Friday, January 16, 2009

Diet Mediterranean memperbaiki sindroma metabolik

Penelitian ini membandingkan efek diet Mediterrania (MedDiet) terhadap diet rendah lemak untuk penderita sindroma metabolik.
Penelitian diikuti lebih dari 1200 partisipan dari multisenter, dengan desain 3-arm randomized clinical trial. Partisipan adalah orang tua yang berisiko menderita penyakit kardiovaskuler.
 
Diet yang diberikan adalah 1)MedDiet + 1 L/minggu virgin olive oil (MedDiet+VOO) ; 2) Med Diet + 30 g/hari kacang2an (MedDiet+nuts) dan 3) diet rendah lemak (grup kontrol). Diet adalah ad libitum (tidak ada pembatasan kalori), dan tidak ada peningkatan aktivitas partisipan (tidak dianjurkan exercise).
 
Pada baseline 61,4% partisipan adalah penderita sindroma metabolik. Setelah 1 tahun menjalani diet maka prevalensi sindroma metabolik menurun.
Untuk MedDiet+VOO turun 6,7%  = .18; untuk MedDiet+nuts turun 13,7% P = .01; untuk diet rendah lemak turun 2%.
Odd rasio untuk reversion sindroma metabolik adalah 1.3 (95% confidence interval, 0.8-2.1) untuk grup MedDiet+VOO. Sedangkan untuk grup MedDiet+nuts adalah 1.7 (1.1-2.6) dibanding grup kontrol.
 
Kesimpulan diet mediterrania ditambah kacang2an bermanfaat dalam manajemen sindroma metabolik.
 
Abstract
 
Effect of a Mediterranean Diet Supplemented With Nuts on Metabolic Syndrome Status

One-Year Results of the PREDIMED Randomized Trial

Jordi Salas-Salvadó, MD, PhD; Joan Fernández-Ballart, MD, PhD; Emilio Ros, MD, PhD; Miguel-Angel Martínez-González, MD, PhD; Montserrat Fitó, MD, PhD; Ramon Estruch, MD, PhD; Dolores Corella, DPharm, PhD; Miquel Fiol, MD, PhD; Enrique Gómez-Gracia, MD, PhD; Fernando Arós, MD, PhD; Gemma Flores, MD; José Lapetra, MD, PhD; Rosa Lamuela-Raventós, DPharm, PhD; Valentina Ruiz-Gutiérrez, DPharm, PhD; Mònica Bulló, PhD; Josep Basora, MD; María-Isabel Covas, DPharm, PhD; for the PREDIMED Study Investigators

Arch Intern Med. 2008;168(22):2449-2458.

Background  Epidemiological studies suggest that the Mediterranean diet (MedDiet) may reduce the risk of developing the metabolic syndrome (MetS). We compared the 1-year effect of 2 behavioral interventions to implement the MedDiet vs advice on a low-fat diet on MetS status.

Methods  A total of 1224 participants were recruited from the PREDIMED (Prevención con Dieta Mediterránea) Study, a multicenter, 3-arm, randomized clinical trial to determine the efficacy of the MedDiet on the primary prevention of cardiovascular disease. Participants were older subjects at high risk for cardiovascular disease. Interventions were quarterly education about the MedDiet plus provision of either 1 L/wk of virgin olive oil (MedDiet + VOO) or 30 g/d of mixed nuts (MedDiet + nuts), and advice on a low-fat diet (control diet). All diets were ad libitum, and there was no increase in physical activity for any of the interventions. Lifestyle variables and MetS features as defined by the National Cholesterol Education Program Adult Treatment Panel III criteria were assessed.

Results  At baseline, 61.4% of participants met criteria for the MetS. One-year prevalence was reduced by 6.7%, 13.7%, and 2.0% in the MedDiet + VOO, MedDiet + nuts, and control diet groups, respectively (MedDiet + nuts vs control groups, P = .01; MedDiet + VOO vs control group,  = .18). Incident rates of the MetS were not significantly different among groups (22.9%, 17.9%, and 23.4%, respectively). After adjustment for sex, age, baseline obesity status, and weight changes, the odds ratios for reversion of MetS were 1.3 (95% confidence interval, 0.8-2.1) for the MedDiet + VOO group and 1.7 (1.1-2.6) for the MedDiet + nuts group compared with the control diet group.

Conclusion  A traditional MedDiet enriched with nuts could be a useful tool in the management of the MetS.