1. 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
- Author
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Lidia Ángeles Daimiel-Ruiz, Rocío Zamanillo Campos, Ricardo Tosca-Segura, Alba Marcos-Delgado, Vicente Martin, Jose Lopez-Miranda, Xavier Pintó Sala, Ramon Sagarra Àlamo, Miguel A. Rubio, Cristina Razquin, Cristina Botella, Josep Basora, Manuela Garcia de la Hera, Mònica Bulló, Rosa Casas, MAIRA BES-RASTROLLO, Monica Domenech, Christopher Papandreou, Juan José Cabré Vila, Miguel Ruiz-Canela, Jesús Francisco García-Gavilán, Lucía Camacho-Barcia, Paula Carrasco, Julia Warnberg, Mario Gutiérrez-Bedmar, Andrés Díaz-López, Laura Forcano Gamazo, Alicia Lopez Maldonado, Mercè López Grau, Joana Ripoll, Ana Maria Ruiz-Leon, Aina M Yañez, Miguel Camafort-Babkowski, FERNANDO FERNANDEZ-ARANDA, José V Sorlí, Laura M Compañ Gabucio, Francisco J Tinahones, Laura Torres-Collado, David Benaiges, Pablo Hernández-Alonso, Olga Castañer Niño, Xavier Corbella, Ana Barabash, Juan Francisco Alcala-Diaz, Jordi Salas-Salvadó, NANCY BABIO SÁNCHEZ, Dora Romaguera, Rafel M. Prieto, GRACIA MARIA QUINTANA-NAVARRO, José Carlos Fernández García, Josep Vidal, David López Heras, Inmaculada Bautista-Castaño, Ernest Vinyoles, Gala Freixer Ballesteros, Sandra González Palacios, Almudena Sanchez Villegas, Susana Gonzalez Torrente, Albert Salas-Huetos, Aurora Bueno Cavanillas, Macarena Torrego-Ellacuría, Jaume Marrugat, Laura Álvarez Álvarez, Jesus Vioque, and Aida Cuenca Royo
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Mediterranean diet ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Overweight ,Diet, Mediterranean ,law.invention ,Prediabetic State ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Weight loss ,Behavior Therapy ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Weight Loss ,Internal Medicine ,Medicine ,Humans ,030212 general & internal medicine ,Obesity ,Exercise physiology ,Exercise ,Life Style ,Aged ,Caloric Restriction ,Advanced and Specialized Nursing ,Metabolic Syndrome ,business.industry ,Leptin ,Middle Aged ,medicine.disease ,Exercise Therapy ,Cardiovascular Diseases ,Female ,medicine.symptom ,Metabolic syndrome ,business ,Follow-Up Studies - Abstract
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 PREvención con DIeta MEDiterránea (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, HbA1c, 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.
- Published
- 2019