Eran Kopel, MD, MPH; Yechezkel Sidi, MD; Shaye Kivity, MD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0108.
Kopel E, Sidi Y, Kivity S. Prevention of Diabetes With Mediterranean Diets. Ann Intern Med. 2014;161:157. doi: 10.7326/L14-5014
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Published: Ann Intern Med. 2014;161(2):157.
We believe that Salas-Salvadó and colleagues' subgroup analysis (1), which found that a Mediterranean diet enriched with extra-virgin olive oil reduces risk for diabetes, is methodologically flawed. During the study, more participants were lost to follow-up in the low-fat diet control group (10.5%) than in the Mediterranean diet groups supplemented with olive oil (4.1%) or mixed nuts (6.9%). The authors state that participants in the control group “who withdrew had a worse cardiovascular risk profile at baseline than those who remained in the study.” This fact indicates that the entire control group in the subgroup analysis had a potentially higher cardiovascular risk profile at baseline than the intervention groups.
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