%0 Journal Article
%A Sala-Vila, Aleix
%A Díaz-López, Andrés
%A Valls-Pedret, Cinta
%A Cofán, Montserrat
%A García-Layana, Alfredo
%A Lamuela-Raventós, Rosa-María
%A Castañer, Olga
%A Zanon-Moreno, Vicente
%A Martinez-Gonzalez, Miguel A
%A Toledo, Estefanía
%A Basora, Josep
%A Salas-Salvadó, Jordi
%A Corella, Dolores
%A Gómez-Gracia, Enrique
%A Fiol, Miquel
%A Estruch, Ramón
%A Lapetra, José
%A Fitó, Montserrat
%A Arós, Fernando
%A Serra-Majem, Luis
%A Pintó, Xavier
%A Ros, Emilio
%A Prevención con Dieta Mediterránea (PREDIMED) Investigators
%T Dietary Marine ω-3 Fatty Acids and Incident Sight-Threatening Retinopathy in Middle-Aged and Older Individuals With Type 2 Diabetes: Prospective Investigation From the PREDIMED Trial.
%D 2016
%U http://hdl.handle.net/10668/10370
%X Diabetic retinopathy (DR) is a devastating complication of individuals with type 2 diabetes mellitus. The retina is rich in long-chain ω-3 polyunsaturated fatty acids (LCω3PUFAs), which are substrate for oxylipins with anti-inflammatory and antiangiogenic properties. Experimental models support dietary LCω3PUFA protection against DR, but clinical data are lacking. To determine whether LCω3PUFA intake relates to a decreased incidence of sight-threatening DR in individuals with type 2 diabetes older than 55 years. In late 2015, we conceived a prospective study within the randomized clinical trial Prevención con Dieta Mediterránea (PREDIMED), testing Mediterranean diets supplemented with extra virgin olive oil or nuts vs a control diet for primary cardiovascular prevention. The trial was conducted in primary health care centers in Spain. From 2003 to 2009, 3614 individuals aged 55 to 80 years with a previous diagnosis of type 2 diabetes were recruited. Full data were available for 3482 participants (48% men; mean age 67 years). Meeting the dietary LCω3PUFA recommendation of at least 500 mg/d for primary cardiovascular prevention, as assessed by a validated food-frequency questionnaire. The main outcome was incident DR requiring laser photocoagulation, vitrectomy, and/or antiangiogenic therapy confirmed by an external adjudication committee. Of the 3482 participants, 48% were men and the mean age was 67 years. A total of 2611 participants (75%) met target LCω3PUFA recommendation. During a median follow-up of 6 years, we documented 69 new events. After adjusting for age, sex, intervention group, and lifestyle and clinical variables, participants meeting the LCω3PUFA recommendation at baseline (≥500 mg/d) compared with those not fulfilling this recommendation ( In middle-aged and older individuals with type 2 diabetes, intake of at least 500 mg/d of dietary LCω3PUFA, easily achievable with 2 weekly servings of oily fish, is associated with a decreased risk of sight-threatening DR. Our results concur with findings from experimental models and the current model of DR pathogenesis. clinicaltrials.gov Identifier: http://www.controlled-trials.com/ISRCTN35739639.
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