51. Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial.
- Author
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Díaz-López A, Babio N, Martínez-González MA, Corella D, Amor AJ, Fitó M, Estruch R, Arós F, Gómez-Gracia E, Fiol M, Lapetra J, Serra-Majem L, Basora J, Basterra-Gortari FJ, Zanon-Moreno V, Muñoz MÁ, and Salas-Salvadó J
- Subjects
- Aged, Aged, 80 and over, Cardiovascular Diseases diet therapy, Cardiovascular Diseases epidemiology, Diabetes Mellitus, Type 2 epidemiology, Diabetic Angiopathies epidemiology, Diabetic Nephropathies epidemiology, Diabetic Retinopathy epidemiology, Female, Humans, Incidence, Male, Microvessels, Middle Aged, Nuts, Risk Factors, Diabetes Mellitus, Type 2 diet therapy, Diabetic Angiopathies diet therapy, Diabetic Nephropathies diet therapy, Diabetic Retinopathy diet therapy, Diet, Mediterranean
- Abstract
Objective: To date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a low-fat control diet., Research Design and Methods: This was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), MedDiet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression., Results: During a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the MedDiet+EVOO and 0.63 (0.35-1.11) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the MedDiet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy., Conclusions: A MedDiet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy., (© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.)
- Published
- 2015
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