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Predimed Revisited...

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
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Juliegee
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Re: Predimed Revisited...

Postby Juliegee » Thu May 14, 2015 5:23 pm

HUGE thanks, Stavia. I promise, I'm not trying to ruin your vacation :roll:

From G:
As I noted before, I wouldn't put a lot of stock in this research effort:

1) Massive conflicts of interest.

Two were noted for this paper. Both involved non-paid affiliations:
Conflict of Interest Disclosures: Dr Salas-Salvadó has reported receiving research funding and is a nonpaid member of the scientific advisory committee of the International Nut Council. Dr Ros has reported receiving research funding and is a nonpaid member of the scientific advisory committee of the California Walnut Commission. No other disclosures were reported.
2) Olive oil is given at 140 g per day; nuts a tiny fraction of that.

HUH??? From what I can glean, olive oil was 50ml per person per day (converted to 3.381 US TBS.) Mixed nuts were 30 g per day per person.
3) The low-fat group wasn't very low-fat (despite the advice).

Agreed! In this paper, the low-fat group averaged 40.17% of calories from fat. Interestingly, the EVOO group only averaged 41.81% and the mixed nut group averaged 43.22%. In fact, the macronutrient ratios across the board for the three arms of the study were surprisingly similar. The Low fat arm: 16.7%-P/39.19%-C/40.17%-F; the EVOO arm: 17.52%-P/37.21%-C/41.81%-F; and the mixed nut arm: 16.81%-P/36.39%-C/43.22%-F.

The biggest difference that I observed between the groups was that of dietary cholesterol. The low-fat group consumed on average 327.8 mg of daily cholesterol; whereas the EVOO group averaged 365 mg and the mixed nut group came in at 364 mg. Another difference can be found in overall caloric intake. The low-fat group averaged the lowest calories at 2053 kcal. The EVOO group came in at 2144 kcal and the mixed nut group averaged 2234 kcal. Lastly, there was a difference in dietary fiber that seems to indicate the EVOO and mixed nut group may have consumed more fruits and vegetables. The low-fat group consumed 11.63 g based on 1,000kcal. The EVOO group came in at 12.44 g. The mixed nut group averaged 12.42 g.

It’s very difficult to make any case pitting macronutrient groups (such as LFHC vs. HFLC) against one another from this paper as G correctly points out; they are VERY similar. Instead, the authors surmise that the abundance of antioxidants and phenolic compounds found in EVOO and nuts may be responsible for the small, but statistically significant cognitive improvements compared to the “low-fat” arm. For anyone who’s got the paper, I find Figure 2. Changes in Cognitive Function Measured With Composites by Intervention Group to be fairly impressive. I’m unfortunately unable to copy it here, but will happily pass the paper along to anyone who wants it- just PM me your email address.

I didn’t see anything earth-shattering here, but it does point towards a trend suggesting cognitive benefit from EVOO, nuts, vegetables, and fruits...nothing new.

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Re: Predimed Revisited...

Postby Gilgamesh » Fri May 15, 2015 10:24 am

Stavia,

Thanks! Just got paper.

J: Here's what I read:

Conflict of interest

Dr. Martínez-Lapiscina has received travel and accommodation expenses from Novartis, Biogen, Teva and Bayer for national and international congress. Dr. Salas-Salvadó reports serving on the board of and receiving grant support through his institution from the International Nut and Dried Fruit Council; reports serving on the board of Instituto Danone (Spain); receiving consulting fees from Danone; and receiving grant support through his institution from Feiraco, Eroski and Nestlé. Dr. Ros is a non paid member of the Scientific Advisory Committee of the California Walnut Commission. He has received research funding (grants) from AMGEN, California Walnut Commission, KARO-BIO, Merck, Sanofi Aventis, and Synageva. He has receveid honoraria for educational conferences from Aegerion, Alter, Astra Zeneka, DANONE, Ferrer International, Merck, Progenika, Roche, and Rottapharm. ER has also received payment for educational presentations for Abbott, Ferrer International, and Ricordati. He has received travel and accommodation expenses from California Walnut Commission and International Nut Council for attending and delivering speeches at international congresses. Dr. Galbete, Dr. Toledo, Dr. Corella, Dr. Buil-Cosiales and Dr. Martinez-Gonzalez declare that they have no conflict of interest.
That's a lot to be conflicted about, seems to me. Maybe I'm too cynical.

HUH??? From what I can glean, olive oil was 50ml per person per day (converted to 3.381 US TBS.) Mixed nuts were 30 g per day per person.
From http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026432/:
Additionally, participants allocated the MedDiet groups received free allotments of either EVOO (1 l/week) or 30 g/day of raw, unprocessed mixed nuts (15 g walnuts, 7.5 g almonds and 7.5 g hazelnuts)
1 Liter (assuming that's what they mean by "l") per week is around 140 g / day.

Ah, and, looking at the new paper:

INTERVENTIONS Participants were randomly assigned to a Mediterranean diet supplemented
with extravirgin olive oil (1 L/wk), a Mediterranean diet supplemented with mixed nuts
(30 g/d), or a control diet (advice to reduce dietary fat).
Capital "L", so they do indeed mean Liter. That's a bit less than 1000 g / week.

BUT, looking at Table 2, it looks like the research subjs. might have given a lot of the EVOO away to neighbors! No time now but I'll have to read the recent papers closely to see how they monitored intake.

There is this:
http://ije.oxfordjournals.org/content/4 ... nsion.html

From:
http://ije.oxfordjournals.org/content/41/2/377.long

"≥4 tbsp" doesn't tell us much....

GB

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Re: Predimed Revisited...

Postby Juliegee » Fri May 15, 2015 11:11 am

Oops! I think we’re talking about two different papers. You are quoting the Conflicts of Interest from the older 2014 paper referenced at the end of my original post. (We dissected that last year.) I’m talking about the brand new one. I thought Stavia sent it to you; sorry. I’m sending it to you via email now.

Both appear to have used the Predimed protocol- that is REALLY hard to track down in terms of the amount of EVOO. I fell down a rabbit hole yesterday; reading dozens of supplements and links from Predimed trying to hunt it down. Yes, participants were given one liter of EVOO per FAMILY per week. However, that is a very imprecise number as we know the sizes of the families will obviously vary. Here, Richard helped us track down a more exact measurement from the original study:
viewtopic.php?f=6&t=1212&hilit=Predimed&start=10
It is a challenge to find the observed intake because most of the 30+ papers based on PREDIMED reference the original paper. This is a common practice for follow-up papers to save space repeating methods that were previously published. The target was 50g EVOO for that arm of the study. I was impressed that the estimated intake was, in fact, very close to 50g/day.

But, I suspect Richard accidentally made an error by using grams instead of milliliters. The best consensus I can find is that it was actually 50 ml of EVOO per day per person; slightly over 3 TBS a day.
http://www.walnuts.org/health-and-walnu ... act-sheet/
http://www.nutsforlife.com.au/wp-conten ... PROVED.pdf

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Re: Predimed Revisited...

Postby Gilgamesh » Sat May 16, 2015 8:48 am

I wasn't talking about a paper, I was talking about the one (right???) trial, which has produced different papers by diff. authors. But maybe there are several separate trials calling themselves PREDIMED?? I don't think so, though. (And that would be confusing!) You're speaking as if the new paper reports on a new trial. From my brief glance (yes, Stavia sent the paper to me!), it seems it's a reanalysis of data from a subgroup. See page E2. The title of the new paper does make things confusing, thoug!h

Either way, thanks for digging into the amounts used! Yes, it's 50 ml (which is probably around 46 g, though olive oil density various slightly -- but olive oil will always float in water!). But that's just an estimate.

Too bad they didn't have a nutritious, (seriously, though not Ornish-oid) low-fat diet for a fair comparison!

GB

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Re: Predimed Revisited...

Postby Juliegee » Sat May 16, 2015 10:30 am

Gotcha' :D FWIW, I'm obviously discussing and analyzing the NEW paper. The "conflicts of interest" I shared were also from the new paper. Yes, it's clearly a subgroup from the original Predimed.
Too bad they didn't have a nutritious, (seriously, though not Ornish-oid) low-fat diet for a fair comparison!

Ha, the same could be said for those advocating higher fat. That also wasn't explored. So many want to turn this into LFHC vs. HFLC. Unfortunately, as the macronutrient ratios clearly spell out; it's the wrong paper for that. The most I could glean were "hints" that EVOO and nuts provided some protection from cognitive decline.


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