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Camacho-Barcia L, Bulló M, García-Gavilán JF, Martínez-González MA, Corella D, Estruch R, Fitó M, Gómez-Gracia E, Arós F, Fiol M, Santos-Lozano JM, Serra-Majem L, Pintó X, Basora J, Toledo E, Muñoz MA, Zanon-Moreno V, García-Layana A, Salas-Salvadó J. Dairy products intake and the risk of incident cataracts surgery in an elderly Mediterranean population: results from the PREDIMED study. Eur J Nutr 2018; 58:619-627. [PMID: 29589119 DOI: 10.1007/s00394-018-1647-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 02/22/2018] [Indexed: 12/20/2022]
Abstract
PROPOSAL The aim of this study was to examine the association between the consumption of total and specific types of dairy products and the risk of incident cataracts in an elderly Mediterranean population at high cardiovascular risk. METHODS We prospectively analyzed 5860 subjects from the PREvención con DIeta MEDiterránea (PREDIMED) Study. The time to cataract surgery was calculated as the time between recruitment and the date of the surgery, last visit of the follow-up, date of death, or until the end of the study. Dairy products intake was assessed using validated food frequency questionnaires. We used Cox proportional hazard regression to assess the risk of cataract surgery according to average dietary energy-adjusted total dairy products, milk, yogurt and cheese consumption. RESULTS We documented a total of 768 new cataract events after a median of 5.6 years of follow-up. Subjects in the second [hazard ratio (HR) 0.62; 95% CI 0.52, 0.74] and third tertile (HR: 0.71; 95% CI 0.60, 0.85) of skimmed yogurt intake had a significantly lower risk of cataracts after adjusting for potential confounders. No significant associations were observed for total dairy products, whole and skimmed milk, whole yogurt and cheese consumption. CONCLUSION The intake of skimmed yogurt was associated with a reduced risk of cataracts in an elderly Mediterranean population with high cardiovascular risk. No significant associations were observed for other type of dairy product. CLINICAL TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005.
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Affiliation(s)
- Lucía Camacho-Barcia
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, St/Sant Llorenç 21, 43201, Reus, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Mònica Bulló
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, St/Sant Llorenç 21, 43201, Reus, Spain. .,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
| | - Jesús F García-Gavilán
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, St/Sant Llorenç 21, 43201, Reus, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Miguel A Martínez-González
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain
| | - Dolores Corella
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramón Estruch
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montse Fitó
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Cardiovascular Risk and Nutrition, Regicor Study Group, Hospital del Mar Medical Research Institute, Barcelona Biomedical Research Park, Barcelona, Spain
| | - Enrique Gómez-Gracia
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Malaga, Malaga, Spain
| | - Fernando Arós
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Cardiology, University Hospital Araba, Vitoria, Spain
| | - Miquel Fiol
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Cardiology, University Hospital Son Dureta, Palma de Mallorca, Spain
| | - José M Santos-Lozano
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Family Medicine, San Pablo Health Center, Sevilla, Spain
| | - Lluís Serra-Majem
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Xavier Pintó
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge, Barcelona, Spain
| | - Josep Basora
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, St/Sant Llorenç 21, 43201, Reus, Spain
| | - Estefanía Toledo
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Emergency Department, Navarra's Hospital Complex, National Health Service-Osasunbidea, Pamplona, Spain
| | - Miguel A Muñoz
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Primary Health Care Division, Institut Català de la Salut and Idiap-Jordi Gol, Barcelona, Spain
| | - Vicente Zanon-Moreno
- Department of Preventive Medicine, University of Valencia, Valencia, Spain.,Ophthalmic Research Unit "Santiago Grisolía" Valencia, Valencia, Spain.,Red Temática de Patología Ocular OFTARED, ISCIII, Madrid, Spain
| | - Alfredo García-Layana
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.,Department of Ophthalmology, University of Navarra, Pamplona, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, University Hospital of Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, St/Sant Llorenç 21, 43201, Reus, Spain. .,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
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3
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García-Layana A, Ciufo G, Toledo E, Martínez-González MA, Corella D, Fitó M, Estruch R, Gómez-Gracia E, Fiol M, Lapetra J, Serra-Majem L, Pintó X, Portillo MP, Sorli JV, Bulló M, Vinyoles E, Sala-Vila A, Ros E, Salas-Salvadó J, Arós F. The Effect of a Mediterranean Diet on the Incidence of Cataract Surgery. Nutrients 2017; 9:E453. [PMID: 28467363 PMCID: PMC5452183 DOI: 10.3390/nu9050453] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/21/2017] [Accepted: 04/28/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cataract is a leading cause of vision impairment worldwide, and surgery is the only available treatment. The process that initiates lens opacification is dependent on the oxidative stress experienced by the lens components. A healthy overall dietary pattern, with the potential to reduce oxidative stress, has been suggested as a means to decrease the risk of developing cataract. We aimed to investigate the hypothesis that an intervention with a Mediterranean diet (MedDiet) rather than a low-fat diet could decrease the incidence of cataract surgery in elderly subjects. METHODS We included 5802 men and women (age range: 55-80 years) from the Prevención con Dieta Mediterránea study (multicenter, parallel-group, randomized controlled clinical trial) who had not undergone cataract surgery. They were randomly assigned to one of three intervention groups: (1) a MedDiet enriched with extra-virgin olive oil (EVOO) (n = 1998); (2) a MedDiet enriched with nuts (n = 1914), and a control group recommended to follow a low-fat diet (n = 1890). The incidence of cataract surgery was recorded yearly during follow-up clinical evaluations. Primary analyses were performed on an intention-to-treat basis. Cox regression analyses were used to assess the relationship between the nutritional intervention and the incidence of cataract surgery. RESULTS During a follow-up period of 7.0 years (mean follow-up period: 5.7 years; median: 5.9 years), 559 subjects underwent cataract surgery. Two hundred and six participants from the MedDiet + EVOO group, 174 from the MedDiet + Nuts group, and 179 from the control group underwent cataract surgery. We did not observe a reduction in the incidence of cataract surgery in the MedDiet groups compared to the control group. The multivariable adjusted hazard ratios were 1.03 (95% confidence interval [CI]: 0.84-1.26, p = 0.79) for the control group versus the MedDiet + EVOO group and 1.06 (95% CI: 0.86-1.31, p = 0.58) for the control group versus the MedDiet + Nuts group. CONCLUSIONS To our knowledge, this is the first large randomized trial assessing the role of a MedDiet on the incidence of cataract surgery. Our results showed that the incidence of cataract surgery was similar in the MedDiet with EVOO, MedDiet with nuts, and low-fat diet groups. Further studies are necessary to investigate whether a MedDiet could have a preventive role in cataract surgery.
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Affiliation(s)
| | - Gianfranco Ciufo
- Department of Ophthalmology, University of Navarra, 31008 Pamplona, Spain.
| | - Estefania Toledo
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain.
| | - Miguel A Martínez-González
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain.
| | - Dolores Corella
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Montse Fitó
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain.
| | - Ramon Estruch
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Department of Internal Medicine, August Pi i Sunyer Institute of Biomedical Research (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
| | - Enrique Gómez-Gracia
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Malaga, 29016 Malaga, Spain.
| | - Miguel Fiol
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, 07122 Palma de Mallorca, Spain.
| | - José Lapetra
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud San Pablo, 41007 Sevilla, Spain.
| | - Lluís Serra-Majem
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain.
| | - Xavier Pintó
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Lipids and Vascular Risk Units. Internal Medicine, University Hospital of Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Maria P Portillo
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Nutrition and Obesity Group Department of Nutrition and Food Science, University of Basque Country and Lucio Lascaray Research Center, 48940 Vitoria, Spain.
| | - José V Sorli
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Mónica Bulló
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, 43003 Reus, Spain.
| | - Ernest Vinyoles
- Cap La Mina, University of Barcelona, 08930 Barcelona, Spain.
| | - Aleix Sala-Vila
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
| | - Emilio Ros
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
| | - Jordi Salas-Salvadó
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Human Nutrition Unit, Faculty of Medicine and Health Sciences, IISPV, Rovira i Virgili University, 43003 Reus, Spain.
| | - Fernando Arós
- CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD/06/0045), Instituto de Salud Carlos III (ISC III), 28029 Madrid, Spain.
- Department of Cardiology, University Hospital Araba, 01009 Vitoria, Spain.
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