Evaluación de la calidad de la dieta española en el estudio DRECEadecuación a las recomendaciones de la Sociedad Española de Arteriosclerosis

Abstract

Background During the last decades, the Spanish diet has moved away from the traditional “Mediterranean diet”, which has shown a protective role against cardiovascular events. In an attempt to revert population trends towards an increasing “westernization” of dietary habits, the Spanish Atherosclerosis Society (SEA) published in 1994 a document with dietary recommendations for the prevention of atherosclerosis. In the DRECE study (Diet and Cardiovascular Events Risk in Spain), the dietary habits of a representative population sample were assessed in 1991 and in 1996-97. The present study describes how well these dietary habits fit the SEA recommendations. Methods Following SEA guidelines, 4787 people participating in the DRECE-I study were classified according to their cardiovascular risk status. One thousand two hundred subjects “with cardiovascular risk” and a control group of 600 “low risk” subjects, randomly chosen by age and sex strata, were studied. A food frequency questionnaire was employed to assess dietary habits. Nutrient intakes were energy-adjusted following Willett’s model. The proportion of subjects following SEA dietary recommendations was evaluated. Results Most subjects did not fit the SEA recommendations. The diet of the participants in the DRECE study was poor in carbohydrates (41% of total energy intake), protein-rich (16%) and with a high fat (43%) and cholesterol intake. Only the recommendations about monounsaturated fat were accomplished by more than 50% of the participants. Although in 1996-97 there was a significantly higher percentage of subjects following the recommendations about total fat, saturated fat and cholesterol than in 1991, they only accounted for 14,2%, 25,7%, and 15,1%, respectively, of subjects with cardiovascular risk. Conclusions With the exception of monounsaturated fat intake, the SEA dietary recommendations for the prevention of atherosclerosis are only followed by a minority of subjects in the population. Restoration of Mediterranean dietary habits, with a higher legume, fruit, and vegetable intake, and a lower consumption of meat and dairy products, should be encouraged at the population level in order to fulfil the objectives proposed by the SEA dietary guidelines.