Prevention of Diabetes With Mediterranean Diets
Authors: Miguel A. Martínez-González, Ramón Estruch, Dolores Corella, Emilio Ros, Jordi Salas-Salvadó
Journal: Annals of Internal Medicine (2014)

Letters15 July 2014Prevention of Diabetes With Mediterranean DietsMiguel A. Martínez-González, MD, PhD, Ramón Estruch, MD, PhD, Dolores Corella, DPharm, PhD, Emilio Ros, MD, PhD, and Jordi Salas-Salvadó, MD, PhDMiguel A. Martínez-González, MD, PhDFrom University of Navarra, Pamplona, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; University of Valencia, Valencia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain., Ramón Estruch, MD, PhDFrom University of Navarra, Pamplona, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; University of Valencia, Valencia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain., Dolores Corella, DPharm, PhDFrom University of Navarra, Pamplona, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; University of Valencia, Valencia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain., Emilio Ros, MD, PhDFrom University of Navarra, Pamplona, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; University of Valencia, Valencia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain., and Jordi Salas-Salvadó, MD, PhDFrom University of Navarra, Pamplona, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; University of Valencia, Valencia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5014-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:With regard to the potential "imbalances" in the baseline characteristics of participants in the PREDIMED (Prevención con Dieta Mediterránea) study and competing risk analyses, sex distribution was the only potentially relevant "imbalance" in our trial. The control group included a slightly higher proportion of women than the Mediterranean diet intervention groups. Female sex was associated with a lower risk for new-onset diabetes (age-adjusted hazard ratio [HR], 0.81 [95% CI, 0.63 to 1.04]) and cardiovascular events (age-adjusted HR, 0.45 [CI, 0.35 to 0.57]) in the overall cohort. It was also associated with a lower risk for cardiovascular disease among ...References1. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279-90. [PMID: 23432189] CrossrefMedlineGoogle Scholar2. Greenland S, Rothman KJ. Introduction to stratified analysis.. In: Rothman KJ, Greenland S, Lash T, eds. Modern Epidemiology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2008:262. Google Scholar3. Ruiz-Canela M, Estruch R, Corella D, Salas-Salvadó J, Martínez-González MA. Association of Mediterranean diet with peripheral artery disease: the PREDIMED randomized trial. JAMA. 2014;311:415-7. [PMID: 24449321] CrossrefMedlineGoogle Scholar4. Andersen PK, Geskus RB, de Witte T, Putter H. Competing risks in epidemiology: possibilities and pitfalls. Int J Epidemiol. 2012;41:861-70. [PMID: 22253319] CrossrefMedlineGoogle Scholar5. Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94:496-509. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Navarra, Pamplona, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; University of Valencia, Valencia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain; and Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1725. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrevention of Diabetes With Mediterranean Diets Jordi Salas-Salvadó , Mònica Bulló , Ramón Estruch , Emilio Ros , Maria-Isabel Covas , Núria Ibarrola-Jurado , Dolores Corella , Fernando Arós , Enrique Gómez-Gracia , Valentina Ruiz-Gutiérrez , Dora Romaguera , José Lapetra , Rosa Maria Lamuela-Raventós , Lluís Serra-Majem , Xavier Pintó , Josep Basora , Miguel Angel Muñoz , José V. Sorlí , and Miguel A. 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