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José I. Recio-Rodríguez
Faculty of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain

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Journal article
Published: 07 August 2021 in Nutrients
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Background: The relationship between the quality of the diet and the adherence to the Mediterranean diet with the presence of persistent or recurrent depressive symptoms have been described. The objective of this study is to analyze the relationship between adherence to the Mediterranean diet and the intake of specific foods in primary care patients aged 45 to 75, having subclinical or major depression. The study also specifically analyzes this relationship in individuals suffering from chronic diseases. Methods: A cross-sectional descriptive study was conducted. 3062 subjects met the inclusion criteria from the EIRA study. Sociodemographic variables, clinical morbidity, depression symptomatology (PHQ-9) and adherence to Mediterranean diet (MEDAS) were collected. Results: Being female, younger, with a higher BMI, consuming more than 1 serving of red meat a day and drinking more than one carbonated or sugary drink daily, not consuming 3 servings of nuts a week and not eating 2 vegetables cooked in olive oil a week are predictors of having higher depressive symptomatology. Conclusions: Assessing the type of diet of patients presenting depressive symptoms and promoting adherence to a healthy diet is important, especially in patients with chronic diseases. However, depression is a very complex issue and the relationship between nutrition and depression must be further examined.

ACS Style

Bárbara Oliván-Blázquez; Alejandra Aguilar-Latorre; Emma Motrico; Irene Gómez-Gómez; Edurne Zabaleta-Del-Olmo; Sabela Couso-Viana; Ana Clavería; José Maderuelo-Fernandez; José Recio-Rodríguez; Patricia Moreno-Peral; Marc Casajuana-Closas; Tomàs López-Jiménez; Bonaventura Bolíbar; Joan Llobera; Concepción Sarasa-Bosque; Álvaro Sanchez-Perez; Juan Bellón; Rosa Magallón-Botaya. The Relationship between Adherence to the Mediterranean Diet, Intake of Specific Foods and Depression in an Adult Population (45–75 Years) in Primary Health Care. A Cross-Sectional Descriptive Study. Nutrients 2021, 13, 2724 .

AMA Style

Bárbara Oliván-Blázquez, Alejandra Aguilar-Latorre, Emma Motrico, Irene Gómez-Gómez, Edurne Zabaleta-Del-Olmo, Sabela Couso-Viana, Ana Clavería, José Maderuelo-Fernandez, José Recio-Rodríguez, Patricia Moreno-Peral, Marc Casajuana-Closas, Tomàs López-Jiménez, Bonaventura Bolíbar, Joan Llobera, Concepción Sarasa-Bosque, Álvaro Sanchez-Perez, Juan Bellón, Rosa Magallón-Botaya. The Relationship between Adherence to the Mediterranean Diet, Intake of Specific Foods and Depression in an Adult Population (45–75 Years) in Primary Health Care. A Cross-Sectional Descriptive Study. Nutrients. 2021; 13 (8):2724.

Chicago/Turabian Style

Bárbara Oliván-Blázquez; Alejandra Aguilar-Latorre; Emma Motrico; Irene Gómez-Gómez; Edurne Zabaleta-Del-Olmo; Sabela Couso-Viana; Ana Clavería; José Maderuelo-Fernandez; José Recio-Rodríguez; Patricia Moreno-Peral; Marc Casajuana-Closas; Tomàs López-Jiménez; Bonaventura Bolíbar; Joan Llobera; Concepción Sarasa-Bosque; Álvaro Sanchez-Perez; Juan Bellón; Rosa Magallón-Botaya. 2021. "The Relationship between Adherence to the Mediterranean Diet, Intake of Specific Foods and Depression in an Adult Population (45–75 Years) in Primary Health Care. A Cross-Sectional Descriptive Study." Nutrients 13, no. 8: 2724.

Journal article
Published: 28 May 2021 in International Journal of Environmental Research and Public Health
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Introduction: We evaluated the effectiveness of an individual, group and community intervention to improve the glycemic control of patients with diabetes mellitus aged 45–75 years with two or three unhealthy life habits. As secondary endpoints, we evaluated the inverventions’ effectiveness on adhering to Mediterranean diet, physical activity, sedentary lifestyle, smoking and quality of life. Method: A randomized clinical cluster (health centers) trial with two parallel groups in Spain from January 2016 to December 2019 was used. Patients with diabetes mellitus aged 45–75 years with two unhealthy life habits or more (smoking, not adhering to Mediterranean diet or little physical activity) participated. Centers were randomly assigned. The sample size was estimated to be 420 people for the main outcome variable. Educational intervention was done to improve adherence to Mediterranean diet, physical activity and smoking cessation by individual, group and community interventions for 12 months. Controls received the usual health care. The outcome variables were: HbA1c (main), the Mediterranean diet adherence score (MEDAS), the international diet quality index (DQI-I), the international physical activity questionnaire (IPAQ), sedentary lifestyle, smoking ≥1 cigarette/day and the EuroQuol questionnaire (EVA-EuroQol5D5L). Results: In total, 13 control centers (n = 356) and 12 intervention centers (n = 338) were included with similar baseline conditions. An analysis for intention-to-treat was done by applying multilevel mixed models fitted by basal values and the health center: the HbA1c adjusted mean difference = −0.09 (95% CI: −0.29–0.10), the DQI-I adjusted mean difference = 0.25 (95% CI: −0.32–0.82), the MEDAS adjusted mean difference = 0.45 (95% CI: 0.01–0.89), moderate/high physical activity OR = 1.09 (95% CI: 0.64–1.86), not living a sedentary lifestyle OR = 0.97 (95% CI: 0.55–1.73), no smoking OR = 0.61 (95% CI: 0.54–1.06), EVA adjusted mean difference = −1.26 (95% CI: −4.98–2.45). Conclusions: No statistically significant changes were found for either glycemic control or physical activity, sedentary lifestyle, smoking and quality of life. The multicomponent individual, group and community interventions only showed a statistically significant improvement in adhering to Mediterranean diet. Such innovative interventions need further research to demonstrate their effectiveness in patients with poor glycemic control.

ACS Style

Francisco Represas-Carrera; Sabela Couso-Viana; Fátima Méndez-López; Bárbara Masluk; Rosa Magallón-Botaya; Jose Recio-Rodríguez; Haizea Pombo; Alfonso Leiva-Rus; Montserrat Gil-Girbau; Emma Motrico; Ruth Martí-Lluch; Francisco Gude; Ana Clavería. Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study). International Journal of Environmental Research and Public Health 2021, 18, 5788 .

AMA Style

Francisco Represas-Carrera, Sabela Couso-Viana, Fátima Méndez-López, Bárbara Masluk, Rosa Magallón-Botaya, Jose Recio-Rodríguez, Haizea Pombo, Alfonso Leiva-Rus, Montserrat Gil-Girbau, Emma Motrico, Ruth Martí-Lluch, Francisco Gude, Ana Clavería. Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study). International Journal of Environmental Research and Public Health. 2021; 18 (11):5788.

Chicago/Turabian Style

Francisco Represas-Carrera; Sabela Couso-Viana; Fátima Méndez-López; Bárbara Masluk; Rosa Magallón-Botaya; Jose Recio-Rodríguez; Haizea Pombo; Alfonso Leiva-Rus; Montserrat Gil-Girbau; Emma Motrico; Ruth Martí-Lluch; Francisco Gude; Ana Clavería. 2021. "Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study)." International Journal of Environmental Research and Public Health 18, no. 11: 5788.

Journal article
Published: 26 November 2020 in JMIR mHealth and uHealth
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Background Mobile health (mHealth) is currently among the supporting elements that may contribute to an improvement in health markers by helping people adopt healthier lifestyles. mHealth interventions have been widely reported to achieve greater weight loss than other approaches, but their effect on body composition remains unclear. Objective This study aimed to assess the short-term (3 months) effectiveness of a mobile app and a smart band for losing weight and changing body composition in sedentary Spanish adults who are overweight or obese. Methods A randomized controlled, multicenter clinical trial was conducted involving the participation of 440 subjects from primary care centers, with 231 subjects in the intervention group (IG; counselling with smartphone app and smart band) and 209 in the control group (CG; counselling only). Both groups were counselled about healthy diet and physical activity. For the 3-month intervention period, the IG was trained to use a smartphone app that involved self-monitoring and tailored feedback, as well as a smart band that recorded daily physical activity (Mi Band 2, Xiaomi). Body composition was measured using the InBody 230 bioimpedance device (InBody Co., Ltd), and physical activity was measured using the International Physical Activity Questionnaire. Results The mHealth intervention produced a greater loss of body weight (–1.97 kg, 95% CI –2.39 to –1.54) relative to standard counselling at 3 months (–1.13 kg, 95% CI –1.56 to –0.69). Comparing groups, the IG achieved a weight loss of 0.84 kg more than the CG at 3 months. The IG showed a decrease in body fat mass (BFM; –1.84 kg, 95% CI –2.48 to –1.20), percentage of body fat (PBF; –1.22%, 95% CI –1.82% to 0.62%), and BMI (–0.77 kg/m2, 95% CI –0.96 to 0.57). No significant changes were observed in any of these parameters in men; among women, there was a significant decrease in BMI in the IG compared with the CG. When subjects were grouped according to baseline BMI, the overweight group experienced a change in BFM of –1.18 kg (95% CI –2.30 to –0.06) and BMI of –0.47 kg/m2 (95% CI –0.80 to –0.13), whereas the obese group only experienced a change in BMI of –0.53 kg/m2 (95% CI –0.86 to –0.19). When the data were analyzed according to physical activity, the moderate-vigorous physical activity group showed significant changes in BFM of –1.03 kg (95% CI –1.74 to –0.33), PBF of –0.76% (95% CI –1.32% to –0.20%), and BMI of –0.5 kg/m2 (95% CI –0.83 to –0.19). Conclusions The results from this multicenter, randomized controlled clinical trial study show that compared with standard counselling alone, adding a self-reported app and a smart band obtained beneficial results in terms of weight loss and a reduction in BFM and PBF in female subjects with a BMI less than 30 kg/m2 and a moderate-vigorous physical activity level. Nevertheless, further studies are needed to ensure that this profile benefits more than others from this intervention and to investigate modifications of this intervention to achieve a global effect. Trial Registration Clinicaltrials.gov NCT03175614; https://clinicaltrials.gov/ct2/show/NCT03175614. International Registered Report Identifier (IRRID) RR2-10.1097/MD.0000000000009633

ACS Style

Cristina Lugones-Sanchez; Maria Antonia Sanchez-Calavera; Irene Repiso-Gento; Esther G Adalia; J Ignacio Ramirez-Manent; Cristina Agudo-Conde; Emiliano Rodriguez-Sanchez; Manuel Angel Gomez-Marcos; Jose I Recio-Rodriguez; Luis Garcia-Ortiz; EVIDENT 3 Investigators. Effectiveness of an mHealth Intervention Combining a Smartphone App and Smart Band on Body Composition in an Overweight and Obese Population: Randomized Controlled Trial (EVIDENT 3 Study). JMIR mHealth and uHealth 2020, 8, e21771 .

AMA Style

Cristina Lugones-Sanchez, Maria Antonia Sanchez-Calavera, Irene Repiso-Gento, Esther G Adalia, J Ignacio Ramirez-Manent, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Manuel Angel Gomez-Marcos, Jose I Recio-Rodriguez, Luis Garcia-Ortiz, EVIDENT 3 Investigators. Effectiveness of an mHealth Intervention Combining a Smartphone App and Smart Band on Body Composition in an Overweight and Obese Population: Randomized Controlled Trial (EVIDENT 3 Study). JMIR mHealth and uHealth. 2020; 8 (11):e21771.

Chicago/Turabian Style

Cristina Lugones-Sanchez; Maria Antonia Sanchez-Calavera; Irene Repiso-Gento; Esther G Adalia; J Ignacio Ramirez-Manent; Cristina Agudo-Conde; Emiliano Rodriguez-Sanchez; Manuel Angel Gomez-Marcos; Jose I Recio-Rodriguez; Luis Garcia-Ortiz; EVIDENT 3 Investigators. 2020. "Effectiveness of an mHealth Intervention Combining a Smartphone App and Smart Band on Body Composition in an Overweight and Obese Population: Randomized Controlled Trial (EVIDENT 3 Study)." JMIR mHealth and uHealth 8, no. 11: e21771.

Research article
Published: 15 November 2020 in Nutritional Neuroscience
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The aim of this research was to evaluate the effects of adding 10 g of cocoa-rich chocolate (99%) to the habitual diet on cognitive performance in postmenopausal women. Following a randomised controlled parallel clinical trial, a total of 140 postmenopausal women aged 50–64 were recruited. The intervention group (n = 73) consumed daily 10 g of chocolate (99% cocoa) in addition to their usual food intake for 6 months, whereas the control group (n = 67) did not receive any intervention. Attention and executive functions, verbal memory, working memory, phonological fluency, category fluency and clinical variables were assessed at baseline and 6 months. Trail Making Test B execution time showed a decreased of −12.08 s (95% CI: −23.99, −0.18; p = 0.047) in the intervention group compared to the control group, after adjusting for age, educational level, time elapsed from the beginning of menopause and daily energy consumption (Cohen’s d = −0.343). Attention, immediate or delayed verbal memory, phonological or category fluency, and working memory remained unchanged. The consumption of cocoa-rich (99%) chocolate in addition to the habitual diet could be related to a slight improvement in cognitive performance regarding cognitive flexibility and processing speed in postmenopausal women, with no changes in the rest of the cognitive performance variables evaluated.Trial registration: This clinical trial has been registered at clinicaltrials.gov as NCT03492983.

ACS Style

Irene A. Garcia-Yu; Luis Garcia-Ortiz; Manuel A. Gomez-Marcos; Emiliano Rodriguez-Sanchez; Sara Mora-Simon; Jose A. Maderuelo-Fernandez; Jose I. Recio-Rodriguez. Effects of cocoa-rich chocolate on cognitive performance in postmenopausal women. A randomised clinical trial. Nutritional Neuroscience 2020, 1 -12.

AMA Style

Irene A. Garcia-Yu, Luis Garcia-Ortiz, Manuel A. Gomez-Marcos, Emiliano Rodriguez-Sanchez, Sara Mora-Simon, Jose A. Maderuelo-Fernandez, Jose I. Recio-Rodriguez. Effects of cocoa-rich chocolate on cognitive performance in postmenopausal women. A randomised clinical trial. Nutritional Neuroscience. 2020; ():1-12.

Chicago/Turabian Style

Irene A. Garcia-Yu; Luis Garcia-Ortiz; Manuel A. Gomez-Marcos; Emiliano Rodriguez-Sanchez; Sara Mora-Simon; Jose A. Maderuelo-Fernandez; Jose I. Recio-Rodriguez. 2020. "Effects of cocoa-rich chocolate on cognitive performance in postmenopausal women. A randomised clinical trial." Nutritional Neuroscience , no. : 1-12.

Journal article
Published: 04 August 2020 in British Journal of Nutrition
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During menopause, women undergo a series of physiological changes that include a redistribution of fat tissue. This study was designed to investigate the effect of adding 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women daily on body composition. We conducted a 6-month, two-arm randomised, controlled trial. Postmenopausal women (57·2 (sd 3·6) years, n 132) were recruited in primary care clinics. Participants in the control group (CG) did not receive any intervention. Those of the intervention group (IG) received 10 g daily of 99 % cocoa chocolate in addition to their habitual diet for 6 months. This quantity comprises 247 kJ (59 kcal) and 65·4 mg of polyphenols. The primary outcomes were the between-group differences in body composition variables, measured by impendancemetry at the end of the study. The main effect of the intervention showed a favourable reduction in the IG with respect to the CG in body fat mass (–0·63 kg (95 % CI –1·15, –0·11), P = 0·019; Cohen’s d = –0·450) and body fat percentage (–0·79 % (95 % CI –1·31, –0·26), P = 0·004; Cohen’s d = –0·539). A non-significant decrease was also observed in BMI (–0·20 kg/m2 (95 % CI –0·44, 0·03), P = 0·092; Cohen’s d = –0·345). Both the body fat mass and the body fat percentage showed a decrease in the IG for the three body segments analysed (trunk, arms and legs). Daily addition of 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women reduces their body fat mass and body fat percentage without modifying their weight.

ACS Style

Irene A Garcia-Yu; Luis Garcia-Ortiz; Manuel A. Gomez-Marcos; Emiliano Rodriguez-Sanchez; Cristina Lugones-Sanchez; Jose A. Maderuelo-Fernandez; Jose I. Recio-Rodriguez. Cocoa-rich chocolate and body composition in postmenopausal women: a randomised clinical trial. British Journal of Nutrition 2020, 125, 548 -556.

AMA Style

Irene A Garcia-Yu, Luis Garcia-Ortiz, Manuel A. Gomez-Marcos, Emiliano Rodriguez-Sanchez, Cristina Lugones-Sanchez, Jose A. Maderuelo-Fernandez, Jose I. Recio-Rodriguez. Cocoa-rich chocolate and body composition in postmenopausal women: a randomised clinical trial. British Journal of Nutrition. 2020; 125 (5):548-556.

Chicago/Turabian Style

Irene A Garcia-Yu; Luis Garcia-Ortiz; Manuel A. Gomez-Marcos; Emiliano Rodriguez-Sanchez; Cristina Lugones-Sanchez; Jose A. Maderuelo-Fernandez; Jose I. Recio-Rodriguez. 2020. "Cocoa-rich chocolate and body composition in postmenopausal women: a randomised clinical trial." British Journal of Nutrition 125, no. 5: 548-556.

Preprint content
Published: 25 June 2020
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BACKGROUND Mobile health (mHealth) is currently among the supporting elements that may contribute to an improvement in health markers by helping people adopt healthier lifestyles. mHealth interventions have been widely reported to achieve greater weight loss than other approaches, but their effect on body composition remains unclear. OBJECTIVE This study aimed to assess the short-term (3 months) effectiveness of a mobile app and a smart band for losing weight and changing body composition in sedentary Spanish adults who are overweight or obese. METHODS A randomized controlled, multicenter clinical trial was conducted involving the participation of 440 subjects from primary care centers, with 231 subjects in the intervention group (IG; counselling with smartphone app and smart band) and 209 in the control group (CG; counselling only). Both groups were counselled about healthy diet and physical activity. For the 3-month intervention period, the IG was trained to use a smartphone app that involved self-monitoring and tailored feedback, as well as a smart band that recorded daily physical activity (Mi Band 2, Xiaomi). Body composition was measured using the InBody 230 bioimpedance device (InBody Co., Ltd), and physical activity was measured using the International Physical Activity Questionnaire. RESULTS The mHealth intervention produced a greater loss of body weight (–1.97 kg, 95% CI –2.39 to –1.54) relative to standard counselling at 3 months (–1.13 kg, 95% CI –1.56 to –0.69). Comparing groups, the IG achieved a weight loss of 0.84 kg more than the CG at 3 months. The IG showed a decrease in body fat mass (BFM; –1.84 kg, 95% CI –2.48 to –1.20), percentage of body fat (PBF; –1.22%, 95% CI –1.82% to 0.62%), and BMI (–0.77 kg/m2, 95% CI –0.96 to 0.57). No significant changes were observed in any of these parameters in men; among women, there was a significant decrease in BMI in the IG compared with the CG. When subjects were grouped according to baseline BMI, the overweight group experienced a change in BFM of –1.18 kg (95% CI –2.30 to –0.06) and BMI of –0.47 kg/m2 (95% CI –0.80 to –0.13), whereas the obese group only experienced a change in BMI of –0.53 kg/m2 (95% CI –0.86 to –0.19). When the data were analyzed according to physical activity, the moderate-vigorous physical activity group showed significant changes in BFM of –1.03 kg (95% CI –1.74 to –0.33), PBF of –0.76% (95% CI –1.32% to –0.20%), and BMI of –0.5 kg/m2 (95% CI –0.83 to –0.19). CONCLUSIONS The results from this multicenter, randomized controlled clinical trial study show that compared with standard counselling alone, adding a self-reported app and a smart band obtained beneficial results in terms of weight loss and a reduction in BFM and PBF in female subjects with a BMI less than 30 kg/m2 and a moderate-vigorous physical activity level. Nevertheless, further studies are needed to ensure that this profile benefits more than others from this intervention and to investigate modifications of this intervention to achieve a global effect. CLINICALTRIAL Clinicaltrials.gov NCT03175614; https://clinicaltrials.gov/ct2/show/NCT03175614. INTERNATIONAL REGISTERED REPORT RR2-10.1097/MD.0000000000009633

ACS Style

Cristina Lugones-Sanchez; Maria Antonia Sanchez-Calavera; Irene Repiso-Gento; Esther G Adalia; J Ignacio Ramirez-Manent; Cristina Agudo-Conde; Emiliano Rodriguez-Sanchez; Manuel Angel Gomez-Marcos; Jose I Recio-Rodriguez; Luis Garcia-Ortiz; EVIDENT 3 investigators. Effectiveness of an mHealth Intervention Combining a Smartphone App and Smart Band on Body Composition in an Overweight and Obese Population: Randomized Controlled Trial (EVIDENT 3 Study) (Preprint). 2020, 1 .

AMA Style

Cristina Lugones-Sanchez, Maria Antonia Sanchez-Calavera, Irene Repiso-Gento, Esther G Adalia, J Ignacio Ramirez-Manent, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Manuel Angel Gomez-Marcos, Jose I Recio-Rodriguez, Luis Garcia-Ortiz, EVIDENT 3 investigators. Effectiveness of an mHealth Intervention Combining a Smartphone App and Smart Band on Body Composition in an Overweight and Obese Population: Randomized Controlled Trial (EVIDENT 3 Study) (Preprint). . 2020; ():1.

Chicago/Turabian Style

Cristina Lugones-Sanchez; Maria Antonia Sanchez-Calavera; Irene Repiso-Gento; Esther G Adalia; J Ignacio Ramirez-Manent; Cristina Agudo-Conde; Emiliano Rodriguez-Sanchez; Manuel Angel Gomez-Marcos; Jose I Recio-Rodriguez; Luis Garcia-Ortiz; EVIDENT 3 investigators. 2020. "Effectiveness of an mHealth Intervention Combining a Smartphone App and Smart Band on Body Composition in an Overweight and Obese Population: Randomized Controlled Trial (EVIDENT 3 Study) (Preprint)." , no. : 1.

Journal article
Published: 12 June 2020 in Nutrients
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This study aimed to evaluate the effects of the intake of 10 g of cocoa-rich chocolate on blood pressure, other cardiovascular risk factors, and vascular structure and function in postmenopausal women. A total of 140 postmenopausal women participated in this randomized and controlled parallel clinical trial. For six months, the intervention group (IG; n = 73) consumed daily 10 g of chocolate (99% cocoa) added to their usual food intake, whereas the control group (CG; n = 67) did not receive any intervention. Blood pressure, pulse pressure (PP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), augmentation index, and laboratory variables were measured at baseline and six months. ANCOVA analyses adjusted for baseline values revealed no significant differences for systolic blood pressure (−1.45 mm Hg; 95% confidence interval (CI): −4.79, 1.88; p = 0.391) or baPWV (0.18 m/s; 95% CI: −0.14, 0.50; p = 0.263) between groups. A decrease in PP was observed in the IG compared to the CG (−2.05 mm Hg; 95% CI: −4.08, −0.02; p = 0.048). The rest of the vascular structure and function parameters and other measured variables remained unchanged. The daily intake of 10 g of cocoa-rich chocolate seems to provide little improvement to cardiovascular health, but neither does it cause any adverse effects on the parameters evaluated in postmenopausal women in the long term.

ACS Style

Irene A Garcia-Yu; Luis Garcia-Ortiz; Manuel A. Gomez-Marcos; Emiliano Rodriguez-Sanchez; Cristina Agudo-Conde; Jesus Gonzalez-Sanchez; Jose A. Maderuelo-Fernandez; Jose I. Recio-Rodriguez. Effects of Cocoa-Rich Chocolate on Blood Pressure, Cardiovascular Risk Factors, and Arterial Stiffness in Postmenopausal Women: A Randomized Clinical Trial. Nutrients 2020, 12, 1758 .

AMA Style

Irene A Garcia-Yu, Luis Garcia-Ortiz, Manuel A. Gomez-Marcos, Emiliano Rodriguez-Sanchez, Cristina Agudo-Conde, Jesus Gonzalez-Sanchez, Jose A. Maderuelo-Fernandez, Jose I. Recio-Rodriguez. Effects of Cocoa-Rich Chocolate on Blood Pressure, Cardiovascular Risk Factors, and Arterial Stiffness in Postmenopausal Women: A Randomized Clinical Trial. Nutrients. 2020; 12 (6):1758.

Chicago/Turabian Style

Irene A Garcia-Yu; Luis Garcia-Ortiz; Manuel A. Gomez-Marcos; Emiliano Rodriguez-Sanchez; Cristina Agudo-Conde; Jesus Gonzalez-Sanchez; Jose A. Maderuelo-Fernandez; Jose I. Recio-Rodriguez. 2020. "Effects of Cocoa-Rich Chocolate on Blood Pressure, Cardiovascular Risk Factors, and Arterial Stiffness in Postmenopausal Women: A Randomized Clinical Trial." Nutrients 12, no. 6: 1758.

Multicenter study
Published: 12 September 2019 in Revista Española de Cardiología (English Edition)
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To describe, for the first time, reference values for the cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (BA-PWV), carotid-femoral pulse wave velocity (CF-PWV), and the central augmentation index and to establish their association with cardiovascular risk factors in the Spanish adult population aged 35 to 75 years without cardiovascular disease. We conducted a cross-sectional study. Through random sampling stratified by age and sex, we included 501 participants without cardiovascular disease. The mean age was 55.9 years and 50.3% were women. The measurements were taken using the SphigmoCor and Vasera VS-1500 devices. Values for all measures, except those for the central augmentation index, were higher in men and increased with age and blood pressure. The mean values were as follows: CAVI, 8.01 ± 1.44; BA-PWV, 12.93 ± 2.68m/s; CF-PWV, 6.53 ± 2.03 m/s, and central augmentation index, 26.84 ± 12.79. On multiple regression analysis, mean blood pressure was associated with the 4 measures, glycated hemoglobin was associated with all measures except the central augmentation index, and body mass index showed an inverse association with CAVI. The explanatory capacity of age, sex, and mean blood pressure was 62% for BA-PWV, 49% for CF-PWV 49%, 54% for the CAVI, and 38% for the central augmentation index. On logistic regression, hypertension was associated with the CAVI (OR = 3.45), VOP-BT (OR = 3.44), VOP-CF (OR = 3.38) and with the central augmentation index (OR = 3.73). All arterial stiffness measures increased with age. The CAVI and CF-PWV were higher in men and the central augmentation index was higher in women, with no differences in BA-PWV. This study is registered at ClinicalTrials.gov. Identifier NCT02623894. Describir por primera vez valores de referencia del índice vascular corazón-tobillo (ICT), la velocidad de la onda de pulso brazo-tobillo (VOP-BT), la velocidad de la onda de pulso carótida-femoral (VOP-CF) y el índice de aumento central y establecer relación con factores de riesgo cardiovascular en población adulta española de 35 a 75 años de edad sin enfermedad cardiovascular. Estudio descriptivo transversal. Mediante muestreo aleatorio estratificado por edad y sexo, se incluyó a 501 sujetos sin enfermedad cardiovascular, con una media de edad de 55,9 años; el 50,3% eran mujeres. Mediante los dispositivos SphigmoCor y Vasera VS-1500 se realizaron las mediciones. Todas las medidas, excepto el índice de aumento central, mostraron valores mayores en varones, y aumentaron con la edad y la presión arterial. Los valores medios fueron: ICT, 8,01 ± 1,44; VOP-BT, 12,93 ± 2,68 m/s; VOP-CF, 6,53 ± 2,03 m/s e índice de aumento central, 26,84 ± 12,79. En el análisis de regresión múltiple, la presión arterial media se asoció con las 4 medidas, la glucohemoglobina, con todas excepto el índice de aumento central, y el índice de masa corporal mostró asociación inversa con el ICT. Por otro lado, la capacidad explicativa de la edad, el sexo y la presión arterial media es para la VOP-BT un 62%; la VOP-CF, un 49%; el ICT, un 54% y el índice de aumento central, un 38%. En la regresión logística, la hipertensión se asoció con el ICT (OR = 3,45), la VOP-BT (OR = 3,44), la VOP-CF (OR = 3,38) y el índice de aumento central (OR = 3,73). Todas las medidas de rigidez aumentan con la edad; el ICT y la VOP-CF presentan valores mayores en los varones y el índice de aumento central, en las mujeres, sin diferencias en la VOP-BT. Este estudio está registrado en ClinicalTrials.gov. Identificador: NCT02623894.

ACS Style

Marta Gómez-Sánchez; M. Carmen Patino-Alonso; Leticia Gómez-Sánchez; José I. Recio-Rodríguez; Emiliano Rodríguez-Sánchez; José A. Maderuelo-Fernández; Luis García-Ortiz; Manuel A. Gómez-Marcos. Reference values of arterial stiffness parameters and their association with cardiovascular risk factors in the Spanish population. The EVA Study. Revista Española de Cardiología (English Edition) 2019, 73, 43 -52.

AMA Style

Marta Gómez-Sánchez, M. Carmen Patino-Alonso, Leticia Gómez-Sánchez, José I. Recio-Rodríguez, Emiliano Rodríguez-Sánchez, José A. Maderuelo-Fernández, Luis García-Ortiz, Manuel A. Gómez-Marcos. Reference values of arterial stiffness parameters and their association with cardiovascular risk factors in the Spanish population. The EVA Study. Revista Española de Cardiología (English Edition). 2019; 73 (1):43-52.

Chicago/Turabian Style

Marta Gómez-Sánchez; M. Carmen Patino-Alonso; Leticia Gómez-Sánchez; José I. Recio-Rodríguez; Emiliano Rodríguez-Sánchez; José A. Maderuelo-Fernández; Luis García-Ortiz; Manuel A. Gómez-Marcos. 2019. "Reference values of arterial stiffness parameters and their association with cardiovascular risk factors in the Spanish population. The EVA Study." Revista Española de Cardiología (English Edition) 73, no. 1: 43-52.

Article
Published: 29 March 2019 in Nutrients
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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.

ACS Style

Carmela Rodríguez-Martín; Luis Garcia-Ortiz; Emiliano Rodriguez-Sanchez; Jose A. Maderuelo-Fernandez; Cristina Lugones-Sanchez; Carlos Martin-Cantera; Jose Soriano-Cano; Maria S. Arietaleanizbeaskoa; Jose F. Magdalena-Belio; Cristina Menendez-Suarez; Manuel A. Gómez-Marcos; José I. Recio-Rodríguez; on behalf of the EVIDENT Investigators EVIDENT Investigators Group. The Relationship of the Atlantic Diet with Cardiovascular Risk Factors and Markers of Arterial Stiffness in Adults without Cardiovascular Disease. Nutrients 2019, 11, 742 .

AMA Style

Carmela Rodríguez-Martín, Luis Garcia-Ortiz, Emiliano Rodriguez-Sanchez, Jose A. Maderuelo-Fernandez, Cristina Lugones-Sanchez, Carlos Martin-Cantera, Jose Soriano-Cano, Maria S. Arietaleanizbeaskoa, Jose F. Magdalena-Belio, Cristina Menendez-Suarez, Manuel A. Gómez-Marcos, José I. Recio-Rodríguez, on behalf of the EVIDENT Investigators EVIDENT Investigators Group. The Relationship of the Atlantic Diet with Cardiovascular Risk Factors and Markers of Arterial Stiffness in Adults without Cardiovascular Disease. Nutrients. 2019; 11 (4):742.

Chicago/Turabian Style

Carmela Rodríguez-Martín; Luis Garcia-Ortiz; Emiliano Rodriguez-Sanchez; Jose A. Maderuelo-Fernandez; Cristina Lugones-Sanchez; Carlos Martin-Cantera; Jose Soriano-Cano; Maria S. Arietaleanizbeaskoa; Jose F. Magdalena-Belio; Cristina Menendez-Suarez; Manuel A. Gómez-Marcos; José I. Recio-Rodríguez; on behalf of the EVIDENT Investigators EVIDENT Investigators Group. 2019. "The Relationship of the Atlantic Diet with Cardiovascular Risk Factors and Markers of Arterial Stiffness in Adults without Cardiovascular Disease." Nutrients 11, no. 4: 742.

Review
Published: 29 March 2019 in Nutrients
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The aim of this review was to determine the relationship between dairy product consumption and arterial stiffness, measured by pulse wave velocity (PWV). We systematically searched the Medline, Embase and Web of Science databases until 30th January 2019 for cross-sectional data from studies addressing the association between dairy product consumption and PWV. This study was registered with PROSPERO (CRD42018110528). Both the inverse-variance fixed effects method and the DerSimonian and Laird method were used to compute pooled estimates of effect size (ES) and the respective 95% confidence intervals (CIs). Seven studies were included in the meta-analysis, with a total of 16,443 patients. Total dairy product (ES = −0.03; 95% CI [−0.04, −0.01]) and cheese (ES = −0.04; 95% CI [−0.07, −0.01]) consumption were weak, but significantly associated with lower PWV levels. Conversely, milk intake showed no significant association with PWV (ES = 0.02; 95% CI [−0.01, 0.05]). Heterogeneity in the ES was not important for the three groups of dairy products assessed. This systematic review and meta-analysis of seven studies found no detrimental effects of dairy product consumption on arterial stiffness measured by PWV. Due to the scarcity of studies, further investigations are warranted to clarify the role of dairy products on arterial stiffness.

ACS Style

Ana Diez-Fernández; Celia Álvarez-Bueno; Vicente Martínez-Vizcaíno; Mercedes Sotos-Prieto; José I Recio-Rodríguez; Iván Cavero-Redondo. Total Dairy, Cheese and Milk Intake and Arterial Stiffness: A Systematic Review and Meta-Analysis of Cross-sectional Studies. Nutrients 2019, 11, 741 .

AMA Style

Ana Diez-Fernández, Celia Álvarez-Bueno, Vicente Martínez-Vizcaíno, Mercedes Sotos-Prieto, José I Recio-Rodríguez, Iván Cavero-Redondo. Total Dairy, Cheese and Milk Intake and Arterial Stiffness: A Systematic Review and Meta-Analysis of Cross-sectional Studies. Nutrients. 2019; 11 (4):741.

Chicago/Turabian Style

Ana Diez-Fernández; Celia Álvarez-Bueno; Vicente Martínez-Vizcaíno; Mercedes Sotos-Prieto; José I Recio-Rodríguez; Iván Cavero-Redondo. 2019. "Total Dairy, Cheese and Milk Intake and Arterial Stiffness: A Systematic Review and Meta-Analysis of Cross-sectional Studies." Nutrients 11, no. 4: 741.

Journal article
Published: 28 March 2019 in Medicina Clínica
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The estimation of cardiovascular risk (CVR) with scores at 30 years old has a special interest in reclassifying in a suitable way <60 year subjects with intermediate CVR. This study analyzes what percentage of patients with intermediate CVR included in the MARK study is reclassified by applying the 30-year Framingham score (FS30). It also analyzes the degree of agreement between the two equations to classify high risk subjects. Cross-sectional study of 966 subjects included in the MARK study. The CVR was calculated with the two versions of the FS30 (based on lipids and body mass index) for "hard" cardiovascular events in subjects with intermediate CVR. The 59% and 61% of the subjects with intermediate CVR would be classified as if they had high CVR to undergo a hard event if we used the FS30 in both versions. 70% of men and 35% of women would be classified as high CVR (p<0.01). The agreement percentage, measured with the Kappa index, between the equations FS30L and FS30BMI to classify the high-risk subjects was 67.9% (in men 67.4% and in women 68.7%). In subjects with intermediate CVR the FS30 reclassifies more than the half as high RCV, 2 out of 3 men and 1 out of 3 women.

ACS Style

Leticia Gomez-Sanchez; Manuel A. Gomez-Marcos; Carmen Patino-Alonso; Jose I Recio-Rodriguez; Marta Gomez-Sanchez; Jesús González-Sánchez; Rosario Alonso-Domínguez; Natalia Sanchez-Aguadero; Jose A. Maderuelo-Fernandez; Rafel Ramos; Luis Garcia-Ortiz; Emiliano Rodriguez-Sanchez; MARK Group. Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study. Medicina Clínica 2019, 153, 351 -356.

AMA Style

Leticia Gomez-Sanchez, Manuel A. Gomez-Marcos, Carmen Patino-Alonso, Jose I Recio-Rodriguez, Marta Gomez-Sanchez, Jesús González-Sánchez, Rosario Alonso-Domínguez, Natalia Sanchez-Aguadero, Jose A. Maderuelo-Fernandez, Rafel Ramos, Luis Garcia-Ortiz, Emiliano Rodriguez-Sanchez, MARK Group. Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study. Medicina Clínica. 2019; 153 (9):351-356.

Chicago/Turabian Style

Leticia Gomez-Sanchez; Manuel A. Gomez-Marcos; Carmen Patino-Alonso; Jose I Recio-Rodriguez; Marta Gomez-Sanchez; Jesús González-Sánchez; Rosario Alonso-Domínguez; Natalia Sanchez-Aguadero; Jose A. Maderuelo-Fernandez; Rafel Ramos; Luis Garcia-Ortiz; Emiliano Rodriguez-Sanchez; MARK Group. 2019. "Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study." Medicina Clínica 153, no. 9: 351-356.

Comparative study
Published: 08 March 2019 in BMC Cardiovascular Disorders
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Daily aerobic exercise such as healthy walking could have an immediate effect on parameters of arterial stiffness; however, there is little evidence in the diabetic population. Our aim, therefore, is to evaluate the association between healthy walking and acute effects on the parameters of arterial stiffness in subjects with type 2 diabetes. The Effectiveness of a multifactorial intervention in diabetics study (EMID), is a study based on an application for smartphones, healthy walking and a nutritional workshop in patients with type 2 diabetes in primary care, is a randomized controlled trial of two parallel groups. This is a subanalysis of the intervention group to evaluate the response to the healthy walking according to age and sex, in 89 subjects with type 2 diabetes, aged between 40 and 70 years. The intervention was a 4 km of a healthy walking at low-moderate intensity. To value our aim, the main study variables were measured before and after it. The study population had an average age of 65.0 years (61.2–68.1). After the healthy walking, there was a decrease in the parameters of arterial stiffness: Cardio ankle vascular index (CAVI) of − 0.2 (95%CI:-0.4 to − 0.1) and pulse pressure (PP) of the lower extremities of − 3.9 mmHg (95%CI: -5.9 to − 2.0). Furthermore, in the lower extremities there was a decrease in systolic blood pressure of − 5.3 mmHg (95% CI: -7.3 mmHg to − 3.3 mmHg), in diastolic blood pressure of − 1.5 mmHg (95% CI: -2.6 mmHg to − 0.4 mmHg) (p < 0.05 for all). It is observed that males have an OR of 2.981 (IC = 95% 1.095 to 8.119) to achieve a reduction in the CAVI (p < 0.05) and an OR of 2.433 (95%CI: 0.871 to 6.794) in the ankle PP (p > 0.05), compared with females. The findings of this study suggest that daily aerobic exercise at a low to moderate intensity, such as healthy walking, has an immediate beneficial effect on the cardio-ankle vascular index, especially in males. ClinicalTrials.gov identifier: NCT02991079.

ACS Style

Rosario Alonso-Domínguez; José I. Recio-Rodríguez; Maria C. Patino-Alonso; Natalia Sánchez-Aguadero; Luis García-Ortiz; Manuel A. Gómez-Marcos. Acute effect of healthy walking on arterial stiffness in patients with type 2 diabetes and differences by age and sex: a pre-post intervention study. BMC Cardiovascular Disorders 2019, 19, 1 -9.

AMA Style

Rosario Alonso-Domínguez, José I. Recio-Rodríguez, Maria C. Patino-Alonso, Natalia Sánchez-Aguadero, Luis García-Ortiz, Manuel A. Gómez-Marcos. Acute effect of healthy walking on arterial stiffness in patients with type 2 diabetes and differences by age and sex: a pre-post intervention study. BMC Cardiovascular Disorders. 2019; 19 (1):1-9.

Chicago/Turabian Style

Rosario Alonso-Domínguez; José I. Recio-Rodríguez; Maria C. Patino-Alonso; Natalia Sánchez-Aguadero; Luis García-Ortiz; Manuel A. Gómez-Marcos. 2019. "Acute effect of healthy walking on arterial stiffness in patients with type 2 diabetes and differences by age and sex: a pre-post intervention study." BMC Cardiovascular Disorders 19, no. 1: 1-9.

Journal article
Published: 26 February 2019 in European Journal of Cardiovascular Nursing
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Background: Regular physical activity is essential for metabolic control in type 2 diabetes mellitus. Aims: The aim of this study was to assess the short and long-term impact of a multifactorial intervention on physical activity and clinically relevant biochemical parameters in patients with type 2 diabetes mellitus. Methods: This randomised, controlled clinical trial (NCT02991079) included two parallel groups aged 25–70 years from a primary care health centre in Salamanca, Spain. The subjects were assigned randomly (1:1) to control and intervention groups, using Epidat 4.0 software. Both were counselled on the importance of physical activity and maintaining a healthy diet. The intervention group also took five low–moderate intensity 4 km nurse-guided walks, received a smartphone application to promote healthy habits and attended a diet workshop. Physical activity was measured objectively using a pedometer and subjectively using a shortened international physical activity questionnaire (at baseline, 3 and 12 months). Results: In total, 204 subjects were included (mean age 60.6 years, 45.6% were women). After 3 months, relative to the control group, the intervention group increased their daily number of steps by 1852, aerobic steps by 1623, distance walked by 994 m, and total metabolic equivalent minutes per week by 1297 and decreased sedentary time by 34.3 minutes per day. Differences from baseline persisted at 12 months, including mean increases of 1141 daily steps, 917 aerobic steps, and 1065 total metabolic equivalent minutes per week in the intervention group relative to the control group ( PConclusions: The success of this multifactorial intervention should help inform future clinical approaches and application designs towards managing type 2 diabetes mellitus and improving patient outcomes.

ACS Style

Rosario Alonso-Domínguez; Carmen Patino-Alonso; Natalia Sanchez-Aguadero; Luis García-Ortiz; Jose I Recio-Rodriguez; Manuel A Gómez-Marcos. Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: a randomized clinical trial (EMID Study). European Journal of Cardiovascular Nursing 2019, 18, 399 -409.

AMA Style

Rosario Alonso-Domínguez, Carmen Patino-Alonso, Natalia Sanchez-Aguadero, Luis García-Ortiz, Jose I Recio-Rodriguez, Manuel A Gómez-Marcos. Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: a randomized clinical trial (EMID Study). European Journal of Cardiovascular Nursing. 2019; 18 (5):399-409.

Chicago/Turabian Style

Rosario Alonso-Domínguez; Carmen Patino-Alonso; Natalia Sanchez-Aguadero; Luis García-Ortiz; Jose I Recio-Rodriguez; Manuel A Gómez-Marcos. 2019. "Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: a randomized clinical trial (EMID Study)." European Journal of Cardiovascular Nursing 18, no. 5: 399-409.

Multicenter study
Published: 12 February 2019 in International Journal of Medical Informatics
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The last few years have seen the appearance many mobile applications aimed at improving health, but studies analyzing their effectiveness on cardiovascular risk factors (CVRFs) are few and far between. Our aim was to assess the effect on CVRFs such as hypertension, dyslipidemia, diabetes and global CVR, of adding the use of a smartphone app to an intervention consisting of standard counseling on physical activity and the Mediterranean diet. This is a multicenter, randomized and controlled clinical trial. From January 2014 and September 2016, a total of 833 subjects selected by random sampling from six health centers participated. Of these, 415 were assigned to the counseling + app group (IG) and 418 to the counseling only group (CG). The IG additionally received training in the use of a mobile application. The main outcome was the change in CVRFs and estimated CVR at 3 and 12 months in the IG compared to the CG. No significant changes were observed at 3 or 12 months in terms of CVR. Nevertheless, an effect between groups was observed in favor of the CG at 12 months in some CVRFS: SBP, DBP, total cholesterol and triglycerides: 2.02 mmHg (95%CI: 0.43 to 3.61), 1.21 mmHg (95%CI: 0.20 to 2.24), 5.24 mg/dL (95%CI: 1.22 to 9.26) and 7.24 mg/dL (95%CI: 0.53 to 14.32). Adding an intervention with the use of an app for three months to standard counseling on diet and physical activity, does not provide additional benefits for improving CVRFs or the estimated CVR in the long term. ClinicalTrials.gov NCT02016014

ACS Style

Jesus Gonzalez-Sanchez; Jose I. Recio-Rodriguez; Alicia Fernandez-Delrio; Alvaro Sanchez-Perez; Jose Felix Magdalena-Belio; Manuel A. Gomez-Marcos; Luis Garcia-Ortiz. Using a smartphone app in changing cardiovascular risk factors: A randomized controlled trial (EVIDENT II study). International Journal of Medical Informatics 2019, 125, 13 -21.

AMA Style

Jesus Gonzalez-Sanchez, Jose I. Recio-Rodriguez, Alicia Fernandez-Delrio, Alvaro Sanchez-Perez, Jose Felix Magdalena-Belio, Manuel A. Gomez-Marcos, Luis Garcia-Ortiz. Using a smartphone app in changing cardiovascular risk factors: A randomized controlled trial (EVIDENT II study). International Journal of Medical Informatics. 2019; 125 ():13-21.

Chicago/Turabian Style

Jesus Gonzalez-Sanchez; Jose I. Recio-Rodriguez; Alicia Fernandez-Delrio; Alvaro Sanchez-Perez; Jose Felix Magdalena-Belio; Manuel A. Gomez-Marcos; Luis Garcia-Ortiz. 2019. "Using a smartphone app in changing cardiovascular risk factors: A randomized controlled trial (EVIDENT II study)." International Journal of Medical Informatics 125, no. : 13-21.

Journal article
Published: 08 February 2019 in JMIR mHealth and uHealth
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More alternatives are needed for recording people's normal diet in different populations, especially adults or the elderly, as part of the investigation into the effects of nutrition on health. The aim of this study was to compare the estimated values of energy intake, macro- and micronutrient, and alcohol consumption gathered using the EVIDENT II smartphone app against the data estimated with a food frequency questionnaire (FFQ) in an adult population aged 18 to 70 years. We included 362 individuals (mean age 52 years, SD 12; 214/362, 59.1% women) who were part of the EVIDENT II study. The participants registered their food intake using the EVIDENT app during a period of 3 months and through an FFQ. Both methods estimate the average nutritional composition, including energy intake, macro- and micronutrients, and alcohol. Through the app, the values of the first week of food recording, the first month, and the entire 3-month period were estimated. The FFQ gathers data regarding the food intake of the year before the moment of interview. The intraclass correlation for the estimation of energy intake with the FFQ and the app shows significant results, with the highest values returned when analyzing the app's data for the full 3-month period (.304, 95% CI 0.144-0.434; P<.001). For this period, the correlation coefficient for energy intake is .233 (P<.001). The highest value corresponds to alcohol consumption and the lowest to the intake of polyunsaturated fatty acids (r=.676 and r=.155; P<.001), respectively. The estimation of daily intake of energy, macronutrients, and alcohol presents higher values in the FFQ compared with the EVIDENT app data. Considering the values recorded during the 3-month period, the FFQ for energy intake estimation (Kcal) was higher than that of the app (a difference of 408.7, 95% CI 322.7-494.8; P<.001). The same is true for the other macronutrients, with the exception g/day of saturated fatty acids (.4, 95% CI -1.2 to 2.0; P=.62). The EVIDENT app is significantly correlated to FFQ in the estimation of energy intake, macro- and micronutrients, and alcohol consumption. This correlation increases with longer app recording periods. The EVIDENT app can be a good alternative for recording food intake in the context of longitudinal or intervention studies. ClinicalTrials.gov NCT02016014; http://clinicaltrials.gov/ct2/show/NCT02016014 (Archived by WebCite at http://www.webcitation.org/760i8EL8Q).

ACS Style

Jose I Recio-Rodriguez; Carmela Rodriguez-Martin; Jesus Gonzalez-Sanchez; Emiliano Rodriguez-Sanchez; Carme Martin-Borras; Vicente Martínez-Vizcaino; Maria Soledad Arietaleanizbeaskoa; Olga Magdalena-Gonzalez; Carmen Fernandez-Alonso; Jose A Maderuelo-Fernandez; Manuel A Gomez-Marcos; Luis Garcia-Ortiz; EVIDENT Investigators. EVIDENT Smartphone App, a New Method for the Dietary Record: Comparison With a Food Frequency Questionnaire. JMIR mHealth and uHealth 2019, 7, e11463 .

AMA Style

Jose I Recio-Rodriguez, Carmela Rodriguez-Martin, Jesus Gonzalez-Sanchez, Emiliano Rodriguez-Sanchez, Carme Martin-Borras, Vicente Martínez-Vizcaino, Maria Soledad Arietaleanizbeaskoa, Olga Magdalena-Gonzalez, Carmen Fernandez-Alonso, Jose A Maderuelo-Fernandez, Manuel A Gomez-Marcos, Luis Garcia-Ortiz, EVIDENT Investigators. EVIDENT Smartphone App, a New Method for the Dietary Record: Comparison With a Food Frequency Questionnaire. JMIR mHealth and uHealth. 2019; 7 (2):e11463.

Chicago/Turabian Style

Jose I Recio-Rodriguez; Carmela Rodriguez-Martin; Jesus Gonzalez-Sanchez; Emiliano Rodriguez-Sanchez; Carme Martin-Borras; Vicente Martínez-Vizcaino; Maria Soledad Arietaleanizbeaskoa; Olga Magdalena-Gonzalez; Carmen Fernandez-Alonso; Jose A Maderuelo-Fernandez; Manuel A Gomez-Marcos; Luis Garcia-Ortiz; EVIDENT Investigators. 2019. "EVIDENT Smartphone App, a New Method for the Dietary Record: Comparison With a Food Frequency Questionnaire." JMIR mHealth and uHealth 7, no. 2: e11463.

Clinical trial
Published: 25 January 2019 in PLoS ONE
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Obesity increases mortality, and is linked to cardiovascular diseases and metabolic syndrome (MetS). Therefore, the purpose of this study was to analyze the ability of different adiposity indices to identify subjects with MetS among people with intermediate cariovascular risk. The cross-sectional study involved 2478 subjects, recruited by the MARK study. Adiposity measures: general adiposity by body mass index (BMI), central adiposity by waist-to-height ratio (WHtR), fat mass percent by the Clínica Universidad de Navarra—body adiposity estimator (CUN-BAE), percentage of body fat and of visceral adipose tissue by body roundness index (BRI) and visceral obesity and general adiposity with body shape index (ABSI). The diagnosis of MetS was made in accordance with the criteria established in the international consensus of the Joint Scientific Statement National Cholesterol Education Program III. The highest correlation coefficients were obtained by the glycemic components (HbA1c and FPG) of the MetS and ranged from 0.155 to 0.320. The exception was ABSI, which showed lower values in the global analysis and in the males. Values of the area under the ROC curve with the adiposity indices ranged from 0.773 with the BMI in males to 0.567 with ABSI in males. In the logistic regression analysis, all adiposity factors, except ABSI, showed similar OR values of MetS after adjusting for possible confounding factors. In the global analysis, the adiposity index that showed a highest OR of MetS was CUN-BAE (OR 5.50; 95% CI 4.27–7.09). In the analysis by gender, the highest ORs were BMI in males (OR 5.98; 95% CI 4.70–7.60) and both WHtR and BRI in females (OR 4.15; 95% CI 3.09–5.58). All adiposity indices, except for ABSI, show an association with MetS and similar ability to detect subjects with MetS among people with intermediate cariovascular risk.

ACS Style

Manuel A. Gomez-Marcos; Leticia Gomez-Sanchez; Carmen Patino-Alonso; Jose I Recio-Rodriguez; Marta Gomez-Sanchez; Fernando Rigo; Ruth Marti; Cristina Agudo-Conde; Jose A. Maderuelo-Fernandez; Rafel Ramos; Luis Garcia-Ortiz; Emiliano Rodriguez-Sanchez. Capacity adiposity indices to identify metabolic syndrome in subjects with intermediate cardiovascular risk (MARK study). PLoS ONE 2019, 14, e0209992 .

AMA Style

Manuel A. Gomez-Marcos, Leticia Gomez-Sanchez, Carmen Patino-Alonso, Jose I Recio-Rodriguez, Marta Gomez-Sanchez, Fernando Rigo, Ruth Marti, Cristina Agudo-Conde, Jose A. Maderuelo-Fernandez, Rafel Ramos, Luis Garcia-Ortiz, Emiliano Rodriguez-Sanchez. Capacity adiposity indices to identify metabolic syndrome in subjects with intermediate cardiovascular risk (MARK study). PLoS ONE. 2019; 14 (1):e0209992.

Chicago/Turabian Style

Manuel A. Gomez-Marcos; Leticia Gomez-Sanchez; Carmen Patino-Alonso; Jose I Recio-Rodriguez; Marta Gomez-Sanchez; Fernando Rigo; Ruth Marti; Cristina Agudo-Conde; Jose A. Maderuelo-Fernandez; Rafel Ramos; Luis Garcia-Ortiz; Emiliano Rodriguez-Sanchez. 2019. "Capacity adiposity indices to identify metabolic syndrome in subjects with intermediate cardiovascular risk (MARK study)." PLoS ONE 14, no. 1: e0209992.

Study protocol
Published: 23 January 2019 in BMC Geriatrics
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The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient’s daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults. ClinicalTrials.gov Identifier: NCT03574480 . Date of trial Registration July 2, 2018.

ACS Style

José I. Recio-Rodríguez; Cristina Lugones-Sanchez; Cristina Agudo-Conde; Jesús González-Sánchez; Olaya Tamayo-Morales; Susana Gonzalez-Sanchez; Carmen Fernandez-Alonso; Jose A. Maderuelo-Fernandez; Sara Mora-Simon; Manuel A. Gómez-Marcos; Emiliano Rodriguez-Sanchez; Luis Garcia-Ortiz. Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study). BMC Geriatrics 2019, 19, 19 .

AMA Style

José I. Recio-Rodríguez, Cristina Lugones-Sanchez, Cristina Agudo-Conde, Jesús González-Sánchez, Olaya Tamayo-Morales, Susana Gonzalez-Sanchez, Carmen Fernandez-Alonso, Jose A. Maderuelo-Fernandez, Sara Mora-Simon, Manuel A. Gómez-Marcos, Emiliano Rodriguez-Sanchez, Luis Garcia-Ortiz. Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study). BMC Geriatrics. 2019; 19 (1):19.

Chicago/Turabian Style

José I. Recio-Rodríguez; Cristina Lugones-Sanchez; Cristina Agudo-Conde; Jesús González-Sánchez; Olaya Tamayo-Morales; Susana Gonzalez-Sanchez; Carmen Fernandez-Alonso; Jose A. Maderuelo-Fernandez; Sara Mora-Simon; Manuel A. Gómez-Marcos; Emiliano Rodriguez-Sanchez; Luis Garcia-Ortiz. 2019. "Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study)." BMC Geriatrics 19, no. 1: 19.

Randomized controlled trial
Published: 14 January 2019 in Nutrients
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The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns and has benefits such as improving glycaemic control among patients with type 2 diabetes (T2DM). Our aim is to assess the effectiveness of a multifactorial intervention to improve adherence to the MD, diet quality and biomedical parameters. The EMID study is a randomized and controlled clinical trial with two parallel groups and a 12-month follow-up period. The study included 204 subjects between 25–70 years with T2DM. The participants were randomized into intervention group (IG) and control group (CG). Both groups received brief advice about healthy eating and physical activity. The IG participants additionally took part in a food workshop, five walks and received a smartphone application for three months. The population studied had a mean age of 60.6 years. At the 3-month follow-up visit, there were improvements in adherence to the MD and diet quality of 2.2 and 2.5 points, compared to the baseline visit, respectively, in favour of the IG. This tendency of the improvement was maintained, in favour of the IG, at the 12-month follow-up visit. In conclusion, the multifactorial intervention performed could improve adherence to the MD and diet quality among patients with T2DM.

ACS Style

Rosario Alonso-Domínguez; Luis Garcia-Ortiz; Maria C. Patino-Alonso; Natalia Sánchez-Aguadero; Manuel A. Gómez-Marcos; José I. Recio-Rodríguez. Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study). Nutrients 2019, 11, 162 .

AMA Style

Rosario Alonso-Domínguez, Luis Garcia-Ortiz, Maria C. Patino-Alonso, Natalia Sánchez-Aguadero, Manuel A. Gómez-Marcos, José I. Recio-Rodríguez. Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study). Nutrients. 2019; 11 (1):162.

Chicago/Turabian Style

Rosario Alonso-Domínguez; Luis Garcia-Ortiz; Maria C. Patino-Alonso; Natalia Sánchez-Aguadero; Manuel A. Gómez-Marcos; José I. Recio-Rodríguez. 2019. "Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study)." Nutrients 11, no. 1: 162.

Article
Published: 26 December 2018 in Hypertension Research
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Our aim was to investigate the effects of an intervention that comprised a brief counseling session on lifestyle habits together with the use of the EVIDENT (Lifestyles and arterial aging) application on the modification of markers that indicated different hemodynamic functions, such as arterial stiffness, blood pressure or wave reflections. The EVIDENT II study (Lifestyles and arterial aging) is a randomized clinical trial with two parallel groups. Each participant had an initial visit and two follow-up visits at 3 and 12 months where the peripheral augmentation index-PAIx75 was measured by tonometry, while an oscillometric method was used for the cardio-ankle vascular index-CAVI and brachial-ankle pulse wave velocity-baPWV. Both groups (intervention-IG and control-CG) were briefly counseled on diet and exercise. The IG also received instructions on the use of the EVIDENT II application during the 3 months. The sample (N = 597; 52 ± 11 years; 64% women) was randomized into IG = 291 and CG = 306. Comparing groups, there was a decrease in the PAIx75 favorable to the IG at 3 months (−4.9%, 95% CI: −7.7 to −2.1) and 12 months (−3.9%, 95% CI: −6.8 to −1.0). There was also a nonsignificant reduction of the CAVI at 3 months in the IG. A group effect was observed in the measurement of the PAIx75 over the 12-month follow-up (p = 0.003). This interaction was only observed in women (p = 0.017). In conclusion, the use of the EVIDENT II application achieved a modification of the PAIx75, a marker of wave reflection and vascular tone, in women through lifestyle improvements (physical activity and adherence to the Mediterranean diet). No significant results were found regarding blood pressure or arterial stiffness markers.

ACS Style

José I. Recio-Rodríguez; on behalf of the EVIDENT Investigators group; Emiliano Rodriguez-Sanchez; Carlos Martin-Cantera; Vicente Martinez-Vizcaino; Maria S. Arietaleanizbeaskoa; Natividad Gonzalez-Viejo; Marta Menendez-Suarez; Manuel A. Gómez-Marcos; Luis Garcia-Ortiz. Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness, blood pressure and wave reflections: a Randomized Controlled Trial (EVIDENT II Study). Hypertension Research 2018, 42, 852 -862.

AMA Style

José I. Recio-Rodríguez, on behalf of the EVIDENT Investigators group, Emiliano Rodriguez-Sanchez, Carlos Martin-Cantera, Vicente Martinez-Vizcaino, Maria S. Arietaleanizbeaskoa, Natividad Gonzalez-Viejo, Marta Menendez-Suarez, Manuel A. Gómez-Marcos, Luis Garcia-Ortiz. Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness, blood pressure and wave reflections: a Randomized Controlled Trial (EVIDENT II Study). Hypertension Research. 2018; 42 (6):852-862.

Chicago/Turabian Style

José I. Recio-Rodríguez; on behalf of the EVIDENT Investigators group; Emiliano Rodriguez-Sanchez; Carlos Martin-Cantera; Vicente Martinez-Vizcaino; Maria S. Arietaleanizbeaskoa; Natividad Gonzalez-Viejo; Marta Menendez-Suarez; Manuel A. Gómez-Marcos; Luis Garcia-Ortiz. 2018. "Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness, blood pressure and wave reflections: a Randomized Controlled Trial (EVIDENT II Study)." Hypertension Research 42, no. 6: 852-862.

Nutrition and metabolism
Published: 14 December 2018 in BMJ Open
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IntroductionThe intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women.Methods and analysisHere we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of ​​at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019.Ethics and disseminationThis study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain (‘CREC of Health Area of Salamanca’), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials.gov provided by the US National Library of Medicine, numberNCT03492983. The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.

ACS Style

Irene A Garcia-Yu; Luis Garcia-Ortiz; Manuel A Gómez-Marcos; Rosario Alonso-Dominguez; Jesus Gonzalez-Sanchez; Sara Mora-Simon; Susana Gonzalez Manzano; Emiliano Rodriguez-Sanchez; Jose-Angel Maderuelo-Fernandez; Jose I Recio-Rodriguez. Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial. BMJ Open 2018, 8, e024095 .

AMA Style

Irene A Garcia-Yu, Luis Garcia-Ortiz, Manuel A Gómez-Marcos, Rosario Alonso-Dominguez, Jesus Gonzalez-Sanchez, Sara Mora-Simon, Susana Gonzalez Manzano, Emiliano Rodriguez-Sanchez, Jose-Angel Maderuelo-Fernandez, Jose I Recio-Rodriguez. Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial. BMJ Open. 2018; 8 (12):e024095.

Chicago/Turabian Style

Irene A Garcia-Yu; Luis Garcia-Ortiz; Manuel A Gómez-Marcos; Rosario Alonso-Dominguez; Jesus Gonzalez-Sanchez; Sara Mora-Simon; Susana Gonzalez Manzano; Emiliano Rodriguez-Sanchez; Jose-Angel Maderuelo-Fernandez; Jose I Recio-Rodriguez. 2018. "Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial." BMJ Open 8, no. 12: e024095.