Factors associated with successful dietary changes in an energy-reduced mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial

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• dc.contributor.author Fernández Lázaro, César I.
• dc.contributor.author Fitó Colomer, Montserrat
• dc.contributor.author Castañer, Olga
• dc.contributor.author Goday Arno, Alberto
• dc.contributor.author Schröder, Helmut, 1958-
• dc.contributor.author Martínez-González, Miguel Ángel, 1957-
• dc.contributor.author PREDIMED-Plus investigators
• dc.date.accessioned 2022-07-26T06:43:18Z
• dc.date.available 2022-07-26T06:43:18Z
• dc.date.issued 2022
• dc.description.abstract Purpose: long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods: longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results: consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25-1.83; OR12-month: 1.66, 95% CI 1.37-2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07-2.46; OR12-month: 1.62, 95% CI 1.07-2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53-0.79; OR12-month: 0.76, 95% CI 0.62-0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64-0.99; OR12-month: 0.71, 95% CI 0.57-0.88). Conclusion: our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions.
• dc.description.sponsorship Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. The PREDIMED-Plus trial was supported by the European Research Council (advanced research grant 2014–2019, 340918 to MAM-G as PI) and by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación en Salud (FIS), which is cofunded by the European Regional Development Fund coordinated by J.S.-S. and J.V., including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, and PI20/01158); the Especial Action Project entitled Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant, the Recercaixa grant (2013ACUP00194), Grants from the Consejería de Salud de la Junta de Andalucía, a grant from the Generalitat Valenciana, a SEMERGEN grant, and funds from the European Regional Development Fund (CB06/03; CB12/03), The International Nut & Dried Fruit; and the AstraZeneca Young Investigators Award in Category of Obesity and T2D 2017 to DR. J.S.-S. is partially supported by ICREA under the ICREA Academia programme. None of the funding sources took part in the design, collection, analysis, or interpretation of the data or in the decision to submit the manuscript for publication.
• dc.format.mimetype application/pdf
• dc.identifier.citation Fernández-Lázaro CI, Toledo E, Buil-Cosiales P, Salas-Salvadó J, Corella D, Fitó M, et al. Factors associated with successful dietary changes in an energy-reduced mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial. Eur J Nutr. 2022 Apr; 61(3):1457-75. DOI: 10.1007/s00394-021-02697-8
• dc.identifier.doi http://dx.doi.org/10.1007/s00394-021-02697-8
• dc.identifier.issn 1436-6207
• dc.identifier.uri http://hdl.handle.net/10230/53809
• dc.language.iso eng
• dc.publisher SpringerOpen
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/340918
• dc.rights Copyright © Fernández-Lázaro CI, Toledo E, Buil-Cosiales P, Salas-Salvadó J, Corella D, Fitó M, 2021. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Dietary adherence
• dc.subject.keyword Dietary change
• dc.subject.keyword Factors
• dc.subject.keyword Mediterranean diet
• dc.subject.keyword PREDIMED-Plus
• dc.subject.keyword Randomized controlled trials
• dc.title Factors associated with successful dietary changes in an energy-reduced mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion