Did the PREDIMED trial test a Mediterranean diet?

New England Journal of Medicine (Impact Factor: 55.87). 04/2013; 368(14):1353-4. DOI: 10.1056/NEJMe1301582
Source: PubMed
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    • "The primary results were outstanding, showing a 30% reduction in cardiovascular events in the treatment arms, proving the effect of the diet [18]. There is some discussion as to whether the PREDIMED study tested the effects of the Mediterranean diet or the supplemental foods (olive oil and nuts) [19]. The recent analyses of the PREDIMED study [9,13] address this concern in part by confirming associations with key foods and food components, showing that it is all these influences occurring together. "
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    ABSTRACT: The recent publication of the PREDIMED trial provided definitive evidence that a Mediterranean diet provides protection against cardiovascular disease. Two articles published in BMC Medicine provide further understanding of why this may be the case, by considering contributory effects of olive oil, a core food in the diet, and polyphenols, a class of identifiable protective compounds. Using a number of statistical models, analyses were conducted to show around a 35% cardiovascular disease risk reduction in the highest consumers of olive oil and a similar degree of risk reduction for all-cause mortality comparing highest to lowest quintiles of polyphenol intake. The effects were an advance on cohort studies not related to trials. This suggests that it may be necessary to have better control of the background diet to enable exposure of the value of individual foods and nutrients in a dietary pattern, bearing in mind that, by nature, it is difficult to separate out effects of foods, nutrients and whole diets. Please see related articles: and
    BMC Medicine 06/2014; 12(1):100. DOI:10.1186/1741-7015-12-100 · 7.25 Impact Factor
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    ABSTRACT: Background and Aim: Coptic Orthodox Christian (COC) diet is unique in that it regularly interchanges between an omnivorous to a vegetarian type of diet, through four fasting periods over the course of the ecclesiastical year. Several studies have described its dietary regulations, however, its possible involvement in health is lacking. The aim of the present study is to detect the metabolic changes during COC fasting. Subjects and Methods: Seventy two devout Orthodox Christian fasters, 25 of whom were diabetics and 40 matched controls, of whom 10 were diabetics, voluntarily participated in this study. A total of 240 blood samples were taken after at least 2 weeks before and during the different fasting periods. The fasting schedule was identified as either vegan (no sea food) or vegetarian (with sea food). Serum glucose (Glu), lipid profile, renal markers and hepatic enzymes, were measured and their within‑subject biological variation was calculated. Results: The within-subject biological change due to fasting differed among subjects of the same group, gender and diet. Still, generally healthy subjects showed a decrease in Glu, triglycerides (TG) and TG/ high-density lipoprotein while the diabetics had a decline in blood urea nitrogen (BUN), BUN/ creatinine ratio and uric acid. Conclusion: The effect of fasting differs among subjects and we cannot generalize its effect on all people. The strong individuality observed supports the preferential use of within-subjects biological variations and the reference change values rather than population-based reference intervals.
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