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 - 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
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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 -