Physical activity (PA) has been hypothesized to be effective to maintaining cognitive function and delay cognitive decline in the elderly, but physical fitness (PF) could be a better predictor of ...cognitive function. We aimed to study the association between PA and PF with cognitive function and quality of life using cross-sectional data from 6874 participants of the PREDIMED-Plus trial (64.9 ± 4.9 years, 48.5% female). PF and PA were measured with a Chair Stand Test, the REGICOR and Rapid Assessment Physical Activity questionnaires. Cognitive function was measured with Mini-mental State Examination, Control Oral Word Association Test, Trail Making Test and Digit Span tests; whereas health-related quality of life was assessed with the SF36-HRQL test. Cognitive and quality of life scores were compared among PF quartiles and PA levels (low, moderate and high) with ANCOVA and with Chair Stand repetitions and energy expenditure from total PA with multivariable linear regression adjusted for confounding factors. PF associated with higher scores in phonemic and semantic verbal fluency tests and with lower TMT A time. However, PA was not associated with the neurocognitive parameters evaluated. Both PF and PA levels were strongly associated with a better quality of life. We concluded that PF, but not PA, is associated with a better cognitive function. This trial was retrospectively registered at the International Standard Randomized Controlled Trial (ISRCTN89898870, https://www.isrctn.com/ISRCTN89898870?q=ISRCTN89898870&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search) on 07/24/2014.
Scope
This study assessed plasmatic antioxidant capabilities and xanthine oxidase (XOX) activity in metabolic syndrome patients after 5 years intervention with Mediterranean diet (MeDiet) ...supplemented with extra‐virgin olive oil or with nuts or with low‐fat diet (the PREDIMED PREvención con Dieta MEDiterránea study).
Methods and results
Seventy‐five participants were randomly selected. Daily energy and nutrient intake were assessed with a validated 137‐item food frequency questionnaire, and adherence to the MeDiet was assessed using a 14‐item questionnaire. Catalase, superoxide dismutase (SOD), myeloperoxidase, XOX activities and protein levels, and protein carbonyl derivatives, nitrotyrosine, nitrite and nitrate levels were determined in overnight fasting venous blood samples. The plasma activity and protein levels of SOD and catalase were significantly higher and XOX activity was lower in MeDiet supplemented with extra‐virgin olive oil and MeDiet supplemented with nuts than in the control group. Participants in both MeDiet groups showed higher plasma nitrate levels than in the control group. Adherence to the MeDiet showed a positive correlation with SOD and catalase plasma antioxidant activities.
Conclusion
A MeDiet enriched with either virgin olive oil or nuts enhances the plasma antioxidant capabilities and decreases XOX activity in patients with the metabolic syndrome but we did not observe changes in myeloperoxidase or markers of oxidative damage.
Adherence to the Mediterranean diet has been associated with a reduction in cardiovascular mortality. Oxidative stress is involved in the origin of this and other metabolic illnesses. This study (part of PREDIMED study) shows that five years intervention with Mediterranean diet enriched with virgin olive oil or nuts enhances antioxidant and decreases oxidative activity in metabolic syndrome patients.
Purpose
We explored the cross-sectional association between the adherence to three different provegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), and ...the cardiometabolic risk in adults with metabolic syndrome (MetS) of the PREDIMED-Plus randomized intervention study.
Methods
We performed a cross-sectional analysis of baseline data from 6439 participants of the PREDIMED-Plus randomized intervention study. The gPVG food pattern was built by positively scoring plant foods (vegetables/fruits/legumes/grains/potatoes/nuts/olive oil) and negatively scoring, animal foods (meat and meat products/animal fats/eggs/fish and seafood/dairy products). The hPVG and uPVG were generated from the gPVG by adding four new food groups (tea and coffee/fruit juices/sugar-sweetened beverages/sweets and desserts), splitting grains and potatoes and scoring them differently. Multivariable-adjusted robust linear regression using MM-type estimator was used to assess the association between PVG food patterns and the standardized Metabolic Syndrome score (MetS z-score), a composed index that has been previously used to ascertain the cardiometabolic risk, adjusting for potential confounders.
Results
A higher adherence to the gPVG and hPVG was associated with lower cardiometabolic risk in multivariable models. The regression coefficients for 5th vs. 1st quintile were − 0.16 (95% CI: − 0.33 to 0.01) for gPVG (
p
trend: 0.015), and − 0.23 (95% CI: − 0.41 to − 0.05) for hPVG (
p
trend: 0.016). In contrast, a higher adherence to the uPVG was associated with higher cardiometabolic risk, 0.21 (95% CI: 0.04 to 0.38) (
p
trend: 0.019).
Conclusion
Higher adherence to gPVG and hPVG food patterns was generally associated with lower cardiovascular risk, whereas higher adherence to uPVG was associated to higher cardiovascular risk.
The development and implementation of effective physical activity (PA) intervention programs is challenging, particularly in older adults. After the first year of the intervention program used in the ...ongoing PREvención con DIeta MEDiterránea (PREDIMED)-Plus trial, we assessed the initial effectiveness of the PA component.
PREDIMED-Plus is an ongoing randomized clinical trial including 6874 participants randomized to an intensive weight-loss lifestyle intervention based on an energy-restricted Mediterranean diet (MedDiet), physical activity promotion and behavioral support and to a control group using MedDiet recommendations but without calorie restriction or PA advice. Body mass index (BMI) and waist circumference (WC) are measured by standard clinical protocols. Duration and intensity of PA is self-reported using the validated REGICOR Short Physical Activity Questionnaire. The primary endpoint of the PREDIMED-Plus trial is a combined cardiovascular outcome: myocardial infarction (acute coronary syndromes with positive troponin test), stroke, or cardiovascular mortality. The present study involved secondary analysis of PA data (n = 6059; mean age 65 ± 4.9 years) with one-year changes in total, light, and moderate-to-vigorous PA within and between intervention groups as the outcome. Generalized estimating equation models were fitted to evaluate time trends of PA, BMI, and WC within groups and differences between intervention and control groups.
After 12 months, average daily MVPA increased by 27.2 (95%CI 5.7;48.7) METs-min/day and 123.1 (95%CI 109.7-136.6) METs-min/day in the control and intervention groups, respectively. Total-PA, light-PA, and MVPA increased significantly (p < 0.01) in both groups. A significant (p < 0.001) time*intervention group interaction was found for Total-PA and MVPA, meaning the PA trajectory over time differed between the intervention and control groups. Age, sex, education level, and BMI did not moderate the effectiveness of the PA intervention. BMI and WC decreased significantly with increasing MVPA, compared with participants who reported no changes in MVPA.
After one year of follow-up, the PREDIMED-Plus PA intervention has been effective in increasing daily PA in older adults.
Retrospectively registered at the International Standard Randomized Controlled Trial ( http://www.isrctn.com/ISRCTN89898870 ), registration date: 24 July 2014.
Purpose
Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors ...associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial.
Methods
Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance.
Results
Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR
6-month
: 1.51, 95% CI 1.25–1.83; OR
12-month
: 1.66, 95% CI 1.37–2.01), higher baseline fiber intake (OR
6-month
: 1.62, 95% CI 1.07–2.46; OR
12-month
: 1.62, 95% CI 1.07–2.45), having > 3 chronic conditions (OR
6-month
: 0.65, 95% CI 0.53–0.79; OR
12-month
: 0.76, 95% CI 0.62–0.93), and suffering depression (OR
6-month
: 0.80, 95% CI 0.64–0.99; OR
12-month
: 0.71, 95% CI 0.57–0.88).
Conclusion
Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions.
Trial registration
ISRCTN registry 89898870, 24th July 2014 retrospectively registered
http://www.isrctn.com/ISRCTN89898870
.
Objectives
To evaluate how glycemic index (GI) and glycemic load (GL) are associated with the metabolic syndrome (MetS) and its features in middle‐aged and elderly adults at high cardiovascular risk.
...Design
Prospective, longitudinal, population‐based cohort.
Setting
PREvención con DIeta MEDiterránea study.
Participants
Men and women (N = 6,606) divided into three age groups (<65, 65–74, ≥75).
Measurements
Energy and nutrient intake was evaluated using a validated 137‐item food frequency questionnaire. MetS and its features were defined in accordance with the criteria of the American Heart Association and National Heart, Lung, and Blood Institute.
Results
A positive association was observed between GI and MetS prevalence in the youngest and middle age groups for participants without diabetes mellitus, but no relationship was found for those with diabetes mellitus. During the median follow‐up of 4.8 years, higher GI and GL were related to greater risk of MetS in the middle age group, independent of the presence of diabetes mellitus. Changes in dietary GI were associated with risk of developing the high fasting glucose component of the MetS in the oldest age category, and changes in dietary GL were associated with risk of developing abdominal obesity, hypertriglyceridemia, low high‐density lipoprotein cholesterol, and high blood pressure in the youngest age category.
Conclusion
Dietary GI and GL have a potential role in the development of MetS and associated clinical features, with particular age‐dependent considerations.
Fiber and fiber-rich foods have been inversely associated with cardiovascular disease (CVD), but the evidence is scarce in young and Mediterranean cohorts. We used Cox regression models to assess the ...association between quintiles of total fiber and fiber from different sources, and the risk of CVD adjusted for the principal confounding factors in a Mediterranean cohort of young adults, the SUN (Seguimiento Universidad de Navarra, Follow-up) cohort. After a median follow-up of 10.3 years, we observed 112 cases of CVD among 17,007 participants (61% female, mean age 38 years). We observed an inverse association between fiber intake and CVD events (
for trend = 0.024) and also between the highest quintile of fruit consumption (hazard ratio (HR) 0.51, 95% confidence interval (CI) 0.27-0.95) or whole grains consumption (HR 0.43 95% CI 0.20-0.93) and CVD compared to the lowest quintile, and also a HR of 0.58 (95% CI 0.37-0.90) for the participants who ate at least 175 g/day of fruit. Only the participants in the highest quintile of fruit-derived fiber intake had a significantly lower risk of CVD (HR 0.52, 95% CI 0.28-0.97). The participants who ate at least one serving per week of cruciferous vegetables had a lower risk than those who did not (HR 0.52, 95% CI 0.30-0.89). In conclusion, high fruit consumption, whole grain consumption, or consumption of at least one serving/week of cruciferous vegetables may be protective against CVD in young Mediterranean populations.
Introducción: el grosor de la íntima media carotídea (GIMC) es un conocido marcador de arteriosclerosis precoz y un buen predictor de eventos cardiovasculares futuros. Aunque se ha demostrado que la ...adhesión a la dieta mediterránea, especialmente si está enriquecida con aceite de oliva virgen extra o frutos secos, tiene efectos beneficiosos sobre los cambios en el GIMC, el papel de los carbohidratos en el desarrollo de la arterioesclerosis sigue siendo controvertido. Objetivo: valorar la relación entre el índice glucémico (IG) o la carga glucémica (CG) de la dieta y el GIMC en una población asintomática con alto riesgo cardiovascular. Métodos: en el marco del estudio PREDIMED (PREvención con Dieta MEDiterránea), se seleccionaron de manera aleatorizada 187 sujetos del centro PREDIMED- NAVARRA. A estos pacientes asintomáticos, pero con alto riesgo cardiovascular, se les realizó una ecografía carotídea basal para determinar su GIMC, y tras un año en el estudio se les repitió la misma medición. Se usó un cuestionario validado de frecuencia de consumo de alimentos (137 ítems) tanto basal como anualmente para obtener el IG y la CG, que fueron categorizados en cuartiles, tras ser ajustados por energía. Mediante modelos multivariables (ANCOVA) se estudió la posible asociación entre el IG o la CG de la dieta y el GIMC o su cambio al año. Resultados: en la población estudiada no se observó una asociación estadísticamente significativa entre el IG o la CG y el GIMC, ni al inicio ni tras un año de seguimiento.
Breast cancer is the leading cause of female cancer burden, and its incidence has increased by more than 20% worldwide since 2008. Some observational studies have suggested that the Mediterranean ...diet may reduce the risk of breast cancer.
To evaluate the effect of 2 interventions with Mediterranean diet vs the advice to follow a low-fat diet (control) on breast cancer incidence.
The PREDIMED study is a 1:1:1 randomized, single-blind, controlled field trial conducted at primary health care centers in Spain. From 2003 to 2009, 4282 women aged 60 to 80 years and at high cardiovascular disease risk were recruited after invitation by their primary care physicians.
Participants were randomly allocated to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat).
Breast cancer incidence was a prespecified secondary outcome of the trial for women without a prior history of breast cancer (n = 4152).
After a median follow-up of 4.8 years, we identified 35 confirmed incident cases of breast cancer. Observed rates (per 1000 person-years) were 1.1 for the Mediterranean diet with extra-virgin olive oil group, 1.8 for the Mediterranean diet with nuts group, and 2.9 for the control group. The multivariable-adjusted hazard ratios vs the control group were 0.32 (95% CI, 0.13-0.79) for the Mediterranean diet with extra-virgin olive oil group and 0.59 (95% CI, 0.26-1.35) for the Mediterranean diet with nuts group. In analyses with yearly cumulative updated dietary exposures, the hazard ratio for each additional 5% of calories from extra-virgin olive oil was 0.72 (95% CI, 0.57-0.90).
This is the first randomized trial finding an effect of a long-term dietary intervention on breast cancer incidence. Our results suggest a beneficial effect of a Mediterranean diet supplemented with extra-virgin olive oil in the primary prevention of breast cancer. These results come from a secondary analysis of a previous trial and are based on few incident cases and, therefore, need to be confirmed in longer-term and larger studies.
ISRCTN.org Identifier: ISRCTN35739639.
Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary ...assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes.
Cross-sectional assessment of all participants in the "PREvención con DIeta MEDiterránea" (PREDIMED) trial.
7,447 participants (55-80 years, 57% women) free of cardiovascular disease, but with either type 2 diabetes or ≥ 3 cardiovascular risk factors. Trained dietitians used both a validated 14-item questionnaire and a full-length validated 137-item food frequency questionnaire to assess dietary habits. Trained nurses measured weight, height and waist circumference.
Strong inverse linear associations between the 14-item tool and all adiposity indexes were found. For a two-point increment in the 14-item score, the multivariable-adjusted differences in WHtR were -0.0066 (95% confidence interval, -0.0088 to -0.0049) for women and -0.0059 (-0.0079 to -0.0038) for men. The multivariable-adjusted odds ratio for a WHtR>0.6 in participants scoring ≥ 10 points versus ≤ 7 points was 0.68 (0.57 to 0.80) for women and 0.66 (0.54 to 0.80) for men. High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity.
A brief 14-item tool was able to capture a strong monotonic inverse association between adherence to a good quality dietary pattern (Mediterranean diet) and obesity indexes in a population of adults at high cardiovascular risk.
PDF
