Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/20269
Title
Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial
Author(s)
Downer, Mary Kathryn | Gea, Alfredo | Stampfer, Meir | Sanchez-Tainta, Ana | Corella, Dolores | Salas-Salvado, Jordi | Ros, Emilio | Estruch, Ramon | Fito, Montserrat | Gomez-Gracia, Enrique | Aros, Fernando | | Garcia de la Corte, Francisco Javier | Serra-Majem, Lluis | Pinto, Xavier | Basora, Josep | Sorli, Jose V | Vinyoles, Ernest | Zazpe, Itziar | Martinez-Gonzalez, Miguel-Angel
Date issued
2016-06-14
Citation
Downer MK, Gea A, Stampfer M, Sanchez-Tainta A, Corella D, Salas-Salvado J, et al. Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial. Int J Behav Nutr Phys Act. 2016 Jun 14;13:67.
Language
Inglés
Document type
research article
Abstract
Background: Dietary intervention success requires strong participant adherence, but very few studies have examined factors related to both short-term and long-term adherence. A better understanding of predictors of adherence is necessary to improve the design and execution of dietary intervention trials. This study was designed to identify participant characteristics at baseline and study features that predict short-term and long-term adherence with interventions promoting the Mediterranean-type diet (MedDiet) in the PREvencion con DIeta MEDiterranea (PREDIMED) randomized trial. Methods: Analyses included men and women living in Spain aged 55-80 at high risk for cardiovascular disease. Participants were randomized to the MedDiet supplemented with either complementary extra-virgin olive oil (EVOO) or tree nuts. The control group and participants with insufficient information on adherence were excluded. PREDIMED began in 2003 and ended in 2010. Investigators assessed covariates at baseline and dietary information was updated yearly throughout follow-up. Adherence was measured with a validated 14-point Mediterranean-type diet adherence score. Logistic regression was used to examine associations between baseline characteristics and adherence at one and four years of follow-up. Results: Participants were randomized to the MedDiet supplemented with EVOO (n = 2,543; 1,962 after exclusions) or tree nuts (n = 2,454; 2,236 after exclusions). A higher number of cardiovascular risk factors, larger waist circumference, lower physical activity levels, lower total energy intake, poorer baseline adherence to the 14-point adherence score, and allocation to MedDiet + EVOO each independently predicted poorer adherence. Participants from PREDIMED recruiting centers with a higher total workload (measured as total number of persons-years of follow-up) achieved better adherence. No adverse events or side effects were reported. Conclusions: To maximize dietary adherence in dietary interventions, additional efforts to promote adherence should be used for participants with lower baseline adherence to the intended diet and poorer health status. The design of multicenter nutrition trials should prioritize few large centers with more participants in each, rather than many small centers.
Subject
Dietary adherence | Short-term dietary adherence | Long-term dietary adherence | Mediterranean Diet | PREDIMED trial | Dietary predictors | Dietary intervention
MESH
Cardiovascular Diseases | Aged | Energy Intake | Spain | Feeding Behavior | Humans | Middle Aged | Nuts | Health Behavior | Male | Health Promotion | Patient Compliance | Female | Risk Factors | Diet, Mediterranean | Olive Oil | Waist Circumference | Exercise | Logistic Models
DECS
Dieta Mediterránea | Ejercicio Físico | Modelos Logísticos | Femenino | Conductas Relacionadas con la Salud | Promoción de la Salud | Aceite de Oliva | Masculino | Conducta Alimentaria | Circunferencia de la Cintura | Cooperación del Paciente | Factores de Riesgo | Humanos | Persona de Mediana Edad | Nueces | Ingestión de Energía | Anciano | Enfermedades Cardiovasculares | España
Online version
DOI
Collections
- Investigación > IIS > IdisBa - Instituto de Investigación Sanitaria Illes Balears (Baleares)
- Investigación > IIS > IDIBAPS - Instituto de Investigaciones Biomédicas August Pi i Sunyer (Cataluña)
- Investigación > IIS > IDIBELL - Instituto de Investigación Biomédica de Bellvitge (Cataluña)
- Investigación > IIS > IdiSNA - Instituto de Investigación Sanitaria de Navarra (Navarra)
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