Did the PREDIMED trial test a Mediterranean diet?

New England Journal of Medicine (Impact Factor: 54.42). 04/2013; 368(14):1353-4. DOI: 10.1056/NEJMe1301582
Source: PubMed
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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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