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 A, Franch-Nadal J, Granado-Casas M, Mauricio D and On Behalf Of The Ilervas Project Collaborators
Publicada:
1 nov 2024
Ahead of Print:
24 oct 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:
Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Bermúdez-López M:
Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen. ISCIII), 25198 Lleida, Spain
Department of Experimental Medicine, University of Lleida, 25198 Lleida, Spain
Castro E:
Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen. ISCIII), 25198 Lleida, Spain
Farràs C:
Centre d'Atenció Primària Cappont, Gerència Territorial de Lleida, Institut Català de la Salut, 08007 Barcelona, Spain
Research Support Unit Lleida, Jordi Gol i Gorina Primary Health Care Research Institute Foundation (IDIAPJGol), 08007 Barcelona, Spain
Torres G:
Department of Respiratory Medicine, Arnau de Vilanova University Hospital, 25198 Lleida, Spain
Translational Research Group Respiratory Medicine, IRBLleida, University of Lleida, 25198 Lleida, Spain
CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ICSIII), 28029 Madrid, Spain
Pamplona R:
Department of Experimental Medicine, University of Lleida, 25198 Lleida, Spain
Lecube A:
Department of Endocrinology and Nutrition, Arnau de Vilanova University Hospital, 25198 Lleida, Spain
Obesity and Metabolism Research Group (ODIM), IRBLleida, University of Lleida, 25198 Lleida, Spain
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
Valdivieso JM:
Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen. ISCIII), 25198 Lleida, Spain
Fernández E:
Vascular and Renal Translational Research Group, IRBLleida, Renal Research Network (RedInRen. ISCIII), 25198 Lleida, Spain
Department of Experimental Medicine, University of Lleida, 25198 Lleida, Spain
Julve J:
Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
Castelblanco E:
Department of Internal Medicine, Endocrinology, Metabolism and Lipid Research Division, Washington University School of Medicine, St. Louis, MO 63110, USA
Alonso N:
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
Department of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
Antentas M:
Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Barranco-Altirriba M:
Departament of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Networking Biomedical Research Centre in the Subject Area of Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain
Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial, Universitat Politècnica de Catalunya, B2SLab, 08034 Barcelona, Spain
Perera A:
Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain
Networking Biomedical Research Centre in the Subject Area of Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain
Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial, Universitat Politècnica de Catalunya, B2SLab, 08034 Barcelona, Spain
Franch-Nadal J:
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
Granado-Casas M:
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
Department of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
Research Group of Health Care (GreCS), IRBLleida, 25198 Lleida, Spain
Mauricio D:
Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 08041 Barcelona, Spain
Departament of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
Green Submitted, Green Accepted, gold
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