MA Martínez-González.
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1 MA Martínez-González Coordinador RD 06/0045 PREDIMED (Alimentación saludable en la prevención primaria de enfermedades crónicas)
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3 Estrategia Estructura organizativa Trabajo en red Comité Científico Externo (CCExt) Plataformas Avances científicos atribuibles a la Red Impacto del programa RETIC
4 Food patterns Food grouping & indexes Food items: olive oil, tomato, garlic, etc. Micronutrients: antioxidants, vitamins, etc. Single macronutrient: CHO, Types of Fat, Protein
5 High Quality of evidence Low Randomized Trial Cohort Case-control Cross-sectional Ecological (cross-cultural, international comparisons)
6 Trials
7 Random No No
8 Ensayo principal n
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10 Rapidly increasing evidence Increased Longevity Prevention of CV mortality Cancer mortality CVD incidence Metabolic syndrome Diabetes Dementia Depression Highly palatable! Scarcity of large randomized trials
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12 de Lorgeril M, Salen P, Martin JL, et al. Final Report of the Diet Heart Study. Circulation 1999;99: Lyon Diet Heart Study. the Lyon
13 Diet ~30% control ~50% experimental No biomarkers No olive oil Stopped 27 months endpoints (14 vs. 44).
14 Men: yr Women: yr High CV risk without CVD type 2 diabetics 3+ risk factors 1. Smoking 2. Hypertension 3. LDL 4. HDL 5. Overweight/obes 6. Family history Random
15 Beyond Lo que nunca se ha hecho es lo que vale la pena
16 Beyond Lo que nunca se ha hecho es lo que vale la pena
17 Navarra 1055 Valencia 1094 Baleares 652 Las Palmas 357 Reus 877 Clinic 674 IMIM 584 Belvitge 246 Vitoria 647 Málaga 593 Sevilla 668 Total 7447 Año % reclut. Cum. % Total 100
18 Mediet + VOO (n= 2543) MeDiet + Nuts (n=2454) Control (n=2450) Age (SD) 67 (6) 67 (6) 67 (6) Women (%) Diabetes (%) Hypertension (%) Current smokers (%) High cholest. (%) BMI (SD) 30 (4) 30 (4) 30 (4) Waist (SD) 100 (10) 100 (11) 101 (11) Person-yr follow-up * CVD major events Colorectal cancer Total Deaths, etc. * Up to July 2nd, 2010
19 Estrategia Estructura organizativa Trabajo en red Comité Científico Externo (CCExt) Plataformas Avances científicos atribuibles a la Red Impacto del programa RETIC
20 11 RECRUITMENT GROUPS 8 ONLY-LAB GROUPS Navarra- MA Martinez-Gonzalez Valencia- D Corella Reus- J Salas-Salvado Mallorca- M Fiol Sevilla- J Lapetra Málaga- E Gomez-Gracia Barcelona-1- R Estruch Vitoria- F Aros Barcelona-2- MI Covas Las Palmas- L Serra-Majem Barcelona-3- X Pinto Barcelona-1- E Ros Sevilla- V Ruiz-Gutierrez Barcelona-2- RM Lamuela-Raventos Navarra- JA Martinez Valencia- G Saez Barcelona-3- MT Mitjavila Mallorca- JA Tur Vitoria- MP Portillo
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23 Barcelona, 12 abril 2008 Málaga, 3 junio 2009 Barcelona, 2 julio 2010 Mallorca, 22 julio 2011 The data from the PREDIMED trial will be analyzed at 5 intervals (4 interim analyses and the final analysis). The 4 interim analyses to decide on the continuation of the PREDIMED trial will be conducted after 2, 3, 4 and 5 years of median follow-up. The 2-sided p-values for stopping the trial at each interim analysis are Yr Benefit Harm BCN'08 2 5*10-6 9*10-5 Málaga'09 BCN'10 Mallorca 11 4th interim analysis
24 PREDIMED (n=7447, mediana>5 años seguim.) Base de datos (Preventiva-Pamplona+IMIM Barcelona) 1907 variables x 7447 participantes (14M) 1204 variables x 7447 participantes (9M) Biobancos (Nutrición-Pamplona) Plasmateca, seroteca (Reus) Uñas-metales pesados (Málaga) Genética Subestudios, entre otros: Calidad de vida (n=880) Deterioro cognitivo (n=1557) Esteatosis no alcohólica (n=250) Aterosclerosis subclínica-imt (n=457) SUN (n=20.785, med>6 años seg) (Preventiva-Pamplona) B. datos estilo vida, alimentación, SF36, incidencia 2281 variables x participantes (47M) Tests cognitivos Genética (>55 años)
25 Estrategia Estructura organizativa Trabajo en red Comité Científico Externo (CCExt) Plataformas Avances científicos atribuibles a la Red Impacto del programa RETIC
26 Web of science: Estrategia de búsqueda AUTHOR: ESTRUCH OR COVAS MI OR MARTINEZ JA OR ROS E OR SALAS-SALVADO OR LAMUELA OR LAMUELA-RAVENTOS OR CORELLA OR SERRA-MAJEM OR RUIZ-GUTIERREZ OR SAEZ G OR AROS F OR GOMEZ-GRACIA OR LAPETRA OR MARTINEZ-GONZALEZ 14 TOPIC: FOOD OR NUTRITION OR DIET OR MEDITERRANEAN OR OBESITY OR OVERWEIGHT OR DIABETES OR CARDIOVASCULAR OR INFARCTION OR STROKE
27 Total:
28 Año Citas Indice h = 54 citas totales = citas/paper =
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30 Proyección internacional
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32 Estrategia Estructura organizativa Trabajo en red Comité Científico Externo (CCExt) Plataformas Avances científicos atribuibles a la Red Impacto del programa RETIC
33 Grupo Nº Σ % Colab. Navarra 131 F.Impacto ,5 CSIC-Sevilla ,0 Nutr-BCN ,0 BQ-Valencia ,0 Belvitge ,3 Málaga ,0 Las Palmas ,6 Nutr-Navarra ,7 Fisiol-BCN ,2 Fisiol-Baleares ,5 Nutr-Vitoria ,3 Publicaciones vinculadas a la RTIC de 1º y 2º Cuartil. Desde I-2007 hasta IV-2010 (excl. CIBER)
34 Valoración Programa Retic Excelente Fortalezas Cohesión clínico+epidemiológ.+laboratorio Masa crítica: n con protocolo común Cultura de rendición de cuentas Continuidad en el tiempo- cohortes a largo plazo Debilidades (y posibles soluciones) Necesidad de flexibilizar Capítulos asignados presupuestariamente Número de grupos mínimo Financiación grupos clínicos asociados Proyectos conjuntos > CV individual
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