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The Mediterranean diet protects against waist circumference enlargement in 12Ala carriers for the PPARγ gene: 2 years' follow-up of 774 subjects at high cardiovascular risk

  • Cristina Razquin (a1), J. Alfredo Martinez (a1), Miguel A. Martinez-Gonzalez (a2), Dolores Corella (a3), José Manuel Santos (a4) and Amelia Marti (a1)
  • DOI:
  • Published online: 14 September 2009

The PPARγ gene regulates insulin sensitivity and adipogenesis. The Pro12Ala polymorphism of this gene has been related to fat accumulation. Our aim was to analyse the effects of a 2-year nutritional intervention with Mediterranean-style diets on adiposity in high-cardiovascular risk patients depending on the Pro12Ala polymorphism of the PPARγ gene. The population consisted of a substudy (774 high-risk subjects aged 55–80 years) of the Prevención con Dieta Mediterránea (PREDIMED) randomised trial aimed at assessing the effect of the Mediterranean diet for CVD prevention. There were three nutritional intervention groups: two of them of a Mediterranean-style diet and the third was a control group advised to follow a conventional low-fat diet. All the participants were genotyped by PCR-restriction fragment length polymorphism (RFLP). The results showed that carriers of the 12Ala allele allocated to the control group had a statistically significant higher change in waist circumference (adjusted difference coefficient = 2·37 cm; P = 0·014) compared with wild-type subjects after 2 years of nutritional intervention. This adverse effect was not observed among 12Ala carriers allocated to both Mediterranean diet groups. In diabetic patients a statistically significant interaction between Mediterranean diet and the 12Ala allele regarding waist circumference change was observed ( − 5·85 cm; P = 0·003). In conclusion, the Mediterranean diet seems to be able to reduce waist circumference in a high-cardiovascular risk population, reversing the negative effect that the 12Ala allele carriers of the PPARγ gene appeared to have. The beneficial effect of this dietary pattern seems to be higher among type 2 diabetic subjects.

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*Corresponding author: Professor Amelia Marti, fax +34 948 42 56 49, email
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1R Estruch , MA Martinez-Gonzalez , D Corella , (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med 145, 111.

2J Robitaille , L Perusse , C Bouchard , (2007) Genes, fat intake, and cardiovascular disease risk factors in the Quebec Family Study. Obesity (Silver Spring) 15, 23362347.

5A Keys & F Grande (1957) Role of dietary fat in human nutrition. III. Diet and the epidemiology of coronary heart disease. Am J Public Health Nations Health 47, 15201530.

6MA Martinez-Gonzalez & A Sanchez-Villegas (2004) The emerging role of Mediterranean diets in cardiovascular epidemiology: monounsaturated fats, olive oil, red wine or the whole pattern? Eur J Epidemiol 19, 913.

8H Schroder (2007) Protective mechanisms of the Mediterranean diet in obesity and type 2 diabetes. J Nutr Biochem 18, 149160.

9E Fernandez-Jarne , E Martinez-Losa , M Prado-Santamaria , (2002) Risk of first non-fatal myocardial infarction negatively associated with olive oil consumption: a case–control study in Spain. Int J Epidemiol 31, 474480.

10MA Martinez-Gonzalez , E Fernandez-Jarne , M Serrano-Martinez , (2004) Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet. Eur J Clin Nutr 58, 15501552.

11CM Albert , JM Gaziano , WC Willett , (2002) Nut consumption and decreased risk of sudden cardiac death in the Physicians' Health Study. Arch Intern Med 162, 13821387.

12FB Hu , MJ Stampfer , JE Manson , (1998) Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 317, 13411345.

13J Sabate & GE Fraser (1994) Nuts: a new protective food against coronary heart disease. Curr Opin Lipidol 5, 1116.

14J Luan , PO Browne , AH Harding , (2001) Evidence for gene–nutrient interaction at the PPARγ locus. Diabetes 50, 686689.

15A Memisoglu , FB Hu , SE Hankinson , (2003) Interaction between a peroxisome proliferator-activated receptor γ gene polymorphism and dietary fat intake in relation to body mass. Hum Mol Genet 12, 29232929.

16A Nieters , N Becker & J Linseisen (2002) Polymorphisms in candidate obesity genes and their interaction with dietary intake of n-6 polyunsaturated fatty acids affect obesity risk in a sub-sample of the EPIC-Heidelberg cohort. Eur J Nutr 41, 210221.

17MC Ochoa , C Razquin , MA Martinez-Gonzalez , (2008) Role of PPARG2 polymorphims in body weight regulation. Future Lipidol 3, 3141.

18SS Deeb , L Fajas , M Nemoto , (1998) A Pro12Ala substitution in PPARγ2 associated with decreased receptor activity, lower body mass index and improved insulin sensitivity. Nat Genet 20, 284287.

19J Ek , SA Urhammer , TI Sorensen , (1999) Homozygosity of the Pro12Ala variant of the peroxisome proliferation-activated receptor-γ2 (PPAR-γ2): divergent modulating effects on body mass index in obese and lean Caucasian men. Diabetologia 42, 892895.

20S Masud & S Ye (2003) Effect of the peroxisome proliferator activated receptor-γ gene Pro12Ala variant on body mass index: a meta-analysis. J Med Genet 40, 773780.

21EC Tok , D Ertunc , O Bilgin , (2006) PPAR-γ2 Pro12Ala polymorphism is associated with weight gain in women with gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol 129, 2530.

22A Tonjes & M Stumvoll (2007) The role of the Pro12Ala polymorphism in peroxisome proliferator-activated receptor γ in diabetes risk. Curr Opin Clin Nutr Metab Care 10, 410414.

23PW Franks , KA Jablonski , L Delahanty , (2007) The Pro12Ala variant at the peroxisome proliferator-activated receptor γ gene and change in obesity-related traits in the Diabetes Prevention Program. Diabetologia 50, 24512460.

25HE Xu , MH Lambert , VG Montana , (1999) Molecular recognition of fatty acids by peroxisome proliferator-activated receptors. Mol Cell 3, 397403.

26I Zazpe , A Sanchez-Tainta , R Estruch , (2008) A large randomized individual and group intervention conducted by registered dietitians increased adherence to Mediterranean-type diets: the PREDIMED study. J Am Diet Assoc 108, 11341145.

27JM Martin-Moreno , P Boyle , L Gorgojo , (1993) Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol 22, 512519.

28MC Ochoa , A Marti , C Azcona , (2004) Gene–gene interaction between PPARγ2 and ADRβ3 increases obesity risk in children and adolescents. Int J Obes Relat Metab Disord 28, Suppl. 3, S37S41.

29T Pischon , H Boeing , K Hoffmann , (2008) General and abdominal adiposity and risk of death in Europe. N Engl J Med 359, 21052120.

30V Lagou , RA Scott , Y Manios , (2008) Impact of peroxisome proliferator-activated receptors γ and δ on adiposity in toddlers and preschoolers in the GENESIS Study. Obesity (Silver Spring) 16, 913918.

31J Pihlajamaki , M Vanhala , P Vanhala , (2004) The Pro12Ala polymorphism of the PPARγ2 gene regulates weight from birth to adulthood. Obes Res 12, 187190.

32M Ghoussaini , D Meyre , S Lobbens , (2005) Implication of the Pro12Ala polymorphism of the PPAR-γ2 gene in type 2 diabetes and obesity in the French population. BMC Med Genet 6, 11.

33HK Biesalski (2004) Diabetes preventive components in the Mediterranean diet. Eur J Nutr 43, Suppl. 1, I/26I/30.

34MA Martinez-Gonzalez , C de la Fuente-Arrillaga , JM Nunez-Cordoba , (2008) Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ 336, 13481351.

35I Shai , D Schwarzfuchs , Y Henkin , (2008) Weight loss with a low-carbohydrate. Mediterranean, or low-fat diet. N Engl J Med 359, 229241.

36SH Woolf , RN Battista , GM Anderson , (1990) Assessing the clinical effectiveness of preventive maneuvers: analytic principles and systematic methods in reviewing evidence and developing clinical practice recommendations. A report by the Canadian Task Force on the Periodic Health Examination. J Clin Epidemiol 43, 891905.

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