title: Carotid intima-media thickness changes with Mediterranean diet: a randomized trial (PREDIMED-Navarra).
abstract: OBJECTIVE
  Observational studies have reported inverse associations between adherence to the Mediterranean diet (MedDiet) and atherosclerotic disease. We tested the effect of two types of MedDiet on progression of subclinical carotid atherosclerosis.
  
  
  METHODS
  We randomized 187 high-cardiovascular-risk asymptomatic subjects (51% women, mean age 67 years) to three treatment arms: MedDiet with supplemental virgin olive oil (VOO), n=66; MedDiet with supplemental nuts, n=59; and control diet, n=62. Participants received nutrition behavioral counseling in quarterly group and individual educational sessions. Free supplemental foods were provided to the MedDiet groups. Changes in mean intima-media thickness (IMT) were measured ultrasonographically in the far wall of bilateral common carotid arteries after 1 year.
  
  
  RESULTS
  Overall, no significant between-group differences in IMT progression were observed after 1-year. However, a significant interaction (p=0.03) between baseline IMT and treatment effect was apparent. Among participants with baseline IMT≥0.9 mm, 1-year IMT changes versus control showed significant differences of -0.079 mm (95% confidence interval, -0.145 to -0.012) for the MedDiet with VOO and -0.072 mm (-0.140 to -0.004) for the MedDiet with nuts. No IMT changes occurred in any intervention group among participants with lower baseline IMT values (<0.9 mm).
  
  
  CONCLUSIONS
  MedDiets enhanced with VOO or nuts were not effective in inducing ultrasonographic regression of carotid atherosclerosis after 1 year intervention. However, they were effective among subjects with elevated baseline IMT, suggesting that subclinical atherosclerosis may respond to dietary intervention within a relatively short time frame only among subjects with a high initial atherosclerotic burden.
authors.affiliation: Department of Neurology, University of Navarra, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Murie-Fernandez
authors.forename: Pablo
authors.initials: P
authors.lastname: Irimia
authors.forename: Estefanía
authors.initials: E
authors.lastname: Toledo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martínez-Vila
authors.forename: Pilar
authors.initials: P
authors.lastname: Buil-Cosiales
authors.forename: Manuel
authors.initials: M
authors.lastname: Serrano-Martínez
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruiz-Gutiérrez
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.forename: Ramon
authors.initials: R
authors.lastname: Estruch
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Martínez-González
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D038441:Diet, Mediterranean; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009754:Nuts; D000069463:Olive Oil; D010938:Plant Oils; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging
chemical_list: D000069463:Olive Oil; D010938:Plant Oils