Adherence to the Spanish dietary guidelines and its association with obesity in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Granada study.
OBJECTIVE
Dietary guidelines are intended to prevent chronic diseases and obesity. The aim of the present study was to develop a diet quality index based on the Spanish Food Pyramid (SFP) and to further explore its association with obesity in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Granada study.


METHODS
Cross-sectional study. The SFP score considered recommendations given for twelve food groups, and for physical activity and alcohol consumption. Obesity was defined as BMI over 30 kg/m2 and abdominal obesity as waist circumference larger than 102 cm (men) and 88 cm (women). Logistic regression was conducted to estimate odds ratios of obesity by quintiles and by 10-point increment in adherence to the score, controlling for potential confounders.


METHODS
EPIC-Granada study.


METHODS
Participants (n 6717) aged 35-69 years (77 % women).


RESULTS
A 10-point increase in adherence to the SFP score was associated with a 14 % (OR=0·86; 95 % CI 0·79, 0·94) lower odds of obesity in men (P interaction by sex=0·02). The odds of abdominal obesity decreased globally by 12 % (OR=0·88; 95 % CI 0·84, 0·93) per 10-point increase in adherence to this score. The effect of higher adherence to the score on abdominal obesity was stronger in physically inactive men and women (ORper 10-point increase=0·79; 95 % CI 0·68, 0·92 and ORper 10-point increase=0·89; 95 % CI 0·84, 0·95, respectively).


CONCLUSIONS
These findings support that the Spanish dietary guidelines might be an effective tool for obesity prevention. However, prospective studies investigating this association are warranted.
1Andalusian School of Public Health,Granada Cancer Registry,Instituto de Investigación Biosanitaria de Granada (Granada.bs),Campus Universitario de Cartuja,Cuesta del Observatorio 4,E-18080 Granada,Spain.
Esther
E
Molina-Montes
3Department of Bioscience and Nutrition,Karolinska Institute,Stockholm,Sweden.
Irina
I
Uzhova
1Andalusian School of Public Health,Granada Cancer Registry,Instituto de Investigación Biosanitaria de Granada (Granada.bs),Campus Universitario de Cartuja,Cuesta del Observatorio 4,E-18080 Granada,Spain.
Elena
E
Molina-Portillo
2CIBER de Epidemiología y Salud Pública (CIBERESP),Madrid,Spain.
José-María
JM
Huerta
5Unit of Nutrition,Environment and Cancer,Cancer Epidemiology Research Programme,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
Genevieve
G
Buckland
2CIBER de Epidemiología y Salud Pública (CIBERESP),Madrid,Spain.
Pilar
P
Amiano
7Public Health Directorate,Asturias,Spain.
Virginia
V
Menéndez
2CIBER de Epidemiología y Salud Pública (CIBERESP),Madrid,Spain.
Aurelio
A
Barricarte
5Unit of Nutrition,Environment and Cancer,Cancer Epidemiology Research Programme,Catalan Institute of Oncology (ICO-IDIBELL),Barcelona,Spain.
Carlos A
CA
González
1Andalusian School of Public Health,Granada Cancer Registry,Instituto de Investigación Biosanitaria de Granada (Granada.bs),Campus Universitario de Cartuja,Cuesta del Observatorio 4,E-18080 Granada,Spain.
María-José
MJ
Sánchez
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D018673:Nutrition Policy; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000517:prevention & control; D010349:Patient Compliance; D013030:Spain; D055105:Waist Circumference; D044465:White People