Benefits of an educational intervention on diet and anthropometric profile of women with one cardiovascular risk factor

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Failde Garrido, María Reyes Pérez Fernández" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Anxela" "apellidos" => "Soto Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "José Luís" "apellidos" => "García Soidán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Manuel" "apellidos" => "de Toro Santos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Fiz" "apellidos" => "Lagoa Labrador" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "José M." "apellidos" => "Failde Garrido" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 5 => array:4 [ "nombre" => "María Reyes" "apellidos" => "Pérez Fernández" "email" => array:1 [ 0 => "mariareyes.perez.fernandez@sergas.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Escuela Universitaria de Enfermería, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad de Vigo, Campus Pontevedra, Pontevedra, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Apoyo a la Investigación, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Universidad de Vigo, Campus Ourense, Ourense, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Beneficios de una intervención educativa en la dieta y en el perfil antropométrico de mujeres con un factor de riesgo cardiovascular" ] ] "textoCompleto" => "IntroductionIn recent years, cardiovascular disease (CVD) has been the leading cause of death in women in our country.<a class="elsevierStyleCrossRef" href="#bib0055">1</a> The transition to menopause produces an acceleration of cardiovascular risk factors, such as increased abdominal obesity and alterations in body composition.<a class="elsevierStyleCrossRef" href="#bib0060">2</a> Eating habits have a crucial role in these two aspects, and, in this sense, the Mediterranean diet has proved to be one of the healthier eating models.<a class="elsevierStyleCrossRef" href="#bib0065">3</a>The aim of this study was to assess whether an educational intervention in women of perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia would be able to improve adherence to a Mediterranean diet pattern and obtain changes in certain anthropometric parameters.Materials and methodsA randomized parallel group clinical trial was conducted with an educational intervention in 2 of the 5 health centres located in the city of Ourense so as to facilitate the patient selection process. These 5 centres provide care to a total population of 14,455 women with a health card, aged between 45 and 60 years. The sample size was calculated by estimating a standardized difference in mean systolic blood pressure of 4.76mmHg between the intervention and control groups. Whereas the expected standard deviation in this parameter was 15.2mmHg, for a confidence level of 95% and a power of 80%, a sample of 320 women was needed, allowing for a loss rate of 30%.Women who had at least one diagnosed cardiovascular risk factor (diabetes mellitus, dyslipidaemia and/or hypertension), excluding those who refused to participate in it and/or those who had a mental condition that would advise against their participation. The study was approved by the Clinical Research Ethics Committee of Galicia.The variables studied were: age, waist and hip circumference, body mass index (BMI) and, finally, parameters related to body fat (total, visceral and trunk). The latter criteria were analyzed with a bioelectrical bioimpedance device, Tanita SC-330. The conditions required for the measurement of these parameters were: having an empty bladder before measurement, not having done any physical activity for 12h, removing all kinds of metal objects or jewellery that may interfere with the measurement results and wearing light clothing. Menopausal status was assessed by self-report on the regularity of their menstrual cycle. Were considered menopausal those women whose menstruation had stopped for more than a year. The MEDAS-14 questionnaire about adherence to the Mediterranean diet was used to assess eating habits.<a class="elsevierStyleCrossRefs" href="#bib0070">4,5</a>Once the questionnaires and tests were performed on the entire sample, an automatically generated randomization list was used to assign patients to one of the 2 groups. This list was prepared by an external collaborator, unfamiliar with the study (technician from the Research Unit of the Cristal-Piñor Hospital of Ourense). The sample was divided into intervention and control group. Women in the intervention group received 3 interactive educational workshops on the prevention of CVD, recommending the adoption and maintenance of healthy habits that favour a change in lifestyle. The importance of following a Mediterranean diet was stressed, reducing consumption of saturated fats, sugar and alcohol and increasing consumption of plant foods and foods rich in polyunsaturated fatty acids.<a class="elsevierStyleCrossRefs" href="#bib0065">3,5</a> 3 workshops were held over a week, with a duration of 1.5h each, in groups of 15 people. To encourage interaction and participation of women, these workshops were organized on different days and times. Moreover, the control group received only a brochure mailed to their address, with information on the same subject. 12 months after the workshops were completed, the questionnaire and anthropometric assessment was repeated on the entire sample.Statistic analysisThe Lilliefors test was carried out to evaluate the normality of continuous variables. McNemar's test and Chi square were used for pre-post-intervention comparison between categorical variables; the Student t test for independent samples and paired data was used for the study of continuous variables, and in the case of not presenting a normal distribution, the non-parametric Wilcoxon test was used. Analyses were performed with R free software.ResultsOf the 320 women who started the study, 230 completed it. In the control group 47 subjects were lost (n=113) and 43 in the intervention group (n=117); therefore, the loss percentage was 28.1%. After studying the characteristics of patients lost during the study, there was no pattern observed which would explain these losses. The average age of the sample was 53.17±4.31 years and the vast majority of women (63.48%) were menopausal at baseline.Initially the homogeneity of the sample was verified after randomization of women in the 2 groups, with no statistically significant differences between the control group and the intervention group (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). However, one year after the training, the difference between the two groups was significant in all the variables of the study (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Regarding the intragroup differences, we observed that women in the control group before the educational intervention presented a BMI of 27.34±5.30kg/m2. After the intervention, this increased significantly to 27.81±5.48 kg/cm2 (p=0.000). Women in the intervention group had a BMI of 27.57±5.52kg/cm2, and a year later their BMI was 27.69±5.81kg/cm2, the difference not being statistically significant (p=0.271) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>A year after the educational intervention, women in the control group significantly increased the parameters of total body fat, visceral fat, trunk fat and waist and hip circumference (p<0.001). Women in the intervention group significantly increased only the amount of visceral fat (p=0.028) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).It was observed that patients in the intervention group significantly improved (p=0.000) adherence to the Mediterranean diet after the educational intervention, and that women in the control group maintained a similar adherence a year later (p=0.188) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).DiscussionThis study shows how a simple educational intervention in perimenopausal age women with hypertension, diabetes mellitus and/or dyslipidaemia, can help control the anthropometric parameters and increase adherence to the Mediterranean diet. These results are consistent with those of other similar studies.<a class="elsevierStyleCrossRefs" href="#bib0080">6,7</a>In this study, a year after the educational intervention, women in the control group significantly increased BMI, while women in the intervention group remained stable. Another important cardiovascular risk factor at this stage is increased abdominal obesity and altered body composition. In connection with this fact, women in the control group significantly increased fat parameters (total body, visceral and trunk), waist and hip circumference. Women in the intervention group only increased significantly the amount of visceral fat. In recent years it has been established that visceral fat is more directly related to the incidence of CVD than the amount of total body fat or BMI,<a class="elsevierStyleCrossRef" href="#bib0090">8</a> therefore, which interventions favour the reduction of this dangerous parameter should be studied in greater depth.Of the 2 groups of women, only those who participated in the intervention group statistically increased adherence to the Mediterranean diet. This fact can be positively evaluated, as the Mediterranean diet has been shown to favour a reduction in cardiovascular risk biomarkers<a class="elsevierStyleCrossRef" href="#bib0095">9</a>; however, only a few studies have used the Mediterranean diet questionnaire in women of perimenopausal age. Currently, the most common health problems, such as cardiovascular disease, can be improved through changes in lifestyle.<a class="elsevierStyleCrossRefs" href="#bib0080">6,7,10</a>This study showed that with a simple educational intervention, 3 interactive talks, women responded positively, making dietary modifications that positively affected anthropometric parameters. It would be interesting to monitor these women to see if the response is maintained over time.Conflict of interestsThe authors declare no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres729244" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec733306" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres729245" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Fundamento y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec733305" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistic analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-10-27" "fechaAceptado" => "2015-12-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec733306" "palabras" => array:5 [ 0 => "Health education" 1 => "Women" 2 => "Menopause" 3 => "Cardiovascular disease" 4 => "Mediterranean diet" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec733305" "palabras" => array:5 [ 0 => "Educación en salud" 1 => "Mujeres" 2 => "Menopausia" 3 => "Enfermedad cardiovascular" 4 => "Dieta mediterránea" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Background and objectiveTo assess whether an educational intervention in perimenopausal women with hypertension, diabetes mellitus and/or dyslipidaemia would improve adherence to a Mediterranean diet pattern and achieve changes in anthropometric parameters. PatientsRandomized clinical trial of parallel groups: 320 women (45–60 years) in 2 urban primary care services. Variables studied: hip and waist circumference, body mass index (BMI), total, visceral and trunk fat (bioimpedance measures) and adherence to Mediterranean diet (MEDAS-14 questionnaire). Intervention group: 3 interactive workshops on prevention of cardiovascular disease, and control group: information by post. ResultsTwo hundred and thirty women completed the study (113 control group and 117 intervention group). The differences between groups were significant in all parameters one year later. In the intragroup comparison, the intervention group maintained their BMI and improved adherence to the Mediterranean diet. The control group increased their BMI, abdominal and hip circumference and fat parameters (total, visceral and trunk fat). ConclusionsA simple educational intervention in perimenopausal women with cardiovascular risk can improve their healthy habits." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "Fundamento y objetivoEvaluar si una intervención educativa en mujeres perimenopáusicas con hipertensión, diabetes mellitus y/o dislipidemia sería capaz de mejorar la adherencia a un patrón de dieta mediterráneo y conseguir cambios en parámetros antropométricos. PacientesEnsayo clínico aleatorizado de grupos paralelos: 320 mujeres (45-60 años) de 2 servicios de atención primaria urbanos. Variables a estudio: perímetro abdominal y de cadera, índice de masa corporal (IMC), grasa corporal total, visceral y de tronco (medidas con bioimpedancia) y adherencia a dieta mediterránea (cuestionario MEDAS-14). Grupo intervención: 3 talleres interactivos sobre prevención de enfermedad cardiovascular, y grupo control: información por correo. ResultadosConcluyeron el estudio 230 mujeres (113 en el grupo control y 117 en el grupo intervención). Un año después, las diferencias entre grupos fueron significativas en todos los parámetros. En la comparación intragrupos, las mujeres del grupo intervención mantuvieron el IMC y mejoraron la adherencia a la dieta mediterránea. El grupo control aumentó el IMC, el perímetro abdominal y de cadera y los parámetros de grasa (corporal total, visceral y tronco). ConclusionesUna sencilla intervención educativa en mujeres perimenopáusicas con riesgo cardiovascular puede mejorar sus hábitos saludables." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Fundamento y objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Soto Rodríguez A, García Soidán JL, de Toro Santos M, Lagoa Labrador F, Failde Garrido JM, Pérez Fernández MR. Beneficios de una intervención educativa en la dieta y en el perfil antropométrico de mujeres con un factor de riesgo cardiovascular. Med Clin (Barc). 2016;146:436–439." ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "MD: Mediterranean diet; BMI: body mass index.Data are expressed as mean (standard deviation)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pre-intervention</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pre-post intervention mean differences</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control group (n=113) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group (n=117) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control group (n=113) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group (n=117) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.34 (5.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.57 (5.52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.824 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.471 (1.47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.116 (1.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.018 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body fat (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.82 (9.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.84 (9.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.952 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.278 (2.93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.219 (3.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Visceral fat (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.69 (2.79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.83 (2.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.744 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.504 (0.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.222 (1.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Trunk fat (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.90 (4.63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.80 (5.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.952 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.907 (2.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.066 (1.75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal circumference (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93.44 (13.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.92 (13.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.768 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.615 (3.59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−0.068 (3.66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Waist circumference (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (9.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105.3 (10.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.621 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.792 (3.50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.034 (3.16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.034 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Adherence to MD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.96 (2.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.06 (2.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.170 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.230 (1.85) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.307 (1.91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1201860.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "p calculated using the Wilcoxon test and Student t test for 2 independent samples." ] ] ] "descripcion" => array:1 [ "en" => "Sample characteristics at baseline and mean differences contrast between the control group and the intervention group one year after the educational intervention." ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "MD: Mediterranean diet; BMI: body mass index.Data are expressed as mean (standard deviation)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control group</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group intervention</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre (n=113) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post (n=113) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre (n=117) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post (n=117) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.34 (5.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.81 (5.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.57 (5.52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.69 (5.81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.271 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body fat (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.82 (9.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.10 (9.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.84 (9.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.06 (9.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.201 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Visceral fat (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.69 (2.79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.19 (2.09) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.83 (2.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.05 (3.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.028 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Trunk fat (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.90 (4.63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.81 (5.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.80 (5.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.87 (5.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.354 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal circumference (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93.44 (13.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95.06 (13.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.92 (13.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.85 (13.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.673 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Waist circumference (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (9.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106.8 (10.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105.3 (10.60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105.4 (10.76) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.450 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Adherence to MD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.96 (2.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.109 (2.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.188 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.06 (2.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.37 (1.75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1201861.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "p calculated using the Wilcoxon test and Student t test for paired samples." ] ] ] "descripcion" => array:1 [ "en" => "Variables studied in the control and intervention groups before and after the educational intervention, and p value when making comparisons." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Defunciones por causas, sexo y edad. Defunciones según la causa de muerte del Instituto Nacional de Estadística (INE)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Ministerio de Sanidad, Servicios Sociales e Igualdad" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2012" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implicación de la progesterona en las reacciones vasomotoras de la menopausia y su relación con el riesgo cardiovascular" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.R. Checa" 1 => "C. Ortiz" 2 => "M. Leal" 3 => "J. 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Benefits of an educational intervention on diet and anthropometric profile of women with one cardiovascular risk factor

Beneficios de una intervención educativa en la dieta y en el perfil antropométrico de mujeres con un factor de riesgo cardiovascular

Anxela Soto Rodrígueza, José Luís García Soidánb, Manuel de Toro Santosc, Fiz Lagoa Labradord, José M. Failde Garridoe, María Reyes Pérez Fernándeza,

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mariareyes.perez.fernandez@sergas.es

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a Escuela Universitaria de Enfermería, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, Spain

b Universidad de Vigo, Campus Pontevedra, Pontevedra, Spain

c Servicio de Medicina Interna, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, Spain

d Unidad de Apoyo a la Investigación, Xerencia de Xestión Integrada de Ourense, SERGAS, Ourense, Spain

e Universidad de Vigo, Campus Ourense, Ourense, Spain

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    "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>"
    "titulo" => "Benefits of an educational intervention on diet and anthropometric profile of women with one cardiovascular risk factor"
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        "autoresLista" => "Anxela Soto Rodr&#237;guez, Jos&#233; Lu&#237;s Garc&#237;a Soid&#225;n, Manuel de Toro Santos, Fiz Lagoa Labrador, Jos&#233; M&#46; Failde Garrido, Mar&#237;a Reyes P&#233;rez Fern&#225;ndez"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years&#44; cardiovascular disease &#40;CVD&#41; has been the leading cause of death in women in our country&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The transition to menopause produces an acceleration of cardiovascular risk factors&#44; such as increased abdominal obesity and alterations in body composition&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Eating habits have a crucial role in these two aspects&#44; and&#44; in this sense&#44; the Mediterranean diet has proved to be one of the healthier eating models&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of this study was to assess whether an educational intervention in women of perimenopausal age with hypertension&#44; diabetes mellitus and&#47;or dyslipidaemia would be able to improve adherence to a Mediterranean diet pattern and obtain changes in certain anthropometric parameters&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">A randomized parallel group clinical trial was conducted with an educational intervention in 2 of the 5 health centres located in the city of Ourense so as to facilitate the patient selection process&#46; These 5 centres provide care to a total population of 14&#44;455 women with a health card&#44; aged between 45 and 60 years&#46; The sample size was calculated by estimating a standardized difference in mean systolic blood pressure of 4&#46;76<span class="elsevierStyleHsp" style=""></span>mmHg between the intervention and control groups&#46; Whereas the expected standard deviation in this parameter was 15&#46;2<span class="elsevierStyleHsp" style=""></span>mmHg&#44; for a confidence level of 95&#37; and a power of 80&#37;&#44; a sample of 320 women was needed&#44; allowing for a loss rate of 30&#37;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Women who had at least one diagnosed cardiovascular risk factor &#40;diabetes mellitus&#44; dyslipidaemia and&#47;or hypertension&#41;&#44; excluding those who refused to participate in it and&#47;or those who had a mental condition that would advise against their participation&#46; The study was approved by the Clinical Research Ethics Committee of Galicia&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The variables studied were&#58; age&#44; waist and hip circumference&#44; body mass index &#40;BMI&#41; and&#44; finally&#44; parameters related to body fat &#40;total&#44; visceral and trunk&#41;&#46; The latter criteria were analyzed with a bioelectrical bioimpedance device&#44; Tanita SC-330&#46; The conditions required for the measurement of these parameters were&#58; having an empty bladder before measurement&#44; not having done any physical activity for 12<span class="elsevierStyleHsp" style=""></span>h&#44; removing all kinds of metal objects or jewellery that may interfere with the measurement results and wearing light clothing&#46; Menopausal status was assessed by self-report on the regularity of their menstrual cycle&#46; Were considered menopausal those women whose menstruation had stopped for more than a year&#46; The MEDAS-14 questionnaire about adherence to the Mediterranean diet was used to assess eating habits&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Once the questionnaires and tests were performed on the entire sample&#44; an automatically generated randomization list was used to assign patients to one of the 2 groups&#46; This list was prepared by an external collaborator&#44; unfamiliar with the study &#40;technician from the Research Unit of the Cristal-Pi&#241;or Hospital of Ourense&#41;&#46; The sample was divided into intervention and control group&#46; Women in the intervention group received 3 interactive educational workshops on the prevention of CVD&#44; recommending the adoption and maintenance of healthy habits that favour a change in lifestyle&#46; The importance of following a Mediterranean diet was stressed&#44; reducing consumption of saturated fats&#44; sugar and alcohol and increasing consumption of plant foods and foods rich in polyunsaturated fatty acids&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;5</span></a> 3 workshops were held over a week&#44; with a duration of 1&#46;5<span class="elsevierStyleHsp" style=""></span>h each&#44; in groups of 15 people&#46; To encourage interaction and participation of women&#44; these workshops were organized on different days and times&#46; Moreover&#44; the control group received only a brochure mailed to their address&#44; with information on the same subject&#46; 12 months after the workshops were completed&#44; the questionnaire and anthropometric assessment was repeated on the entire sample&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistic analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">The Lilliefors test was carried out to evaluate the normality of continuous variables&#46; McNemar&#39;s test and Chi square were used for pre-post-intervention comparison between categorical variables&#59; the Student t test for independent samples and paired data was used for the study of continuous variables&#44; and in the case of not presenting a normal distribution&#44; the non-parametric Wilcoxon test was used&#46; Analyses were performed with R free software&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">Of the 320 women who started the study&#44; 230 completed it&#46; In the control group 47 subjects were lost &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41; and 43 in the intervention group &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&#59; therefore&#44; the loss percentage was 28&#46;1&#37;&#46; After studying the characteristics of patients lost during the study&#44; there was no pattern observed which would explain these losses&#46; The average age of the sample was 53&#46;17<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;31 years and the vast majority of women &#40;63&#46;48&#37;&#41; were menopausal at baseline&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Initially the homogeneity of the sample was verified after randomization of women in the 2 groups&#44; with no statistically significant differences between the control group and the intervention group &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; However&#44; one year after the training&#44; the difference between the two groups was significant in all the variables of the study &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Regarding the intragroup differences&#44; we observed that women in the control group before the educational intervention presented a BMI of 27&#46;34<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; After the intervention&#44; this increased significantly to 27&#46;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;48 <span class="elsevierStyleHsp" style=""></span>kg&#47;cm<span class="elsevierStyleSup">2</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46; Women in the intervention group had a BMI of 27&#46;57<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;52<span class="elsevierStyleHsp" style=""></span>kg&#47;cm<span class="elsevierStyleSup">2</span>&#44; and a year later their BMI was 27&#46;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;81<span class="elsevierStyleHsp" style=""></span>kg&#47;cm<span class="elsevierStyleSup">2</span>&#44; the difference not being statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;271&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">A year after the educational intervention&#44; women in the control group significantly increased the parameters of total body fat&#44; visceral fat&#44; trunk fat and waist and hip circumference &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Women in the intervention group significantly increased only the amount of visceral fat &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">It was observed that patients in the intervention group significantly improved &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; adherence to the Mediterranean diet after the educational intervention&#44; and that women in the control group maintained a similar adherence a year later &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;188&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">This study shows how a simple educational intervention in perimenopausal age women with hypertension&#44; diabetes mellitus and&#47;or dyslipidaemia&#44; can help control the anthropometric parameters and increase adherence to the Mediterranean diet&#46; These results are consistent with those of other similar studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In this study&#44; a year after the educational intervention&#44; women in the control group significantly increased BMI&#44; while women in the intervention group remained stable&#46; Another important cardiovascular risk factor at this stage is increased abdominal obesity and altered body composition&#46; In connection with this fact&#44; women in the control group significantly increased fat parameters &#40;total body&#44; visceral and trunk&#41;&#44; waist and hip circumference&#46; Women in the intervention group only increased significantly the amount of visceral fat&#46; In recent years it has been established that visceral fat is more directly related to the incidence of CVD than the amount of total body fat or BMI&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> therefore&#44; which interventions favour the reduction of this dangerous parameter should be studied in greater depth&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Of the 2 groups of women&#44; only those who participated in the intervention group statistically increased adherence to the Mediterranean diet&#46; This fact can be positively evaluated&#44; as the Mediterranean diet has been shown to favour a reduction in cardiovascular risk biomarkers<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#59; however&#44; only a few studies have used the Mediterranean diet questionnaire in women of perimenopausal age&#46; Currently&#44; the most common health problems&#44; such as cardiovascular disease&#44; can be improved through changes in lifestyle&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7&#44;10</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">This study showed that with a simple educational intervention&#44; 3 interactive talks&#44; women responded positively&#44; making dietary modifications that positively affected anthropometric parameters&#46; It would be interesting to monitor these women to see if the response is maintained over time&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interests</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2015-10-27"
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            1 => "Women"
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            1 => "Mujeres"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess whether an educational intervention in perimenopausal women with hypertension&#44; diabetes mellitus and&#47;or dyslipidaemia would improve adherence to a Mediterranean diet pattern and achieve changes in anthropometric parameters&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Randomized clinical trial of parallel groups&#58; 320 women &#40;45&#8211;60 years&#41; in 2 urban primary care services&#46; Variables studied&#58; hip and waist circumference&#44; body mass index &#40;BMI&#41;&#44; total&#44; visceral and trunk fat &#40;bioimpedance measures&#41; and adherence to Mediterranean diet &#40;MEDAS-14 questionnaire&#41;&#46; Intervention group&#58; 3 interactive workshops on prevention of cardiovascular disease&#44; and control group&#58; information by post&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Two hundred and thirty women completed the study &#40;113 control group and 117 intervention group&#41;&#46; The differences between groups were significant in all parameters one year later&#46; In the intragroup comparison&#44; the intervention group maintained their BMI and improved adherence to the Mediterranean diet&#46; The control group increased their BMI&#44; abdominal and hip circumference and fat parameters &#40;total&#44; visceral and trunk fat&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A simple educational intervention in perimenopausal women with cardiovascular risk can improve their healthy habits&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Fundamento y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar si una intervenci&#243;n educativa en mujeres perimenop&#225;usicas con hipertensi&#243;n&#44; diabetes mellitus y&#47;o dislipidemia ser&#237;a capaz de mejorar la adherencia a un patr&#243;n de dieta mediterr&#225;neo y conseguir cambios en par&#225;metros antropom&#233;tricos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ensayo cl&#237;nico aleatorizado de grupos paralelos&#58; 320 mujeres &#40;45-60 a&#241;os&#41; de 2 servicios de atenci&#243;n primaria urbanos&#46; Variables a estudio&#58; per&#237;metro abdominal y de cadera&#44; &#237;ndice de masa corporal &#40;IMC&#41;&#44; grasa corporal total&#44; visceral y de tronco &#40;medidas con bioimpedancia&#41; y adherencia a dieta mediterr&#225;nea &#40;cuestionario MEDAS-14&#41;&#46; Grupo intervenci&#243;n&#58; 3 talleres interactivos sobre prevenci&#243;n de enfermedad cardiovascular&#44; y grupo control&#58; informaci&#243;n por correo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Concluyeron el estudio 230 mujeres &#40;113 en el grupo control y 117 en el grupo intervenci&#243;n&#41;&#46; Un a&#241;o despu&#233;s&#44; las diferencias entre grupos fueron significativas en todos los par&#225;metros&#46; En la comparaci&#243;n intragrupos&#44; las mujeres del grupo intervenci&#243;n mantuvieron el IMC y mejoraron la adherencia a la dieta mediterr&#225;nea&#46; El grupo control aument&#243; el IMC&#44; el per&#237;metro abdominal y de cadera y los par&#225;metros de grasa &#40;corporal total&#44; visceral y tronco&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Una sencilla intervenci&#243;n educativa en mujeres perimenop&#225;usicas con riesgo cardiovascular puede mejorar sus h&#225;bitos saludables&#46;</p></span>"
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            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Soto Rodr&#237;guez A&#44; Garc&#237;a Soid&#225;n JL&#44; de Toro Santos M&#44; Lagoa Labrador F&#44; Failde Garrido JM&#44; P&#233;rez Fern&#225;ndez MR&#46; Beneficios de una intervenci&#243;n educativa en la dieta y en el perfil antropom&#233;trico de mujeres con un factor de riesgo cardiovascular&#46; Med Clin &#40;Barc&#41;&#46; 2016&#59;146&#58;436&#8211;439&#46;</p>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">MD&#58; Mediterranean diet&#59; BMI&#58; body mass index&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Data are expressed as mean &#40;standard deviation&#41;&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pre-intervention</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pre-post intervention mean differences</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control group &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;34 &#40;5&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;57 &#40;5&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;824&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;471 &#40;1&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;116 &#40;1&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body fat &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;82 &#40;9&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;84 &#40;9&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;952&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;278 &#40;2&#46;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;219 &#40;3&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Visceral fat &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;69 &#40;2&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;83 &#40;2&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;744&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;504 &#40;0&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;222 &#40;1&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Trunk fat &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;90 &#40;4&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;80 &#40;5&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;952&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;907 &#40;2&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;066 &#40;1&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal circumference &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#46;44 &#40;13&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92&#46;92 &#40;13&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;768&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;615 &#40;3&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;068 &#40;3&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Waist circumference &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106 &#40;9&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&#46;3 &#40;10&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;621&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;792 &#40;3&#46;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;034 &#40;3&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Adherence to MD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;96 &#40;2&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;06 &#40;2&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;230 &#40;1&#46;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;307 &#40;1&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control group</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Group intervention</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pre &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>117&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;34 &#40;5&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;81 &#40;5&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;57 &#40;5&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;69 &#40;5&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Body fat &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;82 &#40;9&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;10 &#40;9&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;84 &#40;9&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;06 &#40;9&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Visceral fat &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;69 &#40;2&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;19 &#40;2&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;83 &#40;2&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;05 &#40;3&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Trunk fat &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;90 &#40;4&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;81 &#40;5&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;80 &#40;5&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;87 &#40;5&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;354&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Abdominal circumference &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#46;06 &#40;13&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
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Article information

ISSN: 23870206
Original language: English

DOI:10.1016/j.medcle.2016.06.047

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