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

Author, as appears in the article.: Fernandez-Lazaro, Cesar, I; Toledo, Estefania; Buil-Cosiales, Pilar; Salas-Salvado, Jordi; Corella, Dolores; Fito, Montserrat; Alfredo Martinez, J; Alonso-Gomez, Angel M; Warnberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, Jose; Estruch, Ramon; Tinahones, Francisco J; Lapetra, Jose; Serra-Majem, Luis; Bueno-Cavanillas, Aurora; Tur, Josep A; Martin Sanchez, Vicente; Pinto, Xavier; Delgado-Rodriguez, Miguel; Matia-Martin, Pilar; Vidal, Josep; Ros, Emilio; Vazquez, Clotilde; Daimiel, Lidia; SanJulian, Beatriz; Garcia-Gavilan, Jesus F; Sorli, Jose, V; Castaner, Olga; Angeles Zulet, M; Tojal-Sierra, Lucas; Perez-Farinos, Napoleon; Oncina-Canovas, Alejandro; Monino, Manuel; Garcia-Rios, Antonio; Sacanella, Emilio; Bernal-Lopez, Rosa M; Manuel Santos-Lozano, Jose; Vazquez-Ruiz, Zenaida; Muralidharan, Jananee; Ortega-Azorin, Carolina; Goday, Alberto; Razquin, Cristina; Goicolea-Guemez, Leire; Ruiz-Canela, Miguel; Becerra-Tomas, Nerea; Schroder, Helmut; Martinez Gonzalez, Miguel A

Department: Bioquímica i Biotecnologia

URV's Author/s: Becerra Tomás, Nerea / García Gavilán, Jesús Francisco / Muralidharan, Jananee / Salas Salvadó, Jorge

Keywords: Risk factors; Randomized controlled trials; Predimed-plus; Overweight; Obesity; Nutritional status; Metabolic syndrome; Mediterranean diet; Humans; Factors; Dietary change; Dietary adherence; Diet, mediterranean; Cardiovascular diseases; Aged

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. Trial registration: ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870. © 2021, The Author(s).

Thematic Areas: Serviço social; Saúde coletiva; Química; Nutrition and dietetics; Nutrition & dietetics; Nutrição; Medicine (miscellaneous); Medicina veterinaria; Medicina iii; Medicina ii; Medicina i; Interdisciplinar; Farmacia; Educação física; Ciências biológicas iii; Ciências biológicas ii; Ciências biológicas i; Ciências ambientais; Ciências agrárias i; Ciência de alimentos

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: jesusfrancisco.garcia@urv.cat; nerea.becerra@urv.cat; jesusfrancisco.garcia@urv.cat; jordi.salas@urv.cat

Record's date: 2025-02-19

Paper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://link.springer.com/article/10.1007/s00394-021-02697-8

Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/

Paper original source: European Journal Of Nutrition. 61 (3): 1457-1475

APA: Fernandez-Lazaro, Cesar, I; Toledo, Estefania; Buil-Cosiales, Pilar; Salas-Salvado, Jordi; Corella, Dolores; Fito, Montserrat; Alfredo Martinez, J; Al (2022). Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial. European Journal Of Nutrition, 61(3), 1457-1475. DOI: 10.1007/s00394-021-02697-8

Article's DOI: 10.1007/s00394-021-02697-8

Entity: Universitat Rovira i Virgili

Journal publication year: 2022

Publication Type: Journal Publications