title: Nutritional adequacy according to carbohydrates and fat quality.
abstract: OBJECTIVE
  To investigate the association between carbohydrate quality, fat quality or adherence to the Mediterranean diet and intake adequacy of 19 micronutrients in the PREDIMED (PREvención con DIeta MEDiterránea) trial, a multicenter, randomized, controlled, parallel group and primary prevention trial conducted in Spain.
  
  
  METHODS
  We assessed baseline dietary intake of 6,542 elderly subjects at high cardiovascular risk through a validated food frequency questionnaire (FFQ) and a validated 14-item Mediterranean diet (Med-diet) score. We used a multidimensional carbohydrate quality index (CQI) using four criteria and a fat quality index (FQI) according to the ratio (MUFA + PUFA)/(SFA + TFA). The probability of intake adequacy was calculated comparing the intakes to DRI, and also using the probabilistic approach. Absolute and adjusted probability of having inadequate intake for either ≥6 DRI or ≥8 DRI were estimated to assess nutritional adequacy according to quintiles of each index.
  
  
  RESULTS
  The lowest prevalence of inadequate micronutrient intake (≥8 DRI) was found in the highest quintile of CQI or Med-diet score, and in the lowest quintile of FQI (adjusted fold risk: 1.4, 3.4 and 10.2 respectively in comparison with the lowest quintile). P for trend <0.001 in three multivariable models. A higher CQI or Med-Diet score and a lower FQI were significantly associated with a lower fold risk of unmet EAR values.
  
  
  CONCLUSIONS
  A multidimensional assessment of CQI can be a useful tool to evaluate the quality of carbohydrates. This score and a 14-item Med-diet score were positively related to overall micronutrient adequacy in elderly participants.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain. asanchez4@unav.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez-Tainta
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain. izazpe@unav.es.|Department of Nutrition and Food Sciences, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain. izazpe@unav.es.|Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. izazpe@unav.es.
authors.forename: Itziar
authors.initials: I
authors.lastname: Zazpe
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain. mbes@unav.es.|Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. mbes@unav.es.
authors.forename: Maira
authors.initials: M
authors.lastname: Bes-Rastrollo
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. jordi.salas@urv.cat.|Human Nutrition Unit, Sant Joan Hospital, IISPV, Universitat Rovira i Virgili, Reus, Spain. jordi.salas@urv.cat.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. monica.bullo@urv.cat.|Human Nutrition Department, University Rovira i Virgili, Reus, Spain. monica.bullo@urv.cat.
authors.forename: Mónica
authors.initials: M
authors.lastname: Bullo
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.|Primary Care Division, Valencia Institute of Health and Department of Preventive Medicine, University of Valencia, Valencia, Spain.
authors.forename: José Vicente
authors.initials: JV
authors.lastname: Sorlí
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. dolores.corella@uv.es.|Department of Preventive Medicine, University of Valencia, Valencia, Spain. dolores.corella@uv.es.
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. MCovas@IMIM.ES.|Cardiovascular Epidemiology Unit, Municipal Institute for Medical Research (IMIM), Barcelona, Spain. MCovas@IMIM.ES.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Covas
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. aborau@secardiologia.es.|Department of Cardiology, University Hospital Txagorritxu-University Hospital of Alava, Vitoria, Spain. aborau@secardiologia.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. bedmar@uma.es.|Department of Preventive Medicine and Public Health, University of Málaga, Málaga, Spain. bedmar@uma.es.
authors.forename: Mario
authors.initials: M
authors.lastname: Gutierrez-Bedmar
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. miquelfiol@yahoo.es.|Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Son Espases, Palma de Mallorca, Spain. miquelfiol@yahoo.es.
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. pdelacorte@hotmail.com.|Primary Care Division of Sevilla, Department of Family Medicine, San Pablo Health Center, Sevilla, Spain. pdelacorte@hotmail.com.
authors.forename: F García
authors.initials: FG
authors.lastname: de la Corte
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. lserra@dcc.ulpgc.es.|Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. lserra@dcc.ulpgc.es.
authors.forename: Lluis
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. xpinto@csub.scs.es.|Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. xpinto@csub.scs.es.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pinto
authors.affiliation: IMIM-Hospital del Mar Medical Research Institute and CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain. hschroeder@imim.es.|Instituto de Salud Carlos III, Madrid, Spain. hschroeder@imim.es.
authors.forename: Helmut
authors.initials: H
authors.lastname: Schröeder
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. EROS@clinic.ub.es.|Lipid Clinic, Department of Endocrinology and Nutrition, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain. EROS@clinic.ub.es.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.affiliation: Department of Nutrition and Food Science, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain. mclopez@ub.edu.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: López-Sabater
authors.affiliation: Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. restruch@clinic.ub.es.|Department of Internal Medicine, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain. restruch@clinic.ub.es.
authors.forename: Ramón
authors.initials: R
authors.lastname: Estruch
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinica Universidad de Navarra, University of Navarra, Irunlarrea 1, 31008, Pamplona, Navarra, Spain. mamartinez@unav.es.|Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain. mamartinez@unav.es.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martínez-González
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control; D038441:Diet, Mediterranean; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005227:Fatty Acids / Q000008:administration & dosage; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D008875:Middle Aged; D009753:Nutritive Value; D010349:Patient Compliance; D015203:Reproducibility of Results; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires; D044242:Trans Fatty Acids / Q000008:administration & dosage
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D005227:Fatty Acids; D005229:Fatty Acids, Monounsaturated; D005231:Fatty Acids, Unsaturated; D018977:Micronutrients; D044242:Trans Fatty Acids
keywords: Carbohydrate quality; Fat quality; Mediterranean diet; Micronutrient adequacy; PREDIMED trial