title: Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial.
abstract: 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.
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.forename: Joan
authors.initials: J
authors.lastname: Fernández-Ballart
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Martínez-González
authors.forename: Montserrat
authors.initials: M
authors.lastname: Fitó
authors.forename: Ramon
authors.initials: R
authors.lastname: Estruch
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.forename: Enrique
authors.initials: E
authors.lastname: Gómez-Gracia
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.forename: Gemma
authors.initials: G
authors.lastname: Flores
authors.forename: José
authors.initials: J
authors.lastname: Lapetra
authors.forename: Rosa
authors.initials: R
authors.lastname: Lamuela-Raventós
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruiz-Gutiérrez
authors.forename: Mònica
authors.initials: M
authors.lastname: Bulló
authors.forename: Josep
authors.initials: J
authors.lastname: Basora
authors.forename: María-Isabel
authors.initials: MI
authors.lastname: Covas
mesh_terms: 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