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Title: Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial
Authors: Fernandez-Lazaro, CI
Toledo, E
Buil-Cosiales, P
Salas-Salvado, J
Corella, D
Fito, M
Martinez, JA
Alonso-Gomez, AM
Warnberg, J
Vioque, J
Romaguera, D
Lopez-Miranda, J
Estruch, R
Tinahones, FJ
Lapetra, J
Serra Majem, Luis 
Bueno-Cavanillas, A
Tur, JA
Sanchez, VM
Pinto, X
Delgado-Rodriguez, M
Matia-Martin, P
Vidal, J
Ros, E
Vázquez, Clotilde
Daimiel, L
SanJulian, B
Garcia-Gavilan, JF
Sorli, JV
Castaner, O
Zulet, MA
Tojal-Sierra, L
Perez-Farinos, N
Oncina-Canovas, A
Monino, M
Garcia-Rios, A
Sacanella, E
Bernal-Lopez, RM
Santos-Lozano, JM
Vazquez-Ruiz, Z
Muralidharan, J
Ortega-Azorin, C
Goday, A
Razquin, C
Goicolea-Guemez, L
Ruiz-Canela, M
Becerra-Tomas, N
Schroder, H
Gonzalez, MAM
UNESCO Clasification: 32 Ciencias médicas
3206 Ciencias de la nutrición
Keywords: PREDIMED-Plus
Dietary change
Dietary adherence
Mediterranean diet, et al
Issue Date: 2022
Project: Efecto de la dieta mediterránea hopocalórica y promoción de la actividad física en prevención primaria cardiovascular.Estudio piloto sobre marcadores intermedios. 
Efecto de Una Pérdida de Peso Con Dieta Mediterránea Hipocalórica y Promoción de la Actividad Física en la Prevención Primaria Cardiovascular 
Efecto de una intervención intensiva de pérdida de peso con dieta Mediterránea hipocalórica, actividad física y tratamiento conductual sobre la prevención primaria cardiovascular: ensayo PREDIMED-Plus 
Journal: European Journal of Nutrition 
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
ISSN: 1436-6207
DOI: 10.1007/s00394-021-02697-8
Source: European Journal of Nutrition [ISSN 1436-6207], n. 61, p. 1457–1475
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