Abstract
Background: Studying the adherence of the population to the Atlantic Diet (AD) could be simplified by an easy and quickly applied dietary index. The aim of this study is to analyse the relationship of an index measuring compliance with recommendations regarding the Atlantic diet and physical activity with cardiovascular disease risk factors, cardiovascular risk factors, obesity indexes and arterial stiffness markers. Methods: We included 791 individuals from the EVIDENT study (lifestyles and arterial ageing), (52.3 ± 12 years, 61.7% women) without cardiovascular disease. Compliance with recommendations on AD was collected through the responses to a food frequency questionnaire, while physical activity was measured by accelerometer. The number of recommendations being met was estimated using a global scale between 0 and 14 points (a higher score representing greater adherence). Blood pressure, plasma lipid and glucose values and obesity rates were measured. Cardiovascular risk was estimated with the Framingham equation. Results: In the overall sample, 184 individuals (23.3%) scored between 0–3 on the 14-point index we created, 308 (38.9%) between 4 and 5 points, and 299 (37.8%) 6 or more points. The results of multivariate analysis yield a common tendency in which the group with an adherence score of at least 6 points shows lower figures for total cholesterol (p = 0.007) and triglycerides (p = 0.002). Similarly, overall cardiovascular risk in this group is the lowest (p < 0.001), as is pulse wave velocity (p = 0.050) and the mean values of the obesity indexes studied (p < 0.05 in all cases). Conclusion: The rate of compliance with the Atlantic diet and physical activity shows that greater adherence to these recommendations is linked to lower cardiovascular risk, lower total cholesterol and triglycerides, lower rates of obesity and lower pulse wave velocity values.
Highlights
In recent decades, the study of the effects of nutrition on health has undergone a change in approach, with the focus moving from isolated nutrients to dietary patterns [1]
The aim of this study is to develop a dietary index, based on a food frequency questionnaire, which would allow a quick and easy assessment of compliance with the recommendations regarding the Atlantic diet and physical activity and an analysis of its association with cardiovascular disease risk score as primary outcome and cardiovascular risk factors, obesity indexes and arterial stiffness markers as secondary outcomes
The 791 participants who meet the selection criteria allow detecting a minimum difference in cardiovascular risk of three percentage points between two of the three groups into which we have classified Atlantic Diet (AD) adherence, assuming an alpha risk of 0.05 and a beta risk of 0.2 in bilateral contrast. This minimum difference was based on the results found after a diet and aerobic exercise program intervention, which achieved a reduction of 3.0 points on cardiovascular risk [25]
Summary
The study of the effects of nutrition on health has undergone a change in approach, with the focus moving from isolated nutrients to dietary patterns [1]. Some studies complement the analysis of the effect of these dietary patterns on health by analysing the principal component and/or using a cluster analysis These analyses have been able, for example, to determine that within the concept of a healthy eating pattern, the consumption of a diet rich in cereals, fish, fruit and vegetables is associated with a healthier metabolic profile [7]. They have allow determining that skipping breakfast or the afternoon snack are risk factors for poor cardiovascular health [8].
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