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Lifestyles and Risk Factors Associated with Adherence to the Mediterranean Diet: A Baseline Assessment of the PREDIMED Trial
Open accessAbstract
BACKGROUND: The traditional Mediterranean dietary pattern (MedDiet) is associated with longevity and low rates of cardiovascular disease (CVD). However, there is little information on who is more likely to follow this food pattern. AIM: To evaluate how different factors are associated with lower MedDiet adherence in older Spanish subjects. METHODS: We included 7305 participants (men aged 55-80 y, women 60-80 y) at high-risk of CVD recruited into the PREDIMED trial (ISRCTN35739639). Socioeconomic, anthropometric, lifestyle characteristics and CVD risk factors were recorded. A validated 14-item questionnaire was used to evaluate MedDiet adherence at baseline. Multivariate models were used to estimate odds ratios (OR) and 95% confidence intervals for lower adherence to the MedDiet (<9 points out of 14) and ascertain factors independently associated with it. RESULTS: Former smoking (OR = 0.87; 95% CI, 0.78-0.98), physical activity (OR for the 3(rd) vs. the 1(st)tertile: 0.69; 0.62-0.78), and higher educational level (OR for university vs. less than primary school: 0.54; 0.38-0.77) were associated with higher MedDiet adherence. Conversely, having a larger waist-to-height ratio (OR for 0.1 units, 1.35; 1.22-1.49), being diabetic (OR = 1.13; 1.03-1.24), being single (OR = 1.27; 1.01-1.61) or divorced or separated (OR = 1.44; 1.09-1.89), and current smoking (OR = 1.28; 1.11-1.47) were associated with lower adherence. CONCLUSIONS: Participants with little education, a larger waist-to-height ratio, or diabetes and those who were less physically active, single, divorced or separated, or smokers were less likely to adhere to the MedDiet, an ideal model for food choices. Stronger efforts of health promotion are needed in these groups to foster adoption of the MedDiet.
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“We confirmed findings from the PREDIMED study, showing that individuals with low MD adherence were more likely to be current smokers, have higher BMI and WC and lower PA (10,18).”
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 [18]
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Metadata
- Authors
- Hu, E. A., Toledo, E., Diez-Espino, J., Estruch, R., Corella, D., Salas-Salvado, J., Vinyoles, E., Gomez-Gracia, E., Aros, F., Fiol, M., Lapetra, J., Serra-Majem, L., Pintó, X., Portillo, M. P., Lamuela-Raventos, R. M., Ros, E., Sorli, J. V., & Martinez-Gonzalez, M. A.
- Affiliations
- Harvard University (US)
- Universitat de València (ES)
- Instituto de Salud Carlos III (ES)
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-04-29
- Volume
- 8
- Issue
- 4
- Pages
- e60166
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3639284
- OpenAlex
- W1978195758
- Cited by
- 108
- References
- 50
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 10 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 5 · 2016: 10 · 2015: 10 · 2014: 9 · 2013: 5
- FWCI
- 11.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion, cc-by)
- Acceda (Universidad de Las Palmas de Gran Canaria) (submittedVersion)
- Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Docusalut (Conselleria de Salut i Consum del Govern de les Illes Balears) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Hispana (submittedVersion, cc-by)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, cc-by)
- Funders
- U.S. Department of Veterans Affairs (CDA11-263)
- Generalitat de Catalunya (ACOMP06109, CS2010-AP-111, GVACOMP2011-151)
- Ministerio de Economía y Competitividad (SAF2009-12304, RTIC G03/140)
- Generalitat Valenciana (CS2010-AP-111, GVACOMP2011-151, ACOMP/2011/145, ACOMP06109, BEST/2011/261, CS2011-AP-042, ACOMP/2012/190, GVACOMP2010-181, GVACOMP2011-151, GVACOMP2010-181)
- Centro Nacional de Investigaciones Cardiovasculares (GVACOMP2011–151, PI 07/0473, 06/2007, PI10/01407, CS2010-AP-111, CNIC 06/2007, PI05/2584, P11/02505, PI11/01647, CS2011-AP-042, PI0105/2007, PI07/0954, RTIC G03/140, AGL2010–22319-C03, GVA-COMP2010–181, P27/2011, PI10/02658, PI07/0240, CP06/00100, PI04–2239, ACOMP06109)
- Gobierno de Navarra (P27/2011)
- Instituto de Salud Carlos III (PI 07/0473, AGL2010-22319-C03, PI1002658, RTIC G03/140, RD06/0045, PI07/0954, PI11/, PI07/0240, GVA-COMP2010–181, PI04-2239, SAF2009-12304, AGL-2009-13906-C02, PI05/2584, ACOMP06109, CS2011-AP-042, GVACOMP2011-151, RTIC RD06/0045, CP 06/00100, G03/140, P27/2011, CS2010-AP-111, PI1001407, P11/02505, PI0105/2007, PI11/01647, CNIC‐06/2007)
- European Regional Development Fund (PI11/01647, PI07-0954, PI04–2239, CP06/00100, 06/0045, PI 07/0473, PI 05/2584, P11/02505, PI10/01407, PI07/0240, RTIC G03/140, (RD 06/0045, SAF2009-12304, PI10/02658, G03/140)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Mediterranean diet adherence, PREDIMED trial, cardiovascular risk factors, older adults, smoking, physical activity, educational attainment, waist-to-height ratio, diabetes mellitus, marital status, socioeconomic factors, health promotion
- MeSH terms
- Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Humans, Life Style, Male, Middle Aged, Patient Compliance, Residence Characteristics, Risk Factors, Socioeconomic Factors, Diet, Mediterranean
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