Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial

被引：239

作者：

Salas-Salvado, Jordi ^{[1
,2
]}

Diaz-Lopez, Andres ^{[1
,2
]}

Ruiz-Canela, Miguel ^{[2
,3
]}

Basora, Josep ^{[1
,2
,4
]}

Fito, Montse ^{[2
,5
]}

Corella, Dolores ^{[2
,6
]}

Serra-Majem, Luis ^{[2
,7
]}

Waernberg, Julia ^{[2
,8
]}

Romaguera, Dora ^{[2
,9
]}

Estruch, Ramon ^{[2
,10
]}

Vidal, Josep ^{[11
,12
,13
]}

Alfredo Martinez, J. ^{[2
,14
,15
]}

Aros, Fernando ^{[2
,16
]}

Vazquez, Clotilde ^{[2
,17
]}

Ros, Emilio ^{[2
,18
]}

Vioque, Jesus ^{[19
,20
]}

Lopez-Miranda, Jose ^{[2
,21
]}

Bueno-Cavanillas, Aurora ^{[20
,22
]}

Tur, Josep A. ^{[2
,23
]}

Tinahones, Francisco J. ^{[2
,24
]}

Martin, Vicente ^{[20
,25
,26
]}

Lapetra, Jose ^{[2
,27
]}

Pinto, Xavier ^{[2
,28
]}

Daimiel, Lidia ^{[29
]}

Delgado-Rodriguez, Miguel ^{[20
,30
]}

Matia, Pilar ^{[31
]}

Gomez-Gracia, Enrique ^{[2
,32
]}

Diez-Espino, Javier ^{[2
,3
,33
]}

Babio, Nancy ^{[1
,2
]}

Castaner, Olga ^{[2
]}

Sorli, Jose V. ^{[2
,6
]}

Fiol, Miquel ^{[2
,9
]}

Angeles Zulet, Maria ^{[2
,14
]}

Bullo, Monica ^{[1
,2
]}

Goday, Albert ^{[2
,5
,34
]}

Martinez-Gonzalez, Miguel A. ^{[2
,3
,35
]}

机构：

[1] Rovira & Virgili Univ, Univ Hosp St Joan de Reus, Pere Virgili Inst Hlth Res IISPV, Dept Biochem & Biotechnol,Human Nutr Unit, Reus, Spain

[2] Inst Salud Carlos III, Ctr Invest Biomed Red Fisiopatol Obesidad & Nutr, Madrid, Spain

[3] Univ Navarra, Navarra Inst Hlth Res IdiSNA, Dept Prevent Med & Publ Hlth, Pamplona, Spain

[4] Inst Invest & Recerca Atencio Promaria IDIAP, Catalan Inst Hlth, Primary Care Div, Barcelona, Spain

[5] Hosp Mar Med Res Inst IMIM, Cardiovasc Risk & Nutr Res Grp, Barcelona, Spain

[6] Univ Valencia, Dept Prevent Med, Valencia, Spain

[7] Univ Palmas Gran Canaria, Res Inst Biomed & Hlth Sci, Las Palmas Gran Canaria, Spain

[8] Univ Malaga, Inst Biomed Res Malaga IBIMA, Sch Hlth Sci, Dept Nursing, Malaga, Spain

[9] Univ Hosp Son Espases, Inst Invest Sanitaria Illes Balears IdiSBa, Palma De Mallorca, Spain

[10] Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Hosp Clin, Dept Internal Med, Barcelona, Spain

[11] Hosp Clin Univ, Endocrinol & Nutr Dept, Barcelona, Spain

[12] Inst Invest Biomed August Pi Sunyer IDIBAPS, Barcelona, Spain

[13] Inst Salud Carlos III, Ctr Invest Biomed Red Diabet Enfermedades Metab A, Madrid, Spain

[14] Univ Navarra, Ctr Nutr Res, Dept Nutr Food Sci & Physiol, Pamplona, Spain

[15] Madrid Inst Adv Studies IMDEA, Food Inst, Madrid, Spain

[16] Univ Hosp Araba, Dept Cardiol, Vitoria, Spain

[17] Univ Hosp Fdn Jimenez Diaz, Dept Endocrinol & Nutr, Madrid, Spain

[18] Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi Sunyer IDIBAPS, Lipid Clin Endocrinol & Nutr Serv, Barcelona, Spain

[19] Univ Miguel Hernandez, Nutr Epidemiol Unit, Alicante, Spain

[20] Inst Salud Carlos III, Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Madrid, Spain

[21] Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Lipids & Atherosclerosis Unit, Cordoba, Spain

[22] Univ Granada, Dept Prevent Med & Publ Hlth, Granada, Spain

[23] Univ Balear Isl, Res Grp Community Nutr & Oxidat Stress, Palma De Mallorca, Spain

[24] Univ Malaga, Inst Biomed Res Malaga IBIMA, Virgen Victoria Hosp, Dept Endocrinol & Nutr, Malaga, Spain

[25] Univ Leon, Res Grp Gene Environm Interact & Hlth, Leon, Spain

[26] Univ Leon, Biomed Inst IBIOMED, Leon, Spain

[27] Distrito Sanitario Atenc Primaria Sevilla, Res Unit, Dept Family Med, Seville, Spain

[28] Hosp Univ Bellvitge, Bellvitge Biomed Res Inst IDIBELL, Dept Internal Med, Lipid Unit, Barcelona, Spain

[29] UAM, CSIC, Nutr Genom & Epigen Grp, Madrid Inst Adv Studies IMDEA,Food Inst, Madrid, Spain

[30] Univ Jaen, Dept Hlth Sci, Jaen, Spain

[31] Univ Complutense Madrid, Inst Invest Sanitaria Hosp Clin San Carlos IdiSSC, Fac Med, Endocrinol & Nutr Dept, Madrid, Spain

[32] Univ Malaga, Dept Prevent Med & Publ Hlth, Malaga, Spain

[33] Serv Navarro Salud Osasunbidea, Atenc Primaria, Pamplona, Spain

[34] Univ Barcelona, Dep Med, Barcelona, Spain

[35] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA

来源：

DIABETES CARE | 2019年 / 42卷 / 05期

基金：

欧洲研究理事会;

关键词：

LOW-CARBOHYDRATE; FOLLOW-UP; OBESITY; METAANALYSIS; OVERWEIGHT; INTERLEUKIN-18; INDIVIDUALS; RESISTANCE; DISEASE; HEALTH;

D O I：

10.2337/dc18-0836

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvencion con DIeta MEDiterranea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS Overweight/obese adults with metabolic syndrome aged 55-75 years (n = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss >= 5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P < 0.002). Reductions in insulin resistance, HbA(1c), and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.

引用

页码：777 / 788

页数：12

共 21 条

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