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Abstract

Effect of an Energy-Restricted Mediterranean Diet, Physical Activity and Behavioral Support Lifestyle Intervention on Body Composition in Older Adults with Metabolic Syndrome: Three-Year Results of the PREDIMED-Plus Trial †

by
Dora Romaguera
1,2,*,
Miguel Ruiz-Canela
2,3,
J. Alfredo Martínez
2,4,5,
Vicente Martín
6,7,
Ramón Estruch
2,8,
Jordi Salas-Salvadó
2,9,10 and
Jadwiga Konieczna
1,2
1
Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), 07120 Palma de Mallorca, Spain
2
Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
3
IdiSNA, Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain
4
Department of Nutrition, Food Sciences, and Physiology, University of Navarra, 31008 Pamplona, Spain
5
Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain
6
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
7
Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
8
Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
9
Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, 43201 Reus, Spain
10
Institut d’Investigació Pere Virgili (IISPV), 43007 Reus, Spain
*
Author to whom correspondence should be addressed.
†
Presented at the 14th European Nutrition Conference FENS 2023, Belgrade, Serbia, 14–17 November 2023.
Proceedings 2023, 91(1), 432; https://doi.org/10.3390/proceedings2023091432
Published: 16 July 2024
(This article belongs to the Proceedings of The 14th European Nutrition Conference FENS 2023)
Versions Notes

Abstract

:
Background and objectives: Large and long-term randomized controlled trials (RCT) that test the effect of a weight-loss lifestyle intervention on the changes in the directly quantified body composition are scarce. Here, we aimed to evaluate the effect of an intensive nutritional and behavioral weight-loss intervention with an energy-restricted (er) Mediterranean Diet (MedDiet) on the changes in age-related overall and regional body composition objectively measured over three years. Methods: Body composition was measured with dual energy X-ray absorptiometry (DXA) in a subsample of 1521 participants (aged 55–75 years with overweight/obesity and metabolic syndrome) in the PREDIMED-Plus trial assigned (1:1) to multifactorial intervention with erMedDiet, increased physical activity (PA) and behavioral support (intervention) or usual care with advices to follow MedDiet without energy restriction or PA promotion (control group). The primary outcomes were 3-year changes in total fat and lean mass (expressed as % DXA-derived total body mass) and visceral fat (in grams). The potential interactions of study arm with time were tested in crude and multivariable linear-mixed effects models with repeated measurements at baseline and at 1 and 3 years. Results: After a 3-year follow-up, in the completers-only analysis adjusting for baseline characteristics, participants in the intervention vs. control group showed higher reductions in the % of total fat (mean difference of −0.38%, 95% CI −0.64; −0.12, p < 0.001) and the grams of visceral fat (−70.4 g, −126; −15.2, p < 0.001), as well as an increase in the % of total lean mass (0.34%, 0.09; 0.60, p < 0.001). Discussion: The PREDIMED-Plus lifestyle weight-loss-focused intervention approach with erMedDiet and PA may suppress the age-dependent changes in body composition by reducing total and visceral fat and delaying the loss of lean mass in relation to the total body mass in older overweight/obese adults with metabolic syndrome.

Author Contributions

Conceptualization, D.R. and J.K.; Methodology, D.R., M.R.-C., J.S.-S. and J.K.; Formal Analysis, D.R. and J.K.; Investigation, D.R., M.R.-C., J.A.M., V.M., R.E., J.S.-S. and J.K.; Resources, D.R., M.R.-C., J.A.M., V.M., R.E., J.S.-S. and J.K.; Data Curation, D.R., M.R.-C., J.A.M., V.M., R.E., J.S.-S. and J.K.; Writing—Original Draft Preparation, D.R. and J.K; Writing—Review & Editing, D.R., M.R.-C., J.A.M., V.M., R.E., J.S.-S. and J.K.; Supervision, D.R. and J.K.; Project Administration, J.S.-S. and R.E.; Funding Acquisition, D.R., M.R.-C., J.A.M., V.M., R.E., J.S.-S. and J.K. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by NIH grant 1R01DK127601to, the European Research Council advanced research grant 2014-2019; agreement 340918, and the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is cofunded by the European Regional Development Fund (6 coordinated FIS projects, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226,PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158); the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant; the Recercaixa grant (2013ACUP00194); grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; the SEMERGEN grant; INSA-Ma María de Maeztu Unit of Excellence (grant CEX2021-001234-M funded by MICIN/AEI/FEDER, UE); Juan de la Cierva Research Grant (IJC2019-042420-I/AEI/10.13039/501100011033) from Agencia Estatal de Investigación. This work was also partially supported by ICREA under the ICREA Academia program.

Institutional Review Board Statement

The PREDIMED-Plus study protocol was reviewed and approved by the institutional review boards from all 23 participating centers.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

There are restrictions on data availability for the PREDIMED-Plus trial due to the signed consent agreements around data sharing, which only allow access to external researchers for studies following the project purposes. Requestors wishing to access the PREDIMEDPlus trial data used in this study can make a request to the PREDIMED-Plus trial Steering Committee chair: [email protected]. The request will then be passed to members of the PREDIMED-Plus Steering Committee for deliberation.

Conflicts of Interest

Jordi Salas-Salvadó reported receiving personal fees from Instituto Danone Spain Member as a member of the advisory board, fees or travel expenses for meeting attendant from Danone Institute International and International Nut and Dried Fruit Foundation; and grants from the International Nut and Dried Fruit Foundation grant to his institution; and is an unpaid member of the advisory board outside the submitted work. No other disclosures were reported.
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Share and Cite

MDPI and ACS Style

Romaguera, D.; Ruiz-Canela, M.; Martínez, J.A.; Martín, V.; Estruch, R.; Salas-Salvadó, J.; Konieczna, J. Effect of an Energy-Restricted Mediterranean Diet, Physical Activity and Behavioral Support Lifestyle Intervention on Body Composition in Older Adults with Metabolic Syndrome: Three-Year Results of the PREDIMED-Plus Trial. Proceedings 2023, 91, 432. https://doi.org/10.3390/proceedings2023091432

AMA Style

Romaguera D, Ruiz-Canela M, Martínez JA, Martín V, Estruch R, Salas-Salvadó J, Konieczna J. Effect of an Energy-Restricted Mediterranean Diet, Physical Activity and Behavioral Support Lifestyle Intervention on Body Composition in Older Adults with Metabolic Syndrome: Three-Year Results of the PREDIMED-Plus Trial. Proceedings. 2023; 91(1):432. https://doi.org/10.3390/proceedings2023091432

Chicago/Turabian Style

Romaguera, Dora, Miguel Ruiz-Canela, J. Alfredo Martínez, Vicente Martín, Ramón Estruch, Jordi Salas-Salvadó, and Jadwiga Konieczna. 2023. "Effect of an Energy-Restricted Mediterranean Diet, Physical Activity and Behavioral Support Lifestyle Intervention on Body Composition in Older Adults with Metabolic Syndrome: Three-Year Results of the PREDIMED-Plus Trial" Proceedings 91, no. 1: 432. https://doi.org/10.3390/proceedings2023091432

APA Style

Romaguera, D., Ruiz-Canela, M., Martínez, J. A., Martín, V., Estruch, R., Salas-Salvadó, J., & Konieczna, J. (2023). Effect of an Energy-Restricted Mediterranean Diet, Physical Activity and Behavioral Support Lifestyle Intervention on Body Composition in Older Adults with Metabolic Syndrome: Three-Year Results of the PREDIMED-Plus Trial. Proceedings, 91(1), 432. https://doi.org/10.3390/proceedings2023091432

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