Never Too Late To Switch to a Healthy Mediterranean Diet

Jordi Salas-Salvadó, MD, PhD Human Nutrition Unit, Faculty of Medicine and Healthy Sciences Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, Interview with:
Jordi Salas-Salvadó, MD, PhD
Human Nutrition Unit, Faculty of Medicine and Healthy Sciences
Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, Spain What are the main findings of the study?

Answer: Randomized trials have shown that lifestyle interventions promoting weight loss can reduce the incidence of type-2diabetes, however, whether dietary changes without calorie restriction or increased physical activity also protect from diabetes development has not been evaluated in the past. In our study, we found that a long-term adherence to a high-quality dietary pattern akin to the traditional MedDiet and rich in extra-virgin olive oil was able to reduce the incidence of new cases of diabetes in older individuals at high cardiovascular risk. We have demonstrated for the first time that a beneficial effect on diabetes prevention could be obtained witha healthy dietary pattern (without calorie restriction, increased physical activity or weight loss). These benefits have been observed in participants between 55 to 80 years-old at high cardiovascular risk; therefore,the message is that it is never too late to switch to a healthy diet like the Mediterranean. Were any of the findings unexpected?

Answer: Differences in the reduced risk observed between both mediterranean intervention groups. In a previous single-center PREDIMED report, the two MedDiets (supplemented either with virgin olive oil or nuts) afforded similar protection against diabetes. In the present study we found a significant diabetes preventive effect of the MedDiet+EVOO but only a marginal effect for MedDiet+nuts. The dissimilar benefit of the two MedDiet interventions may be a chance finding, as both EVOO and nuts contributed an extra load of unsaturated fatty acids that have been related to a reduced diabetes risk. It is important to mention that the MedDiet pattern includes other dietary components reported to be beneficial in ameliorating inflammation, oxidative stress and insulin resistance and secretion, pathogenic factors in diabetes that add biologic plausibility to the present results. What should clinicians and patients take away from your report?

Answer: A Mediterranean diet characterized by a high consumption of olive oil, and daily consumption of vegetables, fruits, and cereals; weekly consumption of fish, poultry, tree nuts, and legumes; moderate daily consumption of wine with meals; and a relatively low consumption of red and processed meat and sugar, without calorie restrictions that is supplemented with EVOO or nuts may reduce the risk for type 2 diabetes in individuals at high cardiovascular risk. What recommendations do you have for future research as a result of this study?

Answer: We have millions of data collected in PREDIMED. In the coming years we can evaluate the effect of interventions on the incidence of different types of cancer, quality of life, metabolic syndrome, cognitive status, and many other conditions.
Also we will focus on evaluating the effects of the Mediterranean diet in the context of weight loss. In order to test if an energy-restricted Mediterranean diet have agreater effect in decreasing the risk of diabetes or cardiovascular risk, we have designed the PREDIMED-PLUS study, a randomized, multicenter parallel-group trial of lifestyle intervention comparing the effects of intensive lifestyle intervention with an energy-restricted Mediterranean diet, increased physical activity, and behavioral treatment versus usual care for weight loss combined with recommendations to follow a Mediterranean diet. PREDIMED-PLUS is expected to obtain synergy from the beneficial effects of a high-quality diet (a supplemented MeDiet) plus an intensive weight-loss intervention (using energy restriction and physical activity) on the incidence of major chronic diseases.


Prevention of Diabetes With Mediterranean Diets: A Subgroup Analysis of a Randomized Trial

Jordi Salas-Salvadó, Mònica Bulló, Ramón Estruch, Emilio Ros, Maria-Isabel Covas, Núria Ibarrola-Jurado, Dolores Corella, Fernando Arós, Enrique Gómez-Gracia, Valentina Ruiz-Gutiérrez, Dora Romaguera, José Lapetra, Rosa Maria Lamuela-Raventós, Lluís Serra-Majem, Xavier Pintó, Josep Basora, Miguel Angel Muñoz, José V. Sorlí, Miguel A. Martínez-González; Prevention of Diabetes With Mediterranean DietsA Subgroup Analysis of a Randomized Trial. Annals of Internal Medicine. 2014 Jan;160(1):1-10.


Last Updated on November 26, 2014 by Marie Benz MD FAAD