Dora Romaguera Bosch, Director
Investigadora Titular
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: mariaadoracion.romaguera@ssib.es

Miquel Fiol
Investigador IdISBa emèrit
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: miguel.fiol@ssib.es

Jadwiga Konieczna
Investigadora Miguel Servet
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: jadzia.konieczna@gmail.com

Alice Chaplin
Investigadora postdoctoral contratada CIBER
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN)
a/e: alicemarylillian.chaplin@ssib.es

Ariadna Curto
Investigadora postdoctoral Sara Borrell
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: ariadna.curto@ssib.es

Mar Nafria
Investigadora predoctoral
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: mar.nafria@ssib.es

Janna Wordsworth
Investigadora predoctoral
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: jannaruby.wordsworth@ssib.es

Lara Prohens
Nutricionista de camp
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: marialara.prohens@ssib.es

Marga Morey
Data manager i Nutricionista
Institut d’Investigació Sanitària Illes Balears (IdISBa)
a/e: mmoreyservera@gmail.com

Antoni Estelrich Ballester
Dietista-Nutricionista
Grup de Recerca NUTRECOR (IdISBa)
a/e: antoni.estelrich@idisba.es

Jon Fernandez Iriarte
Dietista-Nutricionista
Grup de Recerca NUTRECOR (IdISBa)
a/e: jon.fernandez@idisba.es

Actualització de Membres del Grup: maig de 2025

El Grup de Recerca NUTRECOR és un grup multidisciplinari format per epidemiòlegs, metges, nutricionistes, i experts en ciències ambientals, que investiga cóm els estils de vida i el nostre entorn influencia l’aparició i desenvolupament de malalties cròniques a estudis epidemiològics. Les nostres exposicions d’estudi són els patrons de dieta i estil de vida, així com diferents exposicions ambientals tals com la contaminació o l’entorn obesogènic, fent servir, en alguns casos, una aproximació exposòmica. També hem desenvolupat i validat diferents cribrados de dieta i estils de vida per ser implementats a l’entorn clínic. Les patologies que estudiem són les malalties cardiovasculars, centrant-nos en la seva fisiopatologia, com són les alteracions electrocardiogràficas o ecocardiogràfiques; l’obesitat, sempre mesurada amb tècniques d’imatge (i.e. DXA, TAC) per tal de diferenciar el greix visceral, greix subcutani o la massa muscular; i el càncer, estudiant tant la seva prevenció com la millora de la qualitat de vida en pacients. Els dissenys d’estudi que emprem són assajos clínics o estudis epidemiològics.
Som un grup categoritzat com a altament competitiu dins l’IdISBa, amb finançament continuat, competitiu, nacional i internacional, amb alta capacitat de obtenció de recursos humans i formació d’investigadors, i una producció científica suficient i d’alta qualitat.

Línia: Ecografia de paret arterial carotídia i femoral: a) relacions entre l’aterosclerosi preclínica i els factors de risc cardiometabòlics i biomarcadors de la dieta habitual; b) aterosclerosi preclínica en obesitat, diabetis tipus 2, i diabetis tipus 1.
Investigador principal: Dra. Jadwiga Konieczna (ISCIII, CP24/00089)

Línia: Viabilidad, aceptabilidad y eficacia de una intervención conductual para mejorar el cumplimiento de las recomendaciones nutricionales para la prevención del cáncer en personas que asisten a programas de cribado del cáncer.
Investigador principal: Dra. Dora Romaguera (ISCIII, PI24/01647)

Línia: OHSIRIS – Open Health Space Infrastructure for Research and Industrial Services.
Investigador principal: Dra. Ariadna Curto (Spanish Ministry of Economy, TSI-100121-2024-114)

Línia: Ability of a screening tool to identify cancer survivors’ needs and concerns and improve their quality of life: a pilot feasibility study.
Investigador principal: Dra. Alice Chaplin (IdISBa, IMP23/01)

Línia: Life S-Can: “A novel clinical tool to effectively assess individual needs in cancer survivorship care and improve quality of life in cancer survivors”.
Investigador principal: Dra. Alice Chaplin (WCRF, 1167806)

Línia: Impact of the combination of LIFEstyle factors promoted for the prevention of diabetes and cardiovascular disease on changes in BODY COMposition in older adults (LIFEBODYCOM).
Investigador principal: Dr. Jadwiga Konieczna (IdISBa, IMP22/09)

Línia: Beyond the body mass index: Dynamics of bOdy coMposItioN and Obesity phenotypes and its association with health and disease (DOMINO).
Investigador principal: Dra. Dora Romaguera (MINECO, CNS2022-135862)

Línia: Development and validation of a short screener to assess adherence to nutrition-based cancer prevention recommendations.
Investigador principal: Dra. Dora Romaguera (IdISBa, SYN21/05)

Línia: Metabolómica, genómica y nutrición para la medicina personalizada de la enfermedad cardiovascular (OMIC-CARD).
Investigador principal: Dra. Dora Romaguera (ISCIII, PMP21/00079)

Línia: Dietary and lifestyle patterns and the risk of female breast cancer: systematic literature review.
Investigador principal: Dra. Dora Romaguera (WCRF, Research contract)

Konieczna J, Chaplin A, Paz-Graniel I, Croker H, Becerra-Tomás N, Markozannes G, Tsilidis KK, Dossus L, Gonzalez-Gil EM, Park Y, Krebs J, Weijenberg MP, Baskin ML, Copson E, Lewis SJ, Seidell JC, Chowdhury R, Hill L, Chan DS, Romaguera D.
Adulthood dietary and lifestyle patterns and risk of breast cancer: Global Cancer Update Programme (CUP Global) systematic literature review.
Am J Clin Nutr. 2025 Jan;121(1):14-31.
doi: 10.1016/j.ajcnut.2024.10.003.
PMID: 39489901

Background: An increasing number of studies in recent years investigate various dietary and lifestyle patterns and associated breast cancer (BC) risk. Objectives: This study aimed to comprehensively synthesize and grade the evidence on dietary and lifestyle patterns and BC risk. Methods: Databases were systematically searched up to 31 March, 2022, for evidence from randomised controlled trials and prospective cohort studies on adherence to a dietary pattern alone or in combination with lifestyle behaviors and incidence of or mortality from primary BC in adult females. Findings in all, premenopausal, and postmenopausal females were descriptively synthesized instead of meta-analyzed due to patterns heterogeneity. An independent Global Cancer Update Programme Expert Panel graded the strength of the evidence. Results: A total of 84 publications were included. Results for patterns reflecting both a healthy diet and lifestyle were more consistent than for patterns that included diet only. There was strong-probable evidence that a priori World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and American Cancer Society (ACS) dietary and lifestyle scores may reduce BC risk in all and postmenopausal females, whereas in premenopausal females, less evidence was found contributing to limited-suggestive grade. There was also a limited-suggestive evidence that adherence to the Healthy Lifestyle Index and other diet and lifestyle scores may reduce BC risk in postmenopausal females; a posteriori Western/Meat/Alcohol dietary patterns may increase BC risk in postmenopausal females; and Prudent/Vegetarian/Mediterranean dietary patterns may reduce BC risk in all females. For the remaining patterns, evidence was graded as limited-no conclusions. Conclusions: Advice to adopt combined aspects of a healthy diet and lifestyle according to WCRF/AICR and ACS scores, encouraging a healthy weight, physical activity, alcohol and smoking avoidance, and a healthy diet rich in fruits, vegetables, (whole)grains and cereals and discouraging red and processed meat, can be proposed to females to lower BC risk. This review was registered at PROSPERO as ID CRD42021270129 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021270129) on 28 August, 2021, and further updated on 4 May, 2022, in order to extend the search period. Keywords: a posteriori dietary patterns; a priori dietary patterns; breast cancer incidence; dietary and lifestyle patterns; evidence grading; hybrid dietary patterns; systematic review.

Rossello X, Ramallal R, Romaguera D, Alonso-Gómez ÁM, Alonso A, Tojal-Sierra L, Fernández-Palomeque C, Martínez-González MÁ, Garrido-Uriarte M, López L, Díaz
A, Zaldua-Irastorza O, Shah AJ, Salas-Salvadó J, Fitó M, Toledo E.
Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome.
Eur J Prev Cardiol. 2024 Mar 27;31(5):629-639.
doi: 10.1093/eurjpc/zwad380.
PMID: 38102071

Aims: To evaluate the effect of an intensive lifestyle intervention (ILI) on the structural and functional cardiac substrate of atrial fibrillation (AF) in overweight or obese people with metabolic syndrome (Mets). Methods and results: Participants of the PREvención con DIeta MEDiterranea-Plus trial (n = 6874) were randomized 1:1 to an ILI programme based on an energy-reduced Mediterranean diet, increased physical activity, and cognitive-behavioural weight management or to a control intervention of low-intensity dietary advice. A core echocardiography lab evaluated left atrial (LA) strain, function, and volumes in 534 participants at baseline, 3-year, and 5-year follow-ups. Mixed models were used to evaluate the effect of the ILI on LA structure and function. In the subsample, the baseline mean age was 65 years [standard deviation (SD) 5 years], and 40% of the participants were women. The mean weight change after 5 years was -3.9 kg (SD 5.3 kg) in the ILI group and -0.3 kg (SD 5.1 kg) in the control group. Over the 5-year period, both groups experienced a worsening of LA structure and function, with increases in LA volumes and stiffness index and decreases in LA longitudinal strain, LA function index, and LA emptying fraction over time. Changes in the ILI and control groups were not significantly different for any of the primary outcomes {LA emptying fraction: -0.95% [95% confidence interval (CI) -0.93, -0.98] in the control group, -0.97% [95% CI -0.94, -1.00] in the ILI group, Pbetween groups = 0.80; LA longitudinal strain: 0.82% [95% CI 0.79, 0.85] in the control group, 0.85% [95% CI 0.82, 0.89] in the ILI group, Pbetween groups = 0.24} or any of the secondary outcomes. Conclusion: In overweight or obese people with Mets, an ILI had no impact on the underlying structural and functional LA substrate measurements associated with AF risk. Keywords: Atrial fibrillation; Intensive lifestyle intervention; Mediterranean diet; Metabolic syndrome; Obesity.

Konieczna J, Ruiz-Canela M, Galmes-Panades AM, Abete I, Babio N, Fiol M, Martín-Sánchez V, Estruch R, Vidal J, Buil-Cosiales P, García-Gavilán JF, Moñino M, Marcos-Delgado A, Casas R, Olbeyra R, Fitó M, Hu FB, Martínez-Gonzalez MÁ, Martínez JA, Romaguera D, Salas-Salvadó J.
An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition: An Interim Subgroup Analysis of the PREDIMED-Plus Randomized Clinical Trial. 
JAMA Netw Open. 2023 Oct 2;6(10):e2337994.
doi 10.1001/jamanetworkopen.2023.37994.
PMID: 37851444

Importance: Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. Objective: To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. Design, setting, and participants: The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. Intervention: Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. Main outcomes and measures: The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imputation was performed to include data of participants lost to follow-up (intention-to-treat analyses). Results: A total of 1521 individuals were included (mean [SD] age, 65.3 [5.0] years; 52.1% men). In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, -0.94% [95% CI, -1.19 to -0.69]; 3 years, -0.38% [95% CI, -0.64 to -0.12] and visceral fat storage after 1 year, -126 g [95% CI, -179 to -73.3 g]; 3 years, -70.4 g [95% CI, -126 to -15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95% CI, 0.09%-0.60%]). The intervention group was more likely to show improvements of 5% or more in baseline body components (absolute risk reduction after 1 year, 13% for total fat mass, 11% for total lean mass, and 14% for visceral fat mass; after 3-years: 6% for total fat mass, 6% for total lean mass, and 8% for visceral fat mass). The number of participants needed to treat was between 12 and 17 to attain at least 1 individual with possibly clinically meaningful improvements in body composition. Conclusions and relevance: The findings of this trial suggest a weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity significantly reduced total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome. Continued follow-up is warranted to confirm the long-term consequences of these changes on cardiovascular clinical end points. Trial registration: isrctn.org Identifier: ISRCTN89898870.

Zamanillo-Campos R, Chaplin A, Romaguera D, Abete I, Salas-Salvadó J, Martín  , Estruch R, Vidal J, Ruiz-Canela M, Babio N, Fiol F, de Paz JA, Casas R, Olbeyra R, Martínez-González MA, García-Gavilán JF, Goday A, Fernandez-Lazaro CI, Martínez JA, Hu FB, Konieczna J. Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators.  Clin Nutr. 2022 Oct;41(10):2264-2274.
doi: 10.1016/j.clnu.2022.08.008.
PMID: 36084360

Background & aims: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. Methods: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. Results: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (β -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. Conclusions: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. Trial registration: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered. Keywords: Adiposity distribution; Carbohydrate quality index; Carbohydrates; DXA; Diet quality; Visceral fat.

Konieczna J, Morey M, Abete I, Bes-Rastrollo M, Ruiz-Canela M, Vioque J, Gonzalez-Palacios S, Daimiel L, Salas-Salvadó J, Fiol M, Martín V, Estruch R, Vidal J, Martínez-González MA, Canudas S, Jover AJ, Fernández-Villa T, Casas R, Olbeyra R, Buil-Cosiales P, Babio N, Schröder H, Martínez JA, Romaguera D; PREDIMED-Plus investigators.
Contribution of ultra-processed foods in visceral fat deposition and other adiposity indicators: Prospective analysis nested in the PREDIMED-Plus trial.
Clin Nutr. 2021 Jun;40(6):4290-4300.
doi: 10.1016/j.clnu.2021.01.019.
PMID: 33610419.

Background & aims: Ultra-processed food and drink products (UPF) consumption has been associated with obesity and its-related comorbidities. Excess of visceral fat, which appears with increasing age, has been considered as the culprit contributing to adiposity-associated adverse health outcomes. However, none of previous studies elucidated the link between UPF and directly quantified adiposity and its distribution. We aimed to prospectively investigate the association between concurrent changes in UPF consumption and objectively assessed adiposity distribution. Methods: A subsample of 1485 PREDIMED-Plus participants (Spanish men and women aged 55-75 years with overweight/obesity and metabolic syndrome) underwent body composition measurements. Consumption of UPF at baseline, 6 and 12 months was evaluated using a validated 143-item semi-quantitative Food Frequency Questionnaire. Food items (g/day) were categorized according to their degree of processing using NOVA system. Regional adiposity (visceral fat (in g) and android-to-gynoid fat ratio) and total fat mass (in g) at three time points were measured with dual-energy X-ray absorptiometry (DXA) and were normalized using sex-specific z-scores. The association of changes in UPF consumption, expressed as the percentage of total daily intake (daily g of UPF/total daily g of food and beverage intake∗100), with adiposity changes was evaluated using linear mixed-effects models. Results: On average, the consumption of UPF accounted for 8.11% (SD 7.41%) of total daily intake (in grams) at baseline. In multivariable-adjusted model, 10% daily increment in consumption of UPF was associated with significantly (all p-values <0.05) greater accumulation of visceral fat (β 0.09 z-scores, 95% CI 0.05; 0.13), android-to-gynoid fat ratio (0.05, 0.00; 0.09) and total fat (0.09, 0.06; 0.13). Conclusion: A higher consumption of UPF was associated with greater age-related visceral and overall adiposity accumulation. Further studies are warranted to confirm these results in other populations and settings. Trial registration: The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered. Keywords: Adiposity distribution; DXA; The PREDIMED-Plus trial; Ultra-processed foods; Visceral fat.

Institut d’Investigació Sanitària Illes Balears (IDISBA)
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN)