Intensive Weight-Loss Lifestyle Intervention Using Mediterranean Diet and COVID-19 Risk in Older Adults: Secondary Analysis of PREDIMED-Plus Trial

The Journal of Nutrition, Health & Aging Pub Date : 2023-12-05 DOI:10.1007/s12603-023-2044-4

Sangeetha Shyam, J. F. García-Gavilán, I. Paz-Graniel, J. J. Gaforio, M. Á. Martínez-González, D. Corella, J. A. Martínez, Á. M. Alonso-Gómez, J. Wärnberg, J. Vioque, D. Romaguera, J. López-Miranda, R. Estruch, F. J. Tinahones, J. Lapetra, J. L. Serra-Majem, A. Bueno-Cavanillas, J. A. Tur, V. Martín Sánchez, X. Pintó, P. Matía-Martín, J. Vidal, M. del Mar Alcarria, L. Daimiel, E. Ros, F. Fernandez-Aranda, S. K. Nishi, Ó. García-Regata, R. Perez Araluce, E. M. Asensio, O. Castañer, A. Garcia-Rios, A. Oncina-Cánovas, C. Bouzas, M. A. Zulet, E. Rayó, R. Casas, S. Martin-Pelaez, L. Tojal-Sierra, M. R. Bernal-López, S. Carlos, J. V. Sorlí, A. Goday, P. J. Peña-Orihuela, A. Pastor-Morel, S. Eguaras, M. D. Zomeño, M. Delgado-Rodríguez, N. Babio, M. Fitó, Jordi Salas-Salvadó

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Abstract

Objectives

We tested the effects of a weight-loss intervention encouraging energy-reduced MedDiet and physical activity (PA) in comparison to ad libitum MedDiet on COVID-19 incidence in older adults.

Design

Secondary analysis of PREDIMED-Plus, a prospective, ongoing, multicentre randomized controlled trial.

Setting

Community-dwelling, free-living participants in PREDIMED-Plus trial.

Participants

6,874 Spanish older adults (55–75 years, 49% women) with overweight/obesity and metabolic syndrome.

Intervention

Participants were randomised to Intervention (IG) or Control (CG) Group. IG received intensive behavioural intervention for weight loss with an energy-reduced MedDiet intervention and PA promotion. CG was encouraged to consume ad libitum MedDiet without PA recommendations.

Measurements

COVID-19 was ascertained by an independent Event Committee until December 31, 2021. COX regression models compared the effect of PREDIMED-Plus interventions on COVID-19 risk.

Results

Overall, 653 COVID-19 incident cases were documented (IG:317; CG:336) over a median (IQR) follow-up of 5.8 (1.3) years (inclusive of 4.0 (1.2) years before community transmission of COVID-19) in both groups. A significantly lowered risk of COVID-19 incidence was not evident in IG, compared to CG (fully-adjusted HR (95% CI): 0.96 (0.81,1.12)).

Conclusions

There was no evidence to show that an intensive weight-loss intervention encouraging energy-reduced MedDiet and PA significantly lowered COVID-19 risk in older adults with overweight/ obesity and metabolic syndrome in comparison to ad libitum MedDiet. Recommendations to improve adherence to MedDiet provided with or without lifestyle modification suggestions for weight loss may have similar effects in protecting against COVID-19 risk in older adults with high cardiovascular risks.

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采用地中海饮食的强化减肥生活方式干预与老年人COVID-19风险:PREDIMED-Plus试验的二次分析

目的:我们测试了鼓励减少能量的MedDiet和身体活动(PA)的减肥干预与随意MedDiet相比对老年人COVID-19发病率的影响。PREDIMED-Plus是一项前瞻性、正在进行的多中心随机对照试验。PREDIMED-Plus试验中社区居住、自由生活的参与者。参与者:6874名患有超重/肥胖和代谢综合征的西班牙老年人(55-75岁，49%为女性)。参与者被随机分为干预组(IG)和对照组(CG)。IG接受强化行为干预以减轻体重，包括减少能量的MedDiet干预和PA推广。CG被鼓励随意食用没有PA推荐的MedDiet。scovid -19由一个独立的事件委员会确定，直至2021年12月31日。COX回归模型比较PREDIMED-Plus干预措施对COVID-19风险的影响。结果共记录新冠肺炎病例653例(IG:317例;两组患者的中位(IQR)随访时间为5.8(1.3)年(包括COVID-19社区传播前的4.0(1.2)年)。与CG组相比，IG组的COVID-19发病率没有明显降低(完全调整后的风险比(95% CI): 0.96(0.81,1.12))。结论:没有证据表明，与随意MedDiet相比，鼓励减少能量的MedDiet和PA的强化减肥干预可显著降低超重/肥胖和代谢综合征老年人的COVID-19风险。改善MedDiet依从性的建议，包括或不包括改变生活方式的减肥建议，可能在保护心血管疾病高风险的老年人免受COVID-19风险方面具有类似的效果。

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The Journal of Nutrition, Health & Aging

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