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Cited by 309Nutritional Studies and DietAgriculture Sustainability and Environmental ImpactDietary Effects on Health

A provegetarian food pattern and reduction in total mortality in the Prevencion con Dieta Mediterranea (PREDIMED) study

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Martínez-González, Miguel A, Sánchez-Tainta, Ana, Corella, Dolores, Salas-Salvadó, Jordi, Ros, Emilio, Arós, Fernando, Gómez-Gracia, Enrique, Fiol, Miquel +6 more·2014·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.113.071431
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Abstract

Background Vegetarian diets have been associated with reduced mortality. Because a pure vegetarian diet might not easily be embraced by many individuals, consuming preferentially plant-derived foods would be a more easily understood message. A provegetarian food pattern (FP) emphasizing preference for plant-derived foods might reduce all-cause mortality.Objective The objective was to identify the association between an a priori-defined provegetarian FP and all-cause mortality.Design We followed 7216 participants (57% women; mean age: 67 y) at high cardiovascular risk for a median of 4.8 y. A validated 137-item semiquantitative food-frequency questionnaire was administered at baseline and yearly thereafter. Fruit, vegetables, nuts, cereals, legumes, olive oil, and potatoes were positively weighted. Added animal fats, eggs, fish, dairy products, and meats or meat products were negatively weighted. Energy-adjusted quintiles were used to assign points to build the provegetarian FP (range: 12-60 points). Deaths were confirmed by review of medical records and the National Death Index.Results There were 323 deaths during the follow-up period (76 from cardiovascular causes, 130 from cancer, 117 for noncancer, noncardiovascular causes). Higher baseline conformity with the provegetarian FP was associated with lower mortality (multivariable-adjusted HR for ≥ 40 compared with <30 points: 0.59; 95% CI: 0.40, 0.88). Similar results were found with the use of updated information on diet (RR: 0.59; 95% CI: 0.39, 0.89).Conclusions Among omnivorous subjects at high cardiovascular risk, better conformity with an FP that emphasized plant-derived foods was associated with a reduced risk of all-cause mortality. This trial was registered at www.controlled-trials.com as ISRCTN35739639.

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Authors
Martínez-González, M. A., Sánchez-Tainta, A., Corella, D., Salas-Salvadó, J., Ros, E., Arós, F., Gómez-Gracia, E., Fiol, M., Lamuela-Raventós, R. M., Schröder, H., Lapetra, J., Serra-Majem, L., Pinto, X., & Ruiz-Gutierrez, V.
Affiliations
Consejo Superior de Investigaciones Científicas (ES)
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2014-07
Volume
100
Pages
320S-328S
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.113.071431
OpenAlex
W2015061677
Cited by
309
References
62
Citations by year
2026: 17 · 2025: 40 · 2024: 40 · 2023: 37 · 2022: 42 · 2021: 42 · 2020: 24 · 2019: 24 · 2018: 23 · 2017: 7 · 2016: 5 · 2015: 4 · 2014: 2
FWCI
5.94
Type
journal article
Language
en
Update notices
erratum (2014-12-01)
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Acceda (Universidad de Las Palmas de Gran Canaria) (submittedVersion)
  • DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
Funders
  • Instituto de Salud Carlos III
  • Generalitat Valenciana
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Physical Sciences › Environmental Science › Ecology › Agriculture Sustainability and Environmental Impact
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
Keywords
plant-based foods, all-cause mortality, Mediterranean diet, cardiovascular risk, dietary adherence, PREDIMED trial, omnivorous diet, cancer mortality, cardiovascular mortality
MeSH terms
Aged, Cardiovascular Diseases, Cause of Death, Feeding Behavior, Female, Humans, Male, Middle Aged, Neoplasms, Surveys and Questionnaires, Diet, Vegetarian, Diet, Mediterranean

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