Author, as appears in the article.: Martínez-González, MA; Montero, P; Ruiz-Canela, M; Toledo, E; Estruch, R; Gómez-Gracia, E; Li, J; Ros, E; Arós, F; Hernáez, A; Corella, D; Fiol, M; Lapetra, J; Serra-Majem, L; Pintó, X; Cofán, M; Sorli, JV; Babio, N; Marquez-Sandoval, YF; Castañer, O; Salas-Salvadó, J
Department: Bioquímica i Biotecnologia
URV's Author/s: Babio Sánchez, Nancy Elvira / Salas Salvadó, Jorge
Keywords: Olive oil Nutritional epidemiology Monounsaturated fats Follow-up Feeding trial Dietary assessment tools Diabetes risk prevention olive oil nutritional epidemiology monounsaturated fats metaanalysis mellitus feeding trial disease dietary assessment tools
Abstract: Several large observational prospective studies have reported a protection by the traditional Mediterranean diet against type 2 diabetes, but none of them used yearly repeated measures of dietary intake. Repeated measurements of dietary intake are able to improve subject classification and to increase the quality of the assessed relationships in nutritional epidemiology. Beyond observational studies, randomized trials provide stronger causal evidence. In the context of a randomized trial of primary cardiovascular prevention, we assessed type 2 diabetes incidence according to yearly repeated measures of compliance with a nutritional intervention based on the traditional Mediterranean diet.PREDIMED (''PREvención con DIeta MEDiterránea'') was a Spanish trial including 7447 men and women at high cardiovascular risk. We assessed 3541 participants initially free of diabetes and originally randomized to 1 of 3 diets: low-fat diet (n = 1147, control group), Mediterranean diet supplemented with extra virgin olive (n = 1154) or Mediterranean diet supplemented with mixed nuts (n = 1240). As exposure we used actual adherence to Mediterranean diet (cumulative average), yearly assessed with the Mediterranean Diet Adherence Screener (scoring 0 to 14 points), and repeated up to 8 times (baseline and 7 consecutive follow-up years). This score was categorized into four groups: < 8, 8-< 10, 10- < 12, and 12-14 points. The outcome was new-onset type 2 diabetes.Multivariable-adjusted hazard ratios from time-varying Cox models were 0.80 (95% confidence interval, 0.70-0.92) per + 2 points in Mediterranean Diet Adherence Screener (linear trend p = .001), and 0.46 (0.25-0.83) for the highest (12-14 points) versus the lowest (< 8) adherence. This inverse association was maintained after additionally adjusting for the randomized arm. Age- and sex-adjusted analysis of a validated plasma metabolomic signature of the Mediterranean Diet Adherence Screener (constituted of 67 metabolites) in a subset of 889 participants also supported these results.Dietary intervention trials should quantify actual dietary adherence throughout the trial period to enhance the benefits and to assist results interpretation. A rapid dietary assessment tool, yearly repeated as a screener, was able to capture a strong inverse linear relationship between Mediterranean diet and type 2 diabetes. Trial registration ISRCTN35739639.© 2023. BioMed Central Ltd., part of Springer Nature.
Thematic Areas: Saúde coletiva Medicina ii Medicina i Internal medicine Interdisciplinar Farmacia Endocrinology, diabetes and metabolism Endocrinology & metabolism Educação física Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems Biotecnología
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: jordi.salas@urv.cat nancy.babio@urv.cat
Author identifier: 0000-0003-2700-7459 0000-0003-3527-5277
Record's date: 2024-08-03
Papper version: info:eu-repo/semantics/publishedVersion
Link to the original source: https://cardiab.biomedcentral.com/articles/10.1186/s12933-023-01994-2
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Cardiovascular Diabetology. 22 (1): 262-
APA: Martínez-González, MA; Montero, P; Ruiz-Canela, M; Toledo, E; Estruch, R; Gómez-Gracia, E; Li, J; Ros, E; Arós, F; Hernáez, A; Corella, D; Fiol, M; La (2023). Yearly attained adherence to Mediterranean diet and incidence of diabetes in a large randomized trial. Cardiovascular Diabetology, 22(1), 262-. DOI: 10.1186/s12933-023-01994-2
Article's DOI: 10.1186/s12933-023-01994-2
Entity: Universitat Rovira i Virgili
Journal publication year: 2023
Publication Type: Journal Publications
Repositori URV