Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-28T13:12:58.005Z Has data issue: false hasContentIssue false

The SUN cohort study (Seguimiento University of Navarra)

Published online by Cambridge University Press:  02 January 2007

Miguel Ángel Martínez-González*
Affiliation:
Department of Preventive Medicine and Public Health, Facultad de Medicina, Clínica Universitaria, Universidad de Navarra, Irunlarrea 1, 31080, Pamplona, Spain
*
*Corresponding author: E-mail mamartinez@unav.es
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

Cohort study (the SUN project) to identify dietary determinants of hypertension, diabetes, obesity and coronary heart disease (CHD), among other conditions.

Design

The SUN project is a Mediterranean dynamic prospective follow-up (cohort) study assessing participants every 2 years. The recruitment started in 2000 and it is permanently open (this is a dynamic cohort). A preliminary case–control study of myocardial infarction was also conducted, selecting incident cases of myocardial infarction and matched hospital controls.

Setting

The SUN study is conducted in Spain with university graduates, most of them being former students of the University of Navarra. The case–control study was conducted in three tertiary hospitals in the city of Pamplona (Spain).

Subjects

The case–control study included 171 cases and 171 controls. We have currently enrolled more than 17 500 participants in the SUN cohort. Approximately 7500 of them were enrolled less than 2 years ago, and have not received yet the invitation to complete the 2-year follow-up assessment. The follow-up rate for the first 10 000 participants approaches 90%.

Results

The case–control study found inverse associations between olive oil (or adherence to a Mediterranean food pattern) and myocardial infarction. In the SUN cohort, after 28.5 months of follow-up a higher adherence to a Mediterranean food pattern rich in olive oil was associated with a reduced risk of hypertension, though the results were statistically significant only among men.

Conclusions

The SUN study and the accompanying case–control study support the benefits of a Mediterranean diet and olive oil against CHD and hypertension.

Type
Research Article
Copyright
Copyright © The Author 2006

References

1Willett, W. Nutritional Epidemiology. New York: Oxford University Press, 1998.CrossRefGoogle Scholar
2Martínez-González, MA, Estruch, R. Mediterranean diet, antioxidants, and cancer: the need for randomised trials. European Journal of Cancer Prevention 2004; 13: 327–35.CrossRefGoogle Scholar
3Jacques, PF, Tucker, KL. Are dietary patterns useful for understanding the role of diet in chronic disease? American Journal of Clinical Nutrition 2001; 73: 12.CrossRefGoogle ScholarPubMed
4Hu, FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Current Opinion in Lipidology 2002; 13: 39.CrossRefGoogle ScholarPubMed
5Jacobs, DR Jr, Steffen, LM. Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. American Journal of Clinical Nutrition 2003; 78(3 Suppl): 508S–13S.CrossRefGoogle ScholarPubMed
6Martínez-González, MA, Sánchez-Villegas, A. The emerging role of Mediterranean diets in cardiovascular epidemiology: monounsaturated fats, olive oil, red wine or the whole pattern? European Journal of Epidemiology 2004; 19: 913.CrossRefGoogle ScholarPubMed
7Trichopoulou, A, Costacou, T, Bamia, C, Trichopoulos, D. Adherence to a Mediterranean diet and survival in a Greek population. New England Journal of Medicine 2003; 348: 2599–608.CrossRefGoogle Scholar
8Martín-Moreno, JM, Boyle, P, Gorgojo, L, Maisonneuve, P, Fernández-Rodríguez, JC, Salvini, S, et al. Development and validation of a food frequency questionnaire in Spain. International Journal of Epidemiology 1993; 22: 512–9.CrossRefGoogle ScholarPubMed
9Martínez-González, MA, Sánchez-Villegas, A, De Irala, J, Martí, A, Martínez, JA. Mediterranean diet and stroke: objectives and design of the SUN project. Nutritional Neuroscience 2002; 5: 6573.CrossRefGoogle ScholarPubMed
10Sánchez-Villegas, A, de Irala-Estévez, J, Martínez-González, MA, et al. Dieta Mediterránea y enfermedad cardiovascular: resultados del estudio piloto del proyecto SUN. Revista de Medicina de la Universidad de Navarra 2002; 46: 916.Google ScholarPubMed
11Sanchez-Villegas, A, Martínez, JA, De Irala, J, Martínez-González, MA. Determinants of the adherence to an ‘a priori’ defined Mediterranean dietary pattern. European Journal of Nutrition 2002; 41: 249–57.CrossRefGoogle Scholar
12Sánchez-Villegas, A, Delgado-Rodriguez, M, Martínez-González, MA, De Irala-Estevez, J. Gender, age, socio-demographic and lifestyle factors associated with major dietary patterns in the Spanish Project SUN (Seguimiento Universidad de Navarra). European Journal of Clinical Nutrition 2003; 57: 285–92.CrossRefGoogle ScholarPubMed
13Alonso, A, de, la, Fuente, C, Martin-Arnau, AM, de Irala, JMartinez, JA, Martinez-Gonzalez, MA. Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) study. British Journal of Nutrition 2004; 92: 311–9.CrossRefGoogle Scholar
14Fernández-Jarne, E, Martínez-Losa, E, Prado-Santamaria, M, Brugarolas-Brufau, C, Serrano-Martínez, M, Martínez-González, MA. Risk of first non-fatal myocardial infarction negatively associated with olive oil consumption: a case–control study in Spain. International Journal of Epidemiology 2002; 31: 474–80.CrossRefGoogle ScholarPubMed
15Fernández-Jarne, E, Alegre Garrido, F, Alonso Gutierrez, A, de La Fuente Arrillaga, C, Martínez-González, MA. Ingesta de ácidos grasos omega 3 y riesgo de infarto de miocardio: un estudio de casos y controles. Medicina Clinica 2002; 118: 121–5.CrossRefGoogle Scholar
16Martínez-González, MA, Fernández-Jarne, E, Martínez-Losa, E, Prado-Santamaria, M, Brugarolas-Brufau, C, Serrano-Martínez, M. Role of fibre and fruit in the Mediterranean diet to protect against myocardial infarction: a case–control study in Spain. European Journal of Clinical Nutrition 2002; 56: 715–22.CrossRefGoogle ScholarPubMed
17Martínez-González, MA, Fernández-Jarne, E, Serrano-Martínez, M, Marti, A, Martínez, JA, Martín-Moreno, JM. Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score. European Journal of Nutrition 2002; 41: 153–60.CrossRefGoogle ScholarPubMed
18Hernandez-Diaz, S, Martínez-Losa, E, Fernández-Jarne, E, Serrano-Martínez, M, Martínez-González, MA. Dietary folate and the risk of nonfatal myocardial infarction. Epidemiology 2002; 13: 700–6.CrossRefGoogle ScholarPubMed
19Martínez-González, MA, Alonso, A, Fernández-Jarne, E, de Irala, J. What is protective in the Mediterranean diet? Atherosclerosis 2003; 166: 405–7.CrossRefGoogle ScholarPubMed
20Alonso, A, Fernández-Jarne, E, Serrano-Martínez, M, Martínez-González, MA. Fish and shellfish consumption in relation to death from myocardial infarction among men in Shanghai China. American Journal of Epidemiology 2003; 157: 85.CrossRefGoogle ScholarPubMed
21Fernández-Jarne, E, Martínez-Losa, E, Serrano-Martínez, M, Prado-Santamaria, M, Brugarolas-Brufau, C, Martínez-González, MA. Type of alcoholic beverage and first acute myocardial infarction: a case–control study in a Mediterranean country. Clinical Cardiology 2003; 26: 313–8.CrossRefGoogle Scholar
22Barzi, F, Woodward, M, Marfisi, RM, Tavazzi, L, Valagussa, F, Marchioli, R. GISSI-Prevenzione Investigators. Mediterranean diet and all-causes mortality after myocardial infarction: results from the GISSI-Prevenzione trial. European Journal of Clinical Nutrition 2003; 57 604–11. Erratum in: European Journal of Clinical Nutrition 2003; 57: 1034.CrossRefGoogle ScholarPubMed
23Chasan-Taber, S, Rimm, EB, Stampfer, MJ, Spiegelman, D, Colditz, GA, Giovannucci, E, et al. Reproducibility and validity of a self-administered physical activity questionnaire for male health professionals. Epidemiology 1996; 7: 81–6.CrossRefGoogle ScholarPubMed
24Ainsworth, BE, Haskell, WL, Whitt, MC, Irwin, ML, Swartz, AM, Strath, SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Medicine and Science in Sports and Exercise 2000; 32: S498S504.CrossRefGoogle ScholarPubMed
25Martínez-González, MA, Varo, JJ, Santos, JL, De Irala, J, Gibney, M, Kearney, J, et al. Prevalence of physical activity during leisure time in the European Union. Medicine and Science in Sports and Exercise 2001; 33: 1142–6.CrossRefGoogle ScholarPubMed
26Panagiotakos, DB, Pitsavos, C, Chrysohoou, C, Stefanadis, C, Toutouzas, P. Risk stratification of coronary heart disease in Greece: final results from the CARDIO2000 epidemiological study. Preventive Medicine 2002; 5: 548–56.CrossRefGoogle Scholar
27Alonso, A, Ruiz-Gutierrez, V, Martínez-González, MA. Monounsaturated fatty acids, olive oil and blood pressure: epidemiological, clinical and experimental evidences. Public Health Nutrition 2006; in press.CrossRefGoogle Scholar
28Alonso, A, Beunza, JJ, Delgado-Rodriguez, M, Martinez-Gonzalez, MA. Validation of self reported diagnosis of hypertension in a cohort of university graduates in Spain. BMC Public Health 2005; 5: 94.CrossRefGoogle Scholar
29Martinez-Gonzalez, MA, Fernandez-Jarne, E, Serrano-Martinez, M, Wright, M, Gomez-Gracia, E. Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet. European Journal of Clinical Nutrition 2004; 58: 1550–2.CrossRefGoogle Scholar
30Alonso, A, Martinez-Gonzalez, MA. Olive oil consumption and reduced incidence of hypertension: the SUN study. Lipids 2004; 39: 1233–8.CrossRefGoogle ScholarPubMed
31Psaltopoulou, T, Naska, A, Orfanos, P, Trichopoulos, D, Mountokalakis, T, Trichopoulou, A. Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. American Journal of Clinical Nutrition 2004; 80: 1012–8.CrossRefGoogle ScholarPubMed
32Ferrara, LA, Raimondi, S, D'Episcopo, l, Guilda, l, Dello Russo, A, Marotta, T. Olive oil and reduced need for antiyhypertensive medications. Archives of Internal Medicine 2000; 160: 837–42.CrossRefGoogle Scholar
33Appel, LJ, Sacks, FM, Carey, VJ, Obarzanek, E, Swain, JF, Miller, ER 3rd, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart Randomized Trial. Journal of the American Medical Association 2005; 294: 2455–64.CrossRefGoogle ScholarPubMed