Intensive Weight-Loss Lifestyle Intervention Using Mediterranean Diet and COVID-19 Risk in Older Adults: Secondary Analysis of PREDIMED-Plus Trial - 18/01/24

Doi : 10.1007/s12603-023-2044-4

Sangeetha Shyam ^1,^2,³ , J.F. García-Gavilán ^1,^2,³, I. Paz-Graniel ^1,^2,³, J.J. Gaforio ^4,⁵, M.Á. Martínez-González ^1,^6,⁷, D. Corella ^1,⁸, J.A. Martínez ^9,^10,¹¹, Á.M. Alonso-Gómez ^1,¹², J. Wärnberg ^1,¹³, J. Vioque ^4,¹⁴, D. Romaguera ^1,¹⁵, J. López-Miranda ^1,¹⁶, R. Estruch ^1,^17,¹⁸, F.J. Tinahones ^1,¹⁹, J. Lapetra ^1,²⁰, J.L. Serra-Majem ^1,²¹, A. Bueno-Cavanillas ^4,²², J.A. Tur ^1,²³, V. Martín Sánchez ^4,²⁴, X. Pintó ^1,²⁵, P. Matía-Martín ^26,²⁷, J. Vidal ^28,²⁹, M. del Mar Alcarria ³⁰, L. Daimiel ^1,^31,³², E. Ros ^1,³³, F. Fernandez-Aranda ^1,^34,³⁵, S.K. Nishi ^1,^2,^3,³⁶, Ó. García-Regata ¹², R. Perez Araluce ⁶, E.M. Asensio ^1,⁸, O. Castañer ^4,³⁷, A. Garcia-Rios ^1,¹⁶, A. Oncina-Cánovas ^4,¹⁴, C. Bouzas ²³, M.A. Zulet ^1,⁹, E. Rayó ¹⁵, R. Casas ^1,^17,¹⁸, S. Martin-Pelaez ^4,²², L. Tojal-Sierra ^1,¹², M.R. Bernal-López ^1,³⁸, S. Carlos ⁶, J.V. Sorlí ^1,⁸, A. Goday ^1,³⁷, P.J. Peña-Orihuela ^1,¹⁶, A. Pastor-Morel ³⁹, S. Eguaras ⁶, M.D. Zomeño ^1,^37,⁴⁰, M. Delgado-Rodríguez ^1,^10,^11,⁴¹, N. Babio ^1,^2,³, M. Fitó ^1,^37,^{^{*
Prof Jordi Salas-Salvadó and Prof Montserrat Fitó are joint senior-authors.}}, Jordi Salas-Salvadó ^1,^2,^3,^{^{*
Prof Jordi Salas-Salvadó and Prof Montserrat Fitó are joint senior-authors.}}
¹ CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
² Departament de Bioquímica i Biotecnologia, Food, Nutrition, Development and Mental Health Group (ANUT-DSM), Human Nutrition Unit, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain
³ Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
⁴ CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
⁵ Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain
⁶ Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain
⁷ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
⁸ Department of Preventive Medicine, University of Valencia, Valencia, Spain
⁹ Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, IdiSNA, Pamplona, Spain
¹⁰ Precision Nutrition and Cardiometabolic Health Program, IMDEA Alimentacion, Madrid, Spain
¹¹ Medicine and Endocrinology, UVA, Valladolid, Spain
¹² Department of Internal Medicine Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
¹³ EpiPHAAN research group, School of Health Sciences, University of Málaga - Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
¹⁴ Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
¹⁵ Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
¹⁶ Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
¹⁷ Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
¹⁸ Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain
¹⁹ Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
²⁰ Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
²¹ Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
²² Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
²³ Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
²⁴ Institute of Biomedicine (IBIOMED), University of León, León, Spain
²⁵ Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat - Barcelona, Barcelona, Spain
²⁶ Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
²⁷ Medicine Department, Universidad Complutense, Madrid, Spain
²⁸ CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
²⁹ Department of Endocrinology, Institut d'Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
³⁰ Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz. Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
³¹ Nutritional Control of the Epigenome Group. Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
³² Departamento de Ciencias Farmacéuticas y de la Salud, Faculty de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain
³³ Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
³⁴ Psychoneurobiology of Eating and Addictive Behaviors Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
³⁵ Department of Clinical Psychology, University Hospital of Bellvitge and University of Barcelona, Barcelona, Spain
³⁶ Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
³⁷ Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
³⁸ Internal Medicine Clinical Management Unit, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma BIONAND), University of Malaga, Malaga, Spain
³⁹ Centro de Salud Cabo Huertas, Alicante, Spain
⁴⁰ Blanquerna-Ramon Llull University, Barcelona, Spain
⁴¹ Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain

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Abstract

Objectives

We tested the effects of a weight-loss intervention encouraging energy-reduced MedDiet and physical activity (PA) in comparison to ad libitum MedDiet on COVID-19 incidence in older adults.

Design

Secondary analysis of PREDIMED-Plus, a prospective, ongoing, multicentre randomized controlled trial.

Setting

Community-dwelling, free-living participants in PREDIMED-Plus trial.

Participants

6,874 Spanish older adults (55–75 years, 49% women) with overweight/obesity and metabolic syndrome.

Intervention

Participants were randomised to Intervention (IG) or Control (CG) Group. IG received intensive behavioural intervention for weight loss with an energy-reduced MedDiet intervention and PA promotion. CG was encouraged to consume ad libitum MedDiet without PA recommendations.

Measurements

COVID-19 was ascertained by an independent Event Committee until December 31, 2021. COX regression models compared the effect of PREDIMED-Plus interventions on COVID-19 risk.

Results

Overall, 653 COVID-19 incident cases were documented (IG:317; CG:336) over a median (IQR) follow-up of 5.8 (1.3) years (inclusive of 4.0 (1.2) years before community transmission of COVID-19) in both groups. A significantly lowered risk of COVID-19 incidence was not evident in IG, compared to CG (fully-adjusted HR (95% CI): 0.96 (0.81,1.12)).

Conclusions

There was no evidence to show that an intensive weight-loss intervention encouraging energy-reduced MedDiet and PA significantly lowered COVID-19 risk in older adults with overweight/ obesity and metabolic syndrome in comparison to ad libitum MedDiet. Recommendations to improve adherence to MedDiet provided with or without lifestyle modification suggestions for weight loss may have similar effects in protecting against COVID-19 risk in older adults with high cardiovascular risks.

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Key words : COVID-19, SARS-CoV2, PREDIMED-Plus, Mediterranean diet, Older adults

Plan

Introduction

Methods

Setting

Randomization and blinding

Intervention

Outcome: COVID-19 incidence

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Vol 27 - N° 12

P. 1162-1167 - décembre 2023 Retour au numéro

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Intensive Weight-Loss Lifestyle Intervention Using Mediterranean Diet and COVID-19 Risk in Older Adults: Secondary Analysis of PREDIMED-Plus Trial - 18/01/24

Abstract

Objectives

Design

Setting

Participants

Intervention

Measurements

Results

Conclusions

Plan

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