title: Eating competence of elderly Spanish adults is associated with a healthy diet and a favorable cardiovascular disease risk profile.
abstract: Eating competence (EC), a bio-psychosocial model for intrapersonal approaches to eating and food-related behaviors, is associated with less weight dissatisfaction, lower BMI, and increased HDL-cholesterol in small U.S. studies, but its relationship to nutrient quality and overall cardiovascular risk have not been examined. Prevención con Dieta Mediterránea (PREDIMED) is a 5-y controlled clinical trial evaluating Mediterranean diet efficacy on the primary prevention of cardiovascular diseases (CVD) in Spain. In a cross-sectional study, 638 PREDIMED participants (62% women, mean age 67 y) well phenotyped for cardiovascular risk factors were assessed for food intake and EC using validated questionnaires. Overall, 45.6% were eating-competent. EC was associated with being male and energy intake (P < 0.01). After gender and energy adjustment, participants with EC compared with those without showed higher fruit intake and greater adherence to the Mediterranean diet (P < 0.05) and tended to consume more fish (P = 0.076) and fewer dairy products (P = 0.054). EC participants tended to have a lower BMI (P = 0.057) and had a lower fasting blood glucose concentration and serum LDL-:HDL-cholesterol ratio (P < 0.05) and a higher HDL-cholesterol concentration (P = 0.025) after gender adjustment. EC participants had lower odds ratios (OR) of having a blood glucose concentration >5.6 mmol/L (0.71; 95% CI 0.51-0.98) and HDL-cholesterol <1.0 mmol/L (0.70; 95% CI 0.68-1.00). The OR of actively smoking, being obese, or having a serum LDL-cholesterol concentration > or =3.4 mmol/L were <1.0, but the 95% CI included the 1.0 (P > 0.1). Our findings support further examination of EC as a strategy for enhancing diet quality and CVD prevention.
authors.affiliation: Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16803, USA. lohseb@psu.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Lohse
authors.forename: Tricia
authors.initials: T
authors.lastname: Psota
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.forename: Itziar
authors.initials: I
authors.lastname: Zazpe
authors.forename: José V
authors.initials: JV
authors.lastname: Sorli
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.forename: Mercè
authors.initials: M
authors.lastname: Serra
authors.forename: Jodi Stotts
authors.initials: JS
authors.lastname: Krall
authors.forename: Fabiola
authors.initials: F
authors.lastname: Márquez
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004032:Diet; D004435:Eating; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D016037:Single-Blind Method; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose