Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Amor, Antonio J.; Serra‐Mir, Mercè; Martínez‐González, Miguel A.; Corella, Dolores; Salas‐Salvadó, Jordi; Fitó, Montserrat; Estruch, Ramón; Serra‐Majem, Lluís; Arós, Fernando; Babió, Nancy; Ros, Emilio; Ortega, Emilio

doi:10.1161/jaha.116.004803

Cited by 18 publications

(10 citation statements)

References 56 publications

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“…In a model adjusted for confounding factors, the “Healthy” pattern was associated to low occurrence of abdominal obesity, dyslipidemia, diabetes, and hypertension. This pattern resembles other cardioprotective patterns described in the literature and associated with low disease risk [15, 51, 52] and low mortality [53–55]. Therefore, the protective effect of this pattern is well established.…”

Section: Discussionsupporting

confidence: 83%

“Traditional” and “Healthy” Dietary Patterns Are Associated with Low Cardiometabolic Risk in Brazilian Subjects

Silveira

Novaes

Reis

et al. 2018

Cardiology Research and Practice

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This study aimed at determining the dietary patterns and investigating their association with cardiometabolic risk markers in a brazilian population at risk. This transversal study was carried out with data of 265 patients (n = 123 M/172 W, age 42 ± 16 years) of the Cardiovascular Health Care Program—PROCARDIO-UFV, Brazil—who had their first appointment between 2012 and 2017. A 24-hour recall was applied. The dietary patterns were determined by Principal Component Analysis. Anthropometric, clinical-metabolic, sociodemographic, and lifestyle data were collected through medical record analysis. Five patterns were identified: “Traditional”, “Caloric”, “Unhealthy”, “Healthy,” and “Healthy Snacks”. In bivariate analysis, the “Healthy” pattern was negatively associated with WC (waist circunference), BMI (body mass index), WHR (waist-to-hip ratio), SBP (systolic blood pressure), fasting glucose, TG/HDL, LDL/HDL, and TG/HDL values and positively to HDL. The “Traditional” pattern was positively associated with adiposity indicators (WC, BMI, and WHR) and negatively associated with body fat, TyG (triglyceride-glucose index), HDL, and LDL (P < 0.05). However, in adjusted models of Poisson regression, individuals with positive factor score (higher adherence) in the “Traditional” and “Healthy” patterns had less occurrence of abdominal obesity (PR 0.85; 95% CI 0.74–0.99/PR 0.88; 95% CI 0.02–0.76), as well as dyslipidemia (PR 0.06; 95% CI 0.02–0.51/PR 0.03; 95% CI 0.01–0.27), diabetes (PR 0.05; 95% CI 0.01–0.45/PR 0.02; 95% CI 0.01–021), and hypertension (PR 0.06; 95% CI 0.02–0.50/PR 0.02; 95% CI 0.01–0.21). A greater adherence to the “Healthy” pattern was associated with lower values to cardiometabolic risk markers and less occurrence of chronic diseases, while the “Traditional” pattern presented contradictory results.

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Section: Discussionsupporting

confidence: 83%

“Traditional” and “Healthy” Dietary Patterns Are Associated with Low Cardiometabolic Risk in Brazilian Subjects

Silveira

Novaes

Reis

et al. 2018

Cardiology Research and Practice

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“…However, our results indicate that the presence of dyslipidemia was associated with a higher aMED score. Scientific studies published about this issue found that the MedDiet reduces the risk of T2D improving postprandial lipemia, lipid profile, and cardiovascular risk factors [3,4,[38][39][40][41][42][43]. Our results could be due to the fact that participants with dyslipidemia may have received specific dietary counselling based on the MedDiet to improve their lipid profile.…”

Section: Discussionmentioning

confidence: 71%

Spanish People with Type 2 Diabetes Show an Improved Adherence to the Mediterranean Diet

Alcubierre¹,

Granado-Casas

Real

et al. 2020

Nutrients

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The aim of this study was to assess the dietary pattern (i.e., Mediterranean Diet (MedDiet) and healthy eating) in people with type 2 diabetes (T2D) compared with those without diabetes. In addition, we explored clinical factors associated with the dietary pattern. This cross-sectional study was performed with a sample of 476 participants (238 with T2D and 238 participants without diabetes, matched for age and sex). The alternate Mediterranean Diet (aMED) score and the alternate Healthy Eating Index (aHEI) were calculated. Statistical analysis included comparison between groups and multivariable models. Participants with T2D showed higher aMED and aHEI scores (mean (SD): 4.3 (1.5) and 43.9 (6.5), respectively) in comparison with the control group (3.5 (1.8) and 39.4 (7.4), respectively; p < 0.001). In addition, a higher proportion of participants with T2D in higher tertiles of aMED (21.8%) and aHEI (39.9%) was observed compared with participants without diabetes (11.3% for the aMED, and 19.3% for the aHEI; p < 0.001). The adjusted multivariable analysis revealed that T2D (p < 0.001), increasing age (p = 0.006 and p = 0.030, respectively), and physical activity (p = 0.009) were positively associated with higher aMED and aHEI scores. Dyslipidemia and female gender were positively associated with aMED and aHEI (p = 0.031 and p < 0.001, respectively). The specific multivariable analysis for the group with T2D yielded a positive association of age (p < 0.001) and dyslipidemia (p = 0.021) with aMED. Regarding the aHEI, only female gender was positively related with this score in diabetes participants (p = 0.025). Participants with T2D showed a higher adherence to the MedDiet and a healthier eating pattern.

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“…In contrast, WHtr and ABSI are the best anthropometric parameters according to FR and SCORE charts for Spanish males, while WHtr, WC and ABSI demonstrate better correlation with CVR according to the ACC/AHA chart. It is noticeable that several CVR studies have been carried out in the Spanish population (IBERICA, DORICA, PREDIMED amongst others) [35–37], but the correlation of anthropometric parameters with the CVR has not been yet studied. Nevertheless, some international studies have contributed to study the relationship between anthropometric indexes and the prediction of cardiovascular events, metabolic variables and total mortality, in a diversity of populations.…”

Section: Discussionmentioning

confidence: 99%

Body fat anthropometric indexes: Which of those identify better high cardiovascular risk subjects? A comparative study in Spanish population

et al. 2019

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Aim To determine the association of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtr) and Body Shape Index (ABSI) with high cardiovascular risk (CVR), as well as to determine whether how strong are these relationships. Material and methods A cross-sectional study was carried out in Spanish Caucasian adults. 3,456 subjects completed the study, 45.78% males, aged < 65 years and non-diabetic subjects. Anthropometric/biochemical variables were measured. We determined ABSI based on WC adjusted for height and weight. High CVR was defined as ≥ 20% according to the Framingham chart, ≥ 5% with the SCORE chart, and ≥ 7.5% with the ACC/AHA guide. Areas under the receiver operating characteristic curves (AUCs) were estimated for each anthropometric measure. Results Most significant AUCs in males were: WHtr and ABSI for Framingham ≥ 20% and SCORE ≥ 5%. Also significant were WHtr, WC and ABSI for ACCA/AHA ≥ 7.5%. On the other hand, most significant AUCs in females were: WHtr and WC for Framingham ≥ 20%; and WHtr and WHR for SCORE ≥ 5%, WHtr, and WC for ACC/AHA guide ≥ 7.5%. Conclusions Overall, the best anthropometric index identifying Spanish males and females who are at high risk for CV events is WHtr. ABSI was also found to be a good anthropometric index to predict high CVR in Spanish males according to FR, SCORE and ACC/AHA charts. For Spanish females, WC is a good anthropometric index according to FR and ACC/AHA guide, while WHR is better according to SCORE.

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Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Cited by 18 publications

References 56 publications

“Traditional” and “Healthy” Dietary Patterns Are Associated with Low Cardiometabolic Risk in Brazilian Subjects

“Traditional” and “Healthy” Dietary Patterns Are Associated with Low Cardiometabolic Risk in Brazilian Subjects

Spanish People with Type 2 Diabetes Show an Improved Adherence to the Mediterranean Diet

Body fat anthropometric indexes: Which of those identify better high cardiovascular risk subjects? A comparative study in Spanish population

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