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% P  = .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, P  = .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.

Perut buncit berakibat gangguan ingatan

Hubungan antara obesitas dan penyakit jantung serta diabetes telah banyak diketahui. Penelitian ini mencari hubungan antara obesitas dan dementia (gangguan ingatan). Diteliti >6500 subyek, dari catatan medis 36 tahun kemudian, sebanyak 1049 pasien (15.9%) didiagnosis dementia.

 

Peneliti mendapatkan bahwa subyek dengan sagittal abdominal diameter (SAD) terbesar (the highest quintiles) berisiko 3 kali lebih besar untuk terkena dementia dibanding mereka dengan SAD terkecil (the lowest quintiles).

 

Bila menyertakan indeks massa tubuh, subyek obes (IMT>30) dan SAD terbesar menghadapi risiko 3,6 kali.

 

Kesimpulan obesitas sentral meningkatkan risiko dementia terlepas dari diabetes dan penyakit jantung. Mekanisme hubungan obesitas dan dementia perlu diteliti lebih lanjut.

Abstract

Neurology, September 30 2008;71:1057-1064 © 2008 American Academy of Neurology
Central obesity and increased risk of dementia more than three decades later.

R. A. Whitmer, PhD, D. R. Gustafson, PhD, E. Barrett-Connor, MD, M. N. Haan, DrPH, E. P. Gunderson, PhD and K. Yaffe, MD

From Kaiser Permanente Division of Research (R.A.W., E.P.G.), Oakland, CA; Goteberg University (D.R.G.), Goteberg, Sweden; the Department of Family Medicine (E.B.-C.), University of California, La Jolla; the Department of Epidemiology (M.N.H.), University of Michigan, Ann Arbor; and the Departments of Psychiatry, Neurology and Epidemiology (K.Y.), University of California, San Francisco.

Background: Numerous reports show that a centralized distribution of adiposity is a more dangerous risk factor for cardiovascular disease and diabetes than total body obesity. No studies have evaluated whether the same pattern exists with dementia. The objective was to evaluate the association between midlife central obesity and risk of dementia three decades later.

Methods: A longitudinal analysis was conducted of 6,583 members of Kaiser Permanente of Northern California who had their sagittal abdominal diameter (SAD) measured in 1964 to 1973. Diagnoses of dementia were from medical records an average of 36 years later, January 1, 1994, to June 16, 2006. Cox proportional hazard models adjusted for age, sex, race, education, marital status, diabetes, hypertension, hyperlipidemia, stroke, heart disease, and medical utilization were conducted.

Results: A total of 1,049 participants (15.9%) were diagnosed with dementia. Compared with those in the lowest quintile of SAD, those in the highest had nearly a threefold increased risk of dementia (hazard ratio, 2.72; 95% CI, 2.33–3.33), and this was only mildly attenuated after adding body mass index (BMI) to the model (hazard ratio, 1.92; 95% CI, 1.58–2.35). Those with high SAD (>25 cm) and normal BMI had an increased risk (hazard ratio, 1.89; 95% CI, 0.98–3.81) vs those with low SAD (<25 cm) and normal BMI (18.5–24.9 kg/m²), whereas those both obese (BMI >30 kg/m²) and with high SAD had the highest risk of dementia (HR, 3.60; 95% CI, 2.85–4.55).

Conclusions: Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.

Perut buncit meningkatkan risiko kematian

Dalam penelitian multisenter di Eropa terhadap 360 ribu partisipan yang di-follow-up selama hampir 10 tahun, ditemukan bahwa risiko kematian pada pria dan wanita dengan lingkar pinggang besar (the highest quintile) meningkat masing-masing 2.05 kali dan 1.78 kali. Demikian pula untuk waist-to-hip ratio besar (the highest quintile) meningkat masing-masing 1.68 dan 1.51.

 

Risiko terendah adalah yang mempunyai indeks massa tubuh <25.3 untuk pria dan <24.3 untuk wanita.

 

Kesimpulan baik general adiposity maupun abdominal adiposity berhubungan dengan risiko kematian. Sebaiknya dilakukan pengukuran lingkar pingang, waist-to-hip ratio, dan indeks massa tubuh untuk menilai risiko kematian.

 

 

 

N Engl J Med 359(20):2105-2120, 13 November 2008 © 2008 to the Massachusetts Medical Society
General and Abdominal Adiposity and Risk of Death in Europe.

T. Pischon, H. Boeing, K. Hoffmann, et al.

 

ABSTRACT

Background Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death.

Methods We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height.

Results During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001).

Conclusions These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death.