Resumen
Background & aims: The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. Methods: PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65 y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. Results: After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]: −0.02% [−0.02, −0.01], P < 0.001), fasting glucose (−0.47 mg/dL [−0.83, −0.11], P = 0.01), triglycerides (−1.29 mg/dL [−2.31, −0.28], P = 0.01), waist circumference (WC) (−0.51 cm [−0.59, −0.43], P < 0.001), and body mass index (BMI) (−0.17 kg/m2 [−0.19, −0.15], P < 0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (−0.03% [−0.04, −0.02], P < 0.001), glucose (−0.84 mg/dL [−1.18, −0.51], P < 0.001), triglycerides (−3.38 mg/dL [−4.37, −2.38], P < 0.001), non-HDL-cholesterol (−0.47 mg/dL [−0.91, −0.04], P = 0.03), WC (−0.69 cm [−0.76, −0.60 cm], P < 0.001), BMI (−0.25 kg/m2 [−0.28, −0.26 kg/m2], P < 0.001), systolic blood pressure (−0.57 mmHg [−0.81, −0.32 mmHg], P < 0.001), diastolic blood pressure (−0.15 mmHg [−0.29, −0.01 mmHg], P = 0.03), and with higher HDL-cholesterol (0.21 mg/dL [0.09, 0.34 mg/dL, P = 0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. Conclusions: Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction.
| Idioma original | Inglés |
|---|---|
| Páginas (desde-hasta) | 2825-2836 |
| Número de páginas | 12 |
| Publicación | Clinical Nutrition |
| Volumen | 40 |
| N.º | 5 |
| DOI | |
| Estado | Publicada - may 2021 |
| Publicado de forma externa | Sí |
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En: Clinical Nutrition, Vol. 40, N.º 5, 05.2021, p. 2825-2836.
Producción científica: Artículo en revista indizada › Artículo › revisión exhaustiva
TY - JOUR
T1 - Longitudinal changes in adherence to the portfolio and DASH dietary patterns and cardiometabolic risk factors in the PREDIMED-Plus study
AU - Glenn, Andrea J.
AU - Hernández-Alonso, Pablo
AU - Kendall, Cyril W.C.
AU - Martínez-González, Miguel Ángel
AU - Corella, Dolores
AU - Fitó, Montserrat
AU - Martínez, J. Alfredo
AU - Alonso-Gómez, Ángel M.
AU - Wärnberg, Julia
AU - Vioque, Jesús
AU - Romaguera, Dora
AU - López-Miranda, José
AU - Estruch, Ramon
AU - Tinahones, Francisco J.
AU - Lapetra, José
AU - Serra-Majem, J. Luís
AU - Bueno-Cavanillas, Aurora
AU - Tur, Josep A.
AU - Celada, Sofia Reguero
AU - Pintó, Xavier
AU - Delgado-Rodríguez, Miguel
AU - Matía-Martín, Pilar
AU - Vidal, Josep
AU - Mas-Fontao, Sebastian
AU - Daimiel, Lidia
AU - Ros, Emilio
AU - Jenkins, David J.A.
AU - Toledo, Estefania
AU - Sorlí, José V.
AU - Castañer, Olga
AU - Abete, Itziar
AU - Rodriguez, Anai Moreno
AU - Barceló, Olga Fernández
AU - Oncina-Canovas, Alejandro
AU - Konieczna, Jadwiga
AU - Garcia-Rios, Antonio
AU - Casas, Rosa
AU - Gómez-Pérez, Ana Maria
AU - Santos-Lozano, José Manuel
AU - Vazquez-Ruiz, Zenaida
AU - Portolés, Olga
AU - Schröder, Helmut
AU - Zulet, Maria A.
AU - Eguaras, Sonia
AU - Lete, Itziar Salaverria
AU - Zomeño, María Dolores
AU - Sievenpiper, John L.
AU - Salas-Salvadó, Jordi
N1 - Funding Information: The PREDIMED-Plus trial was supported by the Spanish government's official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS) and co-funded by European Union ERDF/ESF, “A way to make Europe”/“Investing in your future” (five coordinated FIS projects led by JS-S and JVid , including the following projects: PI13/00673 , PI13/00492 , PI13/00272 , PI13/01123 , PI13/00462 , PI13/00233 , PI13/02184 , PI13/00728 , PI13/01090 , PI13/01056 , PI14/01722 , PI14/00636 , PI14/00618 , PI14/00696 , PI14/01206 , PI14/01919 , PI14/00853 , PI14/01374 , PI14/00972 , PI14/00728 , PI14/01471 , PI16/00473 , PI16/00662 , PI16/01873 , PI16/01094 , PI16/00501 , PI16/00533 , PI16/00381 , PI16/00366 , PI16/01522 , PI16/01120 , PI17/00764 , PI17/01183 , PI17/00855 , PI17/01347 , PI17/00525 , PI17/01827 , PI17/00532 , PI17/00215 , PI17/01441 , PI17/00508 , PI17/01732 , PI17/00926 , PI19/00957 , PI19/00386 , PI19/00309 , PI19/01032 , PI19/00576 , PI19/00017 , PI19/01226 , PI19/00781 , PI19/01560 , and PI19/01332 ), the Special Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S , the European Research Council (Advanced Research Grant 2014–2019, 340918 ) to MÁM-G , the Recercaixa Grant to JS-S ( 2013ACUP00194 ), grants from the Consejería de Salud de la Junta de Andalucía ( PI0458/2013 , PS0358/2016 , and PI0137/2018 ), a grant from the Generalitat Valenciana ( PROMETEO/2017/017 ), a SEMERGEN grant , and funds from the European Regional Development Fund ( CB06/03 ). This research was also partially funded by EU-H2020 Grant ( EAT2BENICE/H2020-SFS-2016-2 ; Ref 728018). Study resulting from the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut”. We thank CERCA Programme/Generalitat de Catalunya for institutional support. This work is partially supported by ICREA under the ICREA Academia programme. IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports ( FPU 17/01925 ). MRBL was supported by “Miguel Servet Type I” program ( CP15/00028 ) from the ISCIII -Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER . AJG was supported by the Nora Martin Fellowship in Nutritional Sciences, the Banting & Best Diabetes Centre Tamarack Graduate Award in Diabetes Research, the Peterborough K.M. Hunter Charitable Foundation Graduate Award and an Ontario Graduate Scholarship. PH-A was supported by a postdoctoral fellowship (Juan de la Cierva-Formación), FJCI-2017–32205, funded by the Ministry of Science and Innovation . RE group has been supported by the ‘Ajut 2017-2021 SGR 1717 from the Generalitat de Catalunya . DJAJ was funded by the Government of Canada through the Canada Research Chair Endowment. JK was supported by the ‘FOLIUM’ programme within the FUTURMed project from the Fundación Instituto de Investigación Sanitaria Illes Balears (financed by 2017 annual plan of the sustainable tourism tax and at 50% with charge to the ESF Operational Program 2014–2020 of the Balearic Islands). JLS was funded by a Diabetes Canada Clinician Scientist Award . Funding Information: AJG has done consulting work for SoLo GI Nutrition and has received an honorarium from the Soy Nutrition Institute . CWCK has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC) , Almond Board of California , American Peanut Council, Barilla , Canadian Institutes of Health Research (CIHR) , Canola Council of Canada , International Nut and Dried Fruit Council , International Tree Nut Council Research and Education Foundation , Loblaw Brands Ltd , Pulse Canada and Unilever . He has received in-kind research support from the Almond Board of California , American Peanut Council, Barilla , California Walnut Commission , Kellogg Canada , Loblaw Companies , Nutrartis , Quaker (PepsiCo) , Primo , Unico , Unilever , WhiteWave Foods/Danone . He has received travel support and/or honoraria from the American Peanut Council, Barilla , California Walnut Commission , Canola Council of Canada , General Mills , International Nut and Dried Fruit Council , International Pasta Organization , Lantmannen , Loblaw Brands Ltd , Nutrition Foundation of Italy , Oldways Preservation Trust , Paramount Farms , Peanut Institute , Pulse Canada , Sun-Maid , Tate & Lyle , Unilever and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, International Pasta Organization, McCormick Science Institute and Oldways Preservation Trust. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD and is a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. DJAJ has received research grants from Loblaw Companies Ltd. , the Almond Board of California , Soy Nutrition Institute (SNI) , and the Canadian Institutes of Health Research (CIHR) . He has received in-kind supplies for trials as a research support from the Almond board of California , Walnut Council of California , American Peanut Council , Barilla , Unilever , Unico , Primo , Loblaw Companies , Quaker (Pepsico) , Pristine Gourmet , Bunge Limited , Kellogg Canada , WhiteWave Foods . He has been on the speaker's panel, served on the scientific advisory board and/or received travel support and/or honoraria from the Loblaw Companies Ltd , Diet Quality Photo Navigation (DQPN) , Better Therapeutics (FareWell) , Verywell , True Health Initiative (THI) , Heali AI Corp , Institute of Food Technologists (IFT) , Soy Nutrition Institute (SNI) , Herbalife Nutrition Institute (HNI) , Herbalife International , Pacific Health Laboratories , Nutritional Fundamentals for Health (NFH) , the Soy Foods Association of North America , the Nutrition Foundation of Italy (NFI) , the Toronto Knowledge Translation Group (St. Michael's Hospital) , the Canadian College of Naturopathic Medicine , The Hospital for Sick Children , the Canadian Nutrition Society (CNS) , and the American Society of Nutrition (ASN) . He is a member of the International Carbohydrate Quality Consortium (ICQC). His wife, Alexandra L Jenkins, is a director and partner of INQUIS Clinical Research for the Food Industry, his 2 daughters, Wendy Jenkins and Amy Jenkins, have published a vegetarian book that promotes the use of the low glycemic index plant foods advocated here, The Portfolio Diet for Cardiovascular Risk Reduction (Academic Press/Elsevier 2020 ISBN:978-0-12-810510-8)and his sister, Caroline Brydson, received funding through a grant from the St. Michael's Hospital Foundation to develop a cookbook for one of his studies. ER has received research funding through his institution from the California Walnut Commission , Folsom, CA, USA; was a paid member of its Health Research Advisory Group; and is a nonpaid member of its Scientific Advisory Council. He has also received research support through his institution from Alexion and serves on its Scientific Advisory board, received fees for scientific presentations and travel support from Danone , and travel support from the International Nut Council . JS-S serves on the board of (and receives grant support through his institution from) the International Nut and Dried Fruit Council and the Eroski Foundation. He also serves on the Executive Committee of the Instituto Danone, Spain, and on the Scientific Committee of the Danone International Institute. He has received research support from the Patrimonio Comunal Olivarero , Spain, and Borges S.A., Spain. He receives consulting fees or travel expenses from Danone , the Eroski Foundation , the Instituto Danone Spain , and Abbot Laboratories . RE reports grants from Cerveza y Salud , Spain, Fundacion Dieta Mediterranea , Spain and Interprofesional del Vino , Spain. Also, personal fees for given lectures from Brewers of Europe , Belgium, Fundacion Cerveza y Salud , Spain, Pernaud-Ricard , Mexico, Instituto Cervantes , Alburquerque , USA; Instituto Cervantes , Milan, Italy, Instituto Cervantes , Tokyo, Japan, Lilly Laboratories , Spain, and Wine and Culinary International Forum , Spain, and non-financial support to organize a National Congress on Nutrition. Also feeding trials with product from Grand Fountain and Uriach Laboratories, Spain. JLS has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, PSI Foundation, Banting and Best Diabetes Centre (BBDC), American Society for Nutrition (ASN), INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, National Honey Board, International Life Sciences Institute (ILSI), Pulse Canada, Quaker, The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), and The Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received in-kind food donations to support a randomized controlled trial from the Almond Board of California, California Walnut Commission, American Peanut Council, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone, and Nutrartis. He has received travel support, speaker fees and/or honoraria from Diabetes Canada, Dairy Farmers of Canada, FoodMinds LLC, International Sweeteners Association, Nestlé, Pulse Canada, Canadian Society for Endocrinology and Metabolism (CSEM), GI Foundation, Abbott, General Mills, Biofortis, ASN, Northern Ontario School of Medicine, INC Nutrition Research & Education Foundation, European Food Safety Authority (EFSA), Comité Européen des Fabricants de Sucre (CEFS), Nutrition Communications, International Food Information Council (IFIC), Calorie Control Council, and Physicians Committee for Responsible Medicine. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Wirtschaftliche Vereinigung Zucker e.V., Danone, and Inquis Clinical Research. He is a member of the European Fruit Juice Association Scientific Expert Panel and Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada. He serves or has served as an unpaid scientific advisor for the Food, Nutrition, and Safety Program (FNSP) and the Technical Committee on Carbohydrates of ILSI North America. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of AB InBev. All other authors declare no conflicts. Publisher Copyright: © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
PY - 2021/5
Y1 - 2021/5
N2 - Background & aims: The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. Methods: PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65 y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. Results: After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]: −0.02% [−0.02, −0.01], P < 0.001), fasting glucose (−0.47 mg/dL [−0.83, −0.11], P = 0.01), triglycerides (−1.29 mg/dL [−2.31, −0.28], P = 0.01), waist circumference (WC) (−0.51 cm [−0.59, −0.43], P < 0.001), and body mass index (BMI) (−0.17 kg/m2 [−0.19, −0.15], P < 0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (−0.03% [−0.04, −0.02], P < 0.001), glucose (−0.84 mg/dL [−1.18, −0.51], P < 0.001), triglycerides (−3.38 mg/dL [−4.37, −2.38], P < 0.001), non-HDL-cholesterol (−0.47 mg/dL [−0.91, −0.04], P = 0.03), WC (−0.69 cm [−0.76, −0.60 cm], P < 0.001), BMI (−0.25 kg/m2 [−0.28, −0.26 kg/m2], P < 0.001), systolic blood pressure (−0.57 mmHg [−0.81, −0.32 mmHg], P < 0.001), diastolic blood pressure (−0.15 mmHg [−0.29, −0.01 mmHg], P = 0.03), and with higher HDL-cholesterol (0.21 mg/dL [0.09, 0.34 mg/dL, P = 0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. Conclusions: Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction.
AB - Background & aims: The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. Methods: PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65 y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. Results: After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]: −0.02% [−0.02, −0.01], P < 0.001), fasting glucose (−0.47 mg/dL [−0.83, −0.11], P = 0.01), triglycerides (−1.29 mg/dL [−2.31, −0.28], P = 0.01), waist circumference (WC) (−0.51 cm [−0.59, −0.43], P < 0.001), and body mass index (BMI) (−0.17 kg/m2 [−0.19, −0.15], P < 0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (−0.03% [−0.04, −0.02], P < 0.001), glucose (−0.84 mg/dL [−1.18, −0.51], P < 0.001), triglycerides (−3.38 mg/dL [−4.37, −2.38], P < 0.001), non-HDL-cholesterol (−0.47 mg/dL [−0.91, −0.04], P = 0.03), WC (−0.69 cm [−0.76, −0.60 cm], P < 0.001), BMI (−0.25 kg/m2 [−0.28, −0.26 kg/m2], P < 0.001), systolic blood pressure (−0.57 mmHg [−0.81, −0.32 mmHg], P < 0.001), diastolic blood pressure (−0.15 mmHg [−0.29, −0.01 mmHg], P = 0.03), and with higher HDL-cholesterol (0.21 mg/dL [0.09, 0.34 mg/dL, P = 0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. Conclusions: Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction.
KW - Cardiometabolic risk
KW - DASH diet
KW - Dietary patterns
KW - Metabolic syndrome
KW - PORTFOLIO diet
KW - PREDIMED-Plus trial
UR - http://www.scopus.com/inward/record.url?scp=85104911946&partnerID=8YFLogxK
U2 - 10.1016/j.clnu.2021.03.016
DO - 10.1016/j.clnu.2021.03.016
M3 - Article
C2 - 33933749
AN - SCOPUS:85104911946
SN - 0261-5614
VL - 40
SP - 2825
EP - 2836
JO - Clinical Nutrition
JF - Clinical Nutrition
IS - 5
ER -