Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial.

Abstract:

OBJECTIVE:To date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a low-fat control diet. RESEARCH DESIGN AND METHODS:This was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), MedDiet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression. RESULTS:During a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the MedDiet+EVOO and 0.63 (0.35-1.11) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the MedDiet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy. CONCLUSIONS:A MedDiet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Díaz-López A,Babio N,Martínez-González MA,Corella D,Amor AJ,Fitó M,Estruch R,Arós F,Gómez-Gracia E,Fiol M,Lapetra J,Serra-Majem L,Basora J,Basterra-Gortari FJ,Zanon-Moreno V,Muñoz MÁ,Salas-Salvadó J,PREDIMED Study Inves

doi

10.2337/dc15-1117

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

2134-41

issue

11

eissn

0149-5992

issn

1935-5548

pii

dc15-1117

journal_volume

38

pub_type

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