Department of Preventive Medicine and Public Health, University of Navarra, IDISNA (Navarra Health Research Institute), Pamplona, Spain; The PREDIMED Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
The PREDIMED Research Network (RD 06/0045), Instituto de Salud Carlos III, Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Human Nutrition Department, Hospital Universitari Sant Joan, Institut d'Investigació Sanitaria Pere Virgili, Universitat Rovira i Virgili, Reus, Spain.
Prog Cardiovasc Dis. 2015 Jul-Aug;58(1):50-60. doi: 10.1016/j.pcad.2015.04.003. Epub 2015 May 1.
The PREDIMED (PREvención con DIeta MEDiterránea) multicenter, randomized, primary prevention trial assessed the long-term effects of the Mediterranean diet (MeDiet) on clinical events of cardiovascular disease (CVD). We randomized 7447 men and women at high CVD risk into three diets: MeDiet supplemented with extra-virgin olive oil (EVOO), MeDiet supplemented with nuts, and control diet (advice on a low-fat diet). No energy restriction and no special intervention on physical activity were applied. We observed 288 CVD events (a composite of myocardial infarction, stroke or CVD death) during a median time of 4.8years; hazard ratios were 0.70 (95% CI, 0.53-0.91) for the MeDiet+EVOO and 0.70 (CI, 0.53-0.94) for the MeDiet+nuts compared to the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 non-diabetic participants were 0.60 (0.43-0.85) and 0.82 (0.61-1.10) for MeDiet+EVOO and MeDiet+nuts, respectively versus control. Significant improvements in classical and emerging CVD risk factors also supported a favorable effect of both MeDiets on blood pressure, insulin sensitivity, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis. In nutrigenomic studies beneficial effects of the intervention with MedDiets showed interactions with several genetic variants (TCF7L2, APOA2, MLXIPL, LPL, FTO, M4CR, COX-2, GCKR and SERPINE1) with respect to intermediate and final phenotypes. Thus, the PREDIMED trial provided strong evidence that a vegetable-based MeDiet rich in unsaturated fat and polyphenols can be a sustainable and ideal model for CVD prevention.
PREDIMED（地中海饮食预防）多中心、随机、一级预防试验评估了地中海饮食（MeDiet）对心血管疾病（CVD）临床事件的长期影响。我们将 7447 名高 CVD 风险的男性和女性随机分为三组饮食：MeDiet 加特级初榨橄榄油（EVOO）、MeDiet 加坚果和对照组（低脂饮食建议）。不限制能量，不特别干预体力活动。在中位数为 4.8 年的时间内，我们观察到 288 例 CVD 事件（心肌梗死、中风或 CVD 死亡的综合事件）；MeDiet+EVOO 组和 MeDiet+坚果组的风险比分别为 0.70（95%CI，0.53-0.91）和 0.70（95%CI，0.53-0.94），与对照组相比。在 3541 名非糖尿病参与者中，分别有 273 例新发糖尿病，MeDiet+EVOO 和 MeDiet+坚果组的风险比分别为 0.60（0.43-0.85）和 0.82（0.61-1.10）。两种 MeDiet 对血压、胰岛素敏感性、血脂谱、脂蛋白颗粒、炎症、氧化应激和颈动脉粥样硬化等心血管疾病新的危险因素也有显著改善。在营养基因组学研究中，MeDiets 干预的有益效果显示与几个遗传变异（TCF7L2、APOA2、MLXIPL、LPL、FTO、M4CR、COX-2、GCKR 和 SERPINE1）存在交互作用，与中间和最终表型有关。因此，PREDIMED 试验提供了强有力的证据，表明富含不饱和脂肪和多酚的植物性 MeDiet 可以成为可持续的理想 CVD 预防模型。
