Benefits of the Mediterranean Diet: Insights From the PREDIMED Study
Miguel A Martínez-González, Jordi Salas-Salvadó, Ramón Estruch, Dolores Corella, Montse Fitó, Emilio Ros, PREDIMED INVESTIGATORS, P Buil-Cosiales, J Diez-Espino, E Toledo, A Garcia-Arellano, M Ruiz-Canela, B Sanjulian, A Marti, F J Basterra-Gortari, V Estremera-Urabayen, A Sola-Larraza, F Barcena-Amigo, C Oreja-Arrayago, M Serrano-Martínez, M J Lasanta-Saez, L Quintana-Pedraza, C Amezcueta-Goñi, P Cia-Lecumberri, F Artal-Moneva, J M Esparza-López, E Figuerido-Garmendia, H Ruiz-Millan, R Oses-Primo, J A Tabar-Sarrias, L Fernandez-Urzainqui, M J Ariz-Arnedo, T Forcen-Alonso, P Pascual-Pascual, M L Garces, V Extremera, L Garcia-Perez, N Babio, M Bullo, J Basora, N Gonzalez, C Molina, F Marquez, P Martínez, N Ibarrola, M Sorli, J García Roselló, A Castro, F Martin, N Tort, A Isach, M Guasch-Ferre, M Baldrich, J J Cabre, G Mestres, F Paris, M Llauradó, R Pedret, J Basells, J Vizcaino, J Fernandez-Ballart, M I Covas, S Tello, J Vila, R de la Torre, D Munoz-Aguayo, R Elosua, J Marrugat, M Ferrer, J V Sorli, P Carrasco, R Osma, M Guillen, P Guillem-Saiz, O Portoles, V Pascual, C Riera, J Valderrama, A Serrano, E Lazaro, A Sanmartin, A Girbes, V Santamaria, C Sanchez, Z Pla, E M Asensio, E Gomez-Gracia, J Fernandez-Crehuet, J Wärnberg, R Benitez Pont, M Bianchi Alba, R Gomez-Huelgas, J Martínez-Gonzalez, V Velasco García, J de Diego Salas, A Baca Osorio, J Gil Zarzosa, J J Sanchez Luque, E Vargas López, M Serra, A Perez-Heras, R Sola, E Ortega, C Vinas, R Casas, L de Santamaria, S Romero, J M Baena, M García, M Oller, J Amat, I Duaso, Y García, C Iglesias, C Simon, Ll Quinzavos, Ll Parra, M Liroz, J Benavent, J Clos, I Pla, M Amoros, M T Bonet, M T Martin, M S Sanchez, J Altirruba, E Manzano, A Altes, M Cofan, C Valls-Pedret, A Sala-Vila, M Domenech, F Arós, I Salaverria, T del Hierro, J Algorta, S Francisco, A Alonso, J San Vicente, A Casi, E Sanz, I Felipe, A Loma-Osorio, M Fiol, D Romaguera, M García-Valdueza, M Monino, A Proenza, R Prieto, G Frontera, M Ginard, F Fiol, A Jover, D Romaguera, J García, J Lapetra, M Leal, E Martínez, M Ortega-Calvo, P Roman, F Jose García, P Iglesias, Y Corchado, E Mayoral, L Mellado, L Miró, J M Lozano, C Lama, L Serra-Majem, A Sanchez-Villegas, J Alvarez-Perez, E Diez Benitez, I Bautista Castaño, I Maldonado Diaz, M J Férnandez-Rodríguez, F Sarmiendo de la Fe, C Simon García, I FalconSanabria, B MaciasGutierrez, J Santana Santana, X Pinto, E de la Cruz, A Galera, Y Soler, F Trias, I Sarasa, E Padres, E Corbella, R M Lamuela-Raventos, M C López- Sabater, A I Castellote-Bargallo, A Medina-Remon, A Tresserra-Rimbau, C Cabezas, E Vinyoles, M A Rovira, L García, G Flores, J M Verdu, P Baby, A Ramos, L Mengual, P Roura, M C Yuste, A Guarner, A Rovira, M I Santamaria, M Mata, C de Juan, A Brau, Miguel A Martínez-González, Jordi Salas-Salvadó, Ramón Estruch, Dolores Corella, Montse Fitó, Emilio Ros, PREDIMED INVESTIGATORS, P Buil-Cosiales, J Diez-Espino, E Toledo, A Garcia-Arellano, M Ruiz-Canela, B Sanjulian, A Marti, F J Basterra-Gortari, V Estremera-Urabayen, A Sola-Larraza, F Barcena-Amigo, C Oreja-Arrayago, M Serrano-Martínez, M J Lasanta-Saez, L Quintana-Pedraza, C Amezcueta-Goñi, P Cia-Lecumberri, F Artal-Moneva, J M Esparza-López, E Figuerido-Garmendia, H Ruiz-Millan, R Oses-Primo, J A Tabar-Sarrias, L Fernandez-Urzainqui, M J Ariz-Arnedo, T Forcen-Alonso, P Pascual-Pascual, M L Garces, V Extremera, L Garcia-Perez, N Babio, M Bullo, J Basora, N Gonzalez, C Molina, F Marquez, P Martínez, N Ibarrola, M Sorli, J García Roselló, A Castro, F Martin, N Tort, A Isach, M Guasch-Ferre, M Baldrich, J J Cabre, G Mestres, F Paris, M Llauradó, R Pedret, J Basells, J Vizcaino, J Fernandez-Ballart, M I Covas, S Tello, J Vila, R de la Torre, D Munoz-Aguayo, R Elosua, J Marrugat, M Ferrer, J V Sorli, P Carrasco, R Osma, M Guillen, P Guillem-Saiz, O Portoles, V Pascual, C Riera, J Valderrama, A Serrano, E Lazaro, A Sanmartin, A Girbes, V Santamaria, C Sanchez, Z Pla, E M Asensio, E Gomez-Gracia, J Fernandez-Crehuet, J Wärnberg, R Benitez Pont, M Bianchi Alba, R Gomez-Huelgas, J Martínez-Gonzalez, V Velasco García, J de Diego Salas, A Baca Osorio, J Gil Zarzosa, J J Sanchez Luque, E Vargas López, M Serra, A Perez-Heras, R Sola, E Ortega, C Vinas, R Casas, L de Santamaria, S Romero, J M Baena, M García, M Oller, J Amat, I Duaso, Y García, C Iglesias, C Simon, Ll Quinzavos, Ll Parra, M Liroz, J Benavent, J Clos, I Pla, M Amoros, M T Bonet, M T Martin, M S Sanchez, J Altirruba, E Manzano, A Altes, M Cofan, C Valls-Pedret, A Sala-Vila, M Domenech, F Arós, I Salaverria, T del Hierro, J Algorta, S Francisco, A Alonso, J San Vicente, A Casi, E Sanz, I Felipe, A Loma-Osorio, M Fiol, D Romaguera, M García-Valdueza, M Monino, A Proenza, R Prieto, G Frontera, M Ginard, F Fiol, A Jover, D Romaguera, J García, J Lapetra, M Leal, E Martínez, M Ortega-Calvo, P Roman, F Jose García, P Iglesias, Y Corchado, E Mayoral, L Mellado, L Miró, J M Lozano, C Lama, L Serra-Majem, A Sanchez-Villegas, J Alvarez-Perez, E Diez Benitez, I Bautista Castaño, I Maldonado Diaz, M J Férnandez-Rodríguez, F Sarmiendo de la Fe, C Simon García, I FalconSanabria, B MaciasGutierrez, J Santana Santana, X Pinto, E de la Cruz, A Galera, Y Soler, F Trias, I Sarasa, E Padres, E Corbella, R M Lamuela-Raventos, M C López- Sabater, A I Castellote-Bargallo, A Medina-Remon, A Tresserra-Rimbau, C Cabezas, E Vinyoles, M A Rovira, L García, G Flores, J M Verdu, P Baby, A Ramos, L Mengual, P Roura, M C Yuste, A Guarner, A Rovira, M I Santamaria, M Mata, C de Juan, A Brau
Abstract
The PREDIMED (PREvención con DIeta MEDiterránea) multicenter, randomized, primary prevention trial assessed the long-term effects of the Mediterranean diet (MeDiet) on clinical events of cardiovascular disease (CVD). We randomized 7447 men and women at high CVD risk into three diets: MeDiet supplemented with extra-virgin olive oil (EVOO), MeDiet supplemented with nuts, and control diet (advice on a low-fat diet). No energy restriction and no special intervention on physical activity were applied. We observed 288 CVD events (a composite of myocardial infarction, stroke or CVD death) during a median time of 4.8years; hazard ratios were 0.70 (95% CI, 0.53-0.91) for the MeDiet+EVOO and 0.70 (CI, 0.53-0.94) for the MeDiet+nuts compared to the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 non-diabetic participants were 0.60 (0.43-0.85) and 0.82 (0.61-1.10) for MeDiet+EVOO and MeDiet+nuts, respectively versus control. Significant improvements in classical and emerging CVD risk factors also supported a favorable effect of both MeDiets on blood pressure, insulin sensitivity, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis. In nutrigenomic studies beneficial effects of the intervention with MedDiets showed interactions with several genetic variants (TCF7L2, APOA2, MLXIPL, LPL, FTO, M4CR, COX-2, GCKR and SERPINE1) with respect to intermediate and final phenotypes. Thus, the PREDIMED trial provided strong evidence that a vegetable-based MeDiet rich in unsaturated fat and polyphenols can be a sustainable and ideal model for CVD prevention.
Keywords: Atrial fibrillation; Dietary intervention; Mediterranean diet; Peripheral artery disease; Primary prevention; Randomized trials; Stroke; Type-2 diabetes.
Copyright © 2015 Elsevier Inc. All rights reserved.
Source: PubMed