Scope
Some very‐low density lipoprotein (VLDL) properties may render them more pro‐atherogenic. We aimed to assess whether a Mediterranean diet (MedDiet) or an energy‐reduced MedDiet with increased ...physical activity improves them.
Methods and results
In a sample of the PREvención con DIeta MEDiterránea (PREDIMED) study, a 1‐year intervention with MedDiet with extra‐virgin olive oil (n = 89) or nuts (MedDiet‐Nuts; n = 79) is compared with a low‐fat diet (n = 90). In the PREDIMED‐Plus study, a 1‐year intervention with energy‐reduced MedDiet and physical activity (n = 103) is compared with an ad libitum MedDiet (n = 101). VLDL levels of apolipoprotein C‐I, C‐III, triglycerides, and cholesterol; the apolipoprotein E‐/C‐I ratio; and VLDL ex‐vivo triglyceride transfer are measured. In PREDIMED participants in both MedDiet groups combined, VLDL apolipoprotein C‐III levels are nominally reduced (−0.023 SD units, 95% CI −0.44 to −0.014, p = 0.037). VLDL triglyceride transfer is nominally increased in the MedDiet‐Nuts group (+0.39 SD units, 95% CI 0.012–0.78, p = 0.045). In PREDIMED‐Plus, no inter‐group differences are detected.
Conclusions
In older adults at high cardiovascular risk, MedDiet is associated with lower VLDL atherogenicity versus a low‐fat diet. No differences are seen after an energy‐reduced MedDiet with physical activity.
According to two randomized controlled trials in older adults at high cardiovascular risk, a traditional Mediterranean diet decreases VLDL atherogenicity relative to a low‐fat control diet (it reduces VLDL levels of apolipoprotein C‐III and boosts the lipoprotein capacity to transfer triglycerides). An energy reduces Mediterranean diet with increased physical activity does not further improve these characteristics.
IMPORTANCE: High-quality dietary patterns may help prevent chronic disease, but limited data exist from randomized trials about the effects of nutritional and behavioral interventions on dietary ...changes. OBJECTIVE: To assess the effect of a nutritional and physical activity education program on dietary quality. DESIGN, SETTING, AND PARTICIPANTS: Preliminary exploratory interim analysis of an ongoing randomized trial. In 23 research centers in Spain, 6874 men and women aged 55 to 75 years with metabolic syndrome and no cardiovascular disease were enrolled in the trial between September 2013 and December 2016, with final data collection in March 2019. INTERVENTIONS: Participants were randomized to an intervention group that encouraged an energy-reduced Mediterranean diet, promoted physical activity, and provided behavioral support (n = 3406) or to a control group that encouraged an energy-unrestricted Mediterranean diet (n = 3468). All participants received allotments of extra-virgin olive oil (1 L/mo) and nuts (125 g/mo) for free. MAIN OUTCOMES AND MEASURES: The primary outcome was 12-month change in adherence based on the energy-reduced Mediterranean diet (er-MedDiet) score (range, 0-17; higher scores indicate greater adherence; minimal clinically important difference, 1 point). RESULTS: Among 6874 randomized participants (mean SD age, 65.0 4.9 years; 3406 52% men), 6583 (96%) completed the 12-month follow-up and were included in the main analysis. The mean (SD) er-MedDiet score was 8.5 (2.6) at baseline and 13.2 (2.7) at 12 months in the intervention group (increase, 4.7 95% CI, 4.6-4.8) and 8.6 (2.7) at baseline and 11.1 (2.8) at 12 months in the control group (increase, 2.5 95% CI, 2.3-2.6) (between-group difference, 2.2 95% CI, 2.1-2.4; P < .001). CONCLUSIONS AND RELEVANCE: In this preliminary analysis of an ongoing trial, an intervention that encouraged an energy-reduced Mediterranean diet and physical activity, compared with advice to follow an energy-unrestricted Mediterranean diet, resulted in a significantly greater increase in diet adherence after 12 months. Further evaluation of long-term cardiovascular effects is needed. TRIAL REGISTRATION: isrctn.com Identifier: ISRCTN89898870
Scope
To evaluate whether increases in the consumption of cardioprotective food groups (virgin olive oil, nuts, fruits/vegetables, legumes, whole grains, fish, and wine) are associated with ...improvements in high‐density lipoprotein (HDL) functions in high cardiovascular risk subjects.
Methods and Results
The association between 1‐year changes in food group consumption and HDL functionality traits in 296 high cardiovascular risk subjects is assessed. Increases in virgin olive oil (10 g d–1) and whole grain consumption (25 g d–1) are associated with increments in cholesterol efflux capacity (+0.7%, P = 0.026, and +0.6%, P = 0.017, respectively). Increases in nut (30 g d–1) and legume intake (25 g d–1) are linked to increments in paraoxonase‐1 activity (+12.2%, P = 0.049, and +11.7%, P = 0.043, respectively). Legume intake increases are also related to decreases in cholesteryl ester transfer protein activity (–4.8%, P = 0.028). Fish consumption increments (25 g d–1) are associated with increases in paraoxonase‐1 activity (+3.9%, P = 0.030) and declines in cholesteryl ester transfer protein activity (–1.6%, P = 0.021), HDL cholesterol concentrations (–1.1%, P = 0.039), and functions related to HDL levels (cholesterol efflux capacity, –1.1%, P = 0.010).
Conclusion
Increases in the consumption of virgin olive oil, nuts, legumes, whole grains, and fish (achievable through a regular diet) were associated with improvements in HDL functions in high cardiovascular risk subjects.
Incrementing the intake of whole grains and legumes is associated in this study with improvements in high‐density lipoprotein (HDL) functionality (increases in cholesterol efflux capacity and paraoxonase‐1 activity and decreases in cholesteryl ester transfer protein activity). The study also confirms the protective effect of consuming virgin olive oil, nuts, and fish on these properties and reinforcesthe idea that a healthy diet promotes HDL functionality in humans.
The association between ultra-processed food (UPF) and risk of cardiometabolic disorders is an ongoing concern. Different food processing-based classification systems have originated discrepancies in ...the conclusions among studies. To test whether the association between UPF consumption and cardiometabolic markers changes with the classification system, we used baseline data from 5636 participants (48.5% female and 51.5% male, mean age 65.1 ± 4.9) of the PREDIMED-Plus (“PREvention with MEDiterranean DIet”) trial. Subjects presented with overweight or obesity and met at least three metabolic syndrome (MetS) criteria. Food consumption was classified using a 143-item food frequency questionnaire according to four food processing-based classifications: NOVA, International Agency for Research on Cancer (IARC), International Food Information Council (IFIC) and University of North Carolina (UNC). Mean changes in nutritional and cardiometabolic markers were assessed according to quintiles of UPF consumption for each system. The association between UPF consumption and cardiometabolic markers was assessed using linear regression analysis. The concordance of the different classifications was assessed with intra-class correlation coefficients (ICC3, overall = 0.51). The highest UPF consumption was obtained with the IARC classification (45.9%) and the lowest with NOVA (7.9%). Subjects with high UPF consumption showed a poor dietary profile. We detected a direct association between UPF consumption and BMI (p = 0.001) when using the NOVA system, and with systolic (p = 0.018) and diastolic (p = 0.042) blood pressure when using the UNC system. Food classification methodologies markedly influenced the association between UPF consumption and cardiometabolic risk markers.
Objective
The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and high levels of triglycerides. In a cross‐sectional assessment of PREDIMED‐Plus trial participants ...at baseline, HTGW phenotype prevalence was evaluated, associated risk factors were analyzed, and the lifestyle of individuals with metabolic syndrome and HTGW was examined.
Methods
A total of 6,874 individuals aged 55 to 75 with BMI ≥ 27 and < 40 kg/m2 were included and classified by presence (HTGW+) or absence (HTGW−) of HTGW (waist circumference: men ≥ 102 cm, women ≥ 88 cm; fasting plasma triglycerides ≥ 150 mg/dL). Analytical parameters and lifestyle (energy intake and expenditure) were analyzed.
Results
A total of 38.2% of the sample met HTGW+ criteria. HTGW+ individuals tended to be younger, have a greater degree of obesity, be sedentary, and be tobacco users. They had higher peripheral glucose, total cholesterol, and low‐density lipoprotein cholesterol levels; had lower high‐density lipoprotein cholesterol levels; and had increased prevalence of type 2 diabetes mellitus. Mediterranean diet (MedDiet) adherence and physical activity were greater in HTGW− patients. Age, BMI, tobacco use, total energy expenditure, hypertension, type 2 diabetes mellitus, and MedDiet adherence were associated with HTGW+.
Conclusions
HTGW is a highly prevalent phenotype in this population associated with younger age, higher BMI, tobacco use, and decreased MedDiet adherence. HTGW− individuals were more physically active with greater total physical activity, and fewer had hypertension.
To assess the comparative effects of glucagon-like peptide-1 receptor agonists (GLP-1RA), 4-dipeptidyl peptidase inhibitors (DPP-4I), and metformin treatment during one year on metabolic syndrome ...(MetS) components and severity in MetS patients.
Prospective study (n = 6165 adults) within the frame of PREDIMED-Plus trial. The major end-point was changes on MetS components and severity after one- year treatment of GLP-1RA, DPP-4I, and metformin. Anthropometric measurements (weight, height and waist circumference), body mass index (BM), and blood pressure were registered. Blood samples were collected after overnight fasting. Plasma glucose, glycosylated hemoglobin (HbA1c), plasma triglycerides and cholesterol were measured. Dietary intakes as well as physical activity were assessed through validated questionnaires.
MetS parameters improved through time. The treated groups improved glycaemia compared with untreated (glycaemia ∆ untreated: −1.7 mg/dL(± 13.5); ∆ metformin: − 2.5(± 23.9) mg/dL; ∆ DPP-4I: − 4.5(± 42.6); mg/dL ∆ GLP-1RA: − 4.3(± 50.9) mg/dL; and HbA1c: ∆ untreated: 0.0(± 0.3) %; ∆ metformin: − 0.1(± 0.7) %; ∆ DPP-4I: − 0.1(± 1.0) %; ∆ GLP-1RA: − 0.2(± 1.2) %. Participants decreased BMI and waist circumference. GLP-1RA and DPP-4I participants registered the lowest decrease in BMI (∆ untreated: −0.8(± 1.6) kg/m2; ∆ metformin: − 0.8(± 1.5) kg/m2; ∆ DPP-4I: − 0.6(± 1.3) kg/m2; ∆ GLP-1RA: − 0.5(± 1.2) kg/m2. and their waist circumference (∆ untreated: −2.8(± 5.2) cm; ∆ metformin: − 2.6(± 15.2) cm; ∆ DPP-4I: − 2.1(± 4.8) cm; ∆ GLP-1RA: − 2.4(± 4.1) cm.
In patients with MetS and healthy lifestyle intervention, those treated with GLP-1RA and DPP-4I obtained better glycemic profile. Anthropometric improvements were modest.
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•Patients treated with GLP-1RA and DPP-4I obtained a better glycemic profile, but anthropometric improvements were modest.•Patients who decreased their energy intake the least at one year of the intervention were those treated with DPP-4I.•The GLP-1RA participants had a higher systolic blood pressure reduction, compared to others.
•Eggs, fish and seafood, and fruits and vegetables contributed the most to the PFOS dietary intake.•Dietary intake of PFOS was associated with fasting plasma glucose and HbA1c at baseline.•Dietary ...intake of PFOS was associated with an increase in HOMA-IR and BMI after 1-year of follow-up.
Endocrine disruptors (EDs) have emerged as potential contributors to the development of type-2 diabetes. Perfluorooctane sulfonate (PFOS), is one of these EDs linked with chronic diseases and gathered attention due to its widespread in food.
To assess at baseline and after 1-year of follow-up associations between estimated dietary intake (DI) of PFOS, and glucose homeostasis parameters and body-mass-index (BMI) in a senior population of 4600 non-diabetic participants from the PREDIMED-plus study.
Multivariable linear regression models were conducted to assess associations between baseline PFOS-DI at lower bound (LB) and upper bound (UB) established by the EFSA, glucose homeostasis parameters and BMI.
Compared to those in the lowest tertile, participants in the highest tertile of baseline PFOS-DI in LB and UB showed higher levels of HbA1c β-coefficient(CI) 0.01 %(0.002 to 0.026), and 0.06 mg/dL(0.026 to 0.087), both p-trend ≤ 0.001, and fasting plasma glucose in the LB PFOS-DI 1.05 mg/dL(0.050 to 2.046),p-trend = 0.022. Prospectively, a positive association between LB of PFOS-DI and BMI 0.06 kg/m2(0.014 to 0.106) per 1-SD increment of energy-adjusted PFOS-DI was shown. Participants in the top tertile showed an increase in HOMA-IR 0.06(0.016 to 0.097), p-trend = 0.005 compared to participants in the reference tertile after 1-year of follow-up.
This is the first study to explore the association between DI of PFOS and glucose homeostasis. In this study, a high baseline DI of PFOS was associated with a higher levels of fasting plasma glucose and HbA1c and with an increase in HOMA-IR and BMI after 1-year of follow-up.
Scope
To examine the association between milk and dairy products intake and the prevalence of cognitive decline among Spanish individuals at high cardiovascular risk.
Methods and results
...Cross‐sectional analyses are performed on baseline data from 6744 adults (aged 55–75 years old). Intake of milk and dairy products is estimated using a food frequency questionnaire grouped into quartiles. The risk of developing cognitive impairment is based on the Mini‐Mental State Examination (MMSE).
A higher prevalence of cognitive decline was found in subjects who consumed more grams. Patients with worse MMSE score (10–24) consumed a mean of 395.14 ± 12.21 g, while patients with better MMSE score (27–30) consumed a mean of 341.23 ± 2.73 g (p < 0.05). Those subjects with the lower milk consumption (<220 g/day) had a higher MMSE score (28.35 ± 0.045). Higher intake of fermented dairy products was observed in participants with a lower MMSE score (OR 1.340, p = 0.003). A positive correlation was found between the consumption of whole milk and the MMSE score (r = 0.066, p < 0.001).
Conclusions
These findings suggest that greater consumption of milk and dairy products could be associated with greater cognitive decline according to MMSE. Conversely, consumption of whole‐fat milk could be linked with less cognitive impairment in the cross‐sectional study.
There are controversial results about potential impact that milk and dairy product consumption have on cognitive decline. It is observed that extensive consumption of milk and dairy products is found in those subjects with worse cognitive function. Higher milk and dairy intake were found in participants with lower MMSE scores. Conversely, whole‐fat milk and dairy product intake may play a protective role in cognitive impairment, as higher whole‐fat dairy products had better results in MMSE.
Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment.
To assess the association between the ...adherence to an energy-restricted Mediterranean diet and the amount of CO
emitted in an older adult population.
Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO
emissions in 6646 participants was assessed.
Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO
emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO
emissions expressed in kg/day: Q1 (≤2.01 kg CO
), Q2 (2.02-2.34 kg CO
), Q3 (2.35-2.79 kg CO
) and Q4 (≥2.80 kg CO
).
More men than women induced higher dietary levels of CO
emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO
through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO
emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference).
The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO
emissions. Mediterranean Diet index may be used as a pollution level index.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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).
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.
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.
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