RT info:eu-repo/semantics/article
T1 An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition
A1 Konieczna, Jadwiga
A1 Ruiz Canela, Miguel
A1 Galmés Panadés, Aina María
A1 Abete, Itziar
A1 Babio, Nancy
A1 Fiol, Miquel
A1 Martín Sánchez, Vicente
A1 Estruch, Ramón
A1 Vidal, Josep
A1 Buil Cosiales, Pilar
A1 García Gavilán, Jesús F.
A1 Moñino, Manuel
A1 Marcos Delgado, Alba
A1 Casas, Rosa
A1 Olbeyra, Romina
A1 Fitó, Montserrat
A1 Hu, Frank B.
A1 Martínez González, Miguel Ángel
A1 Martínez, J. Alfredo
A1 Romaguera, Dora
A1 Salas Salvadó, Jordi
A1 Romero Rodríguez, Esperanza
A1 Amezcua Prieto, Carmen
A1 Morales Suárez-Varela, María
A1 Pérez, Carlos Ayán
A1 Mateos Campos, Ramona
A1 Ortíz Moncada, Rocío
A1 Redondo Martín, Susana
A1 Rodríguez Reinado, Carmen
A1 Delgado Rodríguez, Miguel
A1 Blázquez Abellán, Gemma
A1 Alonso Molero, Jessica
A1 Martín Peláez, Sandra
A1 Cancela Carral, José María
A1 Valero Juan, Luis Félix
A1 Martínez Ruiz, Virginia
A1 Fernández Villa, Tania
A2 Medicina Preventiva
K1 Medicina. Salud
K1 Mediterranean diet
K1 Physical activity
K1 Clinical trial
K1 Adherence
K1 Interventions
K1 Validity
AB [ENG]Importance Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. OBJECTIVE To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. DESIGN, SETTING, AND PARTICIPANTS The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. INTERVENTION Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. MAIN OUTCOMES AND MEASURES The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imputation was performed to include data of participants lost to follow-up (intention-to-treat analyses). RESULTS A total of 1521 individuals were included (mean [SD] age, 65.3 [5.0] years; 52.1% men). In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, −0.94% [95% CI, −1.19 to −0.69]; 3 years, −0.38% [95% CI, −0.64 to −0.12] and visceral fat storage after 1 year, -126 g [95% CI, −179 to −73.3 g]; 3 years, −70.4 g [95% CI, −126 to −15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95%CI, 0.09%-0.60%]). The intervention group was more likely to show improvements of 5% or more in baseline body components (absolute risk reduction after 1 year, 13% for total fat mass, 11% for total lean mass, and 14% for visceral fat mass; after 3-years: 6% for total fat mass, 6% for total lean mass, and 8% for visceral fat mass). The number of participants needed to treat was between 12 and 17 to attain at least 1 individual with possibly clinically meaningful improvements in body composition. CONCLUSIONS AND RELEVANCE The findings of this trial suggest a weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity significantly reduced total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome. Continued follow-up is warranted to confirm the long-term consequences of these changes on cardiovascular clinical end points.
PB American Medical Association
LK https://hdl.handle.net/10612/18186
UL https://hdl.handle.net/10612/18186
NO Konieczna, J., Ruiz Canela, M., Galmes Panades, A. M., Abete, I., Babio, N., Fiol, M., ... y Salas-Salvadó, J. (2023). An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition: An Interim Subgroup Analysis of the PREDIMED-Plus Randomized Clinical Trial. JAMA Network Open, 6(10), e2337994
DS BULERIA. Repositorio Institucional de la Universidad de León
RD Jul 12, 2024