Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial.
BACKGROUND
Epidemiological studies suggest that the Mediterranean diet (MedDiet) may reduce the risk of developing the metabolic syndrome (MetS). We compared the 1-year effect of 2 behavioral interventions to implement the MedDiet vs advice on a low-fat diet on MetS status.


METHODS
A total of 1224 participants were recruited from the PREDIMED (Prevención con Dieta Mediterránea) Study, a multicenter, 3-arm, randomized clinical trial to determine the efficacy of the MedDiet on the primary prevention of cardiovascular disease. Participants were older subjects at high risk for cardiovascular disease. Interventions were quarterly education about the MedDiet plus provision of either 1 L/wk of virgin olive oil (MedDiet + VOO) or 30 g/d of mixed nuts (MedDiet + nuts), and advice on a low-fat diet (control diet). All diets were ad libitum, and there was no increase in physical activity for any of the interventions. Lifestyle variables and MetS features as defined by the National Cholesterol Education Program Adult Treatment Panel III criteria were assessed.


RESULTS
At baseline, 61.4% of participants met criteria for the MetS. One-year prevalence was reduced by 6.7%, 13.7%, and 2.0% in the MedDiet + VOO, MedDiet + nuts, and control diet groups, respectively (MedDiet + nuts vs control groups, P = .01; MedDiet + VOO vs control group, P = .18). Incident rates of the MetS were not significantly different among groups (22.9%, 17.9%, and 23.4%, respectively). After adjustment for sex, age, baseline obesity status, and weight changes, the odds ratios for reversion of MetS were 1.3 (95% confidence interval, 0.8-2.1) for the MedDiet + VOO group and 1.7 (1.1-2.6) for the MedDiet + nuts group compared with the control diet group.


CONCLUSIONS
A traditional MedDiet enriched with nuts could be a useful tool in the management of the MetS.
Salas-Salvadó
Jordi
J
Fernández-Ballart
Joan
J
Ros
Emilio
E
Martínez-González
Miguel-Angel
MA
Fitó
Montserrat
M
Estruch
Ramon
R
Corella
Dolores
D
Fiol
Miquel
M
Gómez-Gracia
Enrique
E
Arós
Fernando
F
Flores
Gemma
G
Lapetra
José
J
Lamuela-Raventós
Rosa
R
Ruiz-Gutiérrez
Valentina
V
Bulló
Mònica
M
Basora
Josep
J
Covas
María-Isabel
MI
D000368:Aged; D038441:Diet, Mediterranean; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy*; D009754:Nuts; D013997:Time Factors