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00925njm 22002777a 4500 dc Martinez-Gonzalez, Miguel A author Zazpe, Itziar author Razquin, Cristina author Sanchez-Tainta, Ana author Corella, Dolores author Salas-Salvado, Jordi author Toledo, Estefanía author Ros, Emilio author Angel Munoz, Miguel author Recondo, Javier author Gomez-Gracia, Enrique author Fiol Sala, Miquel author Lapetra, Jose author Buil-Cosiales, Pilar author Serra-Majem, Lluis author Pinto, Xavier author Schroeder, Helmut author Tur, Josep A author Sorli, Jose V author Lamuela-Raventos, Rosa M author Estruch, Ramon author PREDIMED GRP author 2015-10 Background & aims: There is little evidence on post hoc-derived dietary patterns (DP) and all-cause mortality in Southern-European populations. Furthermore, the potential effect modification of a DP by a nutritional intervention has not been sufficiently assessed. We assessed the association between a posteriori defined baseline major DP and total mortality or cardiovascular events within each of the three arms of a large primary prevention trial (PREDIMED) where participants were randomized to two active interventions with Mediterranean-type diets or to a control group (allocated to a low-fat diet). Design: We followed-up 7216 participants for a median of 4.3 years. A validated 137-item food-frequency questionnaire was administered. Baseline DP were ascertained through factor analysis based on 34 predefined groups. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) for cardiovascular disease (CVD) or mortality across quartiles of DP within each of the-three arms of the trial. Results: We identified two major baseline DP: the first DP was rich in red and processed meats, alcohol, refined grains and whole dairy products and was labeled Western dietary pattern (WDP). The second DP corresponded to a Mediterranean-type dietary pattern (MDP). During follow-up, 328 participants died. After controlling for potential confounders, higher baseline adherence to the MDP was associated with lower risk of CVD (adjusted HR for fourth vs. first quartile: 0.52; 95% Cl (Confidence Interval): 0.36, 0.74; p-trend <0.001) and all-cause mortality (adjusted HR: 0.53; 95% CI: 038, 0.75; p-trend <0.001), regardless of the allocated arm of the trial. An increasing mortality rate was found across increasing quartiles of the WDP in the control group (allocated to a low-fat diet), though the linear trend was not statistically significant (p = 0.098). Conclusions: Higher adherence to an empirically-derived MDP at baseline was associated with a reduced risk of CVD and mortality in the PREDIMED trial regardless of the allocated arm. The WDP was not associated with higher risk of mortality or cardiovascular events. Martinez-Gonzalez Miguel A., Zazpe Itziar, Razquin Cristina, Sanchez-Tainta Ana, Corella Dolores, Salas-Salvado Jordi, et al. Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Clin Nutr. 2015 Oct;34(5):859-867. Epub 2014 Sep 16. 10.1016/j.clnu.2014.09.006 1532-1983 0261-5614 Clinical Nutrition http://hdl.handle.net/20.500.13003/10681 25304294 L602650370 2-s2.0-84939259701 http://hdl.handle.net/20.500.12105/20179 360949800010 Mediterranean diet Dietary pattern Mortality Cardiovascular risk PREDIMED Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study