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1. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study

Author

Serra-Mir, M., Pérez-Heras, A., Viñas, C., Casas, R., Medina-Renom, A., Baena, J.M., García, M., Oller, M., Amat, J., Duaso, I., García, Y., Iglesias, C., Simón, C., Quinzavos, L., Parra, L., Liroz, M., Benavent, J., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Martín, M.T., Sánchez, M.S., Altirriba, J., Manzano, E., Altés, A., Cofán, M., Valls-Pedret, C., Sala-Vila, A., Doménech, M., Bulló, M., Babio, N., Basora, J., González, R., Molina, C., Márquez, F., Martínez, P., Ibarrola, N., Sorlí, M., García Roselló, J., Castro, A., Martin, F., Tort, N., Isach, A., Guasch-Ferre, M., Cabré, J.J., Mestres, G., Paris, F., Llauradó, M., Pedret, R., Basells, J., Vizcaino, J., Segarra, R., Frigola, J., Costa-Vizcaino, J., Salas-Huetos, A., Boj, J., Montañes, D., Papandreou, Christopher, Fernández-Ballart, J., Carrasco, P., Ortega-Azorín, C., Asensio, E.M., Osma, R., Barragán, R., Francés, F., Guillén, M., González, J.I., Sáiz, C., Portolés, O., Giménez, F.J., Coltell, O., Fernández-Carrión, R., Guillem-Sáiz, P., González-Monje, I., Quiles, L., Pascual, V., Riera, C., Pages, M.A., Godoy, D., Carratalá-Calvo, A., Sánchez-Navarro, S., Valero-Barceló, C., Tello, S., Vila, J., de la Torre, R., Muñoz-Aguayo, D., Elosua, R., Marrugat, J., Schröder, H., Molina, N., Maestre, E., Rovira, A., Castañer, O., Farré, M., Toledo, E., Ruiz-Canela, M., Sanjulián, B., Sánchez-Tainta, A., Eguaras, S., Martí, A., Buil-Cosiales, P., SerranoMartínez, M., Diez-Espino, J., García-Arellano, A., Martínez-Lapiscina, E.H., Goñi, E., Vázquez, Z., Berrade, N., Extremera-Urabayen, V., Arroyo-Azpa, C., García-Pérez, L., Villanueva-Telleria, J., Cortés-Ugalde, F., Sagredo-Arce, T., Vigata-López, M.D., Arceiz Campo, M.T., Urtasun-Samper, A., Gueto Rubio, M.V., Churio-Beraza, B., Arós, F., Salaverria, I., del Hierro, T., Algorta, J., Francisco, S., Alonso-Gómez, A., Sanz, E., Rekondo, J., Belló, M.C., Loma-Osorio, A., Gómez-Gracia, E., Wärnberg, J., Benítez Pont, R., Bianchi Alba, M., Gómez-Huelgas, R., Martínez-González, J., Velasco García, V., de Diego Salas, J., Baca Osorio, A., Gil Zarzosa, J., Sánchez Luque, J.J., Vargas López, E., Ruiz-Gutiérrez, V., Sánchez Perona, J., Montero Romero, E., García-García, M., Jurado-Ruiz, E., Fiol, M., Romaguera, D., García-Valdueza, M., Moñino, M., Munuera, S., Vivó, M., Bestard, F., Munar, J.A., Coll, L., Proenza, A., Prieto, R., Frontera, G., Fiol, F., Ginard, M., Jover, A., García, J., Santos-Lozano, J.M., Ortega-Calvo, M., Mellado, L., García-Corte, F.J., Román, P., Iglesias, P., Corchado, Y., Miró-Moriano, L., Domínguez-Espinaco, C., Lozano-Rodriguez, J.M., Vaquero-Diaz, S., López- Sabater, M.C., Castellote-Bargalló, A.I., Quifer-Rada, P., Tresserra-Rimbau, A., Álvarez-Pérez, J., Díaz-Benítez, E.M., Sánchez-Villegas, A., Casañas-Quintana, L.T., Pérez-Cabrera, J., Ruano-Rodríguez, C., Bautista-Castaño, I., Sarmiento de la Fe, F., García Pastor, J.A., Díaz-González, B.V., Castillo Anzalas, J.M., Sosa-Also, R.E., Medina-Ponce, J., de la Cruz, E., Fanlo-Maresma, M., Galera, A., Trias, F., Sarasa, I., Corbella, E., Corbella, X., Cabezas, C., Vinyoles, E., Rovira, M.A., García, L., Flores, G., Verdú, J.M., Baby, P., Ramos, A., Mengual, L., Roura, P., Yuste, M.C., Guarner, A., Santamaría, M.I., Mata, M., de Juan, C., Brau, A., Tur, J.A., Portillo, M.P., Sáez, G., Aldamiz-Echevarría, M., Alonso-Gómez, A.M., Berjón, J., Forga, L., Gállego, J., García-Layana, A., Larrauri, A., Portu-Zapirain, J., Timiraus-Fernández, J., Becerra-Tomás, Nerea, Díaz-López, Andrés, Rosique-Esteban, Núria, Ros, Emilio, Buil-Cosiales, Pilar, Corella, Dolores, Estruch, Ramon, Fitó, Montserrat, Serra-Majem, Lluís, Arós, Fernando, Lamuela-Raventós, Rosa Maria, Fiol, Miquel, Santos-Lozano, José Manuel, Díez-Espino, Javier, Portoles, Olga, and Salas-Salvadó, Jordi

Published
2018
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2. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study

Author

Miguel Fiol, Patricia Guillem-Saiz, Leticia Miró-Moriano, Josep A. Tur, N. Ibarrola, A.I. Castellote-Bargalló, J. Boj, Estefanía Toledo, Ana Jover, V. Extremera-Urabayen, E. Manzano, I. González-Monje, Juan Carlos Martínez-González, María P. Portillo, O. Portolés, C. Simón, Olga Castañer, B. Sanjulián, S. Sánchez-Navarro, R. González, Rosa M. Lamuela-Raventós, R. Pedret, N. Tort, J. Pérez-Cabrera, J. García, J. Portu-Zapirain, Carolina Ortega-Azorín, Dolors Montañes, Helmut Schröder, Guillermo Frontera, Mònica Bulló, Lluis Serra-Majem, J.M. Santos-Lozano, F. Trias, Nuria Rosique-Esteban, P. Martínez, C. Iglesias, Magí Farré, J.M. Lozano-Rodriguez, Valentina Ruiz-Gutiérrez, Luis Forga, L.T. Casañas-Quintana, I. Sarasa, C. de Juan, R. Benítez Pont, Javier Díez-Espino, L. Parra, M. Ginard, Josep Basora, Luis V. García, Rosa Casas, Fernando Arós, L. Quinzavos, A. Larrauri, A. Guarner, Ramon Estruch, A.M. Alonso-Gómez, Aleix Sala-Vila, E. Montero Romero, Cinta Valls-Pedret, F. Bestard, Jesús Berjón, Y. García, José Manuel Santos-Lozano, Emili Corbella, J. Clos, Christopher Papandreou, E. Maestre, R.E. Sosa-Also, J. Altirriba, M. Bianchi Alba, José I. González, Eva M. Asensio, Paula Carrasco, J. Vila, J.A. García Pastor, J. Medina-Ponce, Jordi Salas-Salvadó, L. Mellado, Amelia Marti, Estíbaliz Goñi, Joan Fernández-Ballart, Ana García-Arellano, Pilar Roura, Albert Salas-Huetos, A. Loma-Osorio, E. Jurado-Ruiz, Casandra Riera, Pilar Buil-Cosiales, Ana Galera, J. Gil Zarzosa, Miquel Fiol, Fabiola Márquez, Alfredo García-Layana, Maria Luisa García, B.V. Díaz-González, M.A. Pages, Enrique Gómez-Gracia, D. Godoy, F. Paris, T. del Hierro, F. Cortés-Ugalde, Ernest Vinyoles, J. Marrugat, V. Velasco García, Olga Portolés, F. Sarmiento de la Fe, Roberto Elosua, F.J. García-Corte, J. Timiraus-Fernández, Ana Pérez-Heras, P. Baby, M. Aldamiz-Echevarría, Montse Cofán, Y. Corchado, J. Villanueva-Telleria, T. Sagredo-Arce, C. Valero-Barceló, M.C. Belló, J. Frigola, J.J. Cabré, B. Churio-Beraza, Montserrat Fitó, P. Román, A. Proenza, M.C. López Sabater, P. Iglesias, J.M. Baena, M.T. Martín, Javier Rekondo, S. Vaquero-Diaz, G. Mestres, Nancy Babio, J. Diez-Espino, M. Liroz, M. García-Valdueza, J. Gállego, J.M. Castillo Anzalas, M.V. Gueto Rubio, L. Coll, S. Tello, Manuel Moñino, Anna Tresserra-Rimbau, Susana Munuera, J. Sánchez Perona, Guillermo T. Sáez, Gemma Flores, J. Amat, J. Benavent, M. Sorlí, Manuel Ortega-Calvo, A. Altés, Dolores Corella, Inmaculada Bautista-Castaño, Jacqueline Álvarez-Pérez, Marisa Guillén, Rafel M. Prieto, Ángel M. Alonso-Gómez, A. Ramos, Daniel Muñoz-Aguayo, M.A. Rovira, E. de la Cruz, Manuel Serrano-Martínez, A. Urtasun-Samper, R. Osma, R. de la Torre, J. Basells, N. Berrade, Jaime Algorta, R. Segarra, I. Duaso, Emilio Ros, C. Domínguez-Espinaco, J.A. Munar, A. Brau, M.I. Santamaría, A. Medina-Renom, Mercè Serra-Mir, Jesús Vizcaíno, J. de Diego Salas, M. Amorós, Z. Vázquez, Ana María Castro, E. Sanz, M. García-García, F. Fiol, F.J. Giménez, Itziar Salaverria, M. Vivó, Elena H. Martinez-Lapiscina, C. Viñas, J. García Roselló, A. Baca Osorio, A. Carratalá-Calvo, Francesc Francés, Julia Wärnberg, C. Arroyo-Azpa, Rebeca Fernández-Carrión, E.M. Díaz-Benítez, O. Coltell, Miguel Ruiz-Canela, M.D. Vigata-López, F. Martin, M.S. Sánchez, L. Mengual, Mónica Doménech, V. Pascual, Nerea Becerra-Tomás, Ricardo Gómez-Huelgas, Xavier Corbella, M.C. Yuste, E. Vargas López, Carmen Saiz, J.J. Sánchez Luque, I. Pla, S. Francisco, F. Aros, Marta Guasch-Ferré, Almudena Sánchez-Villegas, A. Isach, Ariadna Rovira, Marta Fanlo-Maresma, Carmen Cabezas, Dora Romaguera, L. Garcia-Pérez, M. Oller, M.T. Bonet, M. Mata, Sonia Eguaras, Ana Sánchez-Tainta, M. Llauradó, J. Costa-Vizcaino, Laura Quiles, Paola Quifer-Rada, C. Molina, N. Molina, M.T. Arceiz Campo, Cristina Ruano-Rodríguez, J.M. Verdú, Rocío Barragán, and Andrés Díaz-López

Subjects
0301 basic medicine, Gerontology, Blood Glucose, Male, Lentils, Mediterranean diet, PREDIMED-study, 030209 endocrinology & metabolism, Context (language use), Type 2 diabetes, Critical Care and Intensive Care Medicine, Lower risk, Diet, Mediterranean, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, medicine, Humans, Prospective Studies, Glycemic, Adiposity, Aged, Proportional Hazards Models, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Fabaceae, Middle Aged, medicine.disease, Legumes, Diet, Glycemic index, Quartile, Diabetes Mellitus, Type 2, Glycemic Index, Female, business, Demography, Follow-Up Studies
Abstract

Background & aims: Legumes, a low-energy, nutrient-dense and low glycemic index food, have shown beneficial effects on glycemic control and adiposity. As such, legumes are widely recommended in diabetic diets, even though there is little evidence that their consumption protects against type 2 diabetes. Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes, and type 2 diabetes risk. We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods. Methods: Prospective assessment of 3349 participants in the PREvención con DIeta MEDiterránea (PREDIMED) study without type 2 diabetes at baseline. Dietary information was assessed at baseline and yearly during follow-up. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes, lentils, chickpeas, dry beans and fresh peas. Results: During a median follow-up of 4.3 years, 266 new cases of type 2 diabetes occurred. Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile (HR: 0.65; 95% CI: 0.43, 0.96; P-trend = 0.04; and HR: 0.67; 95% CI: 0.46–0.98; P-trend = 0.05, respectively). A borderline significant association was also observed for chickpeas consumption (HR 0.68; 95% CI: 0.46, 1.00; P-trend = 0.06). Substitutions of half a serving/day of legumes for similar servings of eggs, bread, rice or baked potato was associated with lower risk of diabetes incidence. Conclusions: A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk. Trial registration: The trial is registered at http://www.controlled-trials.com (ISRCTN35739639). Registration date: 5th October 2005., The authors disclose no conflict of interest related with the article. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN) is an initiative of the Instituto de Salud Carlos III (ISCIII) of Spain which is supported by FEDER funds (CB06/03). Supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through grants provided to research networks specifically developed for the trial (RTIC G03/140 and RD 06/0045) through CIBEROBN, and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–FondoEuropeo de Desarrollo Regional (PI04–2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, and PI11/02505; PI13/00462), Ministerio de Ciencia e Innovación (AGL-2009–13906-C02 and AGL2010–22319-C03), Fundación Mapfre 2010, Consejería de Salud de la Junta de Andalucía (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVA-COMP2010–181, GVACOMP2011–151, CS2010-AP-111, and CS2011-AP-042), and the Navarra Regional Government (27/2011). The Fundación Patrimonio Comunal Olivarero and Hojiblanca SA (Málaga, Spain), California Walnut Commission (Sacramento, CA), Borges SA (Reus, Spain), and Morella Nuts SA (Reus, Spain) donated the olive oil, walnuts, almonds, and hazelnuts, respectively, used in the study. None of the funding sources played a role in the design, collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication. Acknowledgements: The authors thank all the participants for their collaboration, all the PREDIMED personnel for their assistance and all the personnel of affiliated primary care centers for making the study possible. CIBEROBN is an initiative of ISCIII, Spain.

Published
2018

3. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study

Author

Becerra-Tomás, Nerea, Díaz-López, A., Rosique-Esteban, N., Ros, E., Buil-Cosiales, P., Corella, D., Estruch, R., Fitó, Montserrat, Serra-Majem, L., Arós, F., Lamuela-Raventós, Rosa M., Gueto Rubio, M.V., Loma-Osorio, A., Gómez-Gracia, Enrique, Wärnberg, J., Duaso, I., Rovira, M.A., Benítez Pont, R., Perona, Javier S., Bianchi Alba, M., de la Cruz, E., Basora, J., Brau, A., Salas-Salvadó, J., Bonet, M.T., Gómez-Huelgas, R., Guillén, M., Martínez-González, J., Berrade, N., Molina, C., Casas, Ricard, Sáez, G., Guasch-Ferré, Marta, Iglesias, C., Serra-Mir, M., Velasco García, V., Márquez, F., Montero Romero, Emilio, Vila, J., García-García, M., del Hierro, T., Coltell, O., Jurado-Ruíz, Enrique, Cabré, J.J., Romaguera, D., Valero-Barceló, C., García, M., Costa-Vizcaino, J., Altirriba, J., Prieto, R., García-Valdueza, M., Frontera, G., Fiol, F., Ginard, M., Mestres, G., García, Y., Jover, A., Sorlí, M., Ibarrola-Jurado, Nuria, Molina, N., García, J., Salas-Huetos, A., López-Sabater, M.C., Martínez-Lapiscina, E.H., García Pastor, J.A., Sánchez Luque, J.J., González, J.I., Martín, F., Manzano, E., Fanlo-Maresma, M., Viñas, C., Sáiz, C., Galera, A., Churio-Beraza, B., Trias, F., Bestard, F., Extremera-Urabayen, V., de la Torre, Rafael, Medina-Remón, Alexander, Tort, N., Tello, S., Papandreou, C., Verdú, J.M., Sarasa, I., Muñoz-Aguayo, Daniel, Baby, P., Baena, J.M., Paris, F., Ramos, A., Díaz-Benítez, E.M., Francisco, S., Mengual, L., Ruiz-Canela, M., Roura, P., de Diego Salas, J., Castro Dorado, Antonio, Goñi, E., Fernández-Carrión, R., Fernández-Ballart, J., Yuste, M.C., Aldamiz-Echevarría, M., Alonso-Gómez, A.M., Berjón, J., Sanjulián, B., Montañes, D., Forga, L., Schröder, H., Marrugat, J., Llauradó, M., Giménez, F.J., Gallego, J., Vázquez, Z., García-Layana, A., Moñino, M., Larrauri, A., Vinyoles, E., Rovira, A., Guillem-Saiz, P., Eguaras, S., Simón, C., Oller, M., Salaverria, I., Quinzavos, L., Quifer-Rada, P., Parra, L., de Juan, C., Sarmiento de la Fe, F., Liroz, M., Benavent, J., Castellote-Bargalló, Ana I., Farré, M., Baca Osorio, A., Arroyo-Azpa, C., Altés, A., Clos, J., Cofán, M., Valls-Pedret, C., Sala-Vila, A., Sánchez-Tainta, A., Doménech, M., Portolés, Olga, Algorta, J., Pérez-Cabrera, J., Bulló, M., Gil Zarzosa, J., Babio, N., Corbella, Emili, Maestre, E., Munuera, S., Sanz, E., García-Pérez, L., Pedret, R., Isach, A., Vivó, M., Basells, J., Guarner, A., Vizcaino, J., Martín, M. T., Tresserra-Rimbau, A., Castañer, O., Rekondo, J., Díaz-González, B.V., Ruiz-Gutiérrez, Valentina, Carrasco, P., Segarra, R., Álvarez-Pérez, J., Ortega-Azorín, Carolina, Fiol, Miquel, Asensio, E.M., Martínez, P., Tur, J.A., Osma, R., Castillo Anzalas, J.M., Barragán, R., Portu-Zapirain, J., Alonso-Gómez, A., Corbella, X., Coll, L., González-Monje, I., Francés, F., Quiles, L., Pascual, V., Riera, C., Sosa-Also, R.E., Vargas López, E., Pages, M.A., Casañas-Quintana, L.T., Sánchez-Villegas, A., Pérez-Heras, A., Godoy, D., Cabezas, C., Carratalá-Calvo, A., Pla, I., Sánchez-Navarro, S., Boj, J., Santamaría, M.I., Bautista-Castaño, Inmaculada, Proenza, A., Martí, A., Toledo, E., Mata, M., González, R., SerranoMartínez, M., Sánchez, M.S., Díez-Espino, Javier, Santos-Lozano, J.M., Munar, J.A., Timiraus-Fernández, J., García, L., Villanueva-Tellería, J., García-Arellano, A., Cortés-Ugalde, F., Sagredo-Arce, T., Medina-Ponce, J., Vigata-López, M.D., Elosua, R., García Roselló, J., Arceiz Campo, M.T., Amat, J., Urtasun-Samper, A., Frigola, J., Ruano-Rodríguez, C., Amorós, M., Portillo, María P., Flores-Mateo, Gemma, Belló, M.C., Becerra-Tomás, Nerea, Díaz-López, A., Rosique-Esteban, N., Ros, E., Buil-Cosiales, P., Corella, D., Estruch, R., Fitó, Montserrat, Serra-Majem, L., Arós, F., Lamuela-Raventós, Rosa M., Gueto Rubio, M.V., Loma-Osorio, A., Gómez-Gracia, Enrique, Wärnberg, J., Duaso, I., Rovira, M.A., Benítez Pont, R., Perona, Javier S., Bianchi Alba, M., de la Cruz, E., Basora, J., Brau, A., Salas-Salvadó, J., Bonet, M.T., Gómez-Huelgas, R., Guillén, M., Martínez-González, J., Berrade, N., Molina, C., Casas, Ricard, Sáez, G., Guasch-Ferré, Marta, Iglesias, C., Serra-Mir, M., Velasco García, V., Márquez, F., Montero Romero, Emilio, Vila, J., García-García, M., del Hierro, T., Coltell, O., Jurado-Ruíz, Enrique, Cabré, J.J., Romaguera, D., Valero-Barceló, C., García, M., Costa-Vizcaino, J., Altirriba, J., Prieto, R., García-Valdueza, M., Frontera, G., Fiol, F., Ginard, M., Mestres, G., García, Y., Jover, A., Sorlí, M., Ibarrola-Jurado, Nuria, Molina, N., García, J., Salas-Huetos, A., López-Sabater, M.C., Martínez-Lapiscina, E.H., García Pastor, J.A., Sánchez Luque, J.J., González, J.I., Martín, F., Manzano, E., Fanlo-Maresma, M., Viñas, C., Sáiz, C., Galera, A., Churio-Beraza, B., Trias, F., Bestard, F., Extremera-Urabayen, V., de la Torre, Rafael, Medina-Remón, Alexander, Tort, N., Tello, S., Papandreou, C., Verdú, J.M., Sarasa, I., Muñoz-Aguayo, Daniel, Baby, P., Baena, J.M., Paris, F., Ramos, A., Díaz-Benítez, E.M., Francisco, S., Mengual, L., Ruiz-Canela, M., Roura, P., de Diego Salas, J., Castro Dorado, Antonio, Goñi, E., Fernández-Carrión, R., Fernández-Ballart, J., Yuste, M.C., Aldamiz-Echevarría, M., Alonso-Gómez, A.M., Berjón, J., Sanjulián, B., Montañes, D., Forga, L., Schröder, H., Marrugat, J., Llauradó, M., Giménez, F.J., Gallego, J., Vázquez, Z., García-Layana, A., Moñino, M., Larrauri, A., Vinyoles, E., Rovira, A., Guillem-Saiz, P., Eguaras, S., Simón, C., Oller, M., Salaverria, I., Quinzavos, L., Quifer-Rada, P., Parra, L., de Juan, C., Sarmiento de la Fe, F., Liroz, M., Benavent, J., Castellote-Bargalló, Ana I., Farré, M., Baca Osorio, A., Arroyo-Azpa, C., Altés, A., Clos, J., Cofán, M., Valls-Pedret, C., Sala-Vila, A., Sánchez-Tainta, A., Doménech, M., Portolés, Olga, Algorta, J., Pérez-Cabrera, J., Bulló, M., Gil Zarzosa, J., Babio, N., Corbella, Emili, Maestre, E., Munuera, S., Sanz, E., García-Pérez, L., Pedret, R., Isach, A., Vivó, M., Basells, J., Guarner, A., Vizcaino, J., Martín, M. T., Tresserra-Rimbau, A., Castañer, O., Rekondo, J., Díaz-González, B.V., Ruiz-Gutiérrez, Valentina, Carrasco, P., Segarra, R., Álvarez-Pérez, J., Ortega-Azorín, Carolina, Fiol, Miquel, Asensio, E.M., Martínez, P., Tur, J.A., Osma, R., Castillo Anzalas, J.M., Barragán, R., Portu-Zapirain, J., Alonso-Gómez, A., Corbella, X., Coll, L., González-Monje, I., Francés, F., Quiles, L., Pascual, V., Riera, C., Sosa-Also, R.E., Vargas López, E., Pages, M.A., Casañas-Quintana, L.T., Sánchez-Villegas, A., Pérez-Heras, A., Godoy, D., Cabezas, C., Carratalá-Calvo, A., Pla, I., Sánchez-Navarro, S., Boj, J., Santamaría, M.I., Bautista-Castaño, Inmaculada, Proenza, A., Martí, A., Toledo, E., Mata, M., González, R., SerranoMartínez, M., Sánchez, M.S., Díez-Espino, Javier, Santos-Lozano, J.M., Munar, J.A., Timiraus-Fernández, J., García, L., Villanueva-Tellería, J., García-Arellano, A., Cortés-Ugalde, F., Sagredo-Arce, T., Medina-Ponce, J., Vigata-López, M.D., Elosua, R., García Roselló, J., Arceiz Campo, M.T., Amat, J., Urtasun-Samper, A., Frigola, J., Ruano-Rodríguez, C., Amorós, M., Portillo, María P., Flores-Mateo, Gemma, and Belló, M.C.

Abstract

Background & aims: Legumes, a low-energy, nutrient-dense and low glycemic index food, have shown beneficial effects on glycemic control and adiposity. As such, legumes are widely recommended in diabetic diets, even though there is little evidence that their consumption protects against type 2 diabetes. Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes, and type 2 diabetes risk. We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods. Methods: Prospective assessment of 3349 participants in the PREvención con DIeta MEDiterránea (PREDIMED) study without type 2 diabetes at baseline. Dietary information was assessed at baseline and yearly during follow-up. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes, lentils, chickpeas, dry beans and fresh peas. Results: During a median follow-up of 4.3 years, 266 new cases of type 2 diabetes occurred. Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile (HR: 0.65; 95% CI: 0.43, 0.96; P-trend = 0.04; and HR: 0.67; 95% CI: 0.46–0.98; P-trend = 0.05, respectively). A borderline significant association was also observed for chickpeas consumption (HR 0.68; 95% CI: 0.46, 1.00; P-trend = 0.06). Substitutions of half a serving/day of legumes for similar servings of eggs, bread, rice or baked potato was associated with lower risk of diabetes incidence. Conclusions: A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk. Trial registration: The trial is registered at http://www.controlled-trials.com (ISRCTN35739639). Registration dat

Published
2018

4. Prediction of cardiovascular disease by the framingham-REGICOR equation in the high-risk PREDIMED cohort: Impact of the mediterranean diet across different risk strata

Author

Antonio J. Amor, Mercè Serra‐Mir, Miguel A. Martínez‐González, Dolores Corella, Jordi Salas‐Salvadó, Montserrat Fitó, Ramón Estruch, Lluis Serra‐Majem, Fernando Arós, Nancy Babio, Emilio Ros, Emilio Ortega, A. Pérez‐Heras, C. Viñas, R. Casas, L. de Santamaría, S. Romero, E. Sacanella, G. Chiva, P. Valderas, S. Arranz, J. M. Baena, M. García, M. Oller, J. Amat, I. Duaso, Y. García, C. Iglesias, C. Simón, Ll. Quinzavos, Ll. Parra, M. Liroz, J. Benavent, J. Clos, I. Pla, M. Amorós, M. T. Bonet, M. T. Martin, M. S. Sánchez, J. Altirriba, E. Manzano, A. Altés, A. Sala‐Vila, M. Cofán, C. Valls‐Pedret, T. M. Freitas‐Simoes, M. Doménech, R. Gilabert, N. Bargalló, M. Bulló, J. Basora, R. González, A. Díaz‐López, C. Molina, G. Mena, F. Márquez, P. Martínez, N. Ibarrola, M. Sorli, J. García Roselló, F. Martín, N. Tort, A. Isach, A. Salas‐Huetos, N. Becerra‐Tomás, N. Rosique Esteban, J. J. Cabré, G. Mestres, F. Paris, M. Llaurado, R. Pedret, J. Basells, J. Vizcaino, R. Segarra, P. Hernandez‐Alonso, S. Giardina, C. Ferreira‐Pego, C. Papandreou, L. Camacho, E. Toledo, P. Buil‐Cosiales, M. Ruiz‐Canela, J. A. Martínez, B. Sanjulian, A. Sánchez‐Tainta, J. Diez‐Espino, C. Razquin, A. Garcia‐Arellano, E. Goni, Z. Vazquez, N. Berrade, V. Extremera‐Urabayen, S. Eguaras, A. Marti, C. Arroyo‐Azpa, L. García‐Pérez, J. Villanueva Telleria, F. Cortés Ugalde, T. Sagredo Arce, M. D. García de la Noceda Montoy, M. D. Vigata López, M. T. Arceiz Campo, A. Urtasun Samper, M. V. Gueto Rubio, A. Sola, N. Goñi, O. Lecea, S. Tello, J. Vila, R. de la Torre, D. Muñoz‐Aguayo, R. Elosua, J. Marrugat, H. Schröder, N. Molina, E. Maestre, O. Castañer, A. Rovira, M. Farre, J. V. Sorli, V. Zanon‐Moreno, P. Carrasco, C. Ortega‐Azorín, E. M. Asensio, R. Osma, R. Barragán, F. Francés, M. Guillén, J. I. González, C. Saiz, O. Portolés, F. J. Giménez, O. Coltell, P. Guillem‐Saiz, L. Quiles, V. Pascual, C. Riera, M. A. Pages, D. Godoy, A. Carratala‐Calvo, M. J. Martín‐Rillo, E. Llopis‐Osorio, J. Ruiz‐Baixauli, A. Bertolín‐Muñoz, I. Salaverría, T. del Hierro, J. Algorta, S. Francisco, A. Alonso‐Gómez, E. Sanz, J. Rekondo, M. C. Bello, A. Loma‐Osorio, E. Gómez‐Gracia, J. Warnberg, R. Benítez Pont, M. Bianchi Alba, R. Gómez‐Huelgas, J. Martínez‐González, V. Velasco García, J. de Diego Salas, A. Baca Osorio, J. Gil Zarzosa, J. J. Sánchez Luque, E. Vargas López, V. Ruiz‐Gutiérrez, J. Sánchez Perona, E. Montero Romero, M. García‐García, E. Jurado‐Ruiz, M. Fiol, M. García‐Valdueza, M. Moñino, A. Proenza, R. Prieto, G. Frontera, M. Ginard, F. Fiol, A. Jover, D. Romaguera, J. García, J. Lapetra, J. M. Santos‐Lozano, M. Ortega‐Calvo, L. Mellado, M. Leal, E. Martínez, F. José García, P. Román, P. Iglesias, Y. Corchado, L. Miró, C. Domínguez, J. M. Lozano, E. Mayoral, R. M. Lamuela‐Raventós, M. C. López‐Sabater, A. I. Castellote‐Bargallo, A. Tresserra‐Rimbau, J. Álvarez‐Pérez, E. M. Díaz‐Benítez, I. Bautista Castaño, A. Sánchez‐Villegas, M. J. Fernández‐Rodríguez, T. Casanas Quintana, J. Pérez‐Cabrera, M. Nissensohn, V. Díaz‐González, C. Ruano‐Rodríguez, A. P. Ortiz‐Andrelluchi, B. Macías Gutiérrez, A. J. Santana‐Santana, X. Pintó, E. de la Cruz, A. Galera, Y. Soler, F. Trias, I. Sarasa, E. Padres, E. Corbella, C. Cabezas, E. Vinyoles, M. A. Rovira, L. García, G. Flores, J. M. Verdú, P. Baby, A. Ramos, L. Mengual, P. Roura, M. C. Yuste, A. Guarner, M. I. Santamaría, M. Mata, C. de Juan, A. Brau, J. A. Tur, M. P. Portillo, G. Sáez, M. Aldamiz, A. Alonso, J. Berjón, L. Forga, J. Gallego, A. Larrauri, J. Portu, J. Timiraos, M. Serrano‐Martínez, Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), Ministerio de Ciencia e Innovación (España), and California Walnut Commission

Subjects
Male, Mediterranean diet, Epidemiology, Disease, 030204 cardiovascular system & hematology, Diet, Mediterranean, Cohort Studies, 0302 clinical medicine, Risk Factors, Medicine, 030212 general & internal medicine, Risk assessment, Original Research, Diet and Nutrition, Aged, 80 and over, Framingham Risk Score, Diabetis, Diabetes, Middle Aged, Prognosis, Cardiovascular disease, Primary Prevention, Cardiovascular diseases, Cardiovascular Diseases, Cohort, Female, Cardiology and Cardiovascular Medicine, Framingham‐REGICOR equation, PREDIMED, Cardiovascular risk prediction, Scale (ratio), Risk Assessment, 03 medical and health sciences, Humans, cardiovascular diseases, Aged, Proportional Hazards Models, Framingham-REGICOR equation, business.industry, Malalties cardiovasculars, Feeding Behavior, Lifestyle, Predimed, Diabetes Mellitus, Type 2, Spain, Avaluació del risc, Mediterraneam diet, business, Demography
Abstract

Background-The usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham-REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high-risk in the PREvención con DIeta MEDiterránea (PREDIMED) study-a nutrition-intervention primary prevention trial-and the impact of adherence to the Mediterranean diet on CVD across risk categories. Methods and Results-In a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55-74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate-adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham-REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6-year follow-up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata (P > 0.4 for interaction). Conclusions-Incident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non- high-risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD independent of baseline risk., This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission

Published
2017

5. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study

Author

Becerra-Tomás, Nerea, primary, Díaz-López, Andrés, additional, Rosique-Esteban, Núria, additional, Ros, Emilio, additional, Buil-Cosiales, Pilar, additional, Corella, Dolores, additional, Estruch, Ramon, additional, Fitó, Montserrat, additional, Serra-Majem, Lluís, additional, Arós, Fernando, additional, Lamuela-Raventós, Rosa Maria, additional, Fiol, Miquel, additional, Santos-Lozano, José Manuel, additional, Díez-Espino, Javier, additional, Portoles, Olga, additional, Salas-Salvadó, Jordi, additional, Serra-Mir, M., additional, Pérez-Heras, A., additional, Viñas, C., additional, Casas, R., additional, Medina-Renom, A., additional, Baena, J.M., additional, García, M., additional, Oller, M., additional, Amat, J., additional, Duaso, I., additional, García, Y., additional, Iglesias, C., additional, Simón, C., additional, Quinzavos, L., additional, Parra, L., additional, Liroz, M., additional, Benavent, J., additional, Clos, J., additional, Pla, I., additional, Amorós, M., additional, Bonet, M.T., additional, Martín, M.T., additional, Sánchez, M.S., additional, Altirriba, J., additional, Manzano, E., additional, Altés, A., additional, Cofán, M., additional, Valls-Pedret, C., additional, Sala-Vila, A., additional, Doménech, M., additional, Bulló, M., additional, Babio, N., additional, Basora, J., additional, González, R., additional, Molina, C., additional, Márquez, F., additional, Martínez, P., additional, Ibarrola, N., additional, Sorlí, M., additional, García Roselló, J., additional, Castro, A., additional, Martin, F., additional, Tort, N., additional, Isach, A., additional, Guasch-Ferre, M., additional, Cabré, J.J., additional, Mestres, G., additional, Paris, F., additional, Llauradó, M., additional, Pedret, R., additional, Basells, J., additional, Vizcaino, J., additional, Segarra, R., additional, Frigola, J., additional, Costa-Vizcaino, J., additional, Salas-Huetos, A., additional, Boj, J., additional, Montañes, D., additional, Papandreou, Christopher, additional, Fernández-Ballart, J., additional, Carrasco, P., additional, Ortega-Azorín, C., additional, Asensio, E.M., additional, Osma, R., additional, Barragán, R., additional, Francés, F., additional, Guillén, M., additional, González, J.I., additional, Sáiz, C., additional, Portolés, O., additional, Giménez, F.J., additional, Coltell, O., additional, Fernández-Carrión, R., additional, Guillem-Sáiz, P., additional, González-Monje, I., additional, Quiles, L., additional, Pascual, V., additional, Riera, C., additional, Pages, M.A., additional, Godoy, D., additional, Carratalá-Calvo, A., additional, Sánchez-Navarro, S., additional, Valero-Barceló, C., additional, Tello, S., additional, Vila, J., additional, de la Torre, R., additional, Muñoz-Aguayo, D., additional, Elosua, R., additional, Marrugat, J., additional, Schröder, H., additional, Molina, N., additional, Maestre, E., additional, Rovira, A., additional, Castañer, O., additional, Farré, M., additional, Toledo, E., additional, Ruiz-Canela, M., additional, Sanjulián, B., additional, Sánchez-Tainta, A., additional, Eguaras, S., additional, Martí, A., additional, Buil-Cosiales, P., additional, SerranoMartínez, M., additional, Diez-Espino, J., additional, García-Arellano, A., additional, Martínez-Lapiscina, E.H., additional, Goñi, E., additional, Vázquez, Z., additional, Berrade, N., additional, Extremera-Urabayen, V., additional, Arroyo-Azpa, C., additional, García-Pérez, L., additional, Villanueva-Telleria, J., additional, Cortés-Ugalde, F., additional, Sagredo-Arce, T., additional, Vigata-López, M.D., additional, Arceiz Campo, M.T., additional, Urtasun-Samper, A., additional, Gueto Rubio, M.V., additional, Churio-Beraza, B., additional, Arós, F., additional, Salaverria, I., additional, del Hierro, T., additional, Algorta, J., additional, Francisco, S., additional, Alonso-Gómez, A., additional, Sanz, E., additional, Rekondo, J., additional, Belló, M.C., additional, Loma-Osorio, A., additional, Gómez-Gracia, E., additional, Wärnberg, J., additional, Benítez Pont, R., additional, Bianchi Alba, M., additional, Gómez-Huelgas, R., additional, Martínez-González, J., additional, Velasco García, V., additional, de Diego Salas, J., additional, Baca Osorio, A., additional, Gil Zarzosa, J., additional, Sánchez Luque, J.J., additional, Vargas López, E., additional, Ruiz-Gutiérrez, V., additional, Sánchez Perona, J., additional, Montero Romero, E., additional, García-García, M., additional, Jurado-Ruiz, E., additional, Fiol, M., additional, Romaguera, D., additional, García-Valdueza, M., additional, Moñino, M., additional, Munuera, S., additional, Vivó, M., additional, Bestard, F., additional, Munar, J.A., additional, Coll, L., additional, Proenza, A., additional, Prieto, R., additional, Frontera, G., additional, Fiol, F., additional, Ginard, M., additional, Jover, A., additional, García, J., additional, Santos-Lozano, J.M., additional, Ortega-Calvo, M., additional, Mellado, L., additional, García-Corte, F.J., additional, Román, P., additional, Iglesias, P., additional, Corchado, Y., additional, Miró-Moriano, L., additional, Domínguez-Espinaco, C., additional, Lozano-Rodriguez, J.M., additional, Vaquero-Diaz, S., additional, López- Sabater, M.C., additional, Castellote-Bargalló, A.I., additional, Quifer-Rada, P., additional, Tresserra-Rimbau, A., additional, Álvarez-Pérez, J., additional, Díaz-Benítez, E.M., additional, Sánchez-Villegas, A., additional, Casañas-Quintana, L.T., additional, Pérez-Cabrera, J., additional, Ruano-Rodríguez, C., additional, Bautista-Castaño, I., additional, Sarmiento de la Fe, F., additional, García Pastor, J.A., additional, Díaz-González, B.V., additional, Castillo Anzalas, J.M., additional, Sosa-Also, R.E., additional, Medina-Ponce, J., additional, de la Cruz, E., additional, Fanlo-Maresma, M., additional, Galera, A., additional, Trias, F., additional, Sarasa, I., additional, Corbella, E., additional, Corbella, X., additional, Cabezas, C., additional, Vinyoles, E., additional, Rovira, M.A., additional, García, L., additional, Flores, G., additional, Verdú, J.M., additional, Baby, P., additional, Ramos, A., additional, Mengual, L., additional, Roura, P., additional, Yuste, M.C., additional, Guarner, A., additional, Santamaría, M.I., additional, Mata, M., additional, de Juan, C., additional, Brau, A., additional, Tur, J.A., additional, Portillo, M.P., additional, Sáez, G., additional, Aldamiz-Echevarría, M., additional, Alonso-Gómez, A.M., additional, Berjón, J., additional, Forga, L., additional, Gállego, J., additional, García-Layana, A., additional, Larrauri, A., additional, Portu-Zapirain, J., additional, and Timiraus-Fernández, J., additional

Published
2018
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6. Prediction of cardiovascular disease by the framingham-REGICOR equation in the high-risk PREDIMED cohort: Impact of the mediterranean diet across different risk strata

Author

Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), Ministerio de Ciencia e Innovación (España), California Walnut Commission, Amor, A.J., Serra-Mir, M., Martínez-González, M.A., Corella, D., Salas-Salvadó, J., Fitó, Montserrat, Estruch, R., Serra-Majem, L., Arós, F., Babio, N., Ros, E., Cofán, M., Lecea, O., Rosique Esteban, N., Valls-Pedret, C., Freitas-Simoes, T.M., Doménech, M., Gilabert, R., Sagredo Arce, T., Bertolín-Muñoz, A., Tresserra-Rimbau, A., Jurado-Ruíz, Enrique, Salaverría, I., Pages, M.A., Cabré, J.J., Mestres, G., Paris, F., Llauradó, M., Pedret, R., Basells, J., Vizcaino, J., Segarra, R., Sacanella, E., Casas, Ricard, Frontera, G., Alonso-Gómez, A., Godoy, D., López-Sabater, M.C., de la Torre, Rafael, del Hierro, T., Hernandez-Alonso, P., Giardina, S., Ferreira-Pego, C., Pérez-Cabrera, J., Papandreou, C., Baby, P., Camacho, L., Toledo, E., Casanas Quintana, T., Carratalá-Calvo, A., Buil-Cosiales, P., Rovira, A., Ruiz-Canela, M., Martínez, J. Alfredo, Fiol, Miquel, Castellote-Bargalló, Ana I., Algorta, J., Álvarez-Pérez, J., Sanjulian, B., Ortega, E., Sánchez-Tainta, A., Díez-Espino, Javier, Sánchez-Villegas, A., Ginard, M., Fiol, F., García-Valdueza, M., Marrugat, J., Schröder, H., Molina, N., Maestre, E., Castañer, O., Farré, M., Sorli, J.V., Ramos, A., García, J., Moñino, M., Santamaría, M.I., Fernández-Rodríguez, M. J., Jover, A., Pérez-Heras, A., Zanon-Moreno, V., Díaz-Benítez, E.M., Carrasco, P., Ortega-Azorín, Carolina, Asensio, E.M., Oller, M., Proenza, A., Osma, R., Bargalló, N., Barragán, R., Francés, F., García, M., Romaguera, D., Guillén, M., Márquez, F., González, J.I., Saiz, C., Portillo, María P., Mengual, L., Viñas, C., Bautista-Castaño, Inmaculada, de Santamaría, L., Portolés, Olga, Giménez, F.J., Coltell, O., Guillem-Saiz, P., Chiva, G., Mata, M., Sorli, M., de Juan, C., Roura, P., Rekondo, J., Belló, M.C., Loma-Osorio, A., Gómez-Gracia, Enrique, Warnberg, J., Benítez Pont, R., Bianchi Alba, M., Gómez-Huelgas, R., Gueto Rubio, M.V., Bulló, M., Sáez, G., Yuste, M.C., Martínez, P., Valderas, P., Brau, A., Martínez-González, J., Velasco García, V., Romero, S., de Diego Salas, J., Razquin, C., Baca Osorio, A., Gil Zarzosa, J., Becerra-Tomás, Nerea, Guarner, A., Sánchez Luque, J.J., Eguaras, S., Vargas López, E., Ruiz-Gutiérrez, Valentina, Ibarrola-Jurado, Nuria, Tur, J.A., García Roselló, J., Perona, Javier S., Vigata López, M.D., Montero Romero, Emilio, García-García, M., Isach, A., Basora, J., González, R., Nissensohn, M., Díaz-González, V., Ruano-Rodríguez, C., Ortiz-Andrelluchi, A.P., Macías Gutiérrez, B., Santana-Santana, A.J., Pintó, Xavier, de la Cruz, E., García-Arellano, A., Mena, G., Marti, A., Salas-Huetos, A., Díaz-López, A., Arceiz Campo, M.T., Arranz, S., Martín, F., Galera, A., Soler, Y., Trias, F., Elosua, R., Sarasa, I., Quiles, L., Padres, E., Corbella, Emili, Muñoz-Aguayo, Daniel, Molina, C., Cabezas, C., Martín-Rillo, M.J., Vinyoles, E., Rovira, M.A., Goñi, E., Urtasun Samper, A., Tort, N., Sola, A., García, L., Baena, J.M., Flores, G., Verdú, J.M., Tello, S., Arroyo-Azpa, C., García-Pérez, L., Vazquez, Z., Amat, J., Duaso, I., García, Y., Iglesias, C., Simón, C., Quinzavos, L., Parra, L., Liroz, M., Pascual, V., García de la Noceda Montoy, M.D., Berrade, N., Llopis-Osorio, E., Vila, J., Villanueva Telleria, J., Benavent, J., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Sanz, E., Extremera-Urabayen, V., Martín, M. T., Prieto, R., Sánchez, M.S., Altirriba, J., Ruiz-Baixauli, J., Cortés Ugalde, F., Manzano, E., Lamuela-Raventós, Rosa M., Altés, A., Sala-Vila, A., Francisco, S., Riera, C., Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), Ministerio de Ciencia e Innovación (España), California Walnut Commission, Amor, A.J., Serra-Mir, M., Martínez-González, M.A., Corella, D., Salas-Salvadó, J., Fitó, Montserrat, Estruch, R., Serra-Majem, L., Arós, F., Babio, N., Ros, E., Cofán, M., Lecea, O., Rosique Esteban, N., Valls-Pedret, C., Freitas-Simoes, T.M., Doménech, M., Gilabert, R., Sagredo Arce, T., Bertolín-Muñoz, A., Tresserra-Rimbau, A., Jurado-Ruíz, Enrique, Salaverría, I., Pages, M.A., Cabré, J.J., Mestres, G., Paris, F., Llauradó, M., Pedret, R., Basells, J., Vizcaino, J., Segarra, R., Sacanella, E., Casas, Ricard, Frontera, G., Alonso-Gómez, A., Godoy, D., López-Sabater, M.C., de la Torre, Rafael, del Hierro, T., Hernandez-Alonso, P., Giardina, S., Ferreira-Pego, C., Pérez-Cabrera, J., Papandreou, C., Baby, P., Camacho, L., Toledo, E., Casanas Quintana, T., Carratalá-Calvo, A., Buil-Cosiales, P., Rovira, A., Ruiz-Canela, M., Martínez, J. Alfredo, Fiol, Miquel, Castellote-Bargalló, Ana I., Algorta, J., Álvarez-Pérez, J., Sanjulian, B., Ortega, E., Sánchez-Tainta, A., Díez-Espino, Javier, Sánchez-Villegas, A., Ginard, M., Fiol, F., García-Valdueza, M., Marrugat, J., Schröder, H., Molina, N., Maestre, E., Castañer, O., Farré, M., Sorli, J.V., Ramos, A., García, J., Moñino, M., Santamaría, M.I., Fernández-Rodríguez, M. J., Jover, A., Pérez-Heras, A., Zanon-Moreno, V., Díaz-Benítez, E.M., Carrasco, P., Ortega-Azorín, Carolina, Asensio, E.M., Oller, M., Proenza, A., Osma, R., Bargalló, N., Barragán, R., Francés, F., García, M., Romaguera, D., Guillén, M., Márquez, F., González, J.I., Saiz, C., Portillo, María P., Mengual, L., Viñas, C., Bautista-Castaño, Inmaculada, de Santamaría, L., Portolés, Olga, Giménez, F.J., Coltell, O., Guillem-Saiz, P., Chiva, G., Mata, M., Sorli, M., de Juan, C., Roura, P., Rekondo, J., Belló, M.C., Loma-Osorio, A., Gómez-Gracia, Enrique, Warnberg, J., Benítez Pont, R., Bianchi Alba, M., Gómez-Huelgas, R., Gueto Rubio, M.V., Bulló, M., Sáez, G., Yuste, M.C., Martínez, P., Valderas, P., Brau, A., Martínez-González, J., Velasco García, V., Romero, S., de Diego Salas, J., Razquin, C., Baca Osorio, A., Gil Zarzosa, J., Becerra-Tomás, Nerea, Guarner, A., Sánchez Luque, J.J., Eguaras, S., Vargas López, E., Ruiz-Gutiérrez, Valentina, Ibarrola-Jurado, Nuria, Tur, J.A., García Roselló, J., Perona, Javier S., Vigata López, M.D., Montero Romero, Emilio, García-García, M., Isach, A., Basora, J., González, R., Nissensohn, M., Díaz-González, V., Ruano-Rodríguez, C., Ortiz-Andrelluchi, A.P., Macías Gutiérrez, B., Santana-Santana, A.J., Pintó, Xavier, de la Cruz, E., García-Arellano, A., Mena, G., Marti, A., Salas-Huetos, A., Díaz-López, A., Arceiz Campo, M.T., Arranz, S., Martín, F., Galera, A., Soler, Y., Trias, F., Elosua, R., Sarasa, I., Quiles, L., Padres, E., Corbella, Emili, Muñoz-Aguayo, Daniel, Molina, C., Cabezas, C., Martín-Rillo, M.J., Vinyoles, E., Rovira, M.A., Goñi, E., Urtasun Samper, A., Tort, N., Sola, A., García, L., Baena, J.M., Flores, G., Verdú, J.M., Tello, S., Arroyo-Azpa, C., García-Pérez, L., Vazquez, Z., Amat, J., Duaso, I., García, Y., Iglesias, C., Simón, C., Quinzavos, L., Parra, L., Liroz, M., Pascual, V., García de la Noceda Montoy, M.D., Berrade, N., Llopis-Osorio, E., Vila, J., Villanueva Telleria, J., Benavent, J., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Sanz, E., Extremera-Urabayen, V., Martín, M. T., Prieto, R., Sánchez, M.S., Altirriba, J., Ruiz-Baixauli, J., Cortés Ugalde, F., Manzano, E., Lamuela-Raventós, Rosa M., Altés, A., Sala-Vila, A., Francisco, S., and Riera, C.

Abstract

Background-The usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham-REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high-risk in the PREvención con DIeta MEDiterránea (PREDIMED) study-a nutrition-intervention primary prevention trial-and the impact of adherence to the Mediterranean diet on CVD across risk categories. Methods and Results-In a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55-74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate-adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham-REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6-year follow-up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata (P > 0.4 for interaction). Conclusions-Incident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non- high-risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD indepen

Published
2017

7. Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Author

Amor, Antonio J., primary, Serra‐Mir, Mercè, additional, Martínez‐González, Miguel A., additional, Corella, Dolores, additional, Salas‐Salvadó, Jordi, additional, Fitó, Montserrat, additional, Estruch, Ramón, additional, Serra‐Majem, Lluis, additional, Arós, Fernando, additional, Babio, Nancy, additional, Ros, Emilio, additional, Ortega, Emilio, additional, Pérez‐Heras, A., additional, Viñas, C., additional, Casas, R., additional, de Santamaría, L., additional, Romero, S., additional, Sacanella, E., additional, Chiva, G., additional, Valderas, P., additional, Arranz, S., additional, Baena, J. M., additional, García, M., additional, Oller, M., additional, Amat, J., additional, Duaso, I., additional, García, Y., additional, Iglesias, C., additional, Simón, C., additional, Quinzavos, Ll., additional, Parra, Ll., additional, Liroz, M., additional, Benavent, J., additional, Clos, J., additional, Pla, I., additional, Amorós, M., additional, Bonet, M. T., additional, Martin, M. T., additional, Sánchez, M. S., additional, Altirriba, J., additional, Manzano, E., additional, Altés, A., additional, Sala‐Vila, A., additional, Cofán, M., additional, Valls‐Pedret, C., additional, Freitas‐Simoes, T. M., additional, Doménech, M., additional, Gilabert, R., additional, Bargalló, N., additional, Bulló, M., additional, Basora, J., additional, González, R., additional, Díaz‐López, A., additional, Molina, C., additional, Mena, G., additional, Márquez, F., additional, Martínez, P., additional, Ibarrola, N., additional, Sorli, M., additional, García Roselló, J., additional, Martín, F., additional, Tort, N., additional, Isach, A., additional, Salas‐Huetos, A., additional, Becerra‐Tomás, N., additional, Rosique Esteban, N., additional, Cabré, J. J., additional, Mestres, G., additional, Paris, F., additional, Llaurado, M., additional, Pedret, R., additional, Basells, J., additional, Vizcaino, J., additional, Segarra, R., additional, Hernandez‐Alonso, P., additional, Giardina, S., additional, Ferreira‐Pego, C., additional, Papandreou, C., additional, Camacho, L., additional, Toledo, E., additional, Buil‐Cosiales, P., additional, Ruiz‐Canela, M., additional, Martínez, J. A., additional, Sanjulian, B., additional, Sánchez‐Tainta, A., additional, Diez‐Espino, J., additional, Razquin, C., additional, Garcia‐Arellano, A., additional, Goni, E., additional, Vazquez, Z., additional, Berrade, N., additional, Extremera‐Urabayen, V., additional, Eguaras, S., additional, Marti, A., additional, Arroyo‐Azpa, C., additional, García‐Pérez, L., additional, Villanueva Telleria, J., additional, Cortés Ugalde, F., additional, Sagredo Arce, T., additional, de la Noceda Montoy, M. D. García, additional, Vigata López, M. D., additional, Arceiz Campo, M. T., additional, Urtasun Samper, A., additional, Gueto Rubio, M. V., additional, Sola, A., additional, Goñi, N., additional, Lecea, O., additional, Tello, S., additional, Vila, J., additional, de la Torre, R., additional, Muñoz‐Aguayo, D., additional, Elosua, R., additional, Marrugat, J., additional, Schröder, H., additional, Molina, N., additional, Maestre, E., additional, Castañer, O., additional, Rovira, A., additional, Farre, M., additional, Sorli, J. V., additional, Zanon‐Moreno, V., additional, Carrasco, P., additional, Ortega‐Azorín, C., additional, Asensio, E. M., additional, Osma, R., additional, Barragán, R., additional, Francés, F., additional, Guillén, M., additional, González, J. I., additional, Saiz, C., additional, Portolés, O., additional, Giménez, F. J., additional, Coltell, O., additional, Guillem‐Saiz, P., additional, Quiles, L., additional, Pascual, V., additional, Riera, C., additional, Pages, M. A., additional, Godoy, D., additional, Carratala‐Calvo, A., additional, Martín‐Rillo, M. J., additional, Llopis‐Osorio, E., additional, Ruiz‐Baixauli, J., additional, Bertolín‐Muñoz, A., additional, Salaverría, I., additional, del Hierro, T., additional, Algorta, J., additional, Francisco, S., additional, Alonso‐Gómez, A., additional, Sanz, E., additional, Rekondo, J., additional, Bello, M. C., additional, Loma‐Osorio, A., additional, Gómez‐Gracia, E., additional, Warnberg, J., additional, Benítez Pont, R., additional, Bianchi Alba, M., additional, Gómez‐Huelgas, R., additional, Martínez‐González, J., additional, Velasco García, V., additional, de Diego Salas, J., additional, Baca Osorio, A., additional, Gil Zarzosa, J., additional, Sánchez Luque, J. J., additional, Vargas López, E., additional, Ruiz‐Gutiérrez, V., additional, Sánchez Perona, J., additional, Montero Romero, E., additional, García‐García, M., additional, Jurado‐Ruiz, E., additional, Fiol, M., additional, García‐Valdueza, M., additional, Moñino, M., additional, Proenza, A., additional, Prieto, R., additional, Frontera, G., additional, Ginard, M., additional, Fiol, F., additional, Jover, A., additional, Romaguera, D., additional, García, J., additional, Lapetra, J., additional, Santos‐Lozano, J. M., additional, Ortega‐Calvo, M., additional, Mellado, L., additional, Leal, M., additional, Martínez, E., additional, José García, F., additional, Román, P., additional, Iglesias, P., additional, Corchado, Y., additional, Miró, L., additional, Domínguez, C., additional, Lozano, J. M., additional, Mayoral, E., additional, Lamuela‐Raventós, R. M., additional, López‐Sabater, M. C., additional, Castellote‐Bargallo, A. I., additional, Tresserra‐Rimbau, A., additional, Álvarez‐Pérez, J., additional, Díaz‐Benítez, E. M., additional, Bautista Castaño, I., additional, Sánchez‐Villegas, A., additional, Fernández‐Rodríguez, M. J., additional, Casanas Quintana, T., additional, Pérez‐Cabrera, J., additional, Nissensohn, M., additional, Díaz‐González, V., additional, Ruano‐Rodríguez, C., additional, Ortiz‐Andrelluchi, A. P., additional, Macías Gutiérrez, B., additional, Santana‐Santana, A. J., additional, Pintó, X., additional, de la Cruz, E., additional, Galera, A., additional, Soler, Y., additional, Trias, F., additional, Sarasa, I., additional, Padres, E., additional, Corbella, E., additional, Cabezas, C., additional, Vinyoles, E., additional, Rovira, M. A., additional, García, L., additional, Flores, G., additional, Verdú, J. M., additional, Baby, P., additional, Ramos, A., additional, Mengual, L., additional, Roura, P., additional, Yuste, M. C., additional, Guarner, A., additional, Santamaría, M. I., additional, Mata, M., additional, de Juan, C., additional, Brau, A., additional, Tur, J. A., additional, Portillo, M. P., additional, Sáez, G., additional, Aldamiz, M., additional, Alonso, A., additional, Berjón, J., additional, Forga, L., additional, Gallego, J., additional, Larrauri, A., additional, Portu, J., additional, Timiraos, J., additional, and Serrano‐Martínez, M., additional

Published
2017
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8. Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Author

Sala‐Vila, Aleix, Guasch‐Ferré, Marta, Hu, Frank B., Sánchez‐Tainta, Ana, Bulló, Mònica, Serra‐Mir, Mercè, López‐Sabater, Carmen, Sorlí, Jose V., Arós, Fernando, Fiol, Miquel, Muñoz, Miguel A., Serra‐Majem, Luis, Martínez, J. Alfredo, Corella, Dolores, Fitó, Montserrat, Salas‐Salvadó, Jordi, Martínez‐González, Miguel A., Estruch, Ramón, Ros, Emilio, Pérez‐Heras, A., Viñas, C., Casas, R., de Santamaría, L., Romero, S., Sacanella, E., Chiva, G., Valderas, P., Arranz, S., Baena, J.M., García, M., Oller, M., Amat, J., Duaso, I., García, Y., Iglesias, C., Simón, C., Quinzavos, Ll., Parra, Ll., Liroz, M., Benavent, J., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Martin, M.T., Sánchez, M.S., Altirriba, J., Manzano, E., Altés, A., Cofán, M., Valls‐Pedret, C., Doménech, M., Gilabert, R., Bargalló, N., González, R., Molina, C., Márquez, F., Babio, N., Sorli, M., García Roselló, J., Diaz‐López A, A., Martin, F., Tort, R., Isach, A., Costa, B., Cabré, J.J., Fernández‐Ballart, J., Ibarrola‐Jurado, N., Alegret, C., Martínez, P., Millán, S., Piñol, J.L., Basora, T., Hernández, J.M., Toledo, E., Buil‐Cosiales, P., Ruiz‐Canela, M., Sanjulián, B., Díez‐Espino, J., Extremera‐Urabayen, V., García‐Arellano, A., Zazpe, I., Basterra‐Gortari, F.J., Goñi, E, Razquin, C., Serrano‐Martínez, M., Bes‐Rastrollo, M., Gea, A., Martínez‐Lapiscina, E.H., Nuñez‐Córdoba, J.M., Arroyo‐Azpa, C., García‐Pérez, L., Villanueva‐Tellería, J., Cortés‐Ugalde, F., Sagredo‐Arce, T., García de la Noceda‐Montoy, Mª D., Vigata‐López, Mª D., Arceiz‐Campo, Mª T., Urtasun‐Samper, A., Gueto‐Rubio, Mª V., Churio‐Beraza, B., Lamuela‐Raventós, Rosa M., Castellote‐Bargallo, A.I., Medina‐Remón, A., Tresserra‐Rimbau, A., Carrasco, P., Ortega‐ Azorín, C., Asensio, E.M., Osma, R., Barragán, R., Francés, F., Guillén, M., González, J.I., Saiz, C., Portolés, O., Giménez, F.J., Coltell, O., Guillem‐Saiz, P., Quiles, L., Pascual, V., Riera, C., Pages, M.A., Godoy, D., Carratalá‐Calvo, A., Martín‐Rillo, M.J., Llopis‐Osorio, E., Ruiz‐ Baixauli, J., Bertolín‐Muñoz, A., Salaverría, I., del Hierro, T., Algorta, J., Francisco, S., Alonso, A., San Vicente, J., Sanz, E., Felipe, I., Alonso Gómez, A., Loma‐Osorio, A., García‐Valdueza, M., Moñino, M., Proenza, A., Prieto, R., Frontera, G., Ginard, M., Fiol, F., Jover, A., García, J., Covas, M.I., Tello, S., Vila, J., Schröder, H., De la Torre, R, Muñoz‐Aguayo, D., Elosúa, R., Marrugat, J., Ferrer, M., Álvarez‐Pérez, J., DíazBenítez, E., Bautista‐Castaño, I., Maldonado‐Díaz, I., Sánchez‐Villegas, A., Castro, I., Henríquez, P., Ruano, C., Ortiz, A. P., Sarmiendo de la Fe, F, Simón‐García, C., Falcón‐Sanabria, I., Macías‐Gutiérrez, B., Santana‐Santana, A.J., Gomez‐Gracia, E., Fernández‐Crehuet, J., Benítez Pont, R., Bianchi Alba, M., Wärnberg, J., Gómez‐Huelgas, R., Martínez‐González, J., Velasco García, V., de Diego Salas, J, Baca Osorio, A., Gil Zarzosa, J., Sánchez Luque, J.J., Vargas López, E., Ruiz‐Gutierrez, V., Jurado Ruiz, E., Montero Romero, E., García García, M., Lapetra, J., Leal, M., Martínez, E., Santos, J.M., Ortega‐Calvo, M., Román, P., José García, F., Iglesias, P., Corchado, Y., Mayoral, E., Lama, C., Pintó, X., de la Cruz, E, Galera, A., Soler, Y., Trias, F., Sarasa, I., Padres, E., Figueras, R., Solanich, X., Pujol, R., Corbella, E., Cabezas, C., Vinyoles, E., Rovira, M.A., García, L., Flores, G., Verdú, J.M., Baby, P., Ramos, A., Mengual, L., Roura, P., Yuste, M.C., Guarner, A., Rovira, A., Santamaría, M.I., Mata, M., de Juan, C., Brau, A., Marti, A., Mitjavila, M.T., Portillo, M.P., Sáez, G., and Tur, J.

Subjects
fatty acid, nutrition, sudden cardiac death, Diet and Nutrition
Abstract

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639.

Published
2016
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9. Dietary α-Linolenic Acid, Marine ω-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Author

Sala-Vila, A., Guasch-Ferré, Marta, Hu, F.B., Sánchez-Tainta, A., Bulló, M., Serra-Mir, M., López-Sabater, C., Sorlí, J.V., Arós, F., Fiol, M., Muñoz, M.A., Riera, C., Francés, F., Vinyoles, E., Guarner, A., Márquez, F., Guillén, M., Rovira, M.A., Piñol, J.L., Sacanella, E., Basora, T., García, Y., Rovira, A., Santamaría, M.I., Mata, M., de Juan, C., Ruiz-Gutiérrez, Valentina, Pages, M.A., Brau, A., Urtasun-Samper, A., Ruano, C., Tresserra-Rimbau, A., de Santamaría, L., Llopis-Osorio, E., Marti, A., Chiva, G., Moñino, M., Mitjavila, M.T., Valderas, P., Arranz, S., Carrasco, P., Alonso Gómez, A., Galera, A., Alonso, A., Baena, J.M., Basterra-Gortari, F. Javier, Carratalá-Calvo, A., Gil Zarzosa, J., García, M., Pérez-Heras, A., Frontera, G., Oller, M., Benavent, J., Gea, A., Ginard, M., Amat, J., Gueto Rubio, M.V., Diaz-López, A., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Baby, P., de la Torre, Rafael, Martín, M.T., Lapetra, José, Lamuela-Raventós, Rosa M., García-Valdueza, M., Sánchez, M.S., Martin, F., Macías-Gutiérrez, B., Altirriba, J., Tort, R., Isach, A., Fitó, Montserrat, Sarmiendo De La Fe, F., Romero, S., Costa, B., Elosúa, R., García, L., Cabré, J.J., Babio, N., Santana-Santana, A.J., Fernández-Ballart, J., Hernández, J.M., García García, M., Ibarrola-Jurado, Nuria, San Vicente, J., Toledo, E., Buil-Cosiales, P., Ruiz-Canela, M., Vargas López, E., Simón, C., de Diego Salas, J., Sanjulián, B., Felipe, I., Falcón-Sanabria, I., Serra-Majem, L., Trias, F., Díez-Espino, Javier, Viñas, C., Martínez, E., Extremera-Urabayen, V., Núñez-Córdoba, J.M., Proenza, A., Santos, J.M., García-Arellano, A., Marrugat, J., González, J.I., Ferrer, M., Arroyo-Azpa, C., García-Pérez, L., Villanueva-Tellería, J., Cortés-Ugalde, F., Gilabert, R., de la Cruz, E., Sagredo-Arce, T., Ros, E., Duaso, I., Jurado-Ruíz, Enrique, Sarasa, I., De La Noceda-Montoy, M.D.G., Saiz, C., Mengual, L., Vigata-López, M.D., Portolés, O., Giménez, F.J., Montero Romero, Emilio, Verdú, J.M., Martínez, P., Coltell, O., Ortiz, A.P., Soler, Y., Cofán, M., Guillem-Saiz, P., Osma, R., Yuste, M.C., Quiles, L., Ruiz-Baixauli, J., Estruch, R., Pascual, V., Baca Osorio, A., Fiol, F., Bertolín-Muñoz, A., Salaverría, I., del Hierro, T., Corella, D., Razquin, C., Portillo, M.P., Algorta, J., Sánchez Luque, J.J., Ramos, A., Francisco, S., Jover, A., Parra, L., García, J., Covas, María Isabel, Medina-Remón, Alexander, Iglesias, C., Tello, S., Sáez, G., Zazpe, I., Salas-Salvadó, J., Prieto, R., Liroz, M., Vila, J., Álvarez-Pérez, J., Molina, C., Schröder, H., Díaz Benítez, E., Bautista-Castaño, Inmaculada, Martínez-González, M.A., Doménech, M., Godoy, D., Manzano, E., Maldonado-Díaz, I., Flores, G., Quinzavos, L., Churio-Beraza, B., Sánchez-Villegas, A., Barragán, R., Sorli, M., Castro, I., Gómez-Gracia, Enrique, Roura, P., García Roselló, J., Henríquez, P., Tur, J., Ortega-Calvo, M., Fernández-Crehuet, Joaquín, Benítez Pont, R., Bianchi Alba, M., Wärnberg, J., Loma-Osorio, A., Alegret, C., Gómez-Huelgas, R., Asensio, E.M., Alfredo Martínez, J., Bargalló, N., Martínez-González, J., Román, P., Bes-Rastrollo, M., Velasco García, V., García, F.José, Iglesias, P., González, R., Goñi, E., Muñoz-Aguayo, Daniel, Corchado, Y., Millán, S., Sanz, E., Mayoral, E., Leal, M., Martínez-Lapiscina, E.H., Lama, C., Padres, E., Ortega-Azorín, C., Pintó, Xavier, Altés, A., Figueras, R., Solanich, X., Pujol, R., Castellote-Bargalló, A. I., Simón-García, C., Arceiz Campo, M.T., Corbella, E., Valls-Pedret, C., Serrano-Martínez, M., Casas, R., Martín-Rillo, M.J., Cabezas, C., Universitat de Barcelona, Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), and Ministerio de Ciencia e Innovación (España)

Subjects
Male, Gerontology, Time Factors, Epidemiology, modelos de riesgos proporcionales, humanos, 030204 cardiovascular system & hematology, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, estudios prospectivos, evaluación de riesgos, Medicine, Nuts, Sudden cardian death, 030212 general & internal medicine, Food science, Longitudinal Studies, Prospective Studies, mediana edad, Original Research, Diet and Nutrition, Aged, 80 and over, chemistry.chemical_classification, education.field_of_study, anciano, alpha-Linolenic acid, dieta, Factors de risc en les malalties, Hàbits alimentaris, Fatty Acids, ω-3 fatty acids, Fatty acids in human nutrition, alpha-Linolenic Acid, distribución de la ji al cuadrado, Middle Aged, Cardiovascular system, nutrition, Cardiovascular Diseases, Female, Dieta, Cardiology and Cardiovascular Medicine, Nutritive Value, conducta de reducción del riesgo, Risk factors in diseases, Food habits, Population, enfermedades cardiovasculares, 030209 endocrinology & metabolism, Juglans, Risk Assessment, sudden cardiac death, 03 medical and health sciences, alimentos del mar, factores de tiempo, Mediterranean cooking, Àcids grassos en la nutrició, Fatty Acids, Omega-3, Cuina mediterrània, Peix com a aliment, Humans, factores de riesgo, análisis multifactorial, education, Olive Oil, Dieta -- Mediterrània, Regió de la, Dieta mediterranea, ácidos grasos, α-linolenic acid, Aged, Proportional Hazards Models, Sistema cardiovascular, Chi-Square Distribution, business.industry, Correction, Fatty acid, Hàbits alimentaris -- Mediterrània, Regió de la, Protective Factors, Fish consumption, Predimed, Diet, nueces, chemistry, Seafood, Spain, Multivariate Analysis, valor nutritivo, estudios longitudinales, fatty acid, business, Risk Reduction Behavior, ácido alfa-linolénico
Abstract

12 Páginas.-- 6 Tablas.-- 1 Figura, Background-Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results-We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regressionmodels were fitted to estimate hazard ratios. ALA intake correlated towalnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios formeeting ALArecommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-causemortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios formeeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-causemortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]). Conclusions-In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids., This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission. Sala‐Vila holds a Miguel Servet I fellowship from the Ministry of Economy and Competitiveness through the ISCIII.

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