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P1. NUTRITION
General objectives
The general objective of the CIBERobn nutrition programme is to demonstrate, with the maximum level of scientific proof, the effects of foods and nutrients on the prevention and treatment of diseases, as well as the mechanisms responsible for their effects on health, such that the information that is obtained is useful for making recommendations to patients and the population in general . This programme has been divided into 4 subprogrammes:
• Mediterranean diet and Cardiovascular Disease: PREDIMED Study, which seeks to study the effects of a Mediterranean diet supplemented with virgin olive oil or dried fruits and nuts on a set
of events consisting of cardiovascular mortality, myocardial infarction and cerebrovascular acci- dent, and to compare them to events resulting from following a diet low in any type of fat .
• Nutrition and Obesity Genetics: To learn about the main genetic variants associated with obe- sity and related phenotypes (dyslipidemias, diabetes, metabolic syndrome, cardiovascular diseases) in different Spanish population groups (the elderly and people with a high cardiovascular risk, the general population, the morbidly obese, . . .) and to compare them with populations of other coun- tries .
• Mechanisms of the effects of the different diets, foods and nutrients on health for the purpose of learning about the protective mechanisms of different dietary patterns, foods and nutrients on different organs and systems of the body in order to make dietary recommendations plausible .
• Study of weight loss induced by a low-calorie Mediterranean diet and its effects on the risk factors and the incidence of cardiovascular disease in patients who are overweight or obese. PREDIMED II STUDY: for the purposes of evaluating the effect of an intensive inter- vention including a low-calorie Mediterranean diet, a physical exercise programme and beha- vioural therapy on a set of cardiovascular complications, as well as on body weight and adiposity measurements (waist girth) and quality of life .
As a result of the success that the PREDIMED study results have had worldwide, particularly after publica- tion of the main results in the most prestigious international medical journal, The New England Journal of Medicine, edited in Boston (USA), leadership of the group of researchers in the PREDIMED study has been consolidated worldwide . In fact, the main researchers of the study, Dr . Ramón Estruch, Dr . Jordi Salas-Sal- vadó, Dr . Miguel Ángel Martínez-González, Dr . Emillio Ros, Dr . María Isabel Covas and Dr . Dolores Corella, were invited to present the results at leading medical conferences all over the world, including, for example, the American Heart Association (AHA) . The most important paper published in the N Engl J Med was the most downloaded paper in the journal history, and the conventional Mediterranean diet is being included as the basis for dietary treatment in patients with vascular risk, such as in the U .S . Department of Agricul- ture Dietary Guidelines, the American Heart and Neurology Society guidelines, and the European Society of Hypertension guideline, etc . It was a milestone for it to have such enormous repercussion in both scientific societies and in the mass media, primarily Spanish .
The PREDIMED study has shown for the first time with a maximum level of scientific evidence (randomised clinical trial, with the analysis of final variables having the highest clinical value) that the conventional Medi- terranean diet reduces the incidence of major vascular complications (myocardial infarction, cerebrovascular accident and cardiovascular death) in patients with high vascular risk, in addition to improving the main vascular risk factors such as diabetes mellitus, high blood pressure and dyslipidemia . These results show that a healthy eating pattern rich in unsaturated fat is better for cardiovascular protection than another healthy diet, such as a low-fat diet . We have also shown that it is never too late to improve our diet, because the
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