RT Journal Article
T1 Carbohydrate quality changes and concurrent changes in cardiovascular risk factors: a longitudinal analysis in the PREDIMED-Plus randomized trial.
A1 Martinez-Gonzalez, Miguel A
A1 Fernandez-Lazaro, Cesar I
A1 Toledo, Estefanía
A1 Diaz-Lopez, Andres
A1 Corella, Dolores
A1 Goday, Albert
A1 Romaguera, Dora
A1 Vioque, Jesus
A1 Alonso-Gomez, Angel M
A1 Wärnberg, Julia
A1 Martinez, J Alfredo
A1 Serra-Majem, Luís
A1 Estruch, Ramon
A1 Tinahones, Francisco J
A1 Lapetra, Jose
A1 Pinto, Xavier
A1 Tur, Josep A
A1 Lopez-Miranda, Jose
A1 Cano-Ibañez, Naomi
A1 Delgado-Rodriguez, Miguel
A1 Matia-Martin, Pilar
A1 Daimiel, Lidia
A1 Sanchez, Vicente Martin
A1 Vidal, Josep
A1 Vazquez, Clotilde
A1 Ros, Emilio
A1 Buil-Cosiales, Pilar
A1 Portoles, Olga
A1 Soria-Florido, Maria
A1 Konieczna, Jadwiga
A1 Navarrete-Muñoz, Eva M
A1 Tojal-Sierra, Lucas
A1 Fernandez-Garcia, Jose C
A1 Abete, Itziar
A1 Henriquez-Sanchez, Patricia
A1 Muñoz-Garach, Araceli
A1 Santos-Lozano, Jose M
A1 Corbella, Emili
A1 Bibiloni, Maria Del Mar
A1 Becerra-Tomas, Nerea
A1 Barragan, Rocio
A1 Castañer, Olga
A1 Fiol, Miquel
A1 Garcia de la Hera, Manoli
A1 Bello-Mora, Maria C
A1 Gea, Alfredo
A1 Babio, Nancy
A1 Fito, Montse
A1 Ruiz-Canela, Miguel
A1 Zazpe, Itziar
A1 Salas-Salvado, Jordi
K1 PREDIMED-Plus
K1 Carbohydrate
K1 Carbohydrate quality index
K1 Cardiovascular disease
K1 Fiber
K1 Glycemic index
K1 Obesity
K1 Randomized controlled trials
AB Overall quality of dietary carbohydrate intake rather than total carbohydrate intake may determine the risk of cardiovascular disease (CVD). We examined 6- and 12-mo changes in carbohydrate quality index (CQI) and concurrent changes in several CVD risk factors in a multicenter, randomized, primary-prevention trial (PREDIMED-Plus) based on an intensive weight-loss lifestyle intervention program. Prospective analysis of 5373 overweight/obese Spanish adults (aged 55-75 y) with metabolic syndrome (MetS). Dietary intake information obtained from a validated 143-item semiquantitative food-frequency questionnaire was used to calculate 6- and 12-mo changes in CQI (categorized in quintiles), based on 4 criteria (total dietary fiber intake, glycemic index, whole grain/total grain ratio, and solid carbohydrate/total carbohydrate ratio). The outcomes were changes in intermediate markers of CVD. During the 12-mo follow-up, the majority of participants improved their CQI by increasing their consumption of fruits, vegetables, legumes, fish, and nuts and decreasing their consumption of refined cereals, added sugars, and sugar-sweetened beverages. After 6 mo, body weight, waist circumference (WC), systolic and diastolic blood pressure (BP), fasting blood glucose, glycated hemoglobin (HbA1c), triglyceride levels, triglycerides and glucose (TyG) index, and TyG-WC decreased across successive quintiles of improvement in the CQI. After 12 mo, improvements were additionally observed for HDL cholesterol and for the ratio of total to HDL cholesterol. Favorable improvements (expressed in common units of SD and 95% CI) for quintile 5 compared with quintile 1 of CQI change were observed for most risk factors, including TyG-WC (SD -0.20; 95% CI -0.26, -0.15), HbA1c (SD -0.16; 95% CI -0.23, -0.10), weight (SD -0.12; 95% CI -0.14, -0.09), systolic BP (SD -0.11; 95% CI -0.19, -0.02) and diastolic BP (SD -0.11; 95% CI -0.19, -0.04). Improvements in CQI were strongly associated with concurrent favorable CVD risk factor changes maintained over time in overweight/obese adults with MetS. 
PB Elsevier
YR 2019
FD 2019-11-08
LK http://hdl.handle.net/10668/14870
UL http://hdl.handle.net/10668/14870
LA en
NO Martínez-González MA, Fernandez-Lazaro CI, Toledo E, Díaz-López A, Corella D, Goday A, et al. Carbohydrate quality changes and concurrent changes in cardiovascular risk factors: a longitudinal analysis in the PREDIMED-Plus randomized trial. Am J Clin Nutr. 2020 Feb 1;111(2):291-306
DS RISalud
RD Aug 14, 2025