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Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial.

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dc.contributor.author Downer, Mary Kathryn
dc.contributor.author Gea, Alfredo
dc.contributor.author Stampfer, Meir
dc.contributor.author Sánchez-Tainta, Ana
dc.contributor.author Corella, Dolores
dc.contributor.author Salas-Salvadó, Jordi
dc.contributor.author Ros, Emilio
dc.contributor.author Estruch, Ramón
dc.contributor.author Fitó Colomer, Montserrat
dc.contributor.author Gómez-Gracia, Enrique
dc.contributor.author Arós, Fernando
dc.contributor.author Fiol, Miquel
dc.contributor.author Garcia De-la-Corte, Francisco Jose
dc.contributor.author Serra-Majem, Luis
dc.contributor.author Pinto, Xavier
dc.contributor.author Basora, Josep
dc.contributor.author Sorlí, José Vicente
dc.contributor.author Vinyoles, Ernest
dc.contributor.author Zazpe, Itziar
dc.contributor.author Martínez-González, Miguel A.
dc.date.accessioned 2017-01-19T08:22:27Z
dc.date.available 2017-01-19T08:22:27Z
dc.date.issued 2016
dc.identifier.citation Downer MK, Gea A, Stampfer M, Sánchez-Tainta A, Corella D, Salas-Salvadó 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. doi: 10.1186/s12966-016-0394-6
dc.identifier.issn 1479-5868
dc.identifier.uri http://hdl.handle.net/10230/27935
dc.description.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 PREvención con DIeta MEDiterránea (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.
dc.description.sponsorship This study was funded by the Spanish Ministry of Health (ISCIII), PI1001407,Thematic Network G03/140, RD06/0045, FEDER (Fondo Europeo deDesarrollo Regional), and the Centre Català de la Nutrició de l’Institutd’Estudis Catalans. The Fundación Patrimonio Comunal Olivarero andHojiblanca SA (Málaga, Spain), California Walnut Commission (Sacramento,CA), Borges SA (Reus, Spain), and Morella Nuts SA (Reus, Spain) donated theolive oil, walnuts, almonds and hazelnuts, respectively, used in the study.CIBEROBN is an initiative of ISCIII, Spain.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartof International Journal of Behavioral Nutrition and Physical Activity. 2016 Jun 14;13:67
dc.rights © The Author(s). 2016. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject.other Dieta -- Mediterrània, Regió de la
dc.subject.other Dietoteràpia
dc.title Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial.
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1186/s12966-016-0394-6
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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