The cardiovascular effects of recreational cannabis use on arterial stiffness in young adults remain poorly understood. This study aimed to examine the association between cannabis use and arterial stiffness parameters in a young adult population. A descriptive, cross-sectional observational study was conducted. Using non-probabilistic consecutive sampling, 501 participants (222 men and 279 women) aged 18 to 34 years were recruited from an urban setting. Cannabis use was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST V3.0). Arterial stiffness was evaluated via pulse pressure (PP), carotid–femoral pulse wave velocity (cf-PWV), brachial–ankle pulse wave velocity (ba-PWV), cardio–ankle vascular index (CAVI), and heart rate–corrected central augmentation index (CAIx75). Trial registration clinicalTrials.gov identifier: [NCT05866133], registered on July 29, 2023. The mean age of cannabis users was significantly lower than that of non-users (24.83 ± 4.84 vs. 26.74 ± 4.33 years; P = 0.008). No significant differences in arterial stiffness parameters were observed between non-users and cannabis users in the overall cohort or when stratified by sex. However, in the linear regression analysis adjusted for age and sex, we found a positive association between cannabis use and CAIx75 (β 13.682, 6.646–20.719, P < 0.05), which persisted after adjusting for the remaining lifestyle confounding factors (β 10.097, 2.697–17.497, P < 0.05). In the binary logistic regression models, no associations were observed between past or recent cannabis use and arterial stiffness parameters. No significant differences in arterial stiffness parameters were found based on cannabis use. In the linear regression analysis, after adjusting for age, sex, and lifestyle factors, a positive association between cannabis use and CAIx75 was observed. This isolated finding concerning CAIx75 may reflect a subtle functional or hemodynamic difference rather than established structural arterial stiffening. However, residual confounding and the possibility of a chance finding cannot be ruled out.

Background: Arterial stiffness (AS) is a key marker of vascular aging and an independent predictor of cardiovascular risk. Although diet has been proposed as an important modifiable factor influencing vascular health, the independent associations between specific macronutrients and minerals and the progression of arterial stiffness remain insufficiently characterized. Objective: The aim of this longitudinal study was to evaluate the independent associations of baseline dietary macronutrient and mineral intake with the 5-year progression of arterial stiffness (assessed via carotid-femoral pulse wave velocity (cfPWV) and cardio-ankle vascular index (CAVI) in adults without prior cardiovascular disease. Methods: This longitudinal study included 466 participants from the EVA study who were evaluated at baseline and after a five-year follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Arterial stiffness was assessed using cfPWV and CAVI. Dietary intake of macronutrients and minerals was estimated using the EVIDENT smartphone application. Multivariable linear regression models were used to examine the association between nutrient intake and arterial stiffness progression. Model 1 was adjusted for age and sex, and Model 2 was additionally adjusted for lifestyle variables and cardiovascular risk factors. Dietary intake was exclusively documented at baseline using a 3-day dietary record, while arterial stiffness parameters (cfPWV and CAVI) were assessed both at baseline and at the five-year follow-up. Results: Higher dietary fiber intake was independently associated with a lower increment in cfPWV after full adjustment (β = -0.025; 95% CI (confidence interval): -0.046 to -0.005). Alcohol intake showed a positive association with CAVI increment in the fully adjusted model (β = 0.020; 95% CI: 0.006 to 0.034). Iron intake was also independently associated with increased CAVI (β = 0.022; 95% CI: 0.004 to 0.041). Carbohydrate intake showed a small positive association with CAVI, whereas no consistent independent associations were observed for other macronutrients or minerals. Conclusions: In this adult population without previous cardiovascular disease, higher dietary fiber intake was associated with lower progression of central arterial stiffness, whereas alcohol and iron intake showed positive associations with peripheral arterial stiffness. Overall, most nutrients were not independently related to arterial stiffness after comprehensive adjustment. These findings suggest that selected dietary components may contribute modestly to vascular aging.

Background: Arterial stiffness is a key marker of vascular aging and an independent predictor of cardiovascular risk. Although diet has been proposed as an important modifiable factor influencing vascular health, the independent associations between specific macro- and micronutrients and the progression of arterial stiffness remain insufficiently characterized. Objective: To evaluate the association between dietary macronutrient and micronutrient intake and changes in arterial stiffness over a five-year follow-up in adults without previous cardiovascular disease. Methods: This longitudinal study included 466 participants from the EVA study who were evaluated at baseline and after a five-year follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Arterial stiffnes was assessed using carotid–femoral pulse wave velocity (cfPWV) and the cardio-ankle vascular index (CAVI). Dietary intake of macronutrients and micronutrients was estimated using the EVIDENT smartphone application. Multivariable linear regression models were used to examine the association between nutrient intake and arterial stiffness progression. Model 1 was adjusted for age and sex, and Model 2 was additionally adjusted for lifestyle variables and cardiovascular risk factors. Results: Higher dietary fiber intake was independently associated with a lower increment in cfPWV after full adjustment (β = −0.025; 95% CI: −0.046 to −0.005). Alcohol intake showed a positive association with CAVI increment in the fully adjusted model (β = 0.020; 95% CI: 0.006 to 0.034). Iron intake was also independently associated with increased CAVI (β = 0.022; 95% CI: 0.004 to 0.041). Carbohydrate intake showed a small positive association with CAVI, whereas no consistent independent associations were observed for other macro- or micronutrients. Conclusions: In this adult population without previous cardiovascular disease, higher dietary fiber intake was associated with lower progression of central arterial stiffness, whereas alcohol and iron intake showed positive associations with peripheral arterial stiffness. Overall, most nutrients were not independently related to arterial stiffness after comprehensive adjustment. These findings suggest that selected dietary components may contribute modestly to vascular aging.

Background/Objectives: Problematic digital technology use may be associated with unhealthy dietary behaviors, but different forms of digital dependence may not relate to diet quality in the same way. This study examined the association between Mediterranean diet adherence and problematic smartphone, Internet, and video game use in young adults. Methods: A cross-sectional study was conducted in 496 adults aged 18-34 years participating in the EVA-Adic study. Mediterranean diet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). Problematic digital use was evaluated using the EDAS-18 for smartphone dependence, the Compulsive Internet Use Scale (CIUS), and the Questionnaire of Experiences Related to Video Games (CERV). Multivariable regression models were adjusted for sociodemographic, anthropometric, and lifestyle factors. Results: Of the participants, 339 had low-to-moderate Mediterranean diet adherence, and 157 had high adherence. In fully adjusted models, higher EDAS-18 scores were associated with lower MEDAS scores (β = -0.022; 95% CI: -0.041 to -0.003), whereas higher CIUS scores showed a small positive association with MEDAS scores (β = 0.025; 95% CI: 0.002 to 0.049). CERV scores and the global digital addiction index were not associated with overall Mediterranean diet adherence. At the individual dietary-component level, higher smartphone dependence was associated with lower compliance with fruit and sugar-sweetened beverage recommendations. Conclusions: In this cross-sectional sample of young adults, smartphone dependence and compulsive Internet use showed small associations with Mediterranean diet adherence in opposite directions, whereas problematic video-game use and the exploratory global composite were not associated with the overall MEDAS-14 score. The magnitude of the observed associations was modest; their clinical and public-health relevance remains uncertain, and the component-level findings should be considered exploratory in the context of multiple testing. These results do not establish causality and require confirmation in longitudinal, multicenter studies using objective and context-specific measures of digital use.

Long COVID is clinically heterogeneous, and reproducible biomarker patterns remain limited. This cross-sectional study aimed to identify clinical-cognitive profiles in 304 patients with long COVID and examine their associations with inflammatory-endothelial biomarkers and intermediate vascular measures. Latent profile analysis was performed using cognitive, subjective memory, fatigue, sleep, pain, affective, frailty, dyspnea, functional and health-related quality-of-life indicators. Associations between retained profiles and biomarkers or vascular variables were examined using linear models adjusted for age, sex, educational level and body mass index. A four-profile solution was retained, comprising a low global burden profile (42.1%), an intermediate affective-mental profile (22.1%), a high multisystem burden profile (17.9%) and an intermediate physical-functional profile (17.9%), with mean posterior probabilities from 0.924 to 0.965. The two intermediate profiles showed a cross-over SF-36 pattern, with lower MCS and relatively preserved PCS in the affective-mental profile and the reverse pattern in the physical-functional profile. Profiles were associated with ICAM-1, F(3,267) = 5.84, BH-adjusted p = .008, partial ηp2 = .065, but not with vascular measures. ICAM-1 remained significant across analyses accounting for classification uncertainty, whereas the endothelin-1 finding was not consistently reproduced. These findings support latent phenotyping as a descriptive strategy for organising long COVID heterogeneity and identify ICAM-1 as the principal hypothesis-generating inflammatory-endothelial correlate of the clinical profiles.

Introduction:While the deterioration in the general health of patients with long COVID (LC) is well documented, no studies have assessed changes in medication use and their relationships with vascular health. This study aimed to evaluate the increase in the use of various drug classes in LC and its relationship with vascular structure and function. Methods:Each participant in the sample of 305 subjects diagnosed with LC completed a questionnaire on medication use, verified in medical records. Pre-pandemic and current drug use were recorded. Arterial stiffness was measured with the VaSera device, which estimates the cardio-ankle vascular index and brachial-ankle pulse wave velocity (ba-PWV); carotid-femoral pulse wave velocity was determined using the Sphygmocor device. Vascular structure was assessed by carotid intima-media thickness (c-IMT), measured with a Sonosite Micromax ultrasound. This analysis focuses exclusively on macrovascular parameters. Statistical analyses were performed with SPSS software. Results:Use of all classes of medication increased. Patients with a greater rise in drug use after an LC diagnosis showed higher vascular parameters. Greater cardiovascular drug use was positively associated with ba-PWV, an indicator of arterial stiffness (β = 0.301, 95%CI: 0.024-0.577). Increased anti-inflammatory/analgesic drug use was positively associated with c-IMT, a marker of vascular wall thickness (β = 0.012, 95%CI: 0.001-0.023). Conclusions:Medication use rose from 2019 to the time of inclusion in the study. The increase in cardiovascular and anti-inflammatory/analgesic drug use was positively associated with ba-PWV and c-IMT, respectively, suggesting a link between greater drug use and impaired vascular health in LC.

BACKGROUND:Evidence from prospective studies on the relationship of the dietary vitamin intake and the progression of central and peripheral arterial stiffness remains limited. OBJECTIVE:To evaluate the association between dietary vitamin intake with the changes in central and peripheral arterial stiffness over a five-year follow-up in adults without previous cardiovascular disease. METHODS:This five-year longitudinal study included 466 participants from the EVA study who were evaluated at baseline and follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Central arterial stiffness was assessed using carotid-femoral pulse wave velocity (cfPWV), and peripheral arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). Dietary vitamin intake was estimated using the EVIDENT smartphone application, developed and validated by CGB and the Salamanca Primary Care (APISAL; registration number 00/2014/2207). RESULTS:In multivariable linear regression analyses adjusted for age, sex, lifestyle factors, and cardiovascular risk factors, greater increases in cfPWV were inversely associated with vitamin B9 (folate) intake (β = -0.233; 95% CI: -0.390 to -0.075) and vitamin C intake (β = -0.291; 95% CI: -0.507 to -0.075). Similarly, increases in baPWV were inversely associated with vitamin B9 intake (β = -0.156; 95% CI: -0.287 to -0.025) and vitamin C intake (β = -0.223; 95%CI: -0.402 to -0.044). CONCLUSIONS:The progression of central and peripheral arterial stiffness over five years was greater in individuals with lower dietary intakes of vitamin B9 and vitamin C. These findings provide novel evidence supporting the possible role of dietary vitamin intake in the progression of arterial stiffness with aging.

Background: Long COVID (LC) has been associated with persistent inflammation and endothelial dysfunction. Dietary components, particularly vitamins, are involved in inflammation, oxidative stress, and vascular homeostasis, and may influence arterial stiffness in this population. However, the relationship between dietary vitamin intake and vascular stiffness parameters in patients with LC remains poorly understood. Objective: To analyze the association between dietary vitamin intake and central and peripheral arterial stiffness, evaluated by carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV), in patients with LC. Methods: We conducted a cross-sectional study that included 304 patients with LC. Dietary vitamin intake was assessed using a validated 7-day dietary record (EVIDENT tool). Vascular assessment included cfPWV and baPWV, measured using validated devices (SphygmoCor® and VaSera®). Multiple linear regression analyses were performed to evaluate the associations between vitamin intake and vascular parameters. Model 1 was adjusted for age and sex, while Model 2 additionally included the number of metabolic syndrome components, the SF-36 general health domain, and adherence to the Mediterranean diet. Correction for multiple comparisons was performed using the Benjamini-Hochberg procedure across 36 vitamin-outcome-model contrasts. Results: The mean age was 52.78 ± 11.91 years, and 207 participants were women (68.1%); men were older than women (p = 0.004). In multiple regression analysis, inverse estimates for vitamin B1 intake with cfPWV were observed in both Model 1 (β = -0.568; 95% CI: -1.016 to -0.119; p = 0.014) and Model 2 (β = -0.491; 95% CI: -0.923 to -0.059; p = 0.027). Vitamin B6 intake showed a similar pattern with cfPWV in Model 1 (β = -0.312; 95% CI: -0.606 to -0.018; p = 0.039) and Model 2 (β = -0.302; 95% CI: -0.586 to -0.018; p = 0.038). Vitamin B2 showed inverse but non-significant associations with cfPWV. No significant associations were observed between vitamin intake and baPWV. After FDR correction, no vitamin-arterial stiffness association remained statistically significant; the FDR-adjusted q-value for the B1/B6-cfPWV estimates was 0.347. Conclusions: In this exploratory cross-sectional study, habitual food-based vitamin intake was not significantly associated with central or peripheral arterial stiffness after correction for multiple comparisons. Vitamins B1 and B6 showed inverse nominal estimates with cfPWV; however, these estimates did not survive FDR correction and were not reproduced for baPWV. Longitudinal studies incorporating biochemical micronutrient markers, medication and supplementation data, inflammatory and homocysteine-related biomarkers, and repeated vascular assessment are needed to clarify whether vitamin status is related to vascular health among individuals with persistent post-COVID-19 symptoms.

Background/Objectives: Gambling disorder is recognized as a behavioral addiction, and gambling-related problems represent an important public health concern among young adults. However, evidence regarding their association with overall diet quality, particularly adherence to the Mediterranean diet (MedDiet), remains scarce. This exploratory secondary analysis examined whether screening indicators of gambling-related problems were associated with MedDiet adherence in young adults. Methods: We conducted a cross-sectional analysis of 496 participants aged 18–34 years from the EVA-Adic study. MedDiet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14). Gambling-related indicators were assessed using the Short Pathological Gambling Questionnaire (CBJP), the Lie/Bet Questionnaire, and their six individual items. Independent multiple linear regression models were fitted for each indicator. The fully adjusted Model 2 included age, sex, alcohol consumption, sleep quality, sitting time, marital status, and educational level. Given the secondary nature of the analysis, the absence of an a priori sample-size calculation for the present research question, and the limited number of participants with positive gambling-related indicators, the analyses were considered exploratory and hypothesis-generating rather than confirmatory. Results: The mean age was 26.60 ± 4.41 years; 276 participants (55.6%) were women, and 157 (31.7%) had high MedDiet adherence. In the fully adjusted Model 2, feeling guilty about gambling (Q2) was nominally associated with a lower MEDAS-14 score (B = −1.10; 95% CI, −1.97 to −0.22; p = 0.015). However, this association did not remain statistically significant after Benjamini–Hochberg correction (q = 0.116), and none of the eight primary Model 2 associations met the FDR-adjusted significance threshold. Conclusions: Several gambling-related screening indicators showed nominal inverse associations with MedDiet adherence, with gambling-related guilt showing the most consistent estimate across sensitivity analyses. However, no association remained statistically significant in the fully adjusted model after correction for multiple testing, and formal interaction analyses provided no robust evidence of effect modification by sex. Given the small number of positive screens and the cross-sectional design, these findings should be considered exploratory and hypothesis-generating.

Background/Objectives: Long COVID (LC) is associated with more than 200 symptoms. This study aimed to evaluate the correlation between symptoms clusters and pharmacological treatment in patients with LC and to explore differences by sex. Methods: We conducted a cross-sectional descriptive study including 304 participants diagnosed with LC according to the World Health Organization criteria. Symptoms during the acute phase, at the time of diagnosis of LC, and those persisting across both phases were collected by anamnesis. Symptoms were grouped into six clusters: systemic, neurocognitive, respiratory/cardiovascular, musculoskeletal, neurological/neuromuscular, and psychological/psychiatric. Drug use was assessed through a questionnaire verified by the medical records, including the consumption of cardiovascular drugs, antidepressants/anxiolytics, and anti-inflammatory/analgesics. Results: Patients reported a mean of 5.23 ± 1.10 symptoms in the acute phase, 4.20 ± 1.70 at LC diagnosis, and 3.83 ± 1.80 persisting across both phases. The most consumed pharmacological group was cardiovascular drugs (43.3%), followed by antidepressants/anxiolytics (34.8%). Psychotropic drugs and anti-inflammatory/analgesic drugs showed a positive association with all symptomatic groups (p < 0.05). Cardiovascular drugs showed a positive association with cardiorespiratory (β = 0.19, p < 0.05), neuromuscular (β = 0.11, p < 0.05), and psychological (β = 0.14, p < 0.05) symptoms. Conclusions: Psychotropic and anti-inflammatory/analgesic drugs were positively associated with all symptom clusters, while cardiovascular drugs were associated only with cardiorespiratory, neuromuscular, and psychological symptoms, highlighting the relevance of better characterization of treatment patterns in this population.

Background: Long COVID (LC) has been associated with persistent endothelial dysfunction and vascular impairment. Although nutrition is a key modifiable determinant of cardiovascular health, the relationship between dietary macronutrient intake and vascular alterations in LC remains poorly understood. Objective: To evaluate the association between dietary macronutrient intake and markers of vascular structure, arterial stiffness, and vascular aging in patients with LC, including potential sex differences. Methods: We conducted a cross-sectional study including 304 patients with LC. Dietary intake was assessed using a validated 7-day dietary record (EVIDENT study). Vascular evaluation included carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), augmentation index adjusted to a heart rate of 75 beats per minute (AIx@75), and vascular aging index (VAI), measured using carotid ultrasound and validated devices (SphygmoCor® and VaSera®). Results: The mean age was 53 ± 12, higher in men (p = 0.001). The study included 207 women (68%) and 97 men (32%). Energy intake and carbohydrate intake in g/day showed a negative association with cfPWV in Model 2 (energy intake: β = -0.06; 95% CI: -0.11 to -0.01; p = 0.02; carbohydrate intake: β = -0.47; 95% CI: -0.87 to -0.07; p = 0.02). The percentage of carbohydrate/total energy intake was positively associated with AIx@75 in Model 2 (β = 0.8; 95% CI 0.12 to 1.49; p = 0.02), and percentage of fat/total energy intake showed a consistent inverse association (β = -0.30; 95% CI: -0.49 to -0.11; p = 0.002). No significant associations were observed for cIMT, baPWV, CAVI or VAI. Conclusions: In patients with LC, total energy intake and absolute carbohydrate intake were negatively associated with cfPWV, whereas the relative contribution of carbohydrates and fats to total energy intake showed divergent associations with AIx@75. These findings suggest that both absolute macronutrient intake and relative macronutrient distribution may be related to central arterial stiffness and wave reflection parameters LC. However, given the cross-sectional design of the study, these results should be interpreted as exploratory and do not allow causal inference. Further longitudinal and interventional studies are needed to confirm these findings and to assess whether nutritional strategies may contribute to modulating vascular risk in this population.

Background Long COVID (LC) and Chronic Fatigue Syndrome (CFS) share clinical features and are associated with reduced quality of life and functional impairment. However, the additional burden of LC–CFS overlap remains limited. We aimed to assess the prevalence of LC–CFS overlap and its association with health-related quality of life (HRQoL) and health status outcomes, including sex differences. Methods Cross-sectional study including 304 participants with LC. CFS was diagnosed using Fukuda criteria. Health status and HRQoL were assessed with Short Form-36 Survey (SF-36), Goldberg’s Anxiety and Depression Scale (GADS), Post-COVID19 Functional Scale (PCFS), Spanish Chronic Pain Grade Scale (SCPGS), modified Medical Research Council Dyspnea Scale (mMRC) and Malnutrition Universal Screening Tool (MUST). Group comparisons and adjusted regression models were performed. In addition, a sex-by-LC-CFS overlap interaction term was included in all regression models. Results 171 subjects (56.3%) met LC-CFS overlap, more frequently in women (63.8% vs 40.2%). CFS overlap group was related with worse outcomes compared with those with LC alone in most of health questionnaires, including SF-36, GADS, SCPGS, PCFS and mMRC. Compared with LC alone, LC-CFS overlap was associated with poorer scores in SF-36 physical and mental health components (PCS: B=-9.73, MCS: B=-5.36), anxiety (B = 2.02), depression (B = 2.83,95), SCPGS (B = 12.56), PCFS A component (OR = 13.98) and B component (OR 11.27), and mMRC (OR = 7.17). No association was found with MUST or sex interaction. Conclusions Over half of participants met criteria for LC–CFS overlap, more frequently in women. This subgroup showed worse HRQoL and health status. Identifying overlap in Primary Care may improve risk stratification and support targeted management strategies. Trial registration: This study was carried out with data from subjects of BioICOPER project. The study protocol has been published, and it has been registered in ClinicalTrials.gov in April 2023 with the registration number NCT05819840.

Background: The relationship between alcohol consumption and vascular function remains controversial. This study aimed to examine the association between total alcohol intake, type of alcoholic beverage, and arterial stiffness across different vascular territories in young Spanish adults, with special attention to sex-specific patterns. Methods: A descriptive cross-sectional study was conducted. Using consecutive non-probability sampling, 501 participants (222 men and 279 women) aged 18-34 years, were recruited from the urban population of Salamanca. Alcohol consumption was assessed using a standardized questionnaire and quantified in grams per week overall and by different types of drinks (wine, beer or spirits drinks). Arterial stiffness was evaluated using pulse pressure (PP), carotid-femoral pulse wave velocity (cf-PWV), brachial-ankle pulse wave velocity (ba-PWV), cardio-ankle vascular index (CAVI), and central augmentation index corrected to a heart rate of 75 beats per minute (CAIx75). Results: The mean age of the sample was 26.58 ± 4.40 years, and was significantly higher in men than in women (27.04 ± 4.41 vs. 26.22 ± 4.37 years; p = 0.040). The mean values for vascular function parameters were as follows: PP 42.86 ± 8.45 mmHg, cf-PWV 5.60 ± 1.29 m/s, ba-PWV 38 10.80 ± 1.01 m/s, CAVI 6.13 ± 0.75, and CAIx75 7.71 ± 19.74. Participants reporting alcohol consumption showed lower ba-PWV values compared with abstainers, while no consistent associations were observed for central arterial stiffness parameters. In sex-stratified analyses, higher total alcohol intake (β = -0.002, 95% CI: -0.004--0.001), as well as beer (β = -0.004, 95% CI: -0.007--0.001), and spirit consumption (β = -0.004, 95% CI: -0.006--0.001), were inversely associated with ba-PWV exclusively in men. In women, spirit consumption was positively associated with CAIx75 (β = 0.044, 95% CI: 0.006-0.081). The magnitude of the observed differences in ba-PWV was modest and occurred in a predominantly low-risk population. Conclusions: In young adults, alcohol consumption was associated with differences in peripheral arterial stiffness, primarily reflected by ba-PWV, with clear sex-specific patterns. These findings do not support a causal or protective effect of alcohol consumption and should be interpreted cautiously due to the cross-sectional design of the study. The results highlight the importance of considering sex and vascular territory when evaluating early markers of vascular aging in young populations. Clinical trial registration: [ClinicalTrials.gov], identifier [NCT05819840].

Background/Objectives: The Mediterranean diet (MedDiet) is a protective nutritional model against cardiometabolic risk, but current sociodemographic changes have favoured the abandonment of this pattern in favour of sedentary behaviours and increasing digitalisation. Screen-related behavioral addictions represent an emerging challenge for public health and nutritional psychiatry. However, scientific evidence on how different digital dependence profiles influence young adults’ diets remains scarce. The aim of this study was to evaluate the relationship between adherence to the Mediterranean diet and various dimensions of problematic screen use (smartphone dependence, compulsive internet use, and problematic experiences with video games) in a sample of young adults. Methods: Observational, descriptive and cross-sectional study conducted in 496 young adults between 18 and 34 years of age enrolled in the EVA-Adic study. Adherence to the MedDiet was assessed using the 14-item MEDAS questionnaire. Digital addictions were determined using three continuously validated psychometric instruments: the EDAS-18 scale (smartphone), the CIUS questionnaire (internet) and the CERV questionnaire (video games), also generating a Global Digital Addiction index. Hierarchical multivariate linear regression models (adjusted for sociodemographic, anthropometric and lifestyle factors) and binary logistic regression models were performed to analyze each component of the MEDAS individually. Results: The mean age of the 496 subjects analyzed was 26.60 ± 4.41 years. 339 subjects had low-moderate adherence (< 9) and 157 high adherence (≥ 9). The mean values of the psychometric scales of digital addiction were: smartphone dependence: 40.87 ± 12.24 points, for compulsive use of the internet: 13.83 ± 9.89 points, for video game dependence: 3.54 ± 5.22 points, and the global digital addiction index: 58.25 ± 21.76 points. In the multivariate linear regression analysis in the total fit model, smartphone dependence (EDAS-18) was inversely associated with the MEDAS score (β = -0.021 {95% CI} [-0.041 -0.003]). Problematic internet use (CIUS) showed a positive association with dietary adherence (β = 0.025 {95% CI} [0.002, 0.049]). Problematic experiences with video games (CERV) and the global digital addiction index did not demonstrate an association. In the logistic regression analysis of each of the components of the MEDAS: each one-point increase on the EDAS-18 scale reduced the probability of meeting the fruit consumption criterion ≥3 pieces/day (OR = 0.980); the criterion of low consumption of sugary beverages or less than one per day (OR = 0.956) and was linked to a higher probability of meeting the criterion of using olive oil as the main cooking fat (OR = 1.026). Compulsive use of the Internet (CIUS): A higher score on the CIUS scale decreased the probability of registering a low consumption of sugary drinks (OR = 0.955); positive association with compliance with olive oil consumption ≥ 4 tablespoons/day (OR = 1.035) and with the consumption of sofrito ≥ 2 times/week (OR = 1.026). Conclusions: The results of this study suggest that digital addictive behaviors are differentially associated with the quality of the Mediterranean diet. Higher smartphone addiction risk was associated with lower adherence to the Mediterranean diet, which may reflect a less healthy behavioral pattern linked to problematic mobile phone use. In contrast, problematic internet use may represent a different profile in relation to dietary habits, possibly influenced by the type of digital use, the context of exposure, or the characteristics of the participants evaluated. These findings reinforce the need to analyze different forms of digital addiction separately, rather than treating them as a homogeneous phenomenon, and suggest that interventions aimed at improving adherence to healthy dietary patterns should include the assessment of digital behavior.

Background/Objectives: Long COVID-19 (LC) has been associated with persistent inflammation and impaired vascular health. Dietary minerals are involved in oxidative stress, endothelial homeostasis, and arterial stiffness; however, their relationship with vascular health in LC remains poorly explored. This study aimed to examine the association between energy-adjusted dietary mineral intake and markers of vascular stiffness and vascular aging in adults with LC, while exploring potential sex-specific patterns. Methods: A total of 304 adults with LC from the BioICOPER study were included. Dietary mineral intake was assessed using a validated 7-day dietary record from the EVIDENT tool and expressed as mineral density per 1000 kcal for the regression analyses. Vascular assessment included carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), brachial-ankle pulse wave velocity (baPWV), and the vascular aging index (VAI). Hierarchical multivariable linear regression models, false discovery rate (FDR) correction, restricted cubic spline analyses, sensitivity analyses excluding supplement users, and formal sex × mineral interaction tests were performed. Results: In descriptive adequacy analyses, adequate iron intake was associated with lower baPWV. In energy-adjusted linear regression models, no mineral-outcome association remained statistically significant after FDR correction. In the fully adjusted sensitivity model, zinc density showed a nominal positive association with cfPWV, but this association did not survive FDR correction. Restricted cubic spline analyses suggested possible non-linear associations of magnesium and potassium density with cfPWV and VAI. Formal interaction analyses did not provide robust evidence of sex-related effect modification. Conclusions: After energy adjustment and correction for multiple testing, the evidence for independent linear associations between dietary mineral density and vascular outcomes in adults with LC was limited. These exploratory findings suggest that mineral intake, dietary sources, and non-linear patterns deserve further evaluation in prospective studies and nutritional intervention trials.

Background: Long COVID is characterised by persistent symptoms after SARS-CoV-2 infection, and its impact on cardiovascular health is a growing concern. This study aimed to evaluate the association between the presence and severity of metabolic syndrome and vascular structural and functional in patients with long COVID. Methods: We conducted a cross-sectional study of 304 adults diagnosed with long COVID. Vascular health was assessed using carotid intima-media thickness to evaluate arterial structure, and pulse wave velocity to assess arterial stiffness. Metabolic syndrome was defined according to international criteria. Multiple regression models were performed to analyse the association between the number of metabolic syndrome components and vascular parameters, adjusting for age, sex, lifestyle and pharmacological treatments. Results: All vascular measures show a positive association with artery pressure. All measures except cardio-ankle vascular index were positively associated with the number of metabolic syndrome components. Carotid intima-media thickness, carotid-femoral pulse wave velocity and vascular ageing index were positively associated with waist circumference. Brachial-ankle pulse wave was positively associated with all metabolic syndrome components and showed an inverse association with HDL-cholesterol. Cardio-ankle vascular index was inversely associated with waist circumference. Conclusions: In conclusion, among adults with long COVID, metabolic syndrome and the accumulation of its components are associated with poorer vascular structure, function, and vascular ageing.

Background: The relationship between alcohol consumption and vascular structure and arterial stiffness is not clear, especially in people diagnosed with persistent COVID. The aim of this study was to evaluate how alcohol use is related to vascular structure and arterial stiffness in adults with persistent COVID. Methods: A descriptive cross-sectional study was conducted involving 305 individuals (97 men and 208 women) diagnosed with persistent COVID according to the WHO criteria. Arterial stiffness was assessed by measuring the cardio-ankle vascular index (CAVI) and the brachial-ankle pulse wave velocity (ba-PWV) with a VaSera VS-1500 device, and the carotid-femoral pulse wave velocity (cf-PWV) with a Sphygmocor device. Vascular structure was assessed by measuring carotid intima-media thickness (c-IMT) with a Sonosite Micromax ultrasound unit. Alcohol intake was calculated using a standardized questionnaire and quantified in g/week. Results: Mean alcohol intake was 29 ± 53 g/week (men 60 ± 76 g/w and women 15 ± 27 g/w; p < 0.001). Heavy drinkers showed higher levels of c-IMT, cf-PWV, ba-PWV and CAVI than non-drinkers (p < 0.05). The multinomial regression analysis adjusted for sex and lifestyles showed a positive association between heavy drinking and c-IMT and cf-PWV values (β = 1.08 (95% CI 1.01–1.17); β = 1.37 (95% CI 1.04–1.80); ba-PWV and CAVI figures showed a similar trend, without reaching statistical significance. Conclusions: The results of this study indicate that high alcohol use in patients with persistent COVID is linked to higher c-IMT and cf-PWV figures than in non-drinkers.

Obesity and type 2 diabetes are two prevalent health problems worldwide [...]

Introduction: Long COVID (LC) is associated with an increase in cardiovascular risk and chronic inflammation, whereas the Mediterranean Diet (MD) seems to improve the aforementioned factors. The aim of this study is to analyse the relationship between MD and its components with vascular structure, function, and aging in patients diagnosed with LC globally and by sex. Methods: This study was a cross-sectional study with 304 subjects diagnosed with LC; 207 were women and 97 men. Adherence to MD was evaluated with a validated MEDAS questionnaire, composed of 14 items. The vascular structure was assessed using carotid intima-media thickness (cIMT). Three measurements were carried out to evaluate vascular function: cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (baPWV), and carotid-femoral pulse wave velocity (cfPWV). Vascular aging index (VAI) was estimated. Results: The MD score was 7.80 ± 2.33, with no difference between sexes. Vascular function and aging parameter values were higher in men than in women. Use of olive oil as the principal source of fat for cooking, and consuming <1 serving of butter/day and <1 sugar-sweetened beverage/day showed >90% adherence. Logistic regression analysis displayed associations between cIMT< 0.625 and use of olive oil in the global analysis (OR = 0.148) and among men (OR = 0.120), and <2 commercial pastries/week in global (OR = 0.536). cfPWV < 7.400 m/s was associated with DM score ≥ 8 in global (OR = 0.444) and in women, as well as with <2 pastries/week in women (OR = 0.405). baPWV < 12.315 m/s was associated with ≥3 servings of pulses/week in global (OR = 0.481) and among women, as was <2 pastries/week in global (OR = 0.471) and in women. CAVI < 7.450 was associated with ≥4 tablespoons of olive oil/day in men. VAI < 63.693 was associated with DM score ≥ 8 in global (OR = 0.458) and in women, as well as <2 pastries/week in global (OR = 0.392). Conclusions: Adherence to MD was associated with lower cfPWV and VAI measures in the global analysis and among women. In particular, several of the components were associated with a better vascular profile in LC patients.

Introducción y objetivos Analizar el incremento de la rigidez arterial durante 5 años, su asociación con factores de riesgo cardiovascular y diferencias por sexo en población española sin enfermedad cardiovascular. Métodos Estudio descriptivo longitudinal. Análisis del incremento de las medidas de rigidez arterial evaluadas con SphygmoCor y Vasera de 480 sujetos seguidos durante 5 años de los 501 sujetos incluidos en la evaluación basal, seleccionados mediante muestreo aleatorio estratificado por edad y sexo. Resultados Los incrementos de las medidas de rigidez arterial por año han sido: velocidad de onda de pulso carótida-femoral (VOP-CF), 0,22 (DE 0,36) m/s, velocidad de onda de pulso brazo-tobillo (VOP-BT), 0,18 (DE 0,30) m/s, índice corazón-tobillo (ICT), 0,04 (DE 0,18) e índice de aumento central (IAC), 0,38 (DE 2,66). Los incrementos de VOP-CF y VOP-BT mostraron asociación con presión arterial media en global (β=0,02; β=−0,02), y en hombres (β=0,02; β=−0,03). En mujeres, los incrementos de la VOP-BT y del ICT mostraron asociación negativa con el IMC (β=−0,06; β=−0,03). Conclusiones Las 4 medidas de rigidez arterial aumentan a lo largo de 5 años en global y por sexos. Dichos incrementos difieren según: medida utilizada, edad, sexo y factores de riesgo cardiovascular asociados. Los hipertensos presentan mayores incrementos de VOP-BT en global y por sexo. La presión arterial media se asocia con incrementos de VOP-CF y VOP-BT en global y en hombres. El IMC se asocia de manera negativa con incrementos de VOP-BT e ICT en mujeres.Estudio registrado en ClinicalTrials.gov. (NCT02623894).