Mercedes Sotos Prieto

Harvard School of Public Health, United States/ OU

Importance Physical activity (PA) guidelines recommend the same amount of PA through adulthood to live longer. Objective To explore whether there is an age-dependent association between PA and all-cause mortality and to investigate the age-dependent associations between other modifiable health factors (high educational level, not smoking, not regu...

To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean diet-based interventions on anthropometric variables could facilitate the...

Objective To evaluate the long-term, symptomatic recovery of healthcare workers from acute COVID-19 infections up to three years after the initial COVID-19 outbreak. Methods Cross-sectional study among employees of a community-based healthcare system in Massachusetts who had a recorded positive COVID-19 test. Survey responses were collected betwee...

Aims The Planetary Health Diet Index (PHDI) prioritizes the well-being of both individuals and the planet but has yielded mixed results on cardiovascular disease (CVD). The aim of this study was to assess the association between the PHDI and risk of CVD. Methods and results A cohort of 118 469 individuals aged 40–69 years from the UK Biobank, who...

Importance Alcohol consumption is a leading cause of morbidity and mortality that may be more important in older adults with socioeconomic or health-related risk factors. Objective To examine the association of alcohol consumption patterns with 12-year mortality and its modification by health-related or socioeconomic risk factors. Design, Setting...

Background It is unknown whether growth differentiation factor 15 (GDF-15) is associated with chronic musculoskeletal pain (CMP) and whether or not its association with incident cardiovascular disease (CVD) changes according to CMP status. Methods 1,957 randomly-selected adults aged ≥65 years without prior CVD were followed up between 2015-2023. C...

Introduction Dietary choices play a crucial role in influencing systemic inflammation and the eventual development of cardiovascular diseases (CVD). The Dietary Inflammatory Index (DII®) is a novel tool designed to assess the inflammatory potential of one’s diet. Firefighting, which is characterized by high-stress environments and elevated CVD risk...

Background: Substantial evidence supports the inverse association between adherence to healthy dietary patterns and frailtyrisk. However, the role of plant-based diets, particularly their quality, is poorly known. Objective: To examine the association of two plant-based diets with incidence of physical frailty in middle-aged and olderadults. Desi...

Background Oral vitamin C supplementation has been associated with lower risk of chronic postsurgical pain. However, the effect of dietary vitamin C on pain in a non-surgical setting is unknown. We aimed to investigate the association between dietary vitamin C intake and changes over time in chronic pain and its characteristics in community-dwellin...

Aim To examine the independent relationships of lifestyle and social and economic factors with all-cause and cardiovascular disease (CVD) mortality in a large representative sample of the US adult population. Furthermore, the association between the combination of lifestyle and social and economic factors with mortality was analyzed in detail. Met...

Importance Previous research has found that vegetarian diets are associated with lower bone mineral density and higher risk of fractures, but these studies did not differentiate the quality of the plant-based foods. Objective To examine the association between the quality of plant-based diets (not necessarily vegan but also omnivorous) and hip fra...

Background Traffic exposure has been associated with biomarkers of increased biological ageing, age-related chronic morbidities, and increased respiratory, cardiovascular, and all-cause mortality. Whether it is associated with functional impairments and unhealthy ageing trajectories is unknown. Methods Nationally representative population-based co...

Background Frailty is a geriatric syndrome that entails high risk of hospitalization, disability, and death. While adherence to Mediterranean diet has been associated with lower risk of frailty, the joint effect of diet and lifestyle is uncertain. This study examined the association between a Mediterranean lifestyle (diet, customs, and traditions)...

Objective To assess the association of physical activity (PA) type, volume, intensity, and changes over time with all‐cause mortality in older adults. Methods We used data from 3518 and 3273 older adults recruited in the Seniors‐ENRICA‐1 and 2 cohorts. PA was assessed with the EPIC questionnaire. Participants reported how many hours they spent a w...

Background: Selenium is an essential trace element with an antioxidant and anti-inflammatory capacity that has been associated in experimental studies with beneficial effects on appetite control, the regulation of the gut microbiota, and control of the anabolic–catabolic balance. The main aim of the present study was to evaluate the association bet...

In the United States (US), new firefighters’ fitness and health behaviors deteriorate rapidly after fire academy graduation. Over the long-term, this increases their risks for chronic diseases. This study protocol describes the proposed usability testing and pilot study of a newly designed and developed healthy lifestyle smartphone app, “Surviving...

Background There is mounting evidence that the Mediterranean diet prevents type 2 diabetes, but little is known about the role of Mediterranean lifestyles other than diet and among non-Mediterranean populations. This work aimed to examine the association between a comprehensive Mediterranean-type lifestyle and type 2 diabetes incidence in a British...

Introduction and objectives: The American Heart Association (AHA) has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death. Methods: We used data from 11 616 indivi...

Specific foods, nutrients, dietary patterns, and physical activity are associated with lower blood pressure (BP) and heart rate (HR), but little is known about the joint effect of lifestyle factors captured in a multidimensional score. We assessed the association of a validated Mediterranean-lifestyle (MEDLIFE) index with 24-h-ambulatory BP and HR...

Objective: To examine the association between the Mediterranean lifestyle and all-cause, cancer, and cardiovascular disease (CVD) mortality in a British population. Patients and methods: We studied 110,799 individuals 40 to 75 years of age from the UK Biobank cohort, free of CVD or cancer between 2009 and 2012 who were followed-up to 2021. The M...

Importance: US firefighters are a working population at risk of chronic diseases, including obesity, cardiovascular disease, and cancer. This risk may be mitigated by a healthy diet. Objective: To evaluate the effect of a Mediterranean nutrition intervention using a behavioral/environmental approach (firefighter/fire station/home) at the individ...

Objective: frailty is a syndrome characterised by increased vulnerability to stressors, which manifests as higher death risk. Whilst guidelines for frailty management usually entails lifestyle modifications (e.g. physical exercise, diet), the mediating role of lifestyle on the excess mortality associated with frailty is unclear. This study estimat...

To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to effects on anthropometric measures. A better understanding of the effects of Mediterranean diet-based interventions on anthropometric variables could facilitate their i...

Potential environmental determinants of BP and hypertension in older adults are far less known than their lifestyle risk factors. Manganese (Mn) is an essential element for life that may induce changes in blood pressure (BP), but the direction of the association is unclear. We aimed to examine the association of blood manganese (bMn) with 24-h-base...

Introduction: Cardiovascular disease (CVD) remains the leading cause of death for women in the US, yet many young women are unaware of their lifetime risk of CVD. We employed user-centered design principles to adapt a validated CVD risk prediction tool for young women. Hypothesis: We hypothesized that young women would rate the tool (HerHeart) as u...

Background: There is strong evidence that the Mediterranean diet protects from cardiovascular disease (CVD); however, beyond diet, the Mediterranean lifestyle may have synergistic effects through the combination of other health behaviors, such as adequate rest or sociability. While most evidence on this lifestyle pattern comes from Mediterranean co...

Background: United States (US) career firefighters represent a working population at high risk for cardiovascular disease that may benefit from a Mediterranean diet (MedDiet) nutrition intervention (MDNI). The Feeding America’s Bravest trial was the first workplace randomized controlled trial with nutrition education, behavior change, and incentive...

Purpose We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specific mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates. Methods Using baseline information on 12 a priori selected dietary and non...

Supplementary tables and figures.

Introduction: Frailty is a geriatric syndrome that leads to increased risk of hospitalization, disability, and death. The effect of plant-based diets defined by the quality of their plant foods is unclear. Our objective is to study the association between two plant-based diet indices and the occurrence of frailty among community-dwelling older adul...

Background Growth Differentiation Factor 15 (GDF-15) is a marker of inflammation and oxidative stress that has been associated with multiple age-related chronic diseases. Since lifestyle is key for preventing these adverse health outcomes, we examined the association between a Mediterranean lifestyle and GDF-15 serum concentrations in Spanish older...

Background and objectives: A Mediterranean lifestyle may prevent and mitigate cardiometabolic disorders. We explored whether adherence to a Mediterranean lifestyle was prospectively associated with risk of metabolic syndrome (MetS) among coronary heart disease (CHD) patients. Methods: The CORDIOPREV study was an interventional diet study to comp...

Objective: To investigate the associations of a healthful plant-based diet index (hPDI) and an unhealthful plant-based diet index (uPDI) with all-cause and cardiovascular disease (CVD) mortality in Spanish adults. Patients and Methods: We analyzed data from 11,825 individuals 18 years of age or older, representative of the Spanish population, recr...

Introduction and Objectives: The Healthy Heart Score (HHS) is a lifestyle-based equation for predicting cardiovascular disease (CVD) risk and may serve as a tool in primordial prevention. However, its performance outside North American populations is unknown. This study assessed the performance of the HHS for estimating CVD mortality in the adult p...

Background: The Mediterranean diet and other dietary patterns rich in fruits and vegetables have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk. Our aim was to assess the a...

Background: Vitamin D plays a role in bone health, pain signaling, and inflammation. We examined the largely unknown relation of dietary vitamin D intake with pain incidence and pain changes over time in older adults. Methods: Data were taken from the Seniors-ENRICA-1 cohort, which included 950 individuals aged ≥60 years. Habitual vitamin D inta...

Background: Frailty is a geriatric syndrome that entails high risk of hospitalization, disability, and death. While adherence to Mediterranean diet has been associated with lower risk of frailty, the joint effect of diet and lifestyle is uncertain. This study examined the association between a Mediterranean lifestyle (diet, customs, and traditions...

BACKGROUND Cardiovascular disease (CVD) is the number one cause of death in women in the United States. Awareness of CVD and its risk factors are critical to reversing this trend. OBJECTIVE This project aimed to assess CVD awareness among adolescent and young adult women and develop a lifestyle-based cardiovascular risk assessment tool for use wit...

Cardiovascular disease is the leading cause of on-duty mortality among firefighters, with obesity as an important risk factor. However, little is known regarding the dietary patterns which are characteristic in this population and how these patterns relate to cardiometabolic outcomes. The aim of this study was to identify the dietary patterns of US...

There are knowledge gaps regarding healthy lifestyle (HLS) interventions in fire academy settings and also concerning the impacts of the pandemic on training. We enrolled fire recruits from two fire academies (A and B) in New England in early 2019 as the historical control group, and recruits from academies in New England (B) and Florida (C), respe...

Objectives United States (US) career firefighters represent a working population at high risk for chronic diseases that may benefit from a Mediterranean diet intervention at the public health level. The primary objective of this trial was to assess the effect of a Mediterranean diet nutrition intervention (MDNI) vs. a control group on a modified Me...

Background The protective health effects of light alcohol consumption are debated due to potential selection biases, reverse causation and confounding. We examined cross-sectional and prospective associations of alcohol consumption patterns with unhealthy aging among older drinkers addressing these methodological issues. Methods 2081 lifetime drin...

Objective To assess the association between adherence to a Mediterranean lifestyle and changes in pain, and its characteristics over time in older adults. Patients and Methods We analyzed data from 864 and 862 community-dwelling individuals aged 65+ years from the Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain (Seni...

Importance: The Mediterranean diet, and other dietary patterns rich in fruits and vegetables, have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk. Objective: To assess the a...

Background: Growth differentiation factor 15 (GDF-15) is a biomarker for chronic disease burden that might explain the health effects of sedentary behaviours (SBs) and physical activity (PA). We examined associations of device-measured sleep, SB and PA, and time reallocations among them, with GDF-15 in older adults. Methods: We used data from 22...

Background: Evidence on the comprehensive role of lifestyle in frailty risk is scarce. To assess the association between a lifestyle-based Healthy Heart Score (HHS), which estimates the 20-year risk of cardiovascular disease (CVD), and risk of frailty among older women. Methods: Prospective cohort study in 121,700 nurses from the USA participati...

Background The contribution of metabolomic factors to the association of healthy lifestyle with type 2 diabetes risk is unknown. We assessed the association of a composite measure of lifestyle with plasma metabolite profiles and incident type 2 diabetes, and whether relevant metabolites can explain the prospective association between healthy lifest...

Refining existing dietary assessment methods to reduce measurement error and facilitate the routine evaluation of dietary quality is essential to inform health policy. Notable advancements in technology in the past decade have enhanced the precision and transformation of dietary assessment methods with applications toward both population health and...

Aims: To examine the association of alcohol consumption patterns with growth differentiation factor 15 (GDF-15) in older drinkers, separately among individuals with cardiovascular disease (CVD)/diabetes and those without them, since GDF-15 is a strong biomarker of chronic disease burden. Design: Cross-sectional study. Setting: Population-based...

Introduction Cardiovascular disease is the leading cause of on-duty fatalities among U.S. firefighters. Research has demonstrated that many modifiable risk factors are contributors to the high prevalence of cardiometabolic risk factors. The current study aimed to assess whether sleep is associated with cardiometabolic risk factors among Indianapoli...

Background Red meat is a nutrient-dense source of protein fundamental for older adults; however, red meat is also high in detrimental components, including saturated fat. It is unclear whether habitual red meat consumption is associated with risk of frailty. This study aimed to examine the prospective association between the consumption of total, u...

Purpose of review: Workplaces provide a unique opportunity to deliver health promotion interventions to their workers. This review summarizes evidence from the most recent studies (September 2019 to April 2021) of workplace healthy lifestyle interventions and identifies gaps in the literature and key aspects for successful future workplace lifesty...

Background Recent evidence has indicated a greater number of protective factors is associated with a greater decreased risk for depression and depressive symptoms compared with individual factors alone. Moreover, adherence to healthy modifiable lifestyle behaviors may lower the risk of depression regardless of underlying genetic risk. Objective We...

The traditional Mediterranean diet is considered the world’s most evidence-based eating pattern for promoting health and longevity. However, institutional food environments and their busy consumers often sacrifice health benefits for the convenience of faster and cheaper foods that generally are of lower quality and are more processed, and thus, co...

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle...

Objectives The Mediterranean lifestyle (MEDLIFE), as an overall lifestyle pattern rather than individual factors, may be associated with a lower prevalence of metabolic syndrome. The objective was to study the association of a validated MEDLIFE index with metabolic syndrome and its components among a non-Mediterranean working population. Methods A...

Introduction: Cardiovascular disease (CVD) primordial prevention tools applicable to diverse populations are scarce. Hypothesis: We assessed the hypothesis that the Healthy Heart Score, a lifestyle-based tool to estimate CVD risk, will perform well in estimating CVD risk in an African American population. Methods: The Jackson Heart Study (JHS) is a...

Cardiovascular disease (CVD) primordial prevention tools applicable to diverse populations are scarce. Our aim was to assess the performance of a lifestyle-based tool to estimate CVD risk in an African American population. The Jackson Heart Study is a prospective cohort including 5306 African American participants in Jackson, Mississippi (2000–2004...

Epidemiological studies have yielded conflicting results regarding climate and incident SARS-CoV-2 infection, and seasonality of infection rates is debated. Moreover, few studies have focused on COVD-19 deaths. We studied the association of average ambient temperature with subsequent COVID-19 mortality in the OECD countries and the individual Unite...

Background Although some components of the Mediterranean diet have shown benefits in pain risk through its anti-inflammatory/antioxidant properties, no population-based studies have investigated the effect of adherence to this diet on changes in pain over time. Methods We used data from 864 and 862 older adults recruited in the Seniors-ENRICA-1 an...

Purpose of Review To evaluate the multidimensional influence of food environments on food choice, dietary quality, and diet-related health and identify critical gaps necessary to develop effective population interventions that influence food choice. Recent Findings Multicomponent interventions that interact with multiple layers of the food environ...

Background: Growth differentiation factor 15 (GDF-15) is a biomarker for aging and chronic disease burden that may capture the anti-inflammatory and antioxidant effects attributed to healthy diets. Objective: The aim was to examine whether several healthy dietary patterns and a lower inflammatory potential of diet are associated with lower conce...

Background & Aims The Mediterranean lifestyle (MEDLIFE), as an overall lifestyle pattern, may be associated with a lower prevalence of metabolic syndrome. We assessed the association of a validated MEDLIFE index with metabolic syndrome and its components in a non-Mediterranean working population. Methods A cross-sectional analysis was conducted at...

Background: We aimed to examine main changes in health behaviors, mental and physical health among older adults under severe lockdown restrictions during the COVID-19. Methods: We used prospective data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain. Data were obtained using validated questionnaires...

Background The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and North-Western Spain. Higher adherence to the SEAD has been associated with lower levels of some cardiovascular risk factors and reduced risk for myocardial infarction, but whether this translates into lower all-cause mortality is uncertain. We hen...

Background and Aims A healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDL...

Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data we...