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Biomedical subjects

M I Covas

Publications and source records attributed to M I Covas.

At least 19 recordsLinked to original sources

High monetary costs of dietary patterns associated with lower body mass index: a population-based study.

INTRODUCTION: Food choice is strongly influenced through economic constraints. The monetary costs for foods, especially those foods associated with a lower risk of obesity, have considerably increased during the last years. The purpose of this study was to determine the cost differences between low and high adherence to two dietary patterns which have been inversely associated with body mass index (BMI) and obesity. METHODS: The subjects were Spanish men (n=1547) and women (n=1615) aged 25-74 years who were examined in 1999-2000, in a population-based cross-sectional survey in the northeast of Spain (Girona). Dietary intake was assessed using a food frequency questionnaire. Two dietary quality indices, namely the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), were created. Average food prices were calculated. Anthropometric variables were measured. RESULTS: Adjusted linear regression analysis revealed that an increase in 1 Euro (1.25$) of monetary diet costs per day was associated with a change of 0.46 units (P<0.001) and 2.03 units (P<0.001) in the MDS and HEI, respectively. The magnitude of the association was similar for both scores after standardization. Subjects who closely adhered to the MDS and HEI paid daily 1.2 Euro (1.50$) (P<0.001) and 1.4 Euro (1.75$) (P<0.001) more for food consumption, respectively, than those who weakly adhered to these dietary patterns. Multiple linear regression analysis adjusted for several confounders showed an inverse association of the MDS (P=0.011) and the HEI (P<0.001) with BMI. The risk of obesity (BMI> or =30) significantly decreased across quartile distribution of MDS (P=0.004) and HEI (P=0.001). CONCLUSION: Data showed that a high adherence to the MDS and HEI, both inversely associated with BMI and obesity, led to higher monetary costs as compared to a low adherence. This might be of importance for public health policies in an effort to develop strategies to promote healthy diets preventing weight gain.

Adult↗

Antioxidant effect of virgin olive oil in patients with stable coronary heart disease: a randomized, crossover, controlled, clinical trial.

The Mediterranean diet, in which olive oil is the main source of fat, has been associated with a reduced incidence of coronary heart disease (CHD) and low blood pressure levels. Virgin olive oil (VOO), besides containing monounsaturated fat, is rich in phenolic compounds (PC) with antioxidant properties. The aim of this study was to examine the antioxidant and anti-hypertensive effect of two similar olive oils, but with differences in their PC (refined: 14.7 mg/kg versus virgin: 161.0 mg/kg), in 40 males with stable CHD. The study was a placebo controlled, crossover, randomized trial. A raw daily dose of 50 mL of VOO and refined olive oil (ROO) were sequentially administered over two periods of 3 weeks, preceded by 2-week washout periods in which ROO was used. Lower plasma oxidized LDL (p < 0.001) and lipid peroxide levels (p = 0.003), together with higher activities of glutathione peroxidase (p = 0.033), were observed after VOO intervention. Systolic blood pressure decreased after intake of VOO (p = 0.001) in hypertensive patients. No changes were observed in diastolic blood pressure, glucose, lipids, and antibodies against oxidized LDL. Consumption of VOO, rich in PC, could provide beneficial effects in CHD patients as an additional and complementary intervention to the pharmacological treatment.

Aged↗

Bioavailability of phenolic compounds from olive oil and oxidative/antioxidant status at postprandial state in healthy humans.

Olive oil phenolic compounds are generally believed to have beneficial antioxidant effects, but little is known about characteristics of their postprandial bioavailability in natural olive oil at real-life doses. The aim of the present study was to determine the concentrations of olive oil phenolic compounds in urine collected over 24 h (24-h urine) after a bolus ingestion of 25 ml of olive oil with different phenolic content, and to demonstrate the effect of this real-life olive oil dose on postprandial levels of blood lipids and oxidative stress biomarkers, as well as to examine the beneficial effects of olive oil phenols. Oral fat loads of 25 ml olive oil with high, moderate, and low phenolic content were administered to 12 healthy male volunteers in a randomized, controlled, crossover trial. Tyrosol and hydroxytyrosol were absorbed in a dose-dependent manner according to the phenolic content of the olive oil administered. The administered dose of 25 ml, which is close to that used daily in Mediterranean countries, did not induce significant postprandial lipemia nor did it promote an increase of in vivo oxidation markers. With regard to plasma antioxidant enzymes, glutathione peroxidase activity decreased postprandially after low phenolic content olive oil ingestion; however this was not observed after intake of moderate and high phenolic content olive oils. The phenolic content of the olive oils administered may account for the protection of the endogenous antioxidant defenses at postprandial state after ingestion of moderate and high phenolic content olive oils.

Adult↗

Response of oxidative stress biomarkers to a 16-week aerobic physical activity program, and to acute physical activity, in healthy young men and women.

Physical activity (PA) is associated with a reduced risk of coronary heart disease, and may favorably modify the antioxidant-prooxidant balance. This study assessed the effects of aerobic PA training on antioxidant enzyme activity, oxidized LDL concentration, and LDL resistance to oxidation, as well as the effect of acute PA on antioxidant enzyme activity before and after the training period. Seventeen sedentary healthy young men and women were recruited for 16 weeks of training. The activity of superoxide dismutase in erythrocytes (E-SOD), glutathione peroxidase in whole blood (GSH-Px), and glutathione reductase in plasma (P-GR), and the oxidized LDL concentration and LDL composition, diameter, and resistance to oxidation were determined before and after training. Shortly before and after this training period they also performed a bout of aerobic PA for 30 min. The antioxidant enzyme activity was also determined at 0 min, 30 min, 60 min, 120 min, and 24 h after both bouts of PA. Training induces an increase in GSH-Px (27.7%), P-GR (17.6%), and LDL resistance to oxidation, and a decrease in oxidized LDL (-15.9%). After the bout of PA, an increase in E-SOD and GSH-Px was observed at 0 min, with a posterior decrease in enzyme activity until 30-60 min, and a tendency to recover the basal values at 120 min and 24 h. Training did not modify this global response pattern. Regular PA increases endogenous antioxidant activity and LDL resistance to oxidation, and decreases oxidized LDL concentration; 30 min of aerobic PA decreases P-GR and B-GSH-Px activity in the first 30-60 min with a posterior recovery.

Adult↗

Bioavailability of tyrosol, an antioxidant phenolic compound present in wine and olive oil, in humans.

Tyrosol is a phenolic compound present in two of the traditional components of the Mediterranean diet: wine and virgin olive oil. The presence of tyrosol has been described in red and white wines. Tyrosol is also present in vermouth and beer. Tyrosol has been shown to be able to exert antioxidant activity in in vitro studies. Oxidation of low-density lipoprotein (LDL) appears to occur predominantly in arterial intima in microdomains sequestered from antioxidants of plasma. The antioxidant content of the LDL particle is critical for its protection. Thus, phenolics, which are able to bind LDL, could be effective in preventing lipid peroxidation and atherosclerotic processes. The ability of tyrosol to bind human LDL has been reported. We have demonstrated the bioavailability of tyrosol in humans from virgin olive oil in its natural form. Urinary tyrosol increased, reaching a peak at 0-4 h after virgin olive oil administration. Men and women showed a different pattern of urinary excretion of tyrosol. Moreover, tyrosol is absorbed in a dose-dependent manner after sustained and moderate doses of virgin olive oil. In summary, our results suggest that tyrosol from wine or virgin olive oil could exert beneficial effects on human health in vivo if its biological properties are confirmed in in vivo studies.

Antioxidants↗

Postprandial effects of wine consumption on lipids and oxidative stress biomarkers.

Postprandial lipemia has been recognized as a risk factor for atherosclerosis development. Consuming meals with suitable sources of antioxidants such as red wine reduces postprandial oxidative stress. However, information about the postprandial effects of wine ingestion outside meals on lipids and on in vivo low-density lipoprotein (LDL) oxidation in humans is scarce. The aim of this study was to investigate postprandial changes in lipids and in vivo LDL oxidation after moderate (250 ml) red wine ingestion, before and after sustained wine consumption of 250 ml/day for 4 days. After 4 days of sustained wine consumption a decrease in the LDL/high-density lipoprotein cholesterol ratio was observed after wine ingestion (p = 0.026). On day 4, a decrease in oxidized LDL levels and an increase in the antioxidant enzyme glutathione peroxidase activity (p = 0.025) were observed after wine ingestion. Our results show that consumption of red wine at moderate doses outside meals does not promote oxidative stress. Daily consumption of moderate doses of red wine can improve postprandial lipid profile and oxidative status when wine is ingested outside meals.

Adult↗

Scientific aspects that justify the benefits of the Mediterranean diet: mild-to-moderate versus heavy drinking.

The Mediterranean diet is now recognized as being both limited in toxicity and abundant in nutrient and non-nutrient protective factors. A large body of basic, clinical and epidemiological studies have been developed in recent years to provide evidence of the benefits of the Mediterranean diet or its components on health. Evidence-based medicine ranks randomized controlled clinical trials as providing the highest level of evidence and expert opinions the lowest. On the basis of these criteria, the current state of knowledge about Mediterranean diet in primary and secondary prevention of disease and mortality and morbidity as functions of the amount of alcoholic beverage consumption, is reviewed. Efficacy versus effectiveness, the role of basic and animal research, and bioavailability studies providing evidence is also discussed.

Alcohol Drinking↗

Capillary gas chromatography-mass spectrometry quantitative determination of hydroxytyrosol and tyrosol in human urine after olive oil intake.

Recent in vitro studies have demonstrated antioxidant properties of some virgin olive oil phenolic compounds. One of the prerequisites to extrapolate these data to an in vivo situation is the knowledge of their bioavailability in humans. In the present work we describe an analytical method which enables us to perform hydroxytyrosol and tyrosol quantitative determinations in human urine. This method was successfully used in bioavailability studies of both phenolic compounds after acute olive oil administration. Virgin olive oil was administered to healthy volunteers after a low phenolic diet. The dose administered of both phenolic compounds was estimated in reference to free forms of hydroxytyrosol and tyrosol present in virgin olive oil extracts before and after being submitted to hydrolytic conditions. These conditions mimic those occurring during digestion. Urine samples were collected before and after acute olive oil intake and analyzed by capillary gas chromatography-mass spectrometry. Hydroxytyrosol and tyrosol urinary recovery increased in response to olive oil administration, obtaining maximal values in the first 4 h. Our results further indicate that hydroxytyrosol and tyrosol are mainly excreted in conjugated form, since only 5.9 +/- 1.4% (hydroxytyrosol) and 13.8 +/- 5.4% (tyrosol) of the total amounts excreted in urine were in free form.

Adult↗

Variables associated with fibrinogen in a population-based study: interaction between smoking and age on fibrinogen concentration.

The aim of the study was to assess the association between fibrinogen and other cardiovascular risk factors. A cross-sectional population-based study in Gerona (Spain) was designed, 1544 subjects (747 men, 797 women) participated. Anthropometric measurements, blood pressure and blood samples were obtained. Fibrinogen was measured by a coagulometric method. Smoking habits, alcohol consumption and physical activity practice were recorded by questionnaires. Fibrinogen was directly related to age, body mass index (BMI) and female gender and inversely to alcohol and moderate-heavy physical activity practice. Fibrinogen was also higher in men and young women who smoked. In the multivariate analysis, age (regression coefficient (RC): 1.33; standard error (SE): 0.13; unit = 1 year), female gender (RC: 12.24; SE: 3.56) and BMI (RC: 1.83; SE: 0.39; unit = 1 kg/m2) were directly associated with fibrinogen, whereas alcohol (RC: -0.04; SE: 0.01; unit = 1 g/d) was inversely associated. A statistically significant interaction between smoking and age was observed. Age was the strongest variable associated with fibrinogen and modifies the association between smoking and fibrinogen; the magnitude of this association increases with age.

Adult↗

Use of a three-day estimated food record, a 72-hour recall and a food-frequency questionnaire for dietary assessment in a Mediterranean Spanish population.

AIM: To assess the validity and the short-term reproducibility of a semi-quantitative, self-administrated food frequency questionnaire and a structured 72-hour recall in a Mediterranean Spanish population. METHODS: 44 free-living volunteers participated in the study. Macronutrient, vitamin and mineral intake, recorded on the food frequency questionnaire and the structured 72-h recall were compared with intakes derived from a three-day food record (reference method). Validity of the dietary assessment methods was further assessed by comparing urinary nitrogen, plasma vitamin C, plasma beta-carotene and whole blood glutathione peroxidase activity levels with the corresponding nutrient intakes from the questionnaires. The food frequency questionnaire and the 72-h recall were administered twice to assess the short term reproducibility. RESULTS: Pearson's correlation coefficients between urinary nitrogen, plasma vitamin C, plasma beta-carotene and whole blood glutathione peroxidase activity levels and the reported nitrogen, vitamin C, beta-carotene and selenium intakes were 0.26, 0.53, 0.17, 0.26 for the food frequency questionnaire; 0.41, 0.09, 0.34, 0.42 for the structured 72-h recall and 0.50, 0.54, 0.44, 0.38 for the three-day food record, respectively. The short term reproducibility of analysed nutrient intake showed average intra-class correlation coefficients of 0.91 and 0.69 for the food frequency questionnaire and the structured 72-h recall irrespectively. CONCLUSION: The food frequency questionnaire and the structured 72-h recall provide valid estimates of nutrient intake and could be used for dietary assessments.

Adult↗

[Olive oil and inhibition of low density lipoprotein oxidation. Role of phenolic compounds].

BACKGROUND: To investigate the protective effect of several olive oils with different phenolic composition on low density lipoprotein susceptibility to oxidation. PATIENTS AND METHODS: Refined olive oil (phenolic content: 0 mg/l caffeic acid equivalents [CAE]), common olive oil (0.1 and 0.3 mg/l CAE), and virgin olive oil diluted with refined olive oil (0.1 y 0.3 mg/l CAE), were added to isolated low density lipoprotein. Conjugated dienes formation was monitored after copper-mediated low density lipoprotein oxidation. RESULTS: An increase in the lag time of conjugated dienes formation after copper-mediated low density lipoprotein oxidation was observed linked to olive oil phenolic content (p < 0.0001, ANOVA). Multiple regression analysis showed that phenolics were the most significant antioxidants with 0.1 mg/l--increase in phenolic concentration, adjusted for alpha-tocopherol and beta-carotene, was 72 minutes (95% confidence interval [CI] 64 to 80 min) for common olive oil, and 111 min (CI 95%: 100-123 min) for virgin olive oil. In common olive oil alpha-tocopherol levels were significatively associated with the increase in the lag time (p = 0.003), reaching in virgin olive oil a borderline significant (p = 0.084). CONCLUSIONS: Olive oil containing phenolics showed more antioxidant effect on low density lipoprotein oxidation than refined olive in relation to its phenolic content. The nature of the phenolic content influences the antioxidant capacity of an olive oil.

Antioxidants↗

Protective effect of olive oil and its phenolic compounds against low density lipoprotein oxidation.

The protective effect of phenolic compounds from an olive oil extract, and of olive oils with (extra-virgin) and without (refined) phenolic components, on low density lipoprotein (LDL) oxidation was investigated. When added to isolated LDL, phenolics [0.025-0.3 mg/L caffeic acid equivalents (CAE)] increased the lag time of conjugated diene formation after copper-mediated LDL oxidation in a concentration-dependent manner. Concentrations of phenolics greater than 20 mg/L inhibited formation of thiobarbituric-acid reactive substances after AAPH-initiated LDL oxidation. LDL isolated from plasma after preincubation with phenolics (25-160 mg/L CAE) showed a concentration-dependent increase in the lag time of conjugated diene formation after copper-mediated LDL oxidation. Refined olive oil (0 mg/L CAE) and extra-virgin olive oil (0.1 and 0.3 mg/L CAE) added to isolated LDL caused an increase in the lag time of conjugated diene formation after copper-mediated LDL oxidation that was related to olive oil phenolic content. Multiple regression analysis showed that phenolics were significantly associated with the increase in lag time after adjustment for effects of other antioxidants; alpha-tocopherol also achieved a statistically significant effect. These results indicate that olive oil phenolic compounds protect LDL against peroxyl radical-dependent and metal-induced oxidation in vitro and could associate with LDL after their incubation with plasma. Both types of olive oil protect LDL from oxidation. Olive oil containing phenolics, however, shows more antioxidant effect on LDL oxidation than refined olive oil.

Chromatography, High Pressure Liquid↗

Decreased endogenous antioxidant enzymatic status in essential hypertension.

Several lines of evidence suggest that patients with essential hypertension have impaired endothelial nitric oxide activity and increased superoxide anion production. However, the mechanisms underlying these abnormalities remain unknown. We measured enzymatic superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities in erythrocytes and whole blood, respectively, in 30 newly-diagnosed, normolipidaemic untreated mild hypertensive patients and in 164 age-matched healthy controls. SOD and GPX activities in hypertensive patients (806 +/- 225 U/Hb.g and 5491 +/- 2073 U/L, respectively) were significantly lower than in the control group (931 +/- 202 U/Hb.g and 6669 +/- 1560 U/L, respectively) (P < 0.005). No significant association was found between these antioxidant enzyme activities and blood pressure in normotensive controls. In the hypertensives, only log-transformed SOD activity showed a significant negative correlation with systolic and diastolic blood pressure (r = 0.37, P < 0.05; r = 0.64, P < 0.0001, respectively). The low endogenous antioxidant enzyme activities observed may in turn result in decreased superoxide anion removal leading to nitric oxide inactivation. Journal of Human Hypertension (2000) 14, 343-345

Adult↗

Validation of the Minnesota Leisure Time Physical Activity Questionnaire In Spanish Women. Investigators of the MARATDON Group.

PURPOSE: Regular physical activity (PA) is associated with lower risk for several chronic diseases. It is important to validate PA measurement instruments in different populations. The objective was to validate the Minnesota leisure time PA questionnaire among Spanish women. METHODS: A cross-sectional study with quota sampling was designed. Two PA groups (active, expending less than 301 MET-min x d(-1) in PA, and very active, expending more than 300 MET-min x d(-1)) and two age groups (18-40 and 41-60 yr) were defined. The Minnesota questionnaire was administered to obtain total energy expenditure in leisure time PA (EEPAtotal) and classified according to the intensity of the different types of PA (EEPAheavy, EEPAmoderate, and EEPAlight). The 250 women recruited performed an exercise test to assess fitness. RESULTS: Spearman correlation coefficients among EEPAtotal, EEPAheavy, EEPAmoderate, EEPAlight, and fitness were 0.39, 0.51, 0.13, and 0.02, respectively. Multiple linear regression model adjusted by the different EEPAs and age accounted for 46% of fitness variability. Besides age, only EEPAmoderate and EEPAheavy were associated with fitness. CONCLUSION: The Spanish version of the Minnesota questionnaire is a valid instrument for measuring leisure time PA performed in the last year in Spanish women aged 18-60 yr. Moderate and heavy physical activity are adequately assessed whereas light physical activity practice assessment may be questionable.

Adolescent↗

Virgin olive oil phenolic compounds: binding to human low density lipoprotein (LDL) and effect on LDL oxidation.

Oxidation of low density lipoproteins (LDL) appears to occur predominantly in arterial intima in microdomains sequestered from antioxidants of plasma. Therefore phenolic compounds which are able to bind LDL are good drug candidates for the effective prevention of lipid peroxidation and atherosclerotic processes. Plasma from healthy volunteers on nonsupplemented diets was incubated with virgin olive oil phenolic extracts (0-200 mg/l, caffeic acid equivalents). Phenolic compounds in LDL were measured by high-performance liquid chromatography-diode array detection (HPLC-DAD). Copper-mediated LDL oxidation was performed, and conjugated dienes formation was monitored. After plasma preincubation with olive oil phenolic compounds (OOPC), an increased OOPC-concentration dependent was observed in the total phenolic content of LDL (p < 0.001, ANOVA) as well as in the lag time before conjugated diene formation (p < 0.001, ANOVA). Rutin and four phenolics with flavonoid-like spectra were found to be bound to the LDL control. These phenolics, together with tyrosol which was not present in the LDL control, significantly increased in LDL (p < 0.05) after plasma incubation with OOPC. These results show the ability of tyrosol to bind LDL in vitro and the capacity of virgin olive oil phenolics to protect other phenolic compounds previously bound to LDL. These results provide further evidence that phenolic compounds bound to LDL are likely to protect LDL from oxidation.

Analysis of Variance↗

Relationship of lipoprotein(a) levels to physical activity and family history of coronary heart disease.

OBJECTIVES: This study evaluated the association of physical activity with serum lipoprotein(a) [La(a)] levels in individuals according to whether they had a family history of coronary heart disease (CHD). METHODS: Lp(a) levels in 332 healthy Spanish men aged 20 to 60 years were measured. Physical activity and family history of CHD were assessed. RESULTS: For men with a family history of CHD, the odds ratio for Lp(a) levels above the median value was 0.13 (95% confidence interval = 0.03, 0.50) in very active men (energy expended in physical activity > 300 kcal/day) compared with active men (energy expended in physical activity < 300 kcal/day). CONCLUSIONS: Regular daily physical activity in individuals with a family history of CHD could be useful for controlling Lp(a) levels.

Adult↗

Differential expression of double-band apolipoprotein(a) phenotypes in healthy Spanish subjects detected by SDS-agarose immunoblotting.

A sodium dodecyl sulphate-agarose apolipoprotein(a) [apo(a)] phenotyping method was set up to attain accurate scanning densitometry of proteins. Serum samples from 99 healthy Spanish men were analysed and twenty-five different apo(a) isoforms (12 to 37 kringle 4 repeats) were detected. Double-band phenotypes accounted for 39.4% (n = 39) and three different patterns of protein expression were identified: pattern A (20.5% of double-band phenotyped samples) predominantly expressed the highest molecular weight isoform; pattern B (53.9%) mainly the lowest molecular weight isoform, and pattern AB (25.6%), expressed both isoforms equally. A significant linear association between expression pattern and lipoprotein(a) [Lp(a)] concentration > or = 0.30 g/l was observed. Single-band phenotyped samples (n = 60) were stratified according to apo(a) kringle 4 repeat categories and showed that 90% of isoforms < 20 K4 repeats had high Lp(a) concentrations (> or = 0.30 g/l), whereas isoforms with 20 to 24 or more than 24 kringle 4 repeats had Lp(a) concentrations > or = 0.30 g/l in 47% and 14%, respectively. A logistic regression model was fitted to test the association between apo(a) size, expression pattern and Lp(a) concentration. In this model, apo(a) isoform < 25 kringle 4 repeats was significantly associated with serum Lp(a) concentration > or = 0.30 g/l in both single and double-band phenotyped samples (odds ratio = 8.9, p < 0.001). In the latter, a differential expression pattern with respect to smaller size isoforms (pattern AB vs A) was significantly associated with Lp(a) concentration > or = 0.30 g/l (odds ratio = 17.97, P = 0.045). Heterogeneity in protein apo(a) size expressed according to kringle 4 repeat number could be categorized in heterozygous phenotypes as three patterns. When small-sized isoform was expressed (pattern B) or both isoforms were equally expressed (pattern AB), the probability of having Lp(a) > or = 0.30 g/l is higher.

Adult↗