Intensive Weight-Loss Lifestyle Intervention Using Mediterranean Diet and COVID-19 Risk in Older Adults: Secondary Analysis of PREDIMED-Plus Trial

Sangeetha Shyam, J. F. García-Gavilán, I. Paz-Graniel, J. J. Gaforio, M. Martínez-González, D. Corella, J. A. Martínez, M. Alonso-Gómez, J. Wärnberg, J. Vioque, D. Romaguera, J. López-Miranda, R. Estruch, F. J. Tinahones, J. Lapetra, J. L. Serra-Majem, A. Bueno-Cavanillas, J. A. Tur, V. Martín Sánchez, X. PintóP. Matía-Martín, J. Vidal, M. del Mar Alcarria, L. Daimiel, E. Ros, F. Fernandez-Aranda, S. K. Nishi, García-Regata, R. Perez Araluce, E. M. Asensio, O. Castañer, A. Garcia-Rios, A. Oncina-Cánovas, C. Bouzas, M. A. Zulet, E. Rayó, R. Casas, S. Martin-Pelaez, L. Tojal-Sierra, M. R. Bernal-López, S. Carlos, J. V. Sorlí, A. Goday, P. J. Peña-Orihuela, A. Pastor-Morel, S. Eguaras, M. D. Zomeño, M. Delgado-Rodríguez, N. Babio, M. Fitó, Jordi Salas-Salvadó

Research output: Indexed journal article Articlepeer-review

Abstract

Objectives: We tested the effects of a weight-loss intervention encouraging energy-reduced MedDiet and physical activity (PA) in comparison to ad libitum MedDiet on COVID-19 incidence in older adults. Design: Secondary analysis of PREDIMED-Plus, a prospective, ongoing, multicentre randomized controlled trial. Setting: Community-dwelling, free-living participants in PREDIMED-Plus trial. Participants: 6,874 Spanish older adults (55–75 years, 49% women) with overweight/obesity and metabolic syndrome. Intervention: Participants were randomised to Intervention (IG) or Control (CG) Group. IG received intensive behavioural intervention for weight loss with an energy-reduced MedDiet intervention and PA promotion. CG was encouraged to consume ad libitum MedDiet without PA recommendations. Measurements: COVID-19 was ascertained by an independent Event Committee until December 31, 2021. COX regression models compared the effect of PREDIMED-Plus interventions on COVID-19 risk. Results: Overall, 653 COVID-19 incident cases were documented (IG:317; CG:336) over a median (IQR) follow-up of 5.8 (1.3) years (inclusive of 4.0 (1.2) years before community transmission of COVID-19) in both groups. A significantly lowered risk of COVID-19 incidence was not evident in IG, compared to CG (fully-adjusted HR (95% CI): 0.96 (0.81,1.12)). Conclusions: There was no evidence to show that an intensive weight-loss intervention encouraging energy-reduced MedDiet and PA significantly lowered COVID-19 risk in older adults with overweight/ obesity and metabolic syndrome in comparison to ad libitum MedDiet. Recommendations to improve adherence to MedDiet provided with or without lifestyle modification suggestions for weight loss may have similar effects in protecting against COVID-19 risk in older adults with high cardiovascular risks.

Original languageEnglish
Pages (from-to)1162-1167
Number of pages6
JournalJournal of Nutrition, Health and Aging
Volume27
Issue number12
DOIs
Publication statusPublished - Dec 2023

Keywords

  • COVID-19
  • Mediterranean diet
  • Older adults
  • PREDIMED-Plus
  • SARS-CoV2

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