Mediterranean Diet and Cardiovascular Health: Teachings of the PREDIMED Study
Mediterranean Diet and Cardiovascular Health: Teachings of the PREDIMED Study
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DOI：
10.3945/an.113.005389
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发表时间：
2014-05-01
影响因子：
9.3
通讯作者：
Corella, Dolores
中科院分区：
文献类型：
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作者：
Ros, Emilio;Martinez-Gonzalez, Miguel A.;Corella, Dolores
PREDIMED（地中海饮食预防）研究旨在评估无任何能量限制的地中海饮食（MeDiet）对心血管疾病（CVD）的长期影响，作为一项多中心、随机、一级预防试验，在高危人群中进行。受试者随机分为3个饮食组：1)MeDiet中添加特级初榨橄榄油（EVOO）；2)添加坚果的培养基；3)控制饮食（建议低脂饮食）。4.8年后，7447名参与者中发生了288起重大心血管事件；与对照组相比，MeDiet + EVOO的粗风险比为0.70 (95% CI: 0.53, 0.91)， MeDiet +坚果的粗风险比为0.70 （95% CI: 0.53, 0.94）。与对照组相比，3541名无糖尿病的参与者中发生糖尿病的风险比（273例）分别为0.60 （95% CI: 0.43, 0.85）和0.82 （95% CI: 0.61, 1.10）。经过1年的随访，MeDiet +坚果组的参与者代谢综合征患病率显著降低13.7%，而MeDiet + EVOO组和对照组分别降低6.7%和2.0%。对心血管风险中间标记物的分析表明，MeDiets对血压、脂质谱、脂蛋白颗粒、炎症、氧化应激和颈动脉粥样硬化，以及参与血管事件和血栓形成的致动脉粥样硬化基因的表达都有有益的影响。营养基因组学研究表明，MeDiet与环氧化酶-2 （COX-2）、白介素-6 （IL-6）、载脂蛋白A2 （APOA2）、胆固醇酯转移蛋白血浆（CUP）和转录因子7-样2 （TCF7L2）基因多态性之间存在相互作用。PREDIMED研究结果表明，高不饱和脂肪和富含抗氧化剂的饮食模式（如MeDiet）是预防心血管疾病的有用工具。
The PREDIMED (Prevencion con Dieta Mediterranea) study was designed to assess the long-term effects of the Mediterranean diet (MeDiet) without any energy restriction on incident cardiovascular disease (CVD) as a multicenter, randomized, primary prevention trial in individuals at high risk. Participants were randomly assigned to 3 diet groups: 1) MeDiet supplemented with extra-virgin olive oil (EVOO); 2) MeDiet supplemented with nuts; and 3) control diet (advice on a low-fat diet). After 4.8 y, 288 major CVD events occurred in 7447 participants; crude hazard ratios were 0.70 (95% CI: 0.53, 0.91) for the MeDiet + EVOO and 0.70 (95% CI: 0.53, 0.94) for the MeDiet + nuts compared with the control group. Respective hazard ratios for incident diabetes (273 cases) among 3541 participants without diabetes were 0.60 (95% CI: 0.43, 0.85) and 0.82 (95% CI: 0.61, 1.10) compared with the control group. After 1-y follow-up, participants in the MeDiet + nuts group showed a significant 13.7% reduction in prevalence of metabolic syndrome compared with reductions of 6.7% and 2.0% in the MeDiet + EVOO and control groups, respectively. Analyses of intermediate markers of cardiovascular risk demonstrated beneficial effects of the MeDiets on blood pressure, lipid profiles, lipoprotein particles, inflammation, oxidative stress, and carotid atherosclerosis, as well as on the expression of proatherogenic genes involved in vascular events and thrombosis. Nutritional genomics studies demonstrated interactions between a MeDiet and cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), apolipoprotein A2 (APOA2), cholesteryl ester transfer protein plasma (CUP), and transcription factor 7-like 2 (TCF7L2) gene polymorphisms. The PREDIMED study results demonstrate that a high-unsaturated fat and antioxidant-rich dietary pattern such as the MeDiet is a useful tool in the prevention of CVD.