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OBJECTIVE	The Prevencin con Dieta Mediterrnea ( PREDIMED ) trial showed that a Mediterranean diet ( MedDiet ) supplemented with either extra virgin olive oil or 30 g/d of mixed nuts reduced incident cardiovascular events compared with a control ( low fat ) diet .
OBJECTIVE	The mechanisms of cardiovascular protection afforded by MedDiets remain to be uncovered .
OBJECTIVE	We assessed the effect of both supplemented MedDiets on internal carotid intima-media thickness ( ICA-IMT ) and plaque height , the ultrasound features that best predict future cardiovascular events , in subjects at high cardiovascular risk .
RESULTS	In a PREDIMED subcohort ( n = 175 ) , plaque height and carotid IMT of 3 prespecified segments ( ICA , bifurcation , and common ) were sonographically assessed at baseline and after intervention for a mean of 2.4 years .
RESULTS	We evaluated 164 subjects with complete data .
RESULTS	In a multivariate model , mean ICA-IMT progressed in the control diet group ( mean [ 95 % confidence interval ] , 0.052 mm [ -0.014 to 0.118 mm ] ) , whereas it regressed in the MedDiet + nuts group ( -0.084 mm [ -0.158 to -0.010 mm ] ; P = 0.024 versus control ) .
RESULTS	Similar results were observed for maximum ICA-IMT ( control , 0.188 mm [ 0.077 to 0.299 mm ] ; MedDiet + nuts , -0.030 mm [ -0.153 to 0.093 mm ] ; P = 0.034 ) and maximum plaque height ( control , 0.106 mm [ 0.001 to 0.210 mm ] ; MedDiet + nuts , -0.091 mm [ -0.206 to 0.023 mm ] ; P = 0.047 ) .
RESULTS	There were no changes in ICA-IMT or plaque after the MedDiet + extra virgin olive oil .
CONCLUSIONS	Compared with a control diet , consumption of a MedDiet supplemented with nuts is associated with delayed progression of ICA-IMT and plaque .
CONCLUSIONS	The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial .
BACKGROUND	http://www.controlled-trials.com .
BACKGROUND	Unique identifier : ISRCTN35739639 .

