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Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial

  • Identification data

    Identifier: imarina:2006806
    Authors:
    Diaz-Lopez, AndresBabio, NancyMartinez-Gonzalez, Miguel ACorella, DoloresAmor, Antonio JFito, MontseEstruch, RamonAros, FernandoGomez-Gracia, EnriqueFiol, MiquelLapetra, JoseSerra-Majem, LluisBasora, JosepJavier Basterra-Gortari, FZanon-Moreno, VicenteAngel Munoz, MiguelSalas-Salvado, Jordi
    Abstract:
    To date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a low-fat control diet.This was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), MedDiet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression.During a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the MedDiet+EVOO and 0.63 (0.35-1.11) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the MedDiet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy.A MedDiet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy.© 2015 by the American Diabetes Ass
  • Others:

    Author, as appears in the article.: Diaz-Lopez, Andres; Babio, Nancy; Martinez-Gonzalez, Miguel A; Corella, Dolores; Amor, Antonio J; Fito, Montse; Estruch, Ramon; Aros, Fernando; Gomez-Gracia, Enrique; Fiol, Miquel; Lapetra, Jose; Serra-Majem, Lluis; Basora, Josep; Javier Basterra-Gortari, F; Zanon-Moreno, Vicente; Angel Munoz, Miguel; Salas-Salvado, Jordi
    Department: Ciències Mèdiques Bàsiques Medicina i Cirurgia Bioquímica i Biotecnologia
    URV's Author/s: Babio Sánchez, Nancy Elvira / Basora Gallisa, Josep / Becerra Tomás, Nerea / Bulló Bonet, Mònica / Cabre Vila, Juan Jose / Castro Salomó, Antoni / Díaz López, Andres / Fernández Ballart, Joan Domènech / Salas Salvadó, Jorge
    Keywords: Risk factors Nuts Middle aged Microvessels Male Incidence Humans Female Diet, mediterranean Diabetic retinopathy Diabetic nephropathies Diabetic angiopathies Diabetes mellitus, type 2 Cardiovascular diseases Aged, 80 and over Aged
    Abstract: To date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a low-fat control diet.This was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), MedDiet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression.During a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the MedDiet+EVOO and 0.63 (0.35-1.11) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the MedDiet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy.A MedDiet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy.© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
    Thematic Areas: Saúde coletiva Odontología Nutrição Medicina iii Medicina ii Medicina i Internal medicine Interdisciplinar General medicine Engenharias iv Enfermagem Endocrinology, diabetes and metabolism Endocrinology & metabolism Ciências biológicas ii Ciências biológicas i Biotecnología Antropologia / arqueologia Advanced and specialized nursing
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 01495992
    Author's mail: juanjose.cabre@urv.cat josep.basora@urv.cat andres.diaz@urv.cat nerea.becerra@urv.cat monica.bullo@urv.cat josep.basora@urv.cat antoni.castro@urv.cat jordi.salas@urv.cat nancy.babio@urv.cat
    Author identifier: 0000-0003-1082-6861 0000-0002-7500-5629 0000-0002-4429-6507 0000-0002-0218-7046 0000-0001-5441-6333 0000-0003-2700-7459 0000-0003-3527-5277
    Record's date: 2024-10-26
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://diabetesjournals.org/care/article/38/11/2134/37621/Mediterranean-Diet-Retinopathy-Nephropathy-and
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Diabetes Care. 38 (11): 2134-2141
    APA: Diaz-Lopez, Andres; Babio, Nancy; Martinez-Gonzalez, Miguel A; Corella, Dolores; Amor, Antonio J; Fito, Montse; Estruch, Ramon; Aros, Fernando; Gomez- (2015). Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial. Diabetes Care, 38(11), 2134-2141. DOI: 10.2337/dc15-1117
    Article's DOI: 10.2337/dc15-1117
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2015
    Publication Type: Journal Publications
  • Keywords:

    Advanced and Specialized Nursing,Endocrinology & Metabolism,Endocrinology, Diabetes and Metabolism,Internal Medicine
    Risk factors
    Nuts
    Middle aged
    Microvessels
    Male
    Incidence
    Humans
    Female
    Diet, mediterranean
    Diabetic retinopathy
    Diabetic nephropathies
    Diabetic angiopathies
    Diabetes mellitus, type 2
    Cardiovascular diseases
    Aged, 80 and over
    Aged
    Saúde coletiva
    Odontología
    Nutrição
    Medicina iii
    Medicina ii
    Medicina i
    Internal medicine
    Interdisciplinar
    General medicine
    Engenharias iv
    Enfermagem
    Endocrinology, diabetes and metabolism
    Endocrinology & metabolism
    Ciências biológicas ii
    Ciências biológicas i
    Biotecnología
    Antropologia / arqueologia
    Advanced and specialized nursing
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