH, Howard, BV, StJeor, S & Bazarre, TL (2001). Lyon Diet Heart Study. Benefits of a Spanish-Mediterranean-Style, National Cholesterol Education Program/American Heart Association Step I Dietary Pattern on Cardiovascular Disease. Circulation, 103, 1823–1825.
Kromhout, D, Bloemberg, B, Seidell, JC, Nissinen, A & Menotti, A (2001). Physical activity and dietary fiber determine population body fat levels: the Seven Countries Study. Int. J. Obes. Relat. Metab. Disord., 25, 301–306.
Lee, IM, Hsieh, CC & Paffenbarger, RS Jr (1995). Exercise intensity and longevity in men. The Harvard Alumni Health Study. JAMA, 273, 1179–1184.
Liu, S, Manson, JE, Stampfer, MJ, Rexrode, KM, Hu, FB, Rimm, EB & Willett, WC (2000). Whole grain consumption and risk of ischemic stroke in women. JAMA, 284, 1534–1540.
Martínez-González, MA, Sánchez-Villegas, A, De Irala, J, Martí, A & Martínez, JA (2002). Diet and stroke: objectives and design of the SUN Project. Nutr. Neurosci., 5, 65–73.
Martín-Moreno, JM, Boyle, P, Gorgojo, L, Maisonneuve, P, Fernandez-Rodriguez, JC, Salvini, S & Willett, WC (1993). Development and validation of a food frequency questionnaire in Spain. Int. J. Epidemiol., 22, 512–519.
Martín-Moreno, JM, Willett, WC, Gorgojo, L, Banegas, JR, Rodríguez-Artalejo, F, Fernández-Rodríguez, JC, Maisonneuve, P & Boyle, P (1994). Dietary fat, olive oil intake and breast cancer risk. Int. J. Cancer, 58, 774–780.
Mataix, J (1998). Tabla de composición de alimentos españoles, 3rd ed Granada: Universidad de Granada
Moreiras, O (1995). Tablas de composición de alimentos, 3rd ed Madrid: Ediciones Pirámide, S.A
Nube, M, Kok, FJ, Vandenbroucke, JP, van der Heide-Wessel, C & Cander Heide, RM (1987). Scoring of prudent dietary habits and its relation to 25-year survival. J. Am. Diet. Assoc., 87, 171–175.
Oomen, CM, Feskens, EJM, Räsänen, L, Fidanza, F, Nissinen, AM, Menotti, A, Kok, FJ & Kromhout, D (2000). Fish consumption and coronary heart disease mortality in Finland, Italy and the Netherlands. Am. J. Epidemiol., 151, 999–1006.
Raitakari, OT, Leino, M, Rakkonen, K, Porkka, KV, Taimela, S, Rasanen, L & Viikari, JS (1995). Clustering of risk habits in young adults. The Cardiovascular Risk in Young Finns Study. Am. J. Epidemiol., 142, 36–44.
Rodriguez-Artalejo, F, Banegas, JR, Graciani, MA, Hernandez-Vecino, R & Rey-Calero, J (1996). Food and nutrition consumption in Spain in the period 1940–1988. Analysis of its consistency with the Mediterranean diet. Med. Clin (Barc.), 106, 161–168.
Rothman, KJ & Greenland, S (1998). Precision and validity in epidemiologic studies. In:Modern Epidemiology, 2nd edn, pp115–134, Philadelphia, PA: Lippincott-Raven
Ryan, M, McInerney, D, Owens, D, Collins, P, Johnson, A & Tomkin, GH (2000). Diabetes and the Mediterranean diet: a beneficial effect of oleic acid. Q. J. Med., 93, 85–91.
Sacks, FM, Svetkey, LP, Vollmer, WM, Appel, LJ, Bray, GA, Harsha, D, Obarzanek, E, Conlin, PR, Miller, ER III, Simons-Morton, DG, Karanja, N & Lin, PH (2001). Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. New Engl. J. Med., 344, 3–10.
Sánchez-Villegas, A, Martínez-González, MA & Martínez, JA (2001). Dieta Mediterránea: evidencias epidemiológicas de sus efectos beneficiosos sobre la salud. Rev. Chil. Nutr., 28, 244–255.
Sánchez-Villegas, A, De Irala, J & Martínez-González, MA (2002). Mediterranean diet and cardiovascular disease: results of the pilot study of the SUN project. Rev Med Univ Navarra, (in press)
Schroll, K, Carbajal, A, Decarli, B, Martins, I, Grunenberger, F, Blauw, YH & de Groot, CP (1996). Food patterns of elderly Europeans. SENECA Investigators. Eur. J. Clin. Nutr., 50, (Suppl 2) S86–S100.
Serra-Majem, L, La Vecchia, C, Ribas Bara, L, Prieto Ramos, F, Lucchini, F, Ramon, JM & Salleras, L (1993). Changes in diet and mortality from selected cancers in Southern Mediterranean countries, 1960–1989. Eur. J. Clin. Nutr., 47, (Suppl 1) S25–S34.
Slattery, ML, Boucher, KM, Caan, BJ, Potter, JD & Ma, K (1998). Eating patterns and risk of colon cancer. Am. J. Epidemiol., 148, 4–16.
Susser, M & Susser, E (1996a). Choosing a future for epidemiology: I. Eras and paradigms. Am. J. Public Health, 86, 668–673.
Susser, M & Susser, E (1996b). Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. Am. J. Public Health, 86, 674–677.
Trichopoulou, A & Lagiou, P (1997). Healthy traditional Mediterranean diet: an expression of culture, history, and lifestyle. Nutr. Rev., 11, 383–389.
Trichopoulou, A, Lagiou, P, Kuper, H & Trichopoulos, D (2000). Cancer and Mediterranean dietary traditions. Cancer Epidemiol. Biomarkers Prev., 9, 869–873.
Utts, JM (1996). Factor analysis. In:Seeing through Statistics, pp364–419, Belmont: Duxbury Press
WHO (1993). Health for all: statistical database, Geneva: World Health Organisation, Regional Office for Europe
WHO (1997). The world health report, Geneva: World Health Organization
Willett, WC (1994). Diet and health: what should we eat?. Science, 264, 532–537.
Williams, DEM, Prevost, WAT, Whichelow, MJ, Cox, BD, Day, NE & Wareham, NJ (2000). A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. Br. J. Nutr., 83, 257–266.
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The Department of Health of the Navarre Regional Government, Department of Education of the Navarre Regional Government and FIS (Fondo de Investigaciones Sanitarias) of Spanish Ministry of Health are acknowledged.
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Sánchez-Villegas, A., Delgado-Rodríguez, M., Martínez-González, M. et al. Gender, age, socio-demographic and lifestyle factors associated with major dietary patterns in the Spanish Project SUN (Seguimiento Universidad de Navarra). Eur J Clin Nutr 57, 285–292 (2003). https://doi.org/10.1038/sj.ejcn.1601528
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DOI: https://doi.org/10.1038/sj.ejcn.1601528