Mediterranean Diet Is a Predictor of Progression of Subclinical Atherosclerosis in a Mediterranean Population: The ILERVAS Prospective Cohort Study
Por:
Rojo-López, MI, Bermúdez-López, M, Castro, E, Farràs, C, Torres, G, Pamplona, R, Lecube, A, Valdivieso, JM, Fernández, E, Julve, J, Castelblanco, E, Alonso, N, Antentas, M, Barranco-Altirriba, M, Perera-Lluna, A, Franch-Nadal, J, Granado-Casas, M, Mauricio, D
Publicada:
1 nov 2024
Resumen:
Atherosclerotic cardiovascular disease remains a major health issue, often developing silently as subclinical atherosclerotic disease (SAD). The Mediterranean diet (MDiet) is known for its cardiovascular benefits, but the combined influence of both MDiet adherence and physical activity (PA) on SAD progression has not been previously documented. Objective: We aimed to investigate how adherence to a healthy lifestyle, defined as MDiet adherence and PA level, influences SAD progression in subjects from the ILERVAS cohort follow-up. Methods: A study on 3097 participants from the ILERVAS prospective cohort was conducted. MDiet adherence was assessed using the MEDAS score, and PA categories were established using the IPAQ, both categorized into low, moderate, and high levels. Two different lifestyle scores integrating the MDiet and PA categories were built. The presence of atherosclerotic plaques was assessed by carotid and femoral ultrasound examination. Demographic, clinical, and biochemical data were also obtained. Multivariable linear, logistic, and Poisson regression models adjusted for potential confounders were used to analyze the association between the lifestyle scores and SAD progression, as well as the MDiet and PA as separate variables and number of territories with plaque. Results: A healthier lifestyle score did not show an effect on SAD progression. However, a higher MEDAS score was associated with a 3% decrease in the number of territories with plaque (IRR 0.97, 95% CI 0.96-0.99, p < 0.001), suggesting a protective effect of the adherence to the MDiet. PA did not show a significant association (IRR 1.00, 95% CI 1.00-1.00, p = 0.269). Older age, hypertension, dyslipidemia, smoking, and lower eGFR were associated with SAD progression, while the female sex was protective (IRR 0.67, 95% CI 0.63-0.72, p < 0.001). Conclusions: The findings of this study show that higher adherence to the MDiet is associated with reduced incidence of SAD, indicating its potential role in cardiovascular prevention strategies. Although a higher lifestyle score or physical activity levels did not show any significant effect, promoting the MDiet, alongside managing traditional cardiovascular risk factors, could be an effective public health intervention to prevent atherosclerosis and reduce the burden of cardiovascular disease.
Filiaciones:
Rojo-López, MI:
Inst Recerca St Pau IR ST PAU, St Quinti 77 79, Barcelona 08041, Spain
Bermúdez-López, M:
ISCIII, IRBLleida, Renal Res Network RedInRen, Vasc & Renal Translat Res Grp, Lleida 25198, Spain
Univ Lleida, Dept Expt Med, Lleida 25198, Spain
Castro, E:
ISCIII, IRBLleida, Renal Res Network RedInRen, Vasc & Renal Translat Res Grp, Lleida 25198, Spain
Farràs, C:
Inst Catala Salut, Ctr Atencio Primaria Cappont, Gerencia Terr Lleida, Barcelona 08007, Spain
Jordi Gol i Gorina Primary Hlth Care Res Inst Fdn, Res Support Unit Lleida, Barcelona 08007, Spain
Torres, G:
Arnau de Vilanova Univ Hosp, Med Oncol Dept, Lleida 25198, Spain
Inst Recerca Biomed Lleida IRBLleida, IRBLleida, Translat Res Grp Resp Med, Rovira Roure 80, Lleida 25198, Spain
Inst Salud Carlos III ICSIII, CIBER Resp Dis CIBERES, Madrid 28029, Spain
Pamplona, R:
Univ Lleida, Dept Expt Med, Lleida 25198, Spain
Lecube, A:
Arnau de Vilanova Univ Hosp, Dept Endocrinol & Nutr, Lleida 25198, Spain
Univ Lleida, IRBLleida, Obes & Metab Res Grp ODIM, Lleida 25198, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Barcelona 08041, Spain
Valdivieso, JM:
ISCIII, IRBLleida, Renal Res Network RedInRen, Vasc & Renal Translat Res Grp, Lleida 25198, Spain
Fernández, E:
ISCIII, IRBLleida, Renal Res Network RedInRen, Vasc & Renal Translat Res Grp, Lleida 25198, Spain
Univ Lleida, Dept Expt Med, Lleida 25198, Spain
Julve, J:
Inst Recerca St Pau IR ST PAU, St Quinti 77 79, Barcelona 08041, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Barcelona 08041, Spain
Castelblanco, E:
Washington Univ, Sch Med, Dept Internal Med Endocrinol Metab, St Louis, MO 63110 USA
Washington Univ, Lipid Res Div, Sch Med, St Louis, MO 63110 USA
Alonso, N:
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Barcelona 08041, Spain
Hosp Univ Germans Trias i Pujol, Dept Dermatol, Badalona 08916, Spain
Antentas, M:
Inst Recerca St Pau IR ST PAU, St Quinti 77 79, Barcelona 08041, Spain
Barranco-Altirriba, M:
Hosp Santa Creu i St Pau, Dept Endocrinol & Nutr, Barcelona 08041, Spain
Univ Politecn Catalunya BarcelonaTech, Dept Engn Sistemes Automat & Informat Ind, B2SLab, Barcelona 08034, Spain
CIBER BBN, Networking Biomed Res Ctr Subject Area Bioengn Bio, Madrid 28029, Spain
Inst Recerca St Joan de Deu, Esplugas de Llobregat 08950, Barcelona, Spain
Perera-Lluna, A:
Univ Politecn Catalunya BarcelonaTech, Dept Engn Sistemes Automat & Informat Ind, B2SLab, Barcelona 08034, Spain
CIBER BBN, Networking Biomed Res Ctr Subject Area Bioengn Bio, Madrid 28029, Spain
Inst Recerca St Joan de Deu, Esplugas de Llobregat 08950, Barcelona, Spain
Franch-Nadal, J:
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Barcelona 08041, Spain
Fdn Inst Univ Recerca Atencio Primaria Salut Jordi, DAP Cat Grp, Unitat Suport Recerca Barcelona, Barcelona 08007, Spain
Granado-Casas, M:
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Barcelona 08041, Spain
Hosp Univ Germans Trias i Pujol, Dept Dermatol, Badalona 08916, Spain
Univ Lleida, Dept Nursing & Physiotherapy, Lleida 25198, Spain
IRBLleida, Res Grp Hlth Care GreCS, Lleida, Spain
Mauricio, D:
Inst Recerca St Pau IR ST PAU, St Quinti 77 79, Barcelona 08041, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Associated Metab Dis CIBERDEM, Barcelona 08041, Spain
Hosp Santa Creu i St Pau, Dept Endocrinol & Nutr, Barcelona 08041, Spain
Univ Vic Cent Univ Catalonia UVic UCC, Fac Med, Vic 08500, Spain
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