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Adherence to an energy-restricted Mediterranean diet score and prevalence of cardiovascular risk factors in the PREDIMED-Plus: A cross-sectional study

Autores: Alvarez Alvarez, Ismael; Martínez González, Miguel Ángel (Autor de correspondencia); Sánchez Tainta, Ana; Corella, D. ; Diaz-Lopez, A.; Fito, M.; Vioque, J.; Romaguera, D.; Martínez Hernández, Alfredo; Warnberg, J. ; Lopez-Miranda, J.; Estruch, R.; Bueno-Cavanillas, A. ; Aros, F. ; Tur, J. A.; Tinahones, F. J.; Serra-Majem, L. ; Martin, V.; Lapetra, J.; Fontao, S. M. ; Pinto, X. ; Vidal, J.; Daimiel, L. ; Gaforio, J. J.; Matia, P. ; Ros, E.; Ruiz-Canela, Miguel; Sorli, J. V.; Becerra-Tomas, N.; Castaner, O. ; Schroder, H.; Navarrete-Munoz, E. M.; Zulet Alzórriz, María de los Ángeles; Garcia-Rios, A.; Salas-Salvado, J.; Diez-Espino, J.; Toledo Atucha, Estefanía
ISSN: 0300-8932
Volumen: 72
Número: 11
Páginas: 925 - 934
Fecha de publicación: 2019
Introduction and objectives: The cardiovascular benefits of the Mediterranean diet have usually been assessed under assumptions of ad libitum total energy intake (ie, no energy restriction). In the recently launched PREDIMED-Plus, we conducted exploratory analyses to study the baseline associations between adherence to an energy-restricted Mediterranean diet (MedDiet) and the prevalence of cardiovascular risk factors (CVRF). Methods: Cross-sectional assessment of all PREDIMED-Plus participants (6874 older adults with overweight/obesity and metabolic syndrome) at baseline. The participants were assessed by their usual primary care physicians to ascertain the prevalence of 4 CVRF (hypertension, obesity, diabetes, and dyslipidemia). A 17-point PREDIMED-Plus score was used to measure adherence to the MedDiet. Multivariable models were fitted to estimate differences in means and prevalence ratios for individual and clustered CVRF. Results: Better adherence to a MedDiet pattern was significantly associated with lower average triglyceride levels, body mass index, and waist circumference. Compared with low adherence (<= 7 points in the 17-point score), better adherence to the MedDiet (11-17 points) showed inverse associations with hypertension (prevalence ratio = 0.97; 95%CI, 0.94-1.00) and obesity (prevalence ratio = 0.96; 95%CI, 0.92-1.00), but positive associations with diabetes (prevalence ratio = 1.19; 95%CI, 1.07-1.32). Compared with the lowest third of adherence, women in the upper third showed a significantly lower prevalence of the clustering of 3 or more CVRF (prevalence ratio = 0.91; 95%CI, 0.83-0.98). Conclusions: Among participants at high cardiovascular risk, better adherence to a MedDiet showed significant inverse associations with CVRF among women, and improved lipid profiles and adiposity measures. (C) 2018 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.