title: Carbohydrate quality, weight change and incident obesity in a Mediterranean cohort: the SUN Project.
abstract: OBJECTIVE
  To evaluate the association between the carbohydrate quality index (CQI) and weight change or incident overweight/obesity (body mass index ⩾25 kg/m(2)) in the 'Seguimiento Universidad de Navarra (SUN)' cohort.
  
  
  METHODS
  A total of 8741 participants who were initially free of overweight/obesity were followed up for a median of 7.9 years. We evaluated at baseline the CQI according to four criteria: dietary fiber intake, glycemic index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio. Subjects were classified into quintiles according to CQI. Weight was recorded at baseline and updated every 2 years during follow-up.
  
  
  RESULTS
  Increasing CQI of diet was not significantly associated with lower weight gain, although participants in the highest quintile had the lowest average crude weight gain (+211 g/year). We observed 1862 incident cases of overweight/obesity during follow-up. CQI was significantly associated (P for trend 0.006) with a lower risk of overweight/obesity; adjusted odds ratio for the fourth and fifth quintiles were 0.81 (95% confidence interval (CI): 0.66-0.99) and 0.74 (95% CI: 0.60-0.92), respectively.
  
  
  CONCLUSIONS
  In this Mediterranean cohort, CQI showed a significant inverse association with the incidence of overweight/obesity, which highlights that carbohydrate intake guidelines related to obesity prevention should be focused on improving the CQI of the diet.
authors.affiliation: Department of Nutrition and Food Sciences and Physiology, School of Pharmacy, University of Navarra, Pamplona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Santiago
authors.affiliation: 1] Department of Nutrition and Food Sciences and Physiology, School of Pharmacy, University of Navarra, Pamplona, Spain [2] Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain [3] CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Zazpe
authors.affiliation: 1] Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain [2] CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Bes-Rastrollo
authors.affiliation: Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez-Tainta
authors.affiliation: Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Sayón-Orea
authors.affiliation: Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: de la Fuente-Arrillaga
authors.affiliation: Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Benito
authors.affiliation: 1] Department of Nutrition and Food Sciences and Physiology, School of Pharmacy, University of Navarra, Pamplona, Spain [2] CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Martínez
authors.affiliation: 1] Department of Preventive Medicine and Public, School of Medicine-Clínica Universidad de Navarra, Pamplona, Spain [2] CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Martínez-González
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004032:Diet / Q000592:standards; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000145:classification / Q000494:pharmacology / Q000592:standards; D004043:Dietary Fiber / Q000008:administration & dosage* / Q000494:pharmacology; D002523:Edible Grain / Q000145:classification; D005260:Female; D038321:Glycemic Index; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016017:Odds Ratio; D050177:Overweight; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D015430:Weight Gain / Q000187:drug effects*; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D004043:Dietary Fiber