Publications (49) View all
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Article: Pro12Ala variant of the PPARG2 gene increases body mass index: An updated meta-analysis encompassing 49,092 subjects.
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ABSTRACT: The peroxisome proliferator-activated receptor gamma 2 (PPARG2) gene has been intensively studied with relation to obesity and metabolic disorders. Indeed, a large number of studies assessing the association between the PPARG2 polymorphism Pro12Ala (rs1801282) and body mass index (BMI) have been published with some controversial results. OBJECTIVE: In this meta-analysis, the effects of Pro12Ala polymorphism of the PPARG2 gene on BMI were investigated. DESIGN AND METHODS: Externally published data were collected and we included our own novel data from a study in the elderly participants (>55 years) of a Mediterranean cohort, the SUN ("Seguimiento Universidad de Navarra") Project (n = 972). A total of 75 independent studies with 49,092 subjects (39,806 with the genotype Pro12Pro and 9,286 carrier subjects of the Ala allele) were included. RESULTS: The meta-analysis revealed a higher BMI with an overall estimation of +0.065 kg/m(2) (95%CI = 0.026-0.103, P = 0.001) for homo-/heterozygous carriers of the Ala allele of the PPARG2 gene in comparison to non-carriers. The analysis also showed that there was heterogeneity (P for heterogeneity <0.001), but funnel plots did not suggest apparent publication bias. Furthermore, the association between the Pro12Ala polymorphism of the PPARG2 gene and increased BMI was stronger in Caucasian. Thus, carriers of the Ala allele had significantly higher BMI than non-carriers in a subsample of 6,528 Caucasian male subjects (standardized mean difference = 0.090, 95%CI=0.032-0.148, P = 0.002, P for heterogeneity = 0.121). CONCLUSION: This updated meta-analysis showed that carriers of the Ala12 allele of the PPARG2 gene had a higher average BMI.Obesity 11/2012; · 4.28 Impact Factor -
Article: Similar prediction of decreased total mortality, diabetes incidence or cardiovascular events using relative- and absolute-component Mediterranean diet score: The SUN cohort.
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ABSTRACT: BACKGROUND AND AIM: Accumulated evidence supports the effectiveness of Mediterranean-type diets (MeDiet) in reducing mortality and preventing several chronic diseases. Widely used scores to assess adherence to MeDiet are based on specific sample characteristics; alternatively, they might be built according to absolute/normative cut-off points for the consumption of specific food groups (pre-defined servings/day or/week). The aim of this study was to compare sample-specific MeDiet adherence scores (MDS) versus absolute-normative scores (Mediterranean Diet Adherence Screener - MEDAS) on their association with macronutrient intake, total mortality and incidence of chronic diseases. Design: SUN (Seguimiento Universidad de Navarra) dynamic prospective cohort study (60.5% women; mean age 38.4 years). METHODS AND RESULTS: In cross-sectional analyses (n=20,155) we evaluated macronutrient distribution according to MDS (based on 136-item FFQ), MEDAS (based on 13 questions), and variants of both. In prospective analyses (n=9109; mean follow-up: 6.2 years), we evaluated disease incidence or mortality. Adherence to MeDiet increased with age and, as expected, was associated with higher fiber intake, lower total fat intake but higher monounsaturated/saturated fat ratio, using all scores. Among subjects initially free of cancer, diabetes, and cardiovascular disease (CVD), adherence to MeDiet appraised with an absolute-normative score (MEDAS) similarly predicted macronutrient distribution and disease incidence or mortality (diabetes incidence, CVD or all-cause mortality), when compared to a sample-specific score based on 136-item FFQ (MDS). CONCLUSIONS: Adherence to MeDiet was associated with a decreased incidence of a composite outcome including diabetes incidence, cardiovascular events incidence or all-cause mortality.Nutrition, metabolism, and cardiovascular diseases: NMCD 03/2012; · 3.52 Impact Factor -
Article: Mediterranean diet and the incidence of cardiovascular disease: a Spanish cohort.
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ABSTRACT: The Mediterranean diet is considered a model for healthy eating. However, prospective evidence in Mediterranean countries evaluating the relationship between this dietary pattern and non-fatal cardiovascular events is scarce. The aim of the present study was to evaluate the association between the adherence to the Mediterranean diet and the incidence of fatal and non-fatal cardiovascular events among initially healthy middle-aged adults from the Mediterranean area. We followed-up 13,609 participants (60 percent women, mean age: 38 years) initially free of cardiovascular disease (CVD) during 4.9 years. Participants were part of a prospective cohort study of university graduates from all regions of Spain. Baseline diet was assessed using a validated 136-item food-frequency questionnaire. A 9-point score was used to appraise adherence to the Mediterranean diet. Incident clinical events were confirmed by a review of medical records. We observed 100 incident cases of CVD. In multivariate analyses, participants with the highest adherence to the Mediterranean diet (score>6) exhibited a lower cardiovascular risk (hazard ratio=0.41, 95% confidence interval [CI]: 0.18-0.95) compared to those with the lowest score (<3). For each 2-point increment in the score, the adjusted hazard ratios were 0.80 (95% CI: 0.62-1.02) for total CVD and 0.74 (0.55-0.99) for coronary heart disease. There is an inverse association between adherence to the Mediterranean diet and the incidence of fatal and non-fatal CVD in initially healthy middle-aged adults.Nutrition, metabolism, and cardiovascular diseases: NMCD 04/2011; 21(4):237-44. · 3.52 Impact Factor -
Article: Food intake of individuals with and without diabetes across different countries and ethnic groups
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ABSTRACT: Background/Objectives: Given the importance of nutrition therapy in diabetes management, we hypothesized that food intake differs between individuals with and without diabetes. We investigated this hypothesis in two large prospective studies including different countries and ethnic groups.European Journal of Clinical Nutrition 02/2011; 65(5):635-641. · 2.46 Impact Factor -
Article: Food intake of individuals with and without diabetes across different countries and ethnic groups.
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ABSTRACT: Given the importance of nutrition therapy in diabetes management, we hypothesized that food intake differs between individuals with and without diabetes. We investigated this hypothesis in two large prospective studies including different countries and ethnic groups. Study populations were the European Prospective Investigation into Cancer and Nutrition Study (EPIC) and the Multiethnic Cohort Study (MEC). Dietary intake was assessed by food frequency questionnaires, and calibrated using 24h-recall information for the EPIC Study. Only confirmed self-reports of diabetes at cohort entry were included: 6192 diabetes patients in EPIC and 13 776 in the MEC. For the cross-sectional comparison of food intake and lifestyle variables at baseline, individuals with and without diabetes were matched 1:1 on sex, age in 5-year categories, body mass index in 2.5 kg/m(2) categories and country. Higher intake of soft drinks (by 13 and 44% in the EPIC and MEC), and lower consumption of sweets, juice, wine and beer (>10% difference) were observed in participants with diabetes compared with those without. Consumption of vegetables, fish and meat was slightly higher in individuals with diabetes in both studies, but the differences were <10%. Findings were more consistent across different ethnic groups than countries, but generally showed largely similar patterns. Although diabetes patients are expected to undergo nutritional education, we found only small differences in dietary behavior in comparison with cohort members without diabetes. These findings suggest that emphasis on education is needed to improve the current behaviors to assist in the prevention of complications.European journal of clinical nutrition 02/2011; 65(5):635-41. · 3.07 Impact Factor
