[Hot Science] Clinical Trial: Mediterranean diet with extra-virgin olive oil and use of glucose-lowering medications

Background
[Hot Science] Clinical Trial: Mediterranean diet with extra-virgin olive oil and use of glucose-lowering medications
Abstract

Over the course of six years, this study followed a total of 3,230 adults with type 2 diabetes at baseline to observe the effects of three different diet interventions (Mediterranean diet + extra-virgin olive oil, Mediterranean diet + mixed nuts, and low-fat diet as control) on the use of glucose-lowering medications.
 

 

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Study Design and Method

  • Subjects were adults free of cardiovascular disease who had either type 2 diabetes or at least three major cardiovascular risk factors with no glucose-lowering medication use at enrollment (N = 3,230), randomized to the following interventions:
    • Extra Virgin Olive Oil (EVOO) group (N = 2543)
      • Mediterranean diet
      • 1 L per week of EVOO given and at least 4 tablespoons/day intake recommended
      • Dietary training done by dietitians at baseline and quarterly
    • Mixed Nuts group (N = 2454)
      • Mediterranean diet
      • 30 g per day of mixed nuts given  
      • Dietary training done by dietitians at baseline and quarterly
    • Control (N = 2450)
      • General diet with advice on low-fat intake
      • Small nonfood gift given
      • Dietary training done by dietitian at baseline, thereafter, low-fat diet leaflet

Data collection

  • Three sets of questionnaires were administered at randomization and yearly thereafter
    • A general medical questionnaire
    • A validated food frequency questionnaire
    • A validated physical activity questionnaire
  • Time-to-event analyses were performed for two outcomes
    • Introduction of the first glucose-lowering medication (oral or injectable)
    • Insulin initiation

Result

  • After a median follow-up of 3.2 years,
    • When compared with control group, the adjusted hazard ratios of starting a first glucose-lowering medication were,
      • 0.78 (95% CI, 0.62-0.98) for EVOO group
      • 0.89 (95% CI, 0.71-1.12) for Mixed Nuts group
  • After a median follow-up of 5.1 years,
    • When compared with control group, the adjusted hazard ratios of insulin initiation were,
      • 0.87 (95% CI, 0.68-1.11) for EVOO group
      • 0.89 (95% CI, 0.69-1.14) for Mixed Nuts group

Conclusion

A Mediterranean diet with extra-virgin olive oil may delay the introduction of new-onset glucose-lowering medications among those with type 2 diabetes. However, a Mediterranean diet did not result in a significantly lower need for insulin.


Link to Publication: https://www.ncbi.nlm.nih.gov/pubmed/31182491

Reference

Basterra-Gortari et al. Diabetes Care. 2019;42:1390-1397.
 

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