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Title: Mediterranean diet, retinopathy, nephropathy, and microvascular diabetes Complications: A post Hoc analysis of a randomized trial
Authors: Diaz-Ĺopez, Andrés
Babio, Nancy
Martinez-González, Miguel A.
Corella, Dolores
Amor, Antonio J.
Fitó, Montse
Estruch, Ramon
Aŕos, Fernando
Ǵomez-Gracia, Enrique
Fiol, Miquel
Lapetra, José
Serra-Majem, Llúis 
Basora, Josep
Basterra-Gortari, F. Javier
Zanon-Moreno, Vicente
Munoz, Miguel Angel
O, Jordi Salas Salvad
Bautista Castaño, Inmaculada 
Keywords: Kidney-Function
Subgroup Analysis
Style Diet
Olive Oil
Fruit, et al
Issue Date: 2015
Publisher: 0149-5992
Related Publication: Erratum: Mediterranean diet, retinopathy, nephropathy, and microvascular diabetes complications: A post hoc analysis of a randomized trial (Diabetes Care (2015) 38 (2134-2141) DOI: 10.2337/dc15-1117)
Journal: Diabetes Care 
Abstract: OBJECTIVETo 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 METHODSThis was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvencion con Dleta MEDiterranea (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), Med Diet 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.RESULTSDuring 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 Med Diet 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.CONCLUSIONSA Med Diet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy.
ISSN: 0149-5992
DOI: 10.2337/dc15-1117
Source: Diabetes Care[ISSN 0149-5992],v. 38(11), p. 2134-2141
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