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A Large Randomized Individual and Group Intervention Conducted by Registered Dietitians Increased Adherence to Mediterranean-Type Diets: The PREDIMED Study
Abstract
Objective To assess the effectiveness of an intervention aimed to increase adherence to a Mediterranean diet.Design A 12-month assessment of a randomized primary prevention trial.Subjects/settings One thousand five hundred fifty-one asymptomatic persons aged 55 to 80 years, with diabetes or > or =3 cardiovascular risk factors.Intervention Participants were randomly assigned to a control group or two Mediterranean diet groups. Those allocated to the two Mediterranean diet groups received individual motivational interviews every 3 months to negotiate nutrition goals, and group educational sessions on a quarterly basis. One Mediterranean diet group received free virgin olive oil (1 L/week), the other received free mixed nuts (30 g/day). Participants in the control group received verbal instructions and a leaflet recommending the National Cholesterol Education Program Adult Treatment Panel III dietary guidelines.Main outcome measures Changes in food and nutrient intake after 12 months.Statistical analyses Paired t tests (for within-group changes) and analysis of variance (for between-group changes) were conducted.Results Participants allocated to both Mediterranean diets increased their intake of virgin olive oil, nuts, vegetables, legumes, and fruits (P<0.05 for all within- and between-group differences). Participants in all three groups decreased their intake of meat and pastries, cakes, and sweets (P<0.05 for all). Fiber, monounsaturated fatty acid, and polyunsaturated fatty acid intake increased in the Mediterranean diet groups (P<0.005 for all). Favorable, although nonsignificant, changes in intake of other nutrients occurred only in the Mediterranean diet groups.Conclusions A 12-month behavioral intervention promoting the Mediterranean diet can favorably modify an individual's overall food pattern. The individual motivational interventions together with the group sessions and the free provision of high-fat and palatable key foods customary to the Mediterranean diet were effective in improving the dietary habits of participants in this trial.
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“Participants exposed to the MD-based intervention increased consumption of olive oil, nuts, vegetables, legumes and fruit and reduced consumption of meat and pastries, cakes and sweets, thus improving overall dietary patterns and supporting the use of PN in facilitating change towards a Mediterranean-style diet.”
From Effect of an Internet-based, personalized nutrition randomized trial on dietary changes associated with the Mediterranean diet: the Food4Me Study (2016) · cites this paper as [45]
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RETRACTED: Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1200303 · Cited by 4,257
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Self-citationSchröder, H., Fitó, M., Estruch, R., Martínez-González, M. A., Corella, D., Salas-Salvadó, J., Lamuela-Raventós, R., Ros, E., Salaverría, I., Fiol, M., et al. (2011) · The Journal of Nutrition · doi:10.3945/jn.110.135566 · Cited by 1,624
Self-citationMartínez-González, M. A., García-Arellano, A., Toledo, E., Salas-Salvadó, J., Buil-Cosiales, P., Corella, D., Covas, M. I., Schröder, H., Arós, F., Gómez-Gracia, E., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0043134 · Cited by 1,150
Self-citationFernández-Ballart, J. D., Piñol, J. L., Zazpe, I., Corella, D., Carrasco, P., Toledo, E., Perez-Bauer, M., Martínez-González, M. Á., Salas-Salvadó, J., & Martín-Moreno, J. M. (2010) · British Journal of Nutrition · doi:10.1017/s0007114509993837 · Cited by 898
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Metadata
- Authors
- Zazpe, I., Sanchez-Tainta, A., Estruch, R., Lamuela-Raventos, R. M., Schröder, H., Salas-Salvado, J., Corella, D., Fiol, M., Gomez-Gracia, E., Aros, F., Ros, E., Ruíz-Gutierrez, V., Iglesias, P., Conde-Herrera, M., & Martinez-Gonzalez, M. A.
- Venue
- Journal of the American Dietetic Association
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 108
- Issue
- 7
- Pages
- 1134-1144
- ISSN
- 0002-8223 (ISSN-L)
- OpenAlex
- W2171300544
- Cited by
- 193
- References
- 43
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 3 · 2023: 7 · 2022: 14 · 2021: 10 · 2020: 9 · 2019: 12 · 2018: 11 · 2017: 15 · 2016: 10 · 2015: 13 · 2014: 15 · 2013: 10 · 2012: 12
- FWCI
- 13.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Dietetic Association (publishedVersion)
- PubMed (publishedVersion)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
- Funders
- Generalitat Valenciana (ACOMP06109)
- Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición
- Instituto de Salud Carlos III (RTIC RD06/0045, PI41/2005)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Nutrition, Genetics, and Disease
- Health Sciences › Nursing › Nutrition and Dietetics › Nuts composition and effects
- Keywords
- Mediterranean diet, dietary adherence, motivational interviewing, virgin olive oil, mixed nuts, registered dietitians, primary prevention, cardiovascular risk factors, diabetes mellitus, older adults, dietary intake, dietary fiber, monounsaturated fatty acids, polyunsaturated fatty acids
- MeSH terms
- Olive Oil, Aged, Aged, 80 and over, Cardiovascular Diseases, Dietetics, Feeding Behavior, Female, Fruit, Health Promotion, Humans, Fabaceae, Male, Middle Aged, Nuts, Patient Compliance, Plant Oils, Risk Factors, United States, Vegetables, Biomarkers, Prevalence, Diet, Mediterranean
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