Contribution of cardio-vascular risk factors to depressive status in the PREDIMED-PLUS Trial. A cross-sectional and a 2-year longitudinal study.

BACKGROUND: Cardio-vascular disease and depression are thought to be closely related, due to shared risk factors. The aim of the study was to determine the association between cardio-vascular risk (CVR) factors and depressive status in a population (55-75 years) with metabolic syndrome (MetS) from the PREDIMED-Plus trial. METHODS AND FINDINGS: Participants were classified into three groups of CVR according to the Framingham-based REGICOR function: (1) low (LR), (2) medium (MR) or (3) high/very high (HR). The Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms at baseline and after 2 years. The association between CVR and depressive status at baseline (n = 6545), and their changes after 2 years (n = 4566) were evaluated through multivariable regression models (logistic and linear models). HR women showed higher odds of depressive status than LR [OR (95% CI) = 1.78 (1.26, 2.50)]. MR and HR participants with total cholesterol <160 mg/mL showed higher odds of depression than LR [OR (95% CI) = 1.77 (1.13, 2.77) and 2.83 (1.25, 6.42) respectively)] but those with total cholesterol ≥280 mg/mL showed lower odds of depression than LR [OR (95% CI) = 0.26 (0.07, 0.98) and 0.23 (0.05, 0.95), respectively]. All participants decreased their BDI-II score after 2 years, being the decrease smaller in MR and HR diabetic compared to LR [adjusted mean±SE = -0.52±0.20, -0.41±0.27 and -1.25±0.31 respectively). MR and HR participants with total cholesterol between 240-279 mg/mL showed greater decreases in the BDI-II score compared to LR (adjusted mean±SE = -0.83±0.37, -0.77±0.64 and 0.97±0.52 respectively). CONCLUSIONS: Improving cardiovascular health could prevent the onset of depression in the elderly. Diabetes and total cholesterol in individuals at high CVR, may play a specific role in the precise response. International Standard Randomized Controlled Trial (ISRCTN89898870).

Cambios en el Índice de Hígado Graso con una intervención con dieta mediterránea: seguimiento de 6 años del ensayo PREDIMED-Málaga / Changes in fatty liver index after consuming a Mediterranean diet: 6-year follow-up of the PREDIMED-Malaga trial

Objetivo: Analizar el efecto sobre el Índice de Hígado Graso (FLI, Fatty Liver Index) de la intervención con dieta mediterránea enriquecida con aceite de oliva virgen extra o frutos secos frente a un grupo control con una dieta baja en grasas. Metodología: Participantes del ensayo PREDIMED-Málaga, libres de enfermedad cardiovascular basalmente, pero con alto riesgo de desarrollarla. Al inicio, al año y a los 3, 5 y 6 años se les realizó mediciones antropométricas y toma de muestras de sangre para calcular el FLI. Se usaron modelos lineales mixtos para explorar los efectos fijos de los 3 grupos de intervención sobre el FLI, y sus interacciones con el tiempo. Resultados: Cumplían los criterios de participación en el estudio 276 participantes. La edad media fue de 67 años, con un 66% de mujeres. La prevalencia basal de HGNA estimado fue del 57%. El cambio temporal del FLI en el grupo control aumentó con el tiempo (1,13±0,4; p=0,006). En el grupo DietMed+AOVE la evolución fue similar a la de este, aunque por debajo (−3,90±1,9; p=0,038), y en DietMed+FS fue significativamente menor (−1,63±0,62; p=0,009). En el DietMed+FS la evolución del cambio del IMC fue 0,100 puntos menor al año en comparación con el grupo control (p=0,004). En el grupo de control, el cambio del perímetro de cintura aumentó significativamente con el tiempo (0,61±0,16cm/año; p<0,001) en contraste con DietMed+AOVE(−0,51±0,22; p=0,019). Conclusiones: La intervención dietética con dieta mediterránea podría retrasar o enlentecer la progresión natural del HGNA, siendo beneficiosa para la prevención y el tratamiento del mismo. No obstante, se necesitan estudios que ayuden a corroborar las conclusiones obtenidas (AU)

Objective: To analyze the effect of an intervention with a Mediterranean diet supplemented with either extra virgin olive oil or nuts, on the fatty liver index (FLI), compared to a low-fat control diet. Methods: Participants of the PREDIMED-Malaga trial, free from cardiovascular disease at baseline, but with a high risk to develop it, were included in this study. Anthropometric measurements were assessed and blood samples were taken to calculate participants’ FLI at study baseline and after one, 3, 5 and 6 years. Mixed linear models were used to explore the fixed effects of the 3 intervention groups on the FLI as well as their interaction with time. Results: A total of 276 participants were included in the study. Average participant age was 67 years, with 66% of participants being women. The baseline prevalence of NAFL was 57%. The change in the FLI of the control group increased significantly over time (1.13±0.41; P=.006). In the MedDiet+EVOO group, the time trend of the change in the FLI was similar to that of the control group, although it was seen to be lower (−3.90±1.9; P=.038). In the MedDiet+Nuts group, the trend was significantly lower than that of the control group (−1.63±0.62; P=.009). In the MedDiet+Nuts group, the trend of changes in participants’ BMI was 0.100 points lower per year compared to the control group (P=.004). In the control group, the change in waist circumference increased significantly over time (0.61±0.16cm/year; P<.001) in contrast to the MedDiet+EVOO group, in which this variable remained stable (−0.51±0.22; P=.019). Conclusions: A dietary intervention consisting of a Mediterranean diet could delay or slow down the natural progression of NAFL, thus, being beneficial for its prevention and treatment. However, further studies supporting these conclusions have yet to be carried out (AU)

Changes in fatty liver index after consuming a Mediterranean diet: 6-year follow-up of the PREDIMED-Malaga trial. / Cambios en el Índice de Hígado Graso con una intervención con dieta mediterránea: seguimiento de 6 años del ensayo PREDIMED-Málaga.

OBJECTIVE: To analyze the effect of an intervention with a Mediterranean diet supplemented with either extra virgin olive oil or nuts, on the fatty liver index (FLI), compared to a low-fat control diet. METHODS: Participants of the PREDIMED-Malaga trial, free from cardiovascular disease at baseline, but with a high risk to develop it, were included in this study. Anthropometric measurements were assessed and blood samples were taken to calculate participants' FLI at study baseline and after one, 3, 5 and 6 years. Mixed linear models were used to explore the fixed effects of the 3 intervention groups on the FLI as well as their interaction with time. RESULTS: A total of 276 participants were included in the study. Average participant age was 67 years, with 66% of participants being women. The baseline prevalence of NAFL was 57%. The change in the FLI of the control group increased significantly over time (1.13±0.41; P=.006). In the MedDiet+EVOO group, the time trend of the change in the FLI was similar to that of the control group, although it was seen to be lower (-3.90±1.9; P=.038). In the MedDiet+Nuts group, the trend was significantly lower than that of the control group (-1.63±0.62; P=.009). In the MedDiet+Nuts group, the trend of changes in participants' BMI was 0.100 points lower per year compared to the control group (P=.004). In the control group, the change in waist circumference increased significantly over time (0.61±0.16cm/year; P<.001) in contrast to the MedDiet+EVOO group, in which this variable remained stable (-0.51±0.22; P=.019). CONCLUSIONS: A dietary intervention consisting of a Mediterranean diet could delay or slow down the natural progression of NAFL, thus, being beneficial for its prevention and treatment. However, further studies supporting these conclusions have yet to be carried out.