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Background The nutritional determinants of stroke and, more specifically, the association of frying with the risk of incident stroke have rarely been studied. Objectives Our aim was to evaluate prospectively the association between the consumption of fried food and the risk of incident stroke in the European Prospective Investigation into Cancer and Nutrition study using the Spanish cohort. Methods Participants included 40,328 healthy adults (62% women) aged 29-69 y at study entry who were enrolled between 1992 and 1996. Participants were followed up until 31 December, 2017, at which time incident stroke (the main outcome) was measured. The main exposure measure was the percentage of energy obtained from fried-food consumption. Sex-specific quintiles were calculated. Results During a follow-up period of 23.5 y, 975 cases of stroke occurred (750 ischemic, 185 hemorrhagic, and 40 undetermined). Compared with those in the first (lowest) quintile of fried-food consumption, the multivariate HRs (95% CIs) of incident stroke in the consecutive quintiles were 1.05 (0.86, 1.30), 1.11 (0.90, 1.36), 1.05 (0.84, 1.31), and 0.91 (0.72, 1.15; P-trend = 0.45). There were no differences identified when subtypes of stroke were considered. Conclusions In this Spanish cohort, whose participants mainly used olive oil or sunflower oil when frying, the consumption of fried food was not associated with an increased risk of incident stroke.

The effect of above-normal body mass index (BMI) on health outcomes is controversial because it is difficult to distinguish from the effect due to BMI-associated cardiovascular risk factors. The objective was to analyze the impact on 10-year incidence of cardiovascular disease, cancer deaths and overall mortality of the interaction between cardiovascular risk factors and BMI. We conducted a pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79years old at basal examination. Body mass index was measured at baseline being the outcome measures ten-year cardiovascular disease, cancer and overall mortality. Multivariable analyses were adjusted for potential confounders, considering the significant interactions with cardiovascular risk factors. We included 54,446 individuals (46.5% with overweight and 27.8% with obesity). After considering the significant interactions, the 10-year risk of cardiovascular disease was significantly increased in women with overweight and obesity [Hazard Ratio=2.34 (95% confidence interval: 1.19-4.61) and 5.65 (1.54-20.73), respectively]. Overweight and obesity significantly increased the risk of cancer death in women [3.98 (1.53-10.37) and 11.61 (1.93-69.72)]. Finally, obese men had an increased risk of cancer death and overall mortality [1.62 (1.03-2.54) and 1.34 (1.01-1.76), respectively]. In conclusion, overweight and obesity significantly increased the risk of cancer death and of fatal and non-fatal cardiovascular disease in women; whereas obese men had a significantly higher risk of death for all causes and for cancer. Cardiovascular risk factors may act as effect modifiers in these associations.

Resumen Introduccion Desde la introduccion en el calendario de vacunacion infantil de la vacuna conjugada frente al meningococo C (MenCC) en el ano 2000, se ha modificado la pauta y se han realizado campanas de vacunacion en cohortes de nacimiento especificas. El objetivo de este estudio es estimar el impacto y la efectividad de esta vacuna en Navarra hasta 2014. Metodos El impacto se evaluo comparando incidencia, mortalidad y letalidad de enfermedad por meningococo C en los periodos anterior (1995-1999) y posterior (2001-2014) a la vacunacion. La efectividad se estimo mediante el metodo de cribado (Farrington) y el de cohorte indirecta (Broome). Los casos se recogieron del sistema de vigilancia de la enfermedad meningococica en Navarra. Resultados En el periodo 1995-1999 la incidencia media anual de enfermedad por meningococo C era de 1,32 por 100.000 habitantes, y de 7,18 por 100.000 en menores de 15 anos. El descenso de la incidencia fue contundente en los grupos de edad diana de la vacuna desde su introduccion y ha sido progresivo en la poblacion total. Entre 2011 y 2014 no se registraron casos por meningococo C. La efectividad de la vacuna para prevenir casos por este serogrupo se estimo entre el 96% (metodo de cribado) y el 99% (metodo de cohorte indirecta). Conclusion El programa de vacunacion con MenCC ha logrado con exito disminuir la incidencia de la enfermedad por serogrupo C en Navarra, y los ajustes en la pauta vacunal han conseguido mantener una elevada efectividad vacunal en el tiempo.

Background & Aims - Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision. Methods - In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests. Results - After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors. Conclusions - The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.

BACKGROUND: The glycemic potential of a diet is associated with chronically elevated insulin concentrations, which may augment breast cancer (BC) risk by stimulating insulin receptor or by affecting insulin-like growth factor I (IGF-I)-mediated mitogenesis. It is unclear whether this effect differs by BC phenotype. OBJECTIVE: The objective was to investigate the relation between glycemic index (GI), glycemic load (GL), and total carbohydrate intake with BC by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). DESIGN: We identified 11,576 women with invasive BC among 334,849 EPIC women aged 34-66 y (5th to 95th percentiles) at baseline over a median follow-up of 11.5 y. Dietary GI and GL were calculated from country-specific dietary questionnaires. We used multivariable Cox proportional hazards models to quantify the association between GI, GL, and carbohydrate intake and BC risk. BC tumors were classified by receptor status. RESULTS: Overall GI, GL, and carbohydrates were not related to BC. Among postmenopausal women, GL and carbohydate intake were significantly associated with an increased risk of estrogen receptor-negative (ER(-)) BC when extreme quintiles (Q) were compared [multivariable HR(Q5-Q1) (95% CI) = 1.36 (1.02, 1.82; P-trend = 0.010) and HR(Q5-Q1) = 1.41 (1.05, 1.89; P-trend = 0.009), respectively]. Further stratification by progesterone receptor (PR) status showed slightly stronger associations with ER(-)/PR(-) BC [HR(Q5-Q1) (95% CI) = 1.48 (1.07, 2.05; P-trend = 0.010) for GL and HR(Q5-Q1) = 1.62 (1.15, 2.30; P-trend = 0.005) for carbohydrates]. No significant association with ER-positive BC was observed. CONCLUSION: Our results indicate that a diet with a high GL and carbohydrate intake is positively associated with an increased risk of developing ER(-) and ER(-)/PR(-) BC among postmenopausal women.

Background: Olive oil consumption is associated with a decreased risk of several chronic diseases, in particular cardiovascular disease (CVD). However, data on the effects of olive oil on overall mortality are scarce. Objective: We evaluated the association between olive oil and overall and cause-specific mortality in the Spanish population in the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Design: A total of 40,622 participants (62% female) aged 29‐69 y were recruited from 5 Spanish regions in 1992‐1996. The association between olive oil (analyzed as a categorical and continuous variable) and overall and cause-specific mortality (CVD, cancer, and other causes) was analyzed by using Cox proportional hazards regression models adjusted for potential confounders. Results: A total of 1915 deaths were reported during 13.4 y of follow-up; 416 CVD deaths, 956 cancer deaths, and 417 deaths from other causes (for 126 deaths the cause was not available). In comparison with nonconsumers, the highest quartile of olive oil consumption was associated with a 26% (95% CI: 13%, 36%) reduction in risk of overall mortality and a 44% (95% CI: 21%, 60%) reduction in CVD mortality. For each increase in olive oil of 10 g 2000 kcal 21 d 21 , there was a 7% (95% CI: 3%, 10%) decreased risk of overall mortality and a 13% (95% CI: 6%, 20%) decreased risk of CVD mortality. No significant association was observed between olive oil and cancer mortality. Conclusions: Olive oil was associated with a decreased risk of overall mortality and an important reduction in CVD mortality in this large Mediterranean cohort. This provides further evidence on the beneficial effects of one of the key Mediterranean dietary components. Am J Clin Nutr doi: 10.3945/ajcn.111.024216.

Background: In 2007 the World Cancer Research Fund (WCRF) and the American Institute of Cancer Research (AICR) issued 8 recommendations (plus 2 special recommendations) on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. Objective: We aimed to investigate whether concordance with the WCRF/AICR recommendations was related to cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Design: The present study included 386,355 EPIC participants from 9 European countries. At recruitment, dietary, anthropometric, and lifestyle information was collected. A score was constructed based on the WCRF/AICR recommendations on weight management, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks, and breastfeeding for women; the score range was 0-6 for men and 0-7 for women. Higher scores indicated greater concordance with WCRF/AICR recommendations. The association between the score and cancer risk was estimated by using multivariable Cox regression models. Results: Concordance with the score was significantly associated with decreased risk of cancer. A 1-point increment in the score was associated with a risk reduction of 5% (95% Cl: 3%, 7%) for total cancer, 12% (95% CI: 9%, 16%) for colorectal cancer, and 16% (95% CI: 9%, 22%) for stomach cancer. Significant associations were also observed for cancers of the breast, endometrium, lung, kidney, upper aerodigestive tract, liver, and esophagus but not for prostate, ovarian, pancreatic, and bladder cancers. Conclusion: Adherence to the WCRF/AICR recommendations for cancer prevention may lower the risk of developing most types of cancer. Am J Clin Nutr 2012;96:150-63.

Background and Aim No previous study has assessed the association between major dietary patterns and the risk of coronary heart disease (CHD) in a large cohort from a Mediterranean country. Methods and Results We studied prospectively 40,757 persons, aged 29–69 years, participating in the Spanish cohort of the EPIC study. Food consumption was collected between 1992 and 1996 with a validated history method. Individuals were followed-up until 2004 through record linkage with hospital discharge registers, population-based registers of myocardial infarction, and mortality registers to ascertain CHD events (fatal and non-fatal acute myocardial infarction or angina requiring revascularization). Two major dietary patterns were identified from factor analysis. The first pattern was labeled as Westernized, because of the frequent consumption of refined cereals and red meat; the second was called the evolved Mediterranean pattern, because of the frequent intake of plant-based foods and olive oil. During a median follow-up of 11 years, 606 CHD events were ascertained. No association was found between the Westernized pattern and CHD risk. In contrast, the score for the evolved Mediterranean pattern was inversely associated with CHD risk (p for trend = 0.0013); when compared with the lowest quintile of the evolved Mediterranean pattern score, the multivariable hazard ratios for CHD were 0.77 (95% confidence interval 0.61–0.98) for the second quintile, 0.64 (95% CI 0.50–0.83) for the third quintile, 0.56 (95% CI 0.43–0.73) for the fourth quintile, and 0.73 (95% CI 0.57–0.94) for the fifth quintile. Conclusion A Mediterranean diet, as consumed in this study population, was associated with a lower risk of CHD.

Two rotavirus vaccines have been available since 2006. This study evaluates the effectiveness of these vaccines using a test-negative case-control design in Navarre, Spain. We included children 3-59 months of age who sought medical care for gastroenteritis and for whom stool samples were taken between January 2008 and June 2011. About 9% had received the pentavalent vaccine (RotaTeq) and another 8% received the monovalent vaccine (Rotarix). Cases were the 756 children with confirmed rotavirus and controls were the 6036 children who tested negative for rotavirus. Thirty-five percent of cases and 9% of controls had required hospitalization (p

We defined a population-based cohort (596,755 subjects) in Navarre, Spain, using electronic records from physicians, to evaluate the effectiveness of the monovalent A(H1N1)2009 vaccine in preventing influenza in the 2009-2010 pandemic season. During the 9-week period of vaccine availability and circulation of the A(H1N1)2009 virus, 4608 cases of medically attended influenza-like illness (MA-ILI) were registered (46 per 1000 person-years). After adjustment for sociodemographic covariables, outpatient visits and major chronic conditions, vaccination was associated with a 32% (95% CI: 8-50%) reduction in the overall incidence of MA-ILI. In a test negative case-control analysis nested in the cohort, swabs from 633 patients were included, and 123 were confirmed for A(H1N1)2009 influenza. No confirmed case had received A(H1N1)2009 vaccine versus 9.6% of controls (p

Articulo especial Evidencias cientificas disponibles sobre la seguridad de las vacunas Juan J. Picazo, Javier de Aristegui Fernandez, Jose M. Arteagoitia Axpe, Dolores Barranco Ordonez, Aurelio Barricarte Gurrea, Xavier Bosch Jose, Javier Diez Domingo, Fernando Gonzalez Romo, Teresa Hernandez-Sampelayo Matos, Jesus Ruiz Contreras, Lluis Salleras i Sanmarti, Francisco Salmeron Garcia, Luis Urbiztondo Perdices

Background: There is an association between a greater adherence to a Mediterranean diet and a reduced risk of developing chronic diseases. However, it is not clear whether this dietary pattern may be protective also against the development of obesity. Objective: We assessed the association between the adherence to the Mediterranean dietary pattern (MDP), prospective weight change, and the incidence of overweight or obesity. Design: We conducted a prospective cohort study [the European Prospective Investigation into Cancer and Nutrition Physical Activity, Nutrition, Alcohol Consumption, Cessation of Smoking, Eating Out of Home, and Obesity (EPIC-PANACEA) project] in 373,803 individuals (103,455 men and 270,348 women; age range: 25-70 y) from 10 European countries. Anthropometric measurements were obtained at recruitment and after a median follow-up time of 5 y. The relative Mediterranean Diet Score (rMED; score range: 0-18) was used to assess adherence to the MDP according to the consumption of 9 dietary components that are characteristic of the Mediterranean diet. The association between the rMED and 5-y weight change was modeled through multiadjusted mixed-effects linear regression. Results: Individuals with a high adherence to the MDP according to the rMED (11-18 points) showed a 5-y weight change of 0.16 kg (95% CI: 0.24, 0.07 kg) and were 10% (95% CI: 4%, 18%) less likely to develop overweight or obesity than were individuals with a low adherence to the MDP (0-6 points). The low meat content of the Mediterranean diet seemed to account for most of its positive effect against weight gain. Conclusion: This study shows that promoting the MDP as a model of healthy eating may help to prevent weight gain and the development of obesity. Am J Clin Nutr 2010;92:912-21.

Resumen Fundamento y objetivo Se analiza un brote de parotiditis ocurrido en Navarra entre agosto de 2006 y diciembre de 2007, con amplia afectacion de vacunados. Pacientes y metodo Los casos de parotiditis notificados se completaron mediante busqueda en las historias de atencion primaria, de urgencias, de hospitales y en los informes de laboratorio. Se analizan los factores que pudieron incidir en la aparicion de casos segun la cohorte de nacimiento. Resultados Se detectaron 2.866 casos de parotiditis (tasa de ataque de 4,7 por 1.000), con el 61% en varones y la maxima incidencia a los 19 anos (intervalo intercuartil de 16-25 anos). El 14% de los casos se confirmo por laboratorio: 59 por aislamiento viral, 14 por reaccion en cadena de la polimerasa y 333 por presencia de inmunoglobulina M especifica en suero. En 7 casos se identifico el genotipo G1. El 21% de los casos habia nacido antes de 1980 (cohortes prevacunales). El 0,2% todavia no tenia la edad de vacunacion (15 meses). Entre las cohortes nacidas entre 1980 y 2000 (con oportunidad de vacunacion), el 94,5% de los casos habia recibido alguna dosis y el 88,3% habia recibido 2 dosis. El 31% de los casos ocurrio en cohortes vacunadas en la primera dosis (1995–1997) o en la segunda (1986–1988) con la cepa Rubini. Ademas, hubo constancia de 772 casos que tenian 2 dosis con la cepa Jeryl Lynn. Conclusiones Este extenso brote se explica por la concurrencia de varios factores. La vacuna actual ha reducido considerablemente la incidencia de parotiditis, pero no parece capaz de eliminar totalmente la circulacion del virus.

BACKGROUND: Polychlorinated biphenyls (PCBs) are persistent compounds that may pose an environmental hazard to humans, food being the main source of exposure for the general population. OBJECTIVE: To measure the serum concentrations of the main PCBs in subjects from the general population in Spain, and to assess potential determinants of such concentrations. METHODS: Serum was obtained from blood samples of 953 subjects aged 35-64 years, residents in five Spanish regions (three from the North and two from the South), randomly selected from the EPIC-Spain cohort. Blood collection took place during 1992-1996 and four PCB congeners (118, 138, 153 and 180) were determined by means of gas chromatography with electron-capture detection (GC-ECD). RESULTS: The concentration of total PCBs was 459 ng/g lipids (or 3.1 microg/l); the corresponding figures for PCB 153 were 186 ng/g lipids and 1.25 microg/l. Men had higher values than women, PCB levels increased with age, and serum concentration of PCBs was higher in northern regions. Body mass index (BMI) was inversely related to PCB concentrations, and fish intake was the dietary factor showing the greatest association with serum PCBs. The pattern described was similar for each congener separately. CONCLUSIONS: We found concentrations similar to those reported in European countries where blood collection was carried during the same period. Regional differences within Spain are not fully explained by anthropometric or dietary factors. The inverse association with BMI suggests that in the mid-1990s there was still ongoing or recent exposure to PCBs in Spain. Some authors (AA, CAG, PJ) are members of The Environmental Cancer Risk, Nutrition and Individual Susceptibility (ECNIS), a Network of Excellence of the 6th EU Framework Programme (FP6,FOOD-CT- 2005-513943).

BACKGROUND Consumption of fried food has been suggested to promote obesity, but this association has seldom been studied. OBJECTIVE We aimed to assess the association of energy intake from fried food with general and central obesity in Spain, a Mediterranean country where frying with oil is a traditional cooking procedure. DESIGN This was a cross-sectional study of 33 542 Spanish persons aged 29-69 y who were participating in the European Prospective Investigation into Cancer and Nutrition between 1992 and 1996. Dietary intake was assessed by a diet history questionnaire. Height, weight, and waist circumference were measured by trained interviewers. Analyses were performed with logistic regression and were adjusted for total energy intake and other confounders. RESULTS The prevalence of general obesity [body mass index (in kg/m(2)) >or= 30] was 27.6% in men and 27.7% in women. Respective figures for central obesity (waist circumference >or= 102 cm in men and >or= 88 cm in women) were 34.5% and 42.6%. The average proportion of energy intake from fried food was 15.6% in men and 12.6% in women. The adjusted odds ratios for general obesity in the highest versus the lowest quintile of fried food intake were 1.26 (95% CI: 1.09, 1.45; P for trend < 0.001) in men and 1.25 (1.11, 1.41; P for trend < 0.001) in women. The corresponding values for central obesity were 1.17 (1.02, 1.34; P for trend < 0.003) in men and 1.27 (1.13, 1.42; P for trend < 0.001) in women. CONCLUSION Fried food was positively associated with general and central obesity only among subjects in the highest quintile of energy intake from fried food.

BACKGROUND AND OBJECTIVE: The 7-valent pneumococcal conjugate vaccine (PCV7) has been commercialized in Spain since June 2001. We aim to evaluate the impact of this vaccine in the incidence of invasive pneumococcal disease (IPD) in Navarre. POPULATION AND METHOD: The laboratories of microbiology of Navarre declare all the isolations of Streptococcus pneumoniae in samples of normally sterile corporal fluids. We analyzed the incidence of IPD in children younger than 5 years between weeks 41 of 2000 and 40 of 2005. RESULTS: The doses of PCV7 sold up to 2005 would provide a cover of 27% in children younger than 5 years, having assumed 4 dose schedules. In the 5 seasons, 103 cases of IPD were diagnosed. From the 2 first seasons (2000-2002) to the last one (2004-2005) a reduction of 69% in the incidence rate of IPD caused by vaccine serotypes was observed (from 33 to 10 cases by 100,000 children under 5 years; p = 0.003). Between those same periods the incidence of IPD caused by non-vaccine serotypes increased a 36% (from 42 to 57 by 100,000; p = 0.405). The global incidence of IPD diminished a 12% (from 77 to 67 by 100,000; p = 0.689). The percentage of cases that had received PCV7 increased until 45% in season 2004-2005 (p < 0.001). The meningitis and bacteraemic pneumonias supposed 42% of the IPD, without significant changes during the period (p = 0.442). CONCLUSIONS: Since the PCV7 was marketed the pattern of serotypes has changed, but the expected reduction in the total IPD incidence has not been achieved.

Purpose We assessed changes in smoking behavior and its related factors among healthy adults from five regions in Spain. Methods The smoking status at recruitment and after 3 years was compared in 14,288 men and 23,983 women aged 35 to 64 years. The pattern of smoking and several lifestyle factors were investigated as potential predictors of subsequent changes in smoking habits. Results Among current smokers at baseline the age-adjusted rates of cessation per 1000 person-years were 57.4 for men and 43.2 for women. Among former smokers at baseline the relapse rates were 37.6 and 48.8 per 1000 person-years for men and women, respectively. The initiation rate per 1000 person-years among men who had never smoked was 12.5 and 2.7 for women. Higher amount currently smoked and longer time since quitting were strong predictors of lower rates of cessation and relapse, respectively, while age was associated with lower initiation rates in women. Increased alcohol consumption was related to low cessation and high relapse and initiation rates, mainly among men, while more educated women had higher cessation and initiation rates. Conclusions The current pattern of changes in smoking behavior in Spanish populations aged 35 to 64 years results in rather small prevalence reduction. Additional efforts should be made to promote successful cessation and prevent initiation to reduce the tobacco burden in Spain.

ResumenObjetivosLos grupos de nivel social más bajo tienen habitualmente una dieta menos saludable. El objetivo de este estudio es comparar la adhesión al patrón de dieta mediterránea entre diferentes grupos demográficos y sociales de la población adulta.MétodosSe realizó un estudio transversal en regiones del sur y norte de España, en voluntarios sanos (15.634 varones y 25.812 mujeres) de 29 a 69 años de edad, miembros de la cohorte EPIC en España. Se tuvo en cuenta el consumo de nueve grupos de alimentos para definir el patrón de dieta mediterránea: vegetales, frutas, legumbres, cereales, carne roja, pescado, aceite de oliva, leche y productos lácteos y vino. Se aplicaron dos técnicas de análisis: comparación de la media diaria de consumo de cada grupo, y el cálculo de un escore global para todos los alimentos, por nivel educacional y clase social de origen.ResultadosLos grupos de nivel educacional más bajo consumen mas cereales y legumbres, pero menos vegetales, aceite de oliva (las mujeres), leche y productos lácteos (los varones). El consumo de vino está positivamente asociado con la educación en las mujeres y negativamente asociado en los varones. Calculando una puntuación para medir la adhesión global al patrón de dieta mediterránea, las diferencias por cada grupo de alimentos se compensan, y no hay variaciones según el nivel educacional, aunque existen pequeñas diferencias en la clase social de origen (22,52 en la clase más baja y 21,98 en la clase más alta). El índice de adhesión es más bajo en los adultos jóvenes y mujeres, y ligeramente más alto en las poblaciones del sur (23,53 en Murcia) que en las del norte de España (21,64 en Asturias).ConclusionesLos resultados sugieren que el patrón de dieta mediterránea es bastante uniforme, al menos en las poblaciones adultas de las áreas incluidas en el estudio.AbstractObjectivesLower social classes tend to eat a less healthy diet. The aim of this study was to compare adherence to the Mediterranean dietary pattern among different demographic and social groups in the adult population.MethodsA cross-sectional study was performed in southern and northern regions of Spain in healthy volunteers (15,634 men and 25,812 women), aged 29-69 years, who were members of the European Prospective Investigation on Cancer cohort in Spain. Nine groups of food were included in the definition of the Mediterranean diet: vegetables and garden products, fruits, pulses, cereals, red meat, fish, olive oil, milk and milk products, and wine. Two techniques were used in the analysis: comparison of the mean daily intake of each group and calculation of an overall score for all the foods according to educational level ang original social class.ResultsGroups with the lowest educational levels consumed more cereals and pulses and lower quantities of vegetables, olive oil (women), milk and milk products (men). Wine consumption was positively associated with education in women and was negatively associated in men. Calculation of a score to measure overall adherence to the Mediterranean dietary pattern eliminated differences according to each food category. No variations were found according to educational level, but small differences were found in original social class. The adherence score was lowest in young adults and women and was slightly higher in the south than in the north of Spain.ConclusionsThe results suggest that the Mediterranean dietary pattern is fairly uniform, at least in the adult population of the regions included in this study.

BACKGROUND To evaluate lifestyle and dietary intake factors influencing the accumulation of abdominal fat in a Mediterranean population. SUBJECTS AND METHOD A cross-sectional study was carried-out in Spain (Asturias, Granada, Murcia, Navarra and Guipuzkoa) among 23,228 women and 14,332 men aged 29-69 years, participants of a large European prospective cohort (EPIC). Information on usual food intake and other non-dietary factors were collected by interviews. Height, weight, waist circumference and hip circumference were taken by previously trained interviewers. RESULTS In a multiple-linear regression analysis sports activities and educational level were negatively associated with abdominal obesity, while body mass index, age, tobacco and alcohol consumption, saturated fat intake and increased prevalence of hypertension, diabetes and myocardial infarction were positively associated. All dietary and non-dietary variables accounted for 22 and 27% of variance in the waist/hip ratio and 74 and 66% of variance in the waist circumference, in women and men respectively. CONCLUSIONS Body mass index and age are the most important factors influencing the accumulation of abdominal fat. Dietary factors and other lifestyle factors seem to play a minor role in increasing abdominal obesity.

ResumenLa información disponible sobre las pruebas de detección de anticuerpos anti-VIH de los laboratorios públicos de Navarra ha permitido conocer el número de personas diagnosticadas de infección por VIH hasta junio de 1992, así como sus características demográficas y de prácticas de riesgo. Se encontraron 1205 personas VIH positivas, sobre una población de 512.512 personas, lo que implica una incidencia acumulada de 2,35 casos por mil habitantes. Las mayores tasas se observan en varones de 20 a 29 años (13,57 por mil), y a nivel urbano (3,7 por mil). La práctica de riesgo más frecuente entre los VIH positivos es el uso de drogas por vía parenteral (93,7%), seguido de la transmisión sexual (3,5%). Esta metodología aporta el número mínimo de casos VIH positivos existentes en Navarra, ya que no se incluyen los casos no diagnosticados y los diagnosticados en centros privados de Navarra y/o en otras comunidades autónomasSummaryThe information available from public laboratories in Navarra (Spain) on tests for detecting anti-HIV antibodies enabled to find out the number of HIV seropositive subjects from 1985 to June 1992, as well as their demographic characteristics and risk habits. 1205 subjetcts were found to be HIV seropositive, out of a population of 512,512 inhabitants which means an accumulated incidence of a 2.35 cases per thousand inhabitants. Higher rates were observed in young males (13.57 per thousand), and in urban areas (3.7 per thousand). The most frequent risk habit among HIV seropositive is the use drugs by intravenous injection (93.7%) followed by sexual transmission (3.5%). This methodology provides the minimum number of HIV seropositive cases in Navarra, since it does not include those not diagnosed, on diagnosed in private centres in Navarra and/or in other autonomous regions.